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Biomedical subjects

I Bukovsky

Publications and source records attributed to I Bukovsky.

At least 163 records · Page 9Linked to original sources
PubMed1987

Reproductive outcome after fimbrial evacuation of tubal pregnancy.

Thirty-one ectopic pregnancies were manually expressed (i.e., "milked out") by the tubal fimbria during a 13-year period. Reproductive histories and operative findings were unremarkable when compared with the general population with ectopic gestation. The subsequent reproductive performance was evaluated in 27 patients who attempted conception. Twenty-five (92%) of the 27 patients subsequently conceived, 23 (85%) had at least one successful term pregnancy, and the remaining 2 (7%) had abortions only. There was no repeat ectopic pregnancy. Average follow-up time was 38.5 months. Previous experience with this technique has been disappointing with low postoperative rates of successful term pregnancies. Favorable outcomes after fimbrial expression have been reported only in small numbers of patients. It is suggested that the procedure is appropriate for distal tubal gestations that are loosely adherent within the tubal lumen; these are usually expressed with minimal efforts. However, if the gestational mass does not yield to gentle milking of the tube or evacuation has been incomplete, the surgeon can always use a linear salpingotomy. More experience is obviously needed to verify these preliminary results, suggesting that fimbrial evacuation is simple, safe, and advantageous in properly selected cases.

Adult↗
PubMed1987

Fertility following conservative surgery for tubal pregnancy.

Eighty seven conservative surgical interventions for unruptured tubal pregnancy were performed on 83 patients. Salpingotomy was performed in 66 cases and expression of tubal pregnancy in 21 cases. In this patient group, 76.7% (56 out of 73) experienced intra-uterine pregnancy following surgery and 71.2% (52 out of 73) had a live birth. The recurrence rate of tubal pregnancy was 12.3%. Of the 42 patients with a normal contralateral tube, 36 (85.7%) had an intra-uterine pregnancy, 80.9% had a live birth and 7.1% had a recurrent tubal pregnancy. Sixty percent of the patients who underwent operation on their single tube, had a live birth and 66.6% had an intra-uterine pregnancy; the recurrence of tubal pregnancy in this group was 26.6%. No recurrence of tubal pregnancy was found in the group of patients who underwent expression of tubal gestation. It is suggested that the expression of tubal gestation (milking) is a safe procedure for conserving future fertility, and that the indications for conservative surgical management in patients with unruptured tubal gestation should be broadened to include all patients interested in future pregnancies, regardless of the current state of the contralateral tube.

Adolescent↗
PubMed1986

Severe peripheral arteriospasm following oxytocin administration.

A parturient patient with imminent gangrene of the extremity caused by oxytocin-induced arteriospasm is described. The appliance of conventional measures such as anticoagulation and vasodilatation produced an immediate and sustained reversal of the arteriospasm together with dramatic relief of symptoms and signs.

Adult↗
PubMed1985

Perinatal outcome following physicians' strike of 1983.

Organized public medical services were profoundly disturbed during the 4 months of the physicians' strike in 1983. An unknown proportion of patients were referred to private services, but only a minority of them attended the alternative centers. The findings during the strike and the following 6 months were compared with those of the year 1982. The incidence of high-risk cases and of multiple and premature deliveries were unchanged. There was a significant rise (P less than 0.01) in the rate of cesarean sections during the strike, 10.8%, compared with 7.8% in 1982. Also, a significant reduction in instrumental deliveries and labor inductions was observed during the strike and for 4 months afterwards. There was no change in the perinatal mortality (total and corrected) or in Apgar scores. This indicates that good perinatal results were achieved despite drastic disturbances in organized perinatal care.

Apgar Score↗
PubMed1983

Sterilization at the time of cesarean section: tubal ligation or hysterectomy?

The operative, postoperative and subsequent course of 86 patients who underwent cesarean hysterectomy (C.H.) during the years 1970-1979 are compared to an equal number of cesarean sections with tubal ligation (C.S.L.). Both groups are similar regarding age, gravidity, parity, number of living children and indications for abdominal delivery. Operative and postpartum complications of both groups were all minor, although significantly (p less than 0.05) more frequent in the C.S.L. group. More patients of the C.H. group required blood transfusions than the C.S.L. group (p less than 0.01). The mean period of hospitalization was similar in both groups. Two pregnancies occurred after tubal sterilization, a failure rate of 1:43. During the follow-up period, 49 surgical gynecological procedures were performed in the C.S.L. group compared to 1 in the C.H. group. Ten patients of the C.S.L. group subsequently underwent abdominal hysterectomy. Hysterectomy is the procedure of choice for permanent sterilization and prevention of many subsequent gynecological problems. Consideration must be given to coexisting gynecological conditions while considering sterilization at elective C.S. and C.H. should be offered to those patients.

Adult↗
PubMed1983

"Milking"--a conservative surgical technique for a tubal gestation.

Milking technique was utilized in 13 patients with tubal pregnancies. Following this procedure there were we intrauterine pregnancies in nine women and 10 live births in eight women. No ectopic pregnancies recurred in this group. These results suggest that the milking procedure, whenever possible, may represent a valuable method for conservative surgical treatment of tubal gestation.

Fallopian Tubes↗
PubMed1982

Improved fertility following ectopic pregnancy.

The reproductive performance subsequent to operative removal of ectopic pregnancy was examined in 154 women. They represent 64% of 242 women admitted for ectopic pregnancy between 1969 and 1979. The follow-up period averaged 4.2 years. The patients at risk had a conception rate of 81%, with a repeat ectopic pregnancy incidence of 7.8%, and 65% had at least one live birth. Postoperative infertility was significantly associated with (1) previous sterility, (2) coexistent periadnexal adhesions and/or tubual disease, (3) rupture of the ectopic pregnancy, and (4) older age. A statistically significant advantage of conservative over radical treatment, as regards future fertility, was demonstrated only in 53 patients with either history or findings suggestive of previously impaired fertility. Early, prerupture diagnosis and treatment, coupled with conservative and restorative measures, might account for the improved reproductive performance.

Adolescent↗
PubMed1982

Conservative surgery for tubal pregnancy.

Fifty-seven conservative surgical procedures for unruptured tubal pregnancy were performed on 54 patients. Salpingotomy was performed in 44 cases and fimbrial expression of the ectopic gestation was performed in 13 cases. In this patient group, 80% of the patients (39 of 49) experienced intrauterine pregnancy following surgery and 71% (35 of 49) had a live birth. The recurrence rate of tubal pregnancy was 12%. Ninety percent of the patients with a normal contralateral tube had an intrauterine pregnancy following surgery and a 7% recurrence rate of tubal pregnancy, a ratio of 1:15. It is suggested that the indications for the conservative surgical management in patients with unruptured tubal pregnancy should be broadened to all patients interested in future pregnancies and should also be considered in those cases with normal contralateral tube.

Fallopian Tubes↗
PubMed1981

Severe ovarian hemorrhage in congenital afibrinogenemia.

This is a case report of a patient with congenital afibrinogenemia and massive intra-abdominal bleeding from a ruptured corpus luteum cyst. None of the previously reported 100 cases mentioned obstetrical or gynecological complications associated with this rare entity.

Adult↗