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Biomedical subjects

R Matorras

Publications and source records attributed to R Matorras.

At least 19 recordsLinked to original sources
PubMed1998

Endometriosis and spontaneous abortion rate: a cohort study in infertile women.

OBJECTIVE: To ascertain if there is an association between endometriosis and spontaneous abortion. DESIGN: Prospective cohort study. SETTING: Medical School Hospital. POPULATION: 174 infertile women laparoscopically diagnosed with endometriosis and 174 infertile women in which endometriosis was ruled out by laparoscopy, in the same period of time. MAIN OUTCOME MEASURE: Spontaneous abortion. Non-progressive gestational sac and/or histological study. RESULTS: Per woman abortion rate was 7.47% (13/174) in the endometriosis group, similar to 5.74% (10/174) in the infertile women without endometriosis (RR=1.32: CI=0.53-3.36). Nor were there any differences in the per pregnancy abortion rate: 20.96% (13/62) in endometriosis vs. 16.94% (10/59) in non-endometriosis (RR=1.3; CI=0.47-3.57). The abortion rate was similar in the different AFS stages: 22.86% (8/35) in stage I, 16.67% (3/18) in II, 25% (1/4) in III and 20% (1/5) in IV. In stage I no differences were observed in patients who were managed expectantly or with medical treatment. CONCLUSION: Endometriosis is not associated with an increased abortion rate. The severity of disease expressed by AFS staging is not associated with an increase in the abortion rate. In stage I the treatment of endometriosis did not decrease abortion rates.

Abortion, Spontaneous↗
PubMed1998

Fetal cardiotocography and acid-base status during cesarean section.

OBJECTIVE: To assess the fetal well-being during cesarean section, in relation to the previous fetal condition. DESIGN: Observational study. SETTING: University Hospital. PATIENTS PARTICIPANTS: 204 women undergoing cesarean section (203 intrapartum cesarean sections): 177 with general anesthesia and 27 with spinal anesthesia. MATERIAL AND METHODS: We compared the fetal heart records of the last 30 min before cesarean section (during the first stage of labor) with those during cesarean section. Scalp blood analysis 30 min before the beginning of anesthesia induction was compared with umbilical artery analysis at delivery. MAIN OUTCOME MEASURES: Cardiotocography. Acid-base analysis. Apgar scores. RESULTS: During cesarean section there was a reduction in uterine activity, an increase in silent tracings and a decrease in late decelerations. Umbilical artery pH was lower than scalp pH (7.23+/-0.06 vs 7.30+/-0.06). Oxygen saturation was also lower (14.43+/-8.58% vs 18.99+/-8.4%). The values of pCO2 and of base deficit were higher. During cesarean section low values of modified Fischer scores were associated with low pH values of umbilical artery and low Apgar scores. CONCLUSION: Silent tracings appearing during cesarean section usually do not indicate fetal distress. Poor intracesarean fetal heart tracings were associated with worse indicators of neonatal well-being. Although umbilical pH were lower than scalp values, when the correction described in the literature was applied, the difference was of little clinical relevance. It is concluded that anesthesic, pharmacological and surgical events have slight repercussion in fetal well being. However, in a few cases fetal heart monitoring during cesarean section could detect otherwise undiagnosed cases of transient acidemia or depression in the fetus.

Acid-Base Equilibrium↗
PubMed1998

Fatty acid composition of fertilization-failed human oocytes.

The aim of the study was to assess the fatty acid composition of human fertilization-failed oocytes. A total of 150 unfertilized oocytes from 43 women undergoing in-vitro fertilization (IVF) were analysed using capillary gas chromatography. The majority of fatty acids were saturated (79.22%), of which stearic (38.65%) and palmitic (32.66%) acids were the most abundant. Of the monounsaturated fatty acids (14.27%) oleic acid was the most abundant (9.77%). Polyunsaturated fatty acids comprised 6.50% of fatty acids, the n-6:n-3 ratio being 7.73. The ratio of eicosapentaenoic acid:docosahexaenoic acid was approximately 5. It is concluded that the most common fatty acids in human unfertilized oocytes are either saturated or monounsaturated fatty acids, whose main function is to provide an energy source. A number of differences in fatty acid composition were observed, in comparison with other biological samples. In particular, stearic and eicosapentaenoic acids were more prominent, and oleic and linoleic acids were less prominent; this may reflect some specific peculiarity of oocyte metabolism.

Adult↗
PubMed1998

Lack of benefits of left tilt in emergent cesarean sections: a randomized study of cardiotocography, cord acid-base status and other parameters of the mother and the fetus.

OBJECTIVE: To assess the benefits of performing the cesarean section in lateral tilt during active labor. SETTING: University Hospital. PATIENTS: 204 unselected women undergoing cesarean section (21.1% fetal distress, 45.6% cephalo-pelvic disproportion, 26.0% induction failure, 7.4% abnormal presentation) under general (86.8%) or spinal anesthesia (13.2%). DESIGN: Randomized study. INTERVENTION: During anesthesia induction and cesarean section 103 women were in partial left lateralization (20 degrees), whereas the remaining 101 remained in the supine position. MAIN OUTCOME MEASURES: Internal cardiotocography during cesarean section. Umbilical artery acid-base analysis. Newborn evaluation. Maternal hemodynamic parameters. RESULTS: Fetal heart rate during cesarean section was similar in both groups, except for a baseline heart rate which was slightly higher in the lateral tilt group (137.5 +/- 19.2 vs 131.1 +/- 20). The umbilical artery pH values, as well as pCO2, base deficit, CO3H and oxygen saturation were similar in both groups. The pO2 value was significantly lower in the lateral tilt group (14.03 +/- 6.04 Hg mm vs 16.02 +/- 7.65). Newborn evaluation was similar in both groups. The blood pressure and heart rate of the mother during the cesarean section were also similar in both groups. CONCLUSIONS: No benefits were found in performing cesarean section in left lateral tilt.

Acid-Base Equilibrium↗
PubMed1998

Long chain W3 polyunsaturated fatty acids and lipid pattern in the mother and the newborn infant.

We studied 162 mother-neonate pairs to determine the relationship between w3 long chain polyunsaturated fatty acid (w3LCP) intake during pregnancy and their levels in the mother and the neonate, and the general lipid pattern in the mother and the neonate. A dietetic interview was performed to assess the w3LCP intake during pregnancy. In both mothers and neonates we studied the w3LCPs in plasma and erythrocyte phospholipids and also the general lipid profile (total cholesterol, HDL-c, LDL-c, triglycerides, apo A1 and apo B). The w3LCP intake assessed by the dietetic interview (0.74 +/- 0.52 g/day) did not correlated with any of the parameters of the general lipid pattern in mothers or neonates. In mothers, the w3LCP levels in plasma expressed in percentages showed a positive correlation with apo A1 and HDL-c, and a negative correlation with triglycerides and apo B. The w3LCPs levels in mothers showed an inconsistent and weak correlation with triglycerides and apo B in neonates. When w3LCPs levels were assessed in the neonates themselves a consistent positive correlation was found with triglycerides. We concluded that in the dietetic range of our population, the intake of w3LCPs was not associated to any changes in the general lipid pattern of mothers or neonates. Whereas the w3LCP levels in mothers were correlated with the changes in the general lipid pattern reported outside pregnancy, such correlations were not present in regard to the neonate general profile, whereas the newborn's w3LCP levels were correlated with triglycerides. We believe that the hypertriglyceridemia of pregnancy, the placenta and the peculiarities of fetal metabolism are the causes of the aforementioned findings.

Adult↗
PubMed1998

Agreement between hysterosalpingography and laparoscopic chromopertubation in assessment of tubal patency.

BACKGROUND: To assess the agreement between tubal patency assessed by laparoscopy with chromopertubation and by hysterosalpingography using contrast media. SETTING: University Medical School. PATIENTS: 314 consecutive women subjected to laparoscopy and hysterosalpingography for an infertility study. DESIGN: Prospective study. METHODS: Chromopertubation using Methylen blue dye, performed on days 20-24. Hysterosalpingography performed on days 7-10 with water soluble contrast. MAIN OUTCOME MEASURE: Kappa coefficient calculation. RESULTS: Kappa coefficient ranged from 0.40 to 0.36, depending on the categories analyzed, corresponding to a fair agreement. CONCLUSION: The diagnosis of tubal factor requires that both tubal patency tests (Hysterosalpingography and laparoscopy) show an abnormal patency. When one of the aforementioned tests is normal, performing the second one has little clinical advantage. However, it is suggested that when there is a discordant patency the pregnancy rates could be somewhat reduced.

Adult↗
PubMed1998

Biochemical markers of n-3 long chain polyunsaturated fatty acid intake during pregnancy.

BACKGROUND: To assess the relationship between the mothers' intake of n-3 long chain polyunsaturated fatty acids (LC PUFA) during pregnancy and their levels in plasma and tissue. METHODS: 162 mothers were studied during labor. Three groups were differentiated according to the n3 LC PUFA intake assessed by means of a dietetic interview: superior intake (SIG) (> 0.721 g/day), medium intake (MIG) (from 0.382 to 0.721 g/day) and inferior intake (IIG) (< 0.381 g/day). Fatty acids (FA) were studied by capillary chromatography in plasma and in erythrocyte phospholipids. RESULTS: The fatty acids (FA), expressed in absolute values, did not show any significant differences among the aforementioned groups. However, three were some trends which were confirmed when the FA were expressed in percentages. Thus, higher levels of docosahexaenoic acid (DHA) were found in SIG both in plasma and in the erythrocyte membrane, when expressed in percentages. Eicosapentaenoic acid (EPA) was also higher in the SIG in the erythrocyte membrane, whereas in plasma the differences were of marginal significance. On the other hand, arachidonic and linoleic acids had lower values in the SIG in erythrocytes. The theoretical optimal intake of n-3 LC PUFA corresponded to a plasma concentration of 117.9 +/- 45.9 mcg/ml n-3 LC PUFA or 2.54% of the total fatty content (2.29% of DHA). The corresponding cut-offs in erythrocyte membranes were 7.54% of total lipids (5.59% of DHA). CONCLUSION: The best markers of n-3 LC PUFA intake were DHA for plasma and DHA and EPA for erythrocyte phospholipids, all of them expressed in proportions of total FA. The arachidonic and linoleic acids (in percentages) in erythrocyte phospholipids were also good markers of n-3 intake. This probably reflects the metabolic competition between both PUFA families.

Adult↗
PubMed1997

Treatment of the male with follicle-stimulating hormone in intrauterine insemination with husband's spermatozoa: a randomized study.

We have examined the potential of follicle-stimulating hormone (FSH) therapy for the male to improve pregnancy rates in intrauterine insemination (IUI) with husband's spermatozoa. A prospective randomized trial was performed in 148 couples undergoing IUI because of male subfertility. In the treatment group, 150 IU FSH were administered to the husbands, either i.m. or s.c., three times a week, starting 3 months before the beginning of IUI cycles and maintained until the fifth IUI cycle. In the control group no treatment was given. FSH therapy did not change semen parameters. The pregnancy rate per cycle was 13.47% in the FSH group versus 10.07% in the non-FSH group; the pregnancy rate per woman was 44.38% in the FSH group versus 37.18% in the non-FSH group. Although the pregnancy rate increase was > 30% per cycle and > 20% per woman, statistical significance was not achieved. The cumulative pregnancy rate was 59.20% in the FSH group versus 42.91% in the non-FSH group. The pregnancy rate outside the IUI cycle was 14.70% (10/68) in the FSH group versus 2.5% (2/80) in the non-FSH group, the difference being statistically significant. In conclusion, a non-significant trend towards higher pregnancy rates in IUI was observed in the FSH group.

Female↗
PubMed1997

Different postnatal growth between disproportionate and proportionate fetal growth retardation at term.

OBJECTIVE: To evaluate the postnatal growth of full-term infants with fetal growth retardation (FGR) syndrome and their subgroups (disproportionate and proportionate) after six months of delivery. METHODS: This is a prospective follow-up study of 200 full-term gestations. We compare 100 FGRs (34 cases of FGR-disproportionate and 66 FGR-proportionate) infants against 100 normal infants/controls. At the sixth months of postnatal life, the infants were subjected to a standard paediatric evaluation and examination. RESULTS: At the sixth months of postnatal life, the infant weight was 7.183 g +/- 727 in the FGR group vs. 8.019 g +/- 823 in the control group, p < 0.001. 31% of FGR infants were found under the 10th percentile value as read for the 6th months standard, whereas the same value was detected in only 3% of control infants, p < 0.001. Likewise, 38% of FGR cases were under the 10th percentile of height versus 7% of control cases, p < 0.001. Proportionate FGR infants showed a higher increase of height in comparison to those from a disproportionate group (17.3 cm +/- 1.4 vs. 15.5 cm +/- 3.4, p < 0.05). A negative correlation was found between neonatal ponderal index (NPI) and weight gain (R = -0.16, p < 0.05). CONCLUSIONS: Six months after delivery, weight and height were lower in FGR infants than in controls. At that age, disproportionate and proportionate FGR infants had similar weight and height, being the height catch-up more significant in proportionate ones.

Body Height↗
PubMed1996

Spontaneous pregnancy in couples waiting for artificial insemination donor because of severe male infertility.

OBJECTIVE: To assess the spontaneous fertility in couples with severe seminal conditions while waiting for artificial insemination donor. STUDY DESIGN: Prospective follow-up during a period of 24 months. SETTING: University Medical School. PARTICIPANTS: There were 285 couples in which the male had a very severe seminal pathology: 166 azoospermia, 86 oligozoospermia and 33 severe asthenozoospermia. OUTCOME MEASURES: Pregnancy rates after being included on waiting list. RESULTS: The spontaneous pregnancy rate was 3.2% (9/285), per month spontaneous pregnancy rate being 0.13%. Spontaneous pregnancy rate was 0% in azoospermia (0/166). versus 7.6% (9/119) in non-azoospermia cases. Spontaneous pregnancy rate was 8.5% (4/47) in the group with less than 0.1 million motile sperm/cc, 6.5% (3/46) in the group between 0.1 and 1 million/cc and 7.7% (2/26) in the group with 1-2 million/cc. CONCLUSION: In a 2-year follow-up, pregnancy rate among non-azoospermic couples before undergoing artificial insemination was 7.6%. Extramatrimonial pregnancy (based on anamnesis and sperm analysis) seemed to be uncommon. Even in cases with less than 0.1 million of motile sperm/cc there was not a negligible spontaneous pregnancy rate.

Adult↗
PubMed1996

Are there any clinical signs and symptoms that are related to endometriosis in infertile women?

OBJECTIVE: Our purpose was to assess the physical signs and clinical symptoms associated with endometriosis in infertile women. STUDY DESIGN: This case-control study was carried out in an academic tertiary hospital. There were 174 infertile women with endometriosis and 174 infertile women without endometriosis, all of them studied by laparoscopy. Before laparoscopy a standard interview and a standard physical examination were performed. RESULTS: Cul-de-sac nodularity was more frequent in infertile women with endometriosis than in infertile women without endometriosis (6.3% vs 0%). Although uterosacral tenderness was also more frequent in infertile women with endometriosis (7.5% vs 1.7%), uterosacral tenderness without nodularity was similar in both populations. Uterine retroversion and cul-de-sac obstruction frequencies were somewhat higher in the endometriosis group (p<0.10). The remaining signs and symptoms analyzed, including pelvic pain and dysmenorrhea, were similarly frequent in both populations. Symptoms were similarly frequent in all American Fertility Society stages, although adnexal mass was higher in stage IV. CONCLUSION: Uterosacral nodularity was pathognomonic of endometriosis in infertile women. Uterosacral nodularity and uterosacral tenderness (associated with uterosacral nodularity) were the only symptoms or signs of value to indicate endometriosis in infertile patients. The remaining clinical signs, as well as clinical symptoms, were of no value in diagnosing endometriosis in infertile women.

Biopsy↗
PubMed1996

Intrauterine insemination with frozen sperm increases pregnancy rates in donor insemination cycles under gonadotropin stimulation.

OBJECTIVE: To compare the efficacy of IUI donor and pericervical insemination donor in frozen sperm insemination cycles under gonadotropin stimulation. DESIGN: Couples where infertility was caused by male conditions were randomized into two groups: IUI and pericervical insemination. Semen samples, gonadotropin stimulation, and ovarian monitoring were the same in both groups. One IUI was performed per cycle as against two pericervical inseminations. SETTING: The donor insemination program at the Human Reproduction Unit at the Hospital of Cruces, Pais Vasco University. PATIENTS: Eighty-eight women (47 IUI and 41 pericervical insemination) with at least one patent fallopian tube and < 40 years of age. MAIN OUTCOME MEASURE: Intrauterine gestational sac observed by transvaginal ultrasound. RESULTS: Per woman pregnancy rate (PR) was higher in IUI than in pericervical insemination (65.96% versus 41.46%, odds ratio [OR] = 2.73, confidence interval [CI] = 1.06 to 7.2). Pregnancy rates were always higher in IUI irrespective of woman and husband's status, but statistical significance was not reached in any subgroups analyzed independently. Per cycle PR was also significantly higher in IUI than in pericervical insemination: 24.03% (31/129) versus 11.89% (17/143) (OR = 2.34, CI = 1.17 to 4.71). Moreover, cumulative PR was higher in IUI (86% versus 49.5%) (OR = 6, CI = 1.98 to 18.80). CONCLUSION: Per woman and per cycle PRs were significantly higher in IUI.

Adult↗
PubMed1996

Infertile women with and without endometriosis: a case control study of luteal phase and other infertility conditions.

OBJECTIVE: To assess the relationship in infertile women between endometriosis and luteal phase defects and other infertility conditions. SETTING: University Medical School. DESIGN: Case-control study. PATIENTS: One hundred and seventy-four infertile women with endometriosis and 174 infertile women without endometriosis, all of them studied by laparoscopy. The inclusion criteria were failure of six cycles of ovulation stimulation or abnormal preliminary study (abnormal pelvic physical, hysterosalpingographic or ultrasound findings). RESULTS: The frequency of out-of-phase biopsies (16.1% vs 16.7%) as well as other endometrial abnormalities were similar in endometriosis associated infertility (EAI) and in non-endometriosis infertility (NEI). Mean progesterone and prolactin levels, as well as the proportion of abnormal progesterone levels (37.4% vs 44.3%) and of hyperprolactinemia (12.9% vs 13.2%) were similar in EAI and NEI. The frequency of uterine myomas was similar in both groups. Sperm characteristics were not better in EAI than in NEI. Higher endometriosis stages were not associated with a higher frequency of the aforementioned conditions. CONCLUSION: Luteal phase defects, sperm abnormalities and myomas are no more common in EAI than in NEI or in advanced stages of endometriosis.

Adult↗
PubMed1996

Fluctuation of cardiotocographic tracings during labor in fetal growth retardation.

The objective of our study was to analyse the fluctuation of cardiotocographic scores during labor in fetal growth retardation (FGR). The study took place at the University hospital "Principe de Asturias", Alcalá de Henares, Madrid, Spain. 170 at term FGR fetuses and 170 at term fetuses without FGR as control group were compared using modified Fischer scores, which were blindly performed at 3, 5 and 10 cm of cervical dilatation. As results we found out that the mean value of the Fischer score was significantly lower in FGR at 3 cm of cervical dilatation (8.1 +/- 1 vs 8.7 +/- 0.6), as well as at 5 cm (7.6 +/- 0.9 vs 8.1 +/- 0.7) and at 10 cm (6.7 +/- 0.8 vs 7.4 +/- 0.8). Poor prognosis cardiotocograms were also more common in FGR than in the control group in the three cut-offs points studied (7.5% vs 0.6% at 3 cm, 9.8 vs 1.8 at 5 cm and 37.9 vs 11.6 at complete cervical dilatation). The afore mentioned differences were more remarkable as labor advanced. Conclusions are that poor fetal heart rate recordings were detected in FGR at the beginning of labor when compared with control group fetuses and the differences between both groups increased while the labor prolonging.

Adult↗
PubMed1995

Epidemiology of endometriosis in infertile women.

OBJECTIVE: To assess the epidemiological factors linked to endometriosis in infertile women. SETTING: Academic tertiary hospital. DESIGN: Case-control study. PATIENTS: One hundred seventy-four infertile women with endometriosis and 174 infertile women without endometriosis, all of them studied by laparoscopy. RESULTS: Women with endometriosis and infertility had a higher frequency of cycles < or = 27 days (26.4% versus 16.7%). A trend to a protective effect of smoking was detected. Social class, reproductive history, infertility history, previous abortions, age, family history, age at menarche, and duration of menstrual flow were similar in both groups. CONCLUSION: Cycles < or = 27 days was the only risk factor that seemed to be associated to endometriosis in infertile patients. However, predictive values were low. A trend to a protective effect of smoking was detected.

Adult↗
PubMed1995

Levels of CA-19.9, CA-125, and CA-195 in seminal plasma and in vitro fertilization rates.

OBJECTIVE: To assess the relationship between carbohydrate tumor markers in seminal plasma and fertilization rates in IVF cycles. DESIGN: Prospective study. SETTING: Academic tertiary hospital. PATIENTS: Forty-six consecutive couples subjected to IVF in which at least one oocyte was obtained. MAIN OUTCOME MEASURES: Determination of CA-19.9, CA-125, and CA-195 in seminal plasma 1 week before IVF. RESULTS: CA-125 was higher in the group without fertilization (321 +/- 198 U/mL, mean +/- SD) than in the group in which at least one oocyte was fertilized (155 +/- 165 U/mL), whereas CA-19.9 and CA-195 were similar in both groups. However, at the cutoff 66%, lower values of CA-19.9 were found in the fertilization group rate < 66% (707 +/- 1,217 versus 1,069 +/- 1,084) and of CA-195 (67 +/- 44 versus 218 +/- 274). No correlation was found between tumor marker levels and fertilization rates. CONCLUSION: CA-125 seems to be an indicator of sperm fertilization capacity, whereas the importance of CA-195 and CA-19.9 will require further studies.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1995

Sperm morphology analysis (strict criteria) in male infertility is not a prognostic factor in intrauterine insemination with husband's sperm.

OBJECTIVE: To assess the prognostic value of strict sperm morphology analysis in intrauterine insemination with husband's sperm (IUI) cycles performed because of male infertility. DESIGN: Prospective study. SETTING: Academic tertiary hospital. PATIENTS: Seventy-four consecutive couples subjected to 271 IUI cycles because of male infertility. MAIN OUTCOME MEASURE: Strict morphology analysis 1 month before the beginning of IUI following the criteria of Kruger et al. RESULTS: Pregnancy and no pregnancy couples were similar regarding strict normal forms (2.85% +/- 2.07% versus 3.13% +/- 2.63%), slightly amorphous forms, and the morphology index (11.79 +/- 6.06 versus 12.04 +/- 7.13). Pregnancy rates (PRs) were similar when normal forms were <4% (39.1%) or > 4% (35.7%). The PR, although higher in the group with morphology index > 10% (41.4%) than in the group < 10% (33.3%), lacked statistical significance. In pure male infertility group, mean values of morphology were similar in pregnancy and nonpregnancy group. A not significant trend was detected toward higher PRs in morphology index > 10% (50.0%) than in the group < 10% (33.3%). CONCLUSION: Strict morphology analysis 1 month before the beginning of IUI is not a useful prognostic factor in IUI performed because of male infertility.

Adult↗