Biomedical subjects

T Gurgan

Publications and source records attributed to T Gurgan.

28 records · Page 2Linked to original sources

PubMed1997

Pregnancy in infertile PCOD patients. Complications and outcome.

OBJECTIVE: To evaluate the complications and outcome of pregnancy in women with polycystic ovary disease (PCOD). STUDY DESIGN: The course and outcome of 47 singleton pregnancies in women with well-documented PCOD were compared with those in 100 healthy controls. RESULTS: Women with PCOD had a significantly higher body mass index as compared to the control group (P < .05); however, the proportion of lean versus obese subjects in the two groups was similar. The incidence of an abnormal glucose challenge test, gestational diabetes mellitus and pregnancy-induced hypertension was significantly increased in pregnant women with PCOD (P < .05). When lean PCOD subjects were compared with lean control subjects, the difference in the incidence of the above complications was still significant (P < .05). The incidence of pregnancy complications was similar when obese PCOD subjects were compared with obese controls. CONCLUSION: Women with PCOD were at increased risk of gestational diabetes and pregnancy-induced hypertension, and this risk appeared to be independent of body mass index.

Adult↗

PubMed1996

Results of in vitro fertilization and embryo transfer in women with infertility due to genital tuberculosis.

OBJECTIVE: To determine the results of IVF-ET in women with infertility due to genital tuberculosis. DESIGN: Retrospective case-control study. SETTING: In vitro fertilization and ET unit of a university hospital. PATIENTS: Forty-four cycles of IVF-ET were undertaken in 24 women with genital tuberculosis and the results were compared with 366 cycles in 274 nontuberculous tubal factor couples. INTERVENTIONS: All women with genital tuberculosis were evaluated with hysteroscopy, endometrial biopsy, and acid fast bacilli stain before treatment with IVF-ET. RESULTS: Subjects with genital tuberculosis had higher basal FSH levels, required more exogenous gonadotropins for controlled ovarian hyperstimulation, reached lower peak E2 levels, and yielded fewer oocytes and embryos when compared with tubal factor patients. Furthermore, in women with genital tuberculosis, clinical pregnancy rate per cycle was lower and spontaneous abortion rate was higher. CONCLUSIONS: Women with genital tuberculosis appear to represent a less favorable subset within other tubal factor patients when treated with IVF-ET.

Adult↗

PubMed1996

Adhesion formation and reformation after laparoscopic removal of ovarian endometriomas.

STUDY OBJECTIVE: To evaluate the extent of adhesion formation after laparoscopic removal of endometriomas. DESIGN: Prospective case series. SETTING: A university hospital. PATIENTS: Nineteen infertile women with ovarian endometriomas. INTERVENTIONS: All patients underwent laparoscopic cystectomy with total stripping of the cyst capsule when possible. A second-look laparoscopy was performed after 3 months of postoperative treatment with a gonadotropin-releasing hormone analog. MEASUREMENTS AND MAIN RESULTS: The extent of adhesion reformation was dependent on the extent and severity of adhesions at initial laparoscopy. One (5.2%) woman had a residual ovarian endometrioma at second-look laparoscopy. De novo adhesion formation was not seen. Nine women (42.8%) conceived during the postoperative follow-up period (range 11-22 mo). CONCLUSIONS: Laparoscopic removal of endometriomas is effective in eradicating the disease. Adhesions at second-look laparoscopy depend on adhesions at the initial laparoscopy. Crude pregnancy rates are satisfactory in infertile women.

Adult↗

PubMed1996

Pregnancy Outcome, and Adhesion Formation and Reformation after Laparoscopic Cystectomy of Ovarian Endmetriomas

Unilateral or bilateral cystectomy for endometriomas was performed in 90 infertile women. Using a multipuncture technique, a cortical incision was made on the medial aspect of the ovary with sharp-tipped unipolar coagulation. Cystectomy was performed by stripping the cyst capsule from the normal ovarian cortex with the aid of atraumatic grasping forceps. If the capsule removal was incomplete due to technical difficulties, the remaining capsular fragments were vaporized with the carbon dioxide laser. Endometriosis implants elsewhere in the pelvis were vaporized and adhesions, if present, were lysed. The ovarian cortex was closed with a few interrupted 6-0 polyglactin sutures using extracorporeal knot technique. A second-look laparoscopy was performed in 25 patients to evaluate adhesion formation, reformation, postoperative crude pregnancy rates, and factors that would predict conception.

Journal Article↗

PubMed1996

Pathophysiology of adhesion formation and strategies for prevention.

OBJECTIVE: To review the mechanism of adhesion formation and to briefly discuss the possible sites of action of various preventive measures and adjuvants. STUDY DESIGN: Literature review. RESULTS: Although good surgical technique, designed to minimize trauma, is a crucial part of adhesion prevention, technique alone cannot effectively eliminate de novo formation and especially reformation of adhesions. CONCLUSION: To date, no adjuvant has proven uniformly effective in preventing postoperative adhesions. Nonreactive barriers show promise in selected situations, especially in the presence of apposing, injured peritoneal surfaces. Development of new and more effective compounds and advances in molecular cell biology may provide a more definitive answer to this perplexing problem, which has eluded surgeons for so long.

Humans↗

PubMed1995

Diagnosis of early tubal pregnancy by salpingoscopy.

Salpingoscopy was performed to diagnose any early tubal pregnancy that could not be identified at laparoscopy. The procedure may prove to be a valuable tool in such cases not only for diagnosis but also as a guide to proper endoscopic treatment by determining the site of the gestation.

Adult↗

PubMed1994

Results of Second-Look Laparoscopy Following Removal of Endometriomata

Despite widespread use of operative laparoscopy for removal of endometriomata, there are inadequate data regarding subsequent adhesion formation. We performed second look laparoscopy (SLL) within 6 months of laparoscopic endometriosis cystectomy in 21 infertile women. Mean age and mean duration of infertility were 30.5 ± 4.4 and 7.1 ± 4.9 years respectively. Cysts were removed with the following technique: incision of the ovarian cortex, cystoscopy (biopsy when necessary), and total stripping of the cyst capsule. All patients received postoperative suppressive therapy for 3 months. Total AFS score decreased significantly in all patients (34.1 ± 14.7 vs 12.3 ± 10.7; P<0.001). The adhesion score assessed at SLL improved in 3 (14.3%) remained the same in 13 (61.9%) and worsened in 5 (23.8%). Mean adhesion score at SLL was significantly less compared with adhesion score during cystectomy (7.1 ± 5.2 vs 8.7 ± 6.4; P=0.038). None of the patients had de novo adhesions. Adhesion scores were similar in women where ovarian cortical defect was left open or suture closed. Of the 21 women, 4 (19%) conceived within six months of SLL. In conclusion, laparoscopic removal of ovarian endometriomata was not associated with increased adhesion formation at SLL. Adhesions at SLL were mainly dependent upon adhesions at laparoscopic cystectomy.

Journal Article↗

PubMed1994

Colour Doppler hysterosalpingosonography: a simple and potentially useful method to evaluate fallopian tubal patency.

The diagnostic efficacy of colour Doppler hysterosalpingosonography to evaluate Fallopian tubal patency was studied in 17 women. Of the 17 women, 12 were infertile and the remaining five were fertile and requested elective tubal ligation. Colour Doppler sonography was performed using the transabdominal approach 1-4 weeks after diagnostic laparoscopy during infertility work-up in the former, and 1-2 weeks after bilateral isthmic tubal ligation in the latter group. Sterile saline was used as the contrast agent. Laparoscopic chromopertubation was considered as the gold standard. The sensitivity and specificity of colour Doppler sonography were found to be 93 and 83%, respectively. A kappa value of 0.73 reflected good clinical agreement between the two techniques. Colour Doppler hysterosalpingosonography is concluded to be a relatively accurate and simple procedure to test tubal patency. The other advantages include absence of radiation and avoidance of potential allergic reactions to iodinated contrast agents employed for hysterosalpingography. However, the inability to delineate the inner architecture of the genital canal and to determine the exact location of tubal obstruction, when present, remain the disadvantages of this technique.

Color↗

PubMed1994

Abortion associated with Campylobacter upsaliensis.

Campylobacter upsaliensis was isolated from the blood and fetoplacental material of an 18-week-pregnant woman who had contact with a household cat. We believe this is the first report of abortion associated with C. upsaliensis infection.

Abortion, Septic↗

PubMed1993

Circulating CA-125 levels in superovulated women are mainly derived from the ovaries.

A prospective study was designed to determine the individual contribution of the ovaries and the endometrium to total circulating levels of CA-125. Luteal phase CA-125 levels were measured in five women superovulated before and after vaginal hysterectomy performed for pelvic relaxation. The difference in the preoperative and postoperative luteal CA-125 levels of superovulated cycles were similar, suggesting a mainly ovarian source for the antigen although endometrial and other sites of contribution cannot be excluded in view of the small number of patients studied.

Adult↗