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Biomedical subjects

V A Hurley

Publications and source records attributed to V A Hurley.

9 recordsLinked to original sources
PubMed1996

The control of ovulation in mothers of dizygotic twins.

Dizygotic twinning is familial, suggesting that there may be an inherited abnormality of the control of ovulation that predisposes to double ovulation and, therefore, dizygotic twins. The present study examines 17 mothers of dizygotic twins (MODZT) and 8 control mothers of singletons by daily blood sampling throughout an entire menstrual cycle. Blood samples were assayed for LH, FSH, estradiol, progesterone, and inhibin. The process of follicular development was followed by transvaginal ultrasound. The pituitary LH response to iv GnRH was also assessed. Three of the 16 MODZT double ovulated during the study compared to none of the 8 control mothers (P < 0.05). The number of small follicles (<6 mm) declined significantly in control women at midcycle, but not in MODZT. There was no significant difference in serum FSH, LH, estradiol, or inhibin levels between the 2 groups at any stage of the menstrual cycle. During the follicular phase, serum progesterone levels were significantly higher in MODZT. The response to GnRH stimulation was not different between MODZT and controls. In conclusion, this study demonstrates an increased tendency to double ovulate in MODZT that may be due to a reduced rate of atresia in advanced follicles. Furthermore, the elevated progesterone levels in MODZT during the follicular phase suggest altered intrafollicular steroidogenesis that is independent of gonadotropins.

Adult↗
PubMed1993

Percutaneous ultrasound guided uterine needle biopsy.

OBJECTIVE: To determine the safety, accuracy and usefulness of percutaneous ultrasound guided uterine needle biopsy. SETTING: Transabdominal uterine biopsy was performed with an ultrasound directed biopsy gun. The biopsy was performed as an outpatient procedure under local anaesthesia. MAIN OUTCOME MEASURES: The safety, accuracy and clinical value of the procedure; a comparison of the clinical and ultrasound diagnoses with the biopsy and surgical histological diagnoses; and the effect of the biopsy result on the choice of treatment by the surgeon and patient. RESULTS: There were no complications. Accuracy was validated in all seven patients who subsequently had surgical procedures and more extensive myometrial histological investigation. Biopsy diagnosis improved clinical diagnosis in nine of the ten patients, and altered or assisted in the ultrasound diagnosis in eight of the ten patients. Decisions concerning choice of treatment by the doctor or patient were assisted by the biopsy result in seven patients. CONCLUSION: Percutaneous ultrasound guided uterine needle biopsy is a useful procedure in the diagnosis of myometrial disease.

Adult↗
PubMed1993

The value of vaginal ultrasound in the management of menorrhagia.

Vaginal ultrasonography has been carried out on 97 patients with menorrhagia who were either not responding to or not suitable for drug therapy. Ultrasonography demonstrated normal uteri in 33, benign uterine enlargement in 4, bicornuate uteri in 2, intracavitary polyps or fibromyomas in 9, possible adenomyosis in 13 and intramural or subserous fibromyomas in 36. The ultrasound diagnosis markedly increased the accuracy of clinical diagnosis and assisted in the proper choice of treatment which included the avoidance of surgery and the selection of patients most suited to endometrial resection, intrauterine resection of polyps and fibromyomas, and open or laparoscopic myomectomy and hysterectomy. The routine use of high resolution vaginal ultrasound in the management of menorrhagia is recommended.

Endometrium↗
PubMed1991

Ultrasound-guided embryo transfer: a controlled trial.

Embryo transfer (ET) was performed in 94 patients using transvaginal ultrasound guidance. Pregnancy rates were increased over a control group of 246 patients, although statistical significance was reached only in the subgroup of single ETs. Advantages over the traditional blind technique of ET were observed. Acceptance of the procedure by both clinicians and patients was high.

Embryo Transfer↗
PubMed1990

Acute polyhydramnios in twin pregnancies.

This paper reports the experience with acute polyhydramnios complicating twin pregnancies at the Mercy Maternity Hospital for the 10-year and 2-month period from January, 1979 to February, 1989 during which time there were 13 such cases, an incidence of 1 in 4,044 pregnancies. Acute polyhydramnios complicated 1.7% of all twin pregnancies. The perinatal mortality rate was 88.5% and accounted for 16.7% of the perinatal deaths in twins. No major fetal malformations were found. One case of acute polyhydramnios was successfully managed with ultrasonographically guided serial amniocenteses. The management of this rare condition is considered.

Acute Disease↗
PubMed1989

Cervical incompetence in a pregnancy following a cervical ectopic pregnancy.

A case of cervical incompetence is reported which occurred in a pregnancy which followed soon after treatment of a cervical ectopic pregnancy using a Foley catheter. Very few pregnancies following cervical pregnancy have been reported. Although this isolated case is clouded by other risk factors, cervical incompetence should be considered as a potential complication of such pregnancies.

Adult↗
PubMed1988

Cervical pregnancy: hysterectomy avoided with the use of a large Foley catheter balloon.

A case of cervical pregnancy in the late first trimester is reported where hysterectomy was avoided, when it seemed inevitable in the face of heavy uncontrolled haemorrhage. Having read the cases reporting easy control of massive haemorrhage from the expanded cervix in such cases by a Foley catheter, we decided to try this recently reported technique - it was magically effective.

Adult↗