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Biomedical subjects

W F Ziegler

Publications and source records attributed to W F Ziegler.

5 recordsLinked to original sources
PubMed2000

Prediction of endometrial ablation success according to perioperative findings.

OBJECTIVE: The aim of this study was to determine which factors in the perioperative period influence the success of endometrial ablation in alleviating menorrhagia. STUDY DESIGN: We performed a retrospective chart review of 120 women aged 27 to 49 years who underwent endometrial ablation after 2 months of preoperative treatment with danazol (Danocrine, 800 mg/d orally) or leuprolide (Lupron, 3.75 mg in one intramuscular injection each month). Patients who required medical management or additional operations to control the vaginal bleeding during follow-up (median follow-up, 37 weeks) were considered to have ablation failures. RESULTS: Sixty-three percent of patients (76/120) had a successful procedure. The chance of success was greater if a cavity of normal appearance was found (odds ratio, 2.3; P =.04). The finding of an intramural fibroid before the procedure resulted in a reduced trend toward success (odds ratio, 0.4; P =.06). The use of danazol pretreatment improved the rate of success overall (odds ratio, 2.2; P =.05) and especially among women <40 years old (P =.01) CONCLUSION: Perioperative findings may provide useful information in counseling patients regarding endometrial ablation. Success is greater among patients with a normal intrauterine cavity and after preoperative treatment with danazol.

Adult↗
PubMed1999

Regional hemodynamic adaptation during the menstrual cycle.

OBJECTIVE: To determine whether regional differences exist in uterine and systemic hemodynamic responses to the menstrual cycle, whether the hormonal environment correlates with the changes, and whether uterine artery hemodynamic adaptation depends on the side of ovulation. METHODS: Twenty nulliparas had transvaginal Doppler ultrasonographic assessment of the uterine and upper-extremity radial arteries at three time points in each of two menstrual cycles. Doppler indices (peak systolic velocity, end-diastolic velocity, time-averaged maximum velocity, resistance index [RI], and blood flow) were measured in the radial and uterine arteries. Women were examined in the menstrual (cycle day 2-3), follicular (cycle day 9-10), and luteal phases (cycle day LH surge plus 9-10). At each time, serum estradiol (E2) and progesterone were measured by radioimmunoassay. Statistical analyses were repeated-measures analysis of variance and the Fisher least significant difference procedure. RESULTS: Thirty-four nonconception ovulatory cycles were evaluated. Blood flow in each uterine artery increased significantly from a mean (+/- standard deviation) of 22.4 +/- 7.3 mL/minute in the follicular phase to 30.7 +/- 13.7 mL/minute in the luteal phase, which coincided with a reduction in the RI. The changes were independent of the side of ovulation. The radial artery did not parallel these changes (follicular blood flow of 27.2 +/- 13.9 mL/minute; luteal blood flow of 24.7 +/- 10.5 mL/minute). We did not identify any significant correlation between these changes and serum E2 or progesterone concentrations. CONCLUSION: We identified differences in the hemodynamic responses of the uterine artery compared with the radial artery during the menstrual cycle. We believe the difference indicates distinct regional control of vascular response during the menstrual cycle.

Adaptation, Physiological↗
PubMed1996

Delayed delivery of a triplet pregnancy without surgical intervention: a case report.

Multiple gestations have a significantly increased incidence of preterm labor and preterm rupture of membranes. This leads to an increase in neonatal morbidity and mortality due to prematurity. In this case, a 30-year-old woman achieved a triplet pregnancy by ovulation induction and intrauterine inseminations. Preterm premature rupture of membranes occurred at 21 6/7 weeks' gestation. At 24 weeks' gestation, preterm labor ensued and a vaginal delivery of the presenting triplet followed. Magnesium sulfate tocolysis was started after delivery. The patient was placed on bed rest, magnesium sulfate tocolysis, and weekly steroid injections. The second and third triplet delivered vaginally after a 46-day delay due to preterm labor. This is the first reported case of delayed delivery of the two remaining fetuses of a triplet pregnancy, after spontaneous preterm delivery of the presenting triplet, without surgical intervention. Although the first fetus expired 48 hours after delivery secondary to complications of prematurity, the other fetuses were subjected to tocolysis, bed rest, and steroids. This case illustrates that conservative management of a triplet pregnancy after preterm delivery of the presenting triplet may have a good outcome.

Adult↗
PubMed1995

High success with gestational carriers and oocyte donors using synchronized cycles.

PURPOSE: Our purpose was to determine if exogenous hormone stimulation of the endometrium improves the implantation and pregnancy rate with a host uterus or gestational carrier. RESULTS: Nine couples underwent 14 embryo transfer cycles with a gestational carrier. The median age was 31.3 years for the infertile women donating the oocytes and 36.6 years for the gestational carriers. Eight pregnancies were achieved documented by ultrasound confirmation of cardiac activity. The pregnancy rate was 64.3%, with 1.6 cycles per patient. CONCLUSION: We show that synchronized exogenous hormone stimulation of the gestational carrier improves the success rate of embryo transfer. When the success rate is compared to a timed embryo transfer with the gestational carrier's natural cycle, from previous reported studies, exogenous hormonal stimulation appears to enhance endometrial receptivity and improve the implantation rate.

Adult↗