The aim of this study was to evaluate the efficacy of vaginal misoprostol for cervical priming at doses of 200 mcg and 400 mcg, 12 to 15 hours before diagnostic office hysteroscopy (OH) without anesthesia in patients with infertility. Sixty infertile patients requiring a diagnostic office hysteroscopy for investigation of infertility were included in the study. The patients were randomly allocated into 3 vaginally administered misoprostol groups: (1) control group, (2) 200-mcg dose group, and (3) 400-mcg dose group. Misoprostol significantly facilitated the procedure of OH: cervical entry was easier; procedural time was shorter; baseline cervical width was larger; and pain scoring was lower in the misoprostol groups compared with the control group. Increasing the dose of misoprostol from 200 mcg to 400 mcg did not improve the effect on cervical dilation. Misoprostol is a promising analog to use for cervical priming before OH. Since doses of 200 mcg and 400 mcg vaginal misoprostol 12 hours before the OH both have proven to be effective regimens, 200 mcg may be preferred. However, before routine clinical usage, further research is needed through large, randomized, controlled trials powered to detect a difference in complications to determine whether misoprostol reduces complications in OH.

Routine use of endometrial thickness measurement with TVUS does not seem to be an effective diagnostic tool for endometrial cancer because it has a low diagnostic performance in asymptomatic postmenopausal women. Further prospective studies are required to assess the endometrial thickness measurement with TVUS as a screening method in these women.

Objective: The purpose of this study was to determine the frequency of chromosomal anomalies among the fetuses with isolated and non-isolated aberrant right subclavian artery (ARSA), and to evaluate the sonographic findings associated with ARSA. Methods: This is a retrospective study conducted during the period between January 2008 and December 2012 at the maternal fetal medicine units of three different referral centers. Results: Among the 148 cases of ARSA, 98 were isolated and 50 were associated with cardiac anomalies, extracardiac malformations or soft markers. Trisomy 21 was the only chromosomal anomaly with a prevalence of 6.8% (10/148). The corresponding rate was 6.1% (6/98) and 8% (4/50) for isolated and non-isolated ARSA, respectively. Cardiac anomalies, extracardiac findings and soft markers were detected in 5.4% (8), 10.8% (16) and 24.3% (36) of cases, respectively. Among the 10 fetuses with trisomy 21, 6 were isolated, 4 were associated with soft markers, 2 were associated with fetal growth restriction and 1 was associated with hydrops fetalis. Cardiac anomalies were not observed in any of these fetuses. Conclusion: The prenatal diagnosis of ARSA should prompt meticulous anatomic survey, and karyotype analysis might be offered even in the absence of associated findings.

Background Congenital vaginal agenesis is a rare malformation with an incidence of one in 4000 to 5000 female newborns. The purpose of vaginal agenesis treatment is not only to create an adequate passageway for penetration but also to facilitate satisfactory sexual intercourse. Objective To present the results of a modified McIndoe technique with respect to sexual function, vaginal length and complication rates in patients with vaginal agenesis. Methods Between 2002 and 2010, 23 patients with vaginal agenesis were admitted to the Gynecology Clinic of Istanbul University School of Medicine (Istanbul, Turkey) for vaginal reconstruction. All patients underwent a modified McIndoe procedure. The long-term results with a follow-up period ranging from 18 to 118 months are presented. Results The postoperative mean vaginal length was 8.4 cm (range 6 cm to 11 cm) in 19 patients who used the mould regularly. Among 14 patients who used the mould regularly and had partners, only one experienced severe pain during intercourse and 13 reported that they were engaging in satisfactory sexual activity with mild or no pain, and with good mucosal sensitivity. Conversely, two of three patients who used the mould irregularly experienced severe pain during intercourse and had a mean vaginal length of 6 cm (range 4 cm to 8 cm). Conclusion The findings suggest that a modified McIndoe technique is a simple, effective procedure for the treatment of vaginal agenesis; however, proper mould use after surgery remains the cornerstone of the treatment.

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SUMMARY Introduction: A major problem of practitioners of assisted reproductive techniques (ART) is fertile aging,