The purpose of this study is to analyse the effect of luteal-phase support on pregnancy rates in gonadotropin + intra-uterine insemination (Gn/IUI) and clomiphene citrate (CC) +IUI (CC/IUI) cycles in patients with unexplained infertility. Equal numbers of patients were recruited in two treatment arms (CC/IUI and Gn/IUI) (n = 100, n = 100, respectively). In each group, 50 patients received vaginal progesterone for 14 days (Crinone 8% vaginal gel, 90 mg per day) for luteal-phase support from the day after IUI and continued until menstruation or the 10th week of gestation if pregnant. There were 29 clinical pregnancies among 200 patients. Pregnancy rates were 12% in CC/IUI cycles, 10% in luteal-phase-supported CC/IUI cycles 16% in Gn/IUI cycles and 20% in luteal-phase-supported Gn/IUI cycles. Although pregnancy rates were higher in Gn/IUI cycles compared to CC/IUI cycles, luteal-phase support did not significantly affect the pregnancy rates in both groups. This study implies that luteal-phase support with progesterone has no pronounced beneficial effect on pregnancy rates in either CC/IUI or Gn/IUI cycles in patients with unexplained infertility.
This guideline is prepared as a consensus report of the "Pregnancy and Diabetes Workshop of PUDER", in Ordu, on 6 October 2019; the authors are listed according to the alphabetic order of surnames. ABS TRACT Diabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0-40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis.
Introduction Uterocervical angle measurements in pregnant women with
idiopathic polyhydramnios were appraised for their predictive value for
spontaneous preterm labor.
Material and Methods In this prospective study, we included nulliparous
and multiparous pregnant women diagnosed with idiopathic polyhydramnios at
24?28 weeks at our polyclinic; the uterocervical angle and cervical
length were measured by transvaginal ultrasound at the time of diagnosis.
Routine pregnancy follow-up was done by our team and gestational age at delivery
and maternal-fetal outcomes were noted.
Results In total, 24 patients delivered before 37 weeks and 36 patients
delivered at 37 weeks or later. Preterm labor subjects had larger UCA values
(126.7?12.9? vs. 100.8?16.2?) and term labor
patients had larger cervical length values (34.3?4.5 mm vs.
40.6?5.2 mm). In women with idiopathic polyhydramnios, the area under
the curve for the uterocervical angle was 0.885 (p<0.001) and it was
0.823 for the cervical length (p<0.001).
Discussion The uterocervical angle, a sagittal transvaginal cervical
image measurement, is a practical method that successfully predicts spontaneous
preterm labor risk in singleton pregnancies with idiopathic polyhydramnios. In
addition, the uterocervical angle displayed greater sensitivity, but lower
specificity, compared with cervical length measures.
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