Objective (s): Aim of the study was to evaluate the safety and feasibility of myomectomy during cesarean section.Materials and methods: This prospective observational study was carried out in a private setting at Dhaka city from January 2006 to June 2015. Forty five (45) women with fibroid uterus with pregnancy who needed caesarean section were the target population for this study. Myomectomy was done during caesarean section. Main outcome measures were: difficulty of myomectomy and caesarean section, time needed for operation, per-operative complications, need for blood transfusion, postoperative complications and duration of hospital stay.Results: During the study period total 45 women were found who had pregnancy with myoma and needed caesarean section for various indications. Twenty nine (64.4%) women were of age 26-35 years, 30 (66.7%) were para 0 and in 37 (82%) cases were term pregnancy. In forty one (91.1%) cases myomas were diagnosed preoperatively. Twenty five (55.6%) women had multiple myomas. Commonest site of myoma was body of the uterus (82.2%) and commonest type was intramural (75.6%). Thirty (66.7%) women had myoma of less than 5cm in size. In forty two (93.3%) cases myomectomy was done after delivery of the baby. Myomectomy was successful in all 45 (100%) cases. In thirty (80%) cases caesarean myomectomy was completed within 1 hour. Thirty seven (82.2%) women did not need blood transfusion and thirty eight (84.4%) women had no postoperative complication. Other had minor complications. Forty one (90.1%) women were discharged from hospital within 72 hours of operations.Conclusion: Myomectomy during cesarean section is a safe procedure and it is feasible in almost all cases. Though large scale RCT is needed before giving final conclusion it is not far away when myomectomy during cesarean section will be norm discarding the traditional view of not touching the myoma in pregnancyBangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 10-14
Objective: The aim of the study was to explore the efficacy of glucocorticoid in folliculogenesis and ovulation during induction of ovulation by letrozole in polycystic ovarian syndrome (PCOS). Materials and methods:This experimental study was conducted in Dhaka Medical College and Hospital and Infertility Care and Research Centre (ICRC) Dhaka, Bangladesh. Two hundred and eighty infertile patients with PCOS, who failed to ovulate by letrozole 10 mg/day for 5 days were the target population of this study. The patients received glucocorticoid (Dexamethasone) 0.5 mg every alternate day from D2 of the cycle till D10 along with same dose of letrozole in subsequent cycles. Only letrozole-treated cycles were taken as control and letrozole plus glucocorticoid-treated cycles were taken as experimental. Monitoring was done by transvaginal ultrasonography. Six ovulatory cycles were observed for pregnancy. Main outcome measures were ovulation and pregnancy.Results: Baseline characteristics were similar as same patients were taken as control and experimental. One hundred and eighty-two (65%) patients were ovulated and 93 (33.21%) patients got pregnant after addition of glucocorticoid. Conclusion:In PCOS addition of glucocorticoid during induction of ovulation appears to cause significant improvement in folliculogenesis, ovulation and pregnancy.
Three or more consecutive pregnancy losses are considered as recurrent pregnancy loss (RPL). About 1% of all pregnant women face this distressing problem and o.5% to 5% of spontaneous abortions are recurrent. Genetic, environmental, anatomic, hormonal, infectious and immunological factors are associated with RPL. Sometimes several factors might simultaneously be responsible for RPL. So diagnostic work up is to be extended. Life style changes, hormonal supplementation, anticoagulant and immunotherapy and surgical correction of certain uterine anatomic defects might help the couple to be parent. Genetic problem can be overcome by pre-implantation genetic diagnosis (PGD) and transferring good healthy embryos. Key Words: Recurrent Pregnancy Loss (RPL); Pre Implantation Genetic Diagnosis (PGD) DOI: http://dx.doi.org/10.3329/akmmcj.v2i2.8170 AKMMC J 2011; 2(2): 29-35
Many researchers have tried for aspiration of endometrioma followed by alcohol or tetracycline sclerotherapy in order to avoid delicate surgical procedure as well as to keep a functioning ovarian reserve. It has traditionally being used for recurrent cases of endometriomas. But this case report illustrates the importance of applying this procedure in unavoidable and exceptional circumstances.
Objective: Aim of this study was to identify the necessity of use of exogenous or surrogate LH for triggering of ovulation in induced cycles. Materials and methods: This study was conducted in Infertility Care and Research Center (ICRC) Dhaka, Bangladesh. Three hundred anovulatory patients with polycystic ovarian syndrome (PCOS) were the target population for this study. The patients were treated by different ovulation inducing agents to produce mature follicles. When follicle got the size of 18 mm or more LH was given to 150 patients (Group A) and 150 patients did not receive LH (Group B). Follicular rupture was monitored by USG. Main outcome measure was rupture of the follicle.Result: In group A 33.33% and in group B 34.67% patients responded by letrozole only, whereas 66.66% in group A and 65.34% in group B needed additional drugs like metformin glucocorticoids and gonadotropins. In both the groups response was similar in terms of number of follicular recruitment, follicular maturity, endometrial development and hormone production. Follicular rupture rate was similar in both hCG and non-hCG treated group. LUFS was detected only in 2.67% in group A and 2% cases in group B.Conclusion: If follicular development is adequate exogenous LH is not necessary for triggering of ovulation in all stimulated cycles. DOI: http://dx.doi.org/10.3329/bjog.v26i2.13783 Bangladesh J Obstet Gynaecol, 2011; Vol. 26(2) : 72-76
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