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Objective. To evaluate the safety and effectiveness of transvaginal ultrasound guided injection of hot saline into the ovarian stroma in polycystic ovary syndrome (PCOS) cases in an office based gynecology practice under local anesthesia. Setting. Outpatient gynecologic clinic. Study design. Pilot study. Participants. Fifty-two anovulatory infertile females diagnosed as PCOS by clinical, chemical and ultrasound criteria were recruited for the study. All cases were resistant to clomiphene citrate for more than 6 months. Intervention. Injection of warm sterile saline (75C) into the ovarian stroma under transvaginal monitoring using ovum pickup needle. Outcome measures. Cycle regularity, ovulation rate and safety were primary outcomes. Pregnancy rate and patient convenience were our secondary outcomes. Results. Ovulation has been achieved in 73.1% of clomiphene citrate resistant PCOS cases and resulted in pregnancy in 26.9% of these cases. No adverse effects were recorded and the procedure was tolerable in most cases. Conclusion. Transvaginal ultrasound guided ovarian stroma hydrocoagulation (TOSH) in an office setting seems to be a safe, economic and practical procedure that is acceptable by the patients. If larger studies confirm its effectiveness it may be an attractive alternative to conventional ovarian drilling.

Transvaginal ultrasound-guided aspiration and systemic methotrexate administration can be safely and easily used to treat cervical ectopic pregnancies and to preserve the fertility of the patient without any major complications.

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ObjectivesTo detect the association between Helicobacter pylori infection and hyperemesis gravidarum among Egyptian women. Participants and methods Thirty pregnant women with hyperemesis gravidarum were recruited from the Cairo University outpatient clinics and 30 healthy pregnant volunteers with no vomiting were selected as controls. The age range in both the groups were between 18 and 39 years and the gestational age ranged from 5 to 12 weeks. All participants were subjected to full history taking, clinical examination, and ultrasound to exclude obstetric causes of hyperemesis gravidarum. Routine and special laboratory investigations were performed to test the serum for H. pylori seropositivity IgG using an enzyme-linked immunosorbent assay. ResultsThere was a highly significant difference in the H. pylori IgG antibody titer between the cases (18.1-100 U/ml) and the controls (0.9-62.7 U/ml) (Po0.01). The number of cases found to be seropositive to H. pylori IgG (100%) was higher than the number of the control individuals (86.67%), but the difference between both the groups was not statistically significant (P = 0.37). ConclusionOur results showed that there might be an association between H. pylori infection and hyperemesis gravidarum. We recommend that further studies be carried out to confirm this finding with a larger number of participants and for a longer duration of time.

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