Background: Objective of current study was to correlate uterine artery Doppler parameters with endometrial findings on hysteroscopy and its importance for the prediction of intrauterine pathology inconclusive on 2-dimensional transvaginal imaging prior to frozen embryo transfer.Methods: This was a retrospective study conducted at Medicover fertility center, New Delhi, India. The study population comprised of women with infertility who have undergone hysteroscopy before frozen embryo transfer. Total 70 patients were recruited based on inclusion/exclusion criteria. Intrauterine pathology found in 57.2% (n= 40) patients and 42.8% (n=30) had normal endometrial cavity on hysteroscopy, they were categorized as group 1 and group 2 respectively based on their findings. Both the groups were compared for pre hysteroscopy uterine artery Doppler parameters, resistivity index and pulsatility index. Further clinical pregnancy rate and miscarriage rate were determined in both groups.Results: Both the groups were comparable for age, body mass index, duration, and type of infertility. Mean RI and PI was significantly higher in group 1 as compared to group 2 (0.90±0.025, 2.89±0.291 vs. 0.76±0.043, 1.82±0.27; p value <0.001). The best cut-off value of uterine artery RI was ≥0.87 with sensitivity of 90% (95% CI=0.7634-0.9721), specificity of 100% (95% CI=0.8843-1.0000) and PI was 2.46 with sensitivity of 100% (95% CI=0.9119-1.0000), specificity of 96.7% (95% CI=0.8278-0.9992).Conclusions: Uterine artery Doppler is a non-invasive, cost- effective useful add-on tool for routine endometrial evaluation and can be a good predictor for screening intrauterine pathology and valuable in decision making for pre-IVF hysteroscopy.
Background: Preeclampsia (PE) is a multifactorial disease that might be caused by a concurrent or preceding inflammatory stimulus. Inflammatory changes similar to those reported in chronic Chlamydia pneumoniae infection are seen in PE. It is suggested that persistent or chronic Chlamydia pneumoniae infection might have a role in the pathogenesis of PE and antichlamydial treatment in early pregnancy may prevent reactivation of infection and hence the development of preeclampsia.Methods: This randomized interventional study was conducted to determine the prevalence of C.pneumoniae IgG seropositivity in early pregnancy, its association with PE and the effect of treatment with oral azithromycin. A total of 330 primigravidae included in the study were followed up till delivery. C.pneumoniae IgG antibodies measured by ELISA technique at 14-20 weeks of gestation revealed seropositivity in 32.4%. These women were at higher risk of developing severe PE (odds’ ratio 3.2) as compared to the C. pneumoniae seronegative cases.Results: Treatment with oral azithromycin resulted in reduction in the occurrence of PE amongst the C.pneumoniae seropositive cases; as well as significant reduction in the incidence of low birth weight babies in the C.pneumonie seropositive group (p<0.001, ARR= 0.204).Conclusions: Pregnant women who were C.pneumonia IgG seropositive are at higher risk of developing severe preeclmapsia as compared to the C.pneumoniae seronegative cases. This association needs to be further evaluated.
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