Summary:The course and complications of pregnancies in 46 patients with valvular disease and congestive heart failure with or without valve prostheses are described. In group I consisting of 33 women without valve replacement and without anticoagulant therapy one thromboembolic event was seen, emergency closed or open heart surgery was necessary five times. One stillbirth happened after open heart surgery. In group 11, of 13 patients with prosthetic valve replacement and anticoagulation therapy there was no thromboembolism, but 2 spontaneous abortions and 2 premature stillbirths; 2 fetuses died after delivery, 3 had congenital abnormalities. Pregnancies in patients with valvular disease and congestive heart failure can be sustained relatively safely for the mother, even if emergency heart surgery becomes necessary. Heart surgery and anticoagulation treatment carry a higher risk for the fetus. Uterine blood loss is not increased, if coumadine treatment is switched to heparin administration shortly before delivery.
In 200 consecutive routine diagnostic laparoscopies, 31 cases (15.5%) of endometriosis were found. Of these 200 cases, 131 patients (65.5%) were referred for laparoscopy because of infertility. In 22 (71.0%) out of 31 patients with endometriosis infertility was the indication for laparoscopy. In the remainder of the patients laparoscopy was performed because of other indications. Half of the patients with endometriosis showed moderate or severe degrees of the disease. Seventy-one percent of the patients were below the age of 29. According to our findings, the presumption that endometriosis is a rare disease in Iran is considered to be erroneous.
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