3D-HyCoSy provided advantages of better assessment of uterine cavity over XHSG. Compared with conventional XHSG, the efficacy of 3D-HyCoSy to assess tubal patency was acceptable. In addition, the procedure of 3D-HyCoSy appears to be better tolerated, requiring no sedation or anesthesia and a reduced examination time. Thus, 3D-HyCoSy with saline as a contrast medium is feasible and could comprise a routine outpatient procedure in the initial evaluation of infertile women.
Objectives: This study was aimed to assess the use of three-dimensional hysterosalpingocontrast sonography (3D-HyCoSy) as a routine tool for evaluating infertile women in the office. Methods: In 25 non-selected infertile patients, tubal patency and uterine cavity were investigated by 3D-HyCoSy with saline as a contrast medium. The efficacy of the procedure was evaluated with X-ray hysterosalpingography (XHSG) as reference.Results: The positive predictive value, negative predictive value, sensitivity and specificity of predicting tubal patency by 3D-HyCoSy were 100, 33.3, 84.4 and 100%, respectively. The full contour of uterine cavity was depicted in 96% of cases by 3D-HyCoSy and 64% by XHSG (P < 0.005). The uterine cavity area measured on 3D-HyCoSy correlated well with the volume of contrast media required on XHSG (R 2 ¼ 0.8166). Conclusion: 3D-HyCoSy provided advantages of better assessment of uterine cavity over XHSG. Compared with conventional XHSG, the efficacy of 3D-HyCoSy to assess tubal patency was acceptable. In addition, the procedure of 3D-HyCoSy appears to be better tolerated, requiring no sedation or anesthesia and a reduced examination time. Thus, 3D-HyCoSy with saline as a contrast medium is feasible and could comprise a routine outpatient procedure in the initial evaluation of infertile women. S T A G 0 6 : F E T A L T H E R A P Y STAG-02Impact of sonohysterography on the management of women with uterine myomas D. H. Pretorius, E. Becker & A. S. Lev-ToaffPurpose: Assess the importance of sonohysterography findings in women with suspected/known myomas particularly with regard to location within/near the endometrial cavity and its impact on treatment. Methods: Review of 240 sonohysterograms identified 109 women (age 24-76, mean 42.4; 84.4% pre-menopausal, 15.6% post-menopausal) with suspected/known myomas. Images, reports, pathology/ surgery results, and clinical/imaging follow up were reviewed. Myoma location with respect to the cavity was described and feasibility of hysteroscopic resection assessed. Results: Indications for sonohysterography abnormal bleeding (74.3%), infertility (8.3%), other (17.4%). Five groups were defined (1) normal cavity (19/109 patients, 17.4%); (2) normal but displaced cavity (7/109, 6.4%); (3) myoma with endoluminal component (50/ 109, 45.9%); (4) other endoluminal findings, mostly polyps (25/109, 22.9%); (5) myoma plus other (8/109, 7.3%). An intracavitary myoma(s) (ICM), a submucous myoma >50% within the cavity, was found in 45 patients; submucous -20; mural -71; and subserosal -37 (57 patients had myomas in more than one location). SHG indicated that myomas were amenable to hysteroscopic resection (HR) in 45 women; in 39 others SHG revealed that myoma(s) were not amenable to HR. There was a significant difference in the use of hysteroscopic resection between these two groups; HR was performed in 21/45 (46.7%) of the former but only in 2/39 (5.1%) of the latter (P < 0.01). Other treatments were not significantly different between the two groups: hysterectomy in 7/45(1...
Some of the physiological roles of prolactin (PRL) in lactating rats were studied by passive immunization. Antibody to rat PRL (A/S PRL) was produced in rabbits immunized with rat PRL. Then the sera of the rabbits were tested for the potency and specificity of antibody to PRL by double antibody radio‐immunoassay technique. One ml of antiserum was inferred to be capable of sufficiently neutralizing endogenous PRL in lactating rats. From the 5th day of postpartum, 11 rats were daily injected intraperitoneally with 1 ml of A/S PRL. In the control group, each of 7 rats was daily injected with 1 ml of normal rabbit serum (NRS). Most pups in the treated group died between the 16th and 20th postpartum days, but all pups in the control group grew normally. Serum oxytocin (OT) levels in the treated group were significantly increased, suggesting that mechanical stimulation of the nipples by pups might increase OT levels, presumably because a lack of PRL decreased milk production. Serum growth hormone (GH) levels in both groups were virtually identical, suggesting that GH could not compensate PRL during the period of passive immunization.
One of the major goals in modern obstetrics is to provide more detailed information on prenatal fetal physiology. Since 1972, more than 200 amniocenteses were performed in our department of Obstetrics and Gynecology. The importance of prenatal genetic diagnosis has been well recognized, indicating the necessity of the development of other methods to obtain further direct data on the fetus within the uterine cavity. Among gynecological endoscopies, fetoscopy which is the direct visualization of the fetus by introduction of an endoscope into the amniotic cavity can be expected to obtain direct information from the uterine environment in pregnant women. With our newly developed fetoscope, we investigated the clinical indications and contraindications of fetoscopy as well as future possibilities of this endoscope. Our present study indicates that further development and future benefits of fetoscopy entirely depend on the progress of laboratory techniques which can provide more accurate data through specimens obtained by fetoscopy.
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