摘要:

The present report assesses 15 years' experience with electrocoagulation diathermy in the treatment of cervical intraepithelial neoplasia (CIN). Selection is based on the ability to visualize the boundaries of the lesion colposcopically. Visualization, together with cytology and target biopsy, should exclude invasive carcinoma. Histologically confirmed CIN of varying severity (almost two thirds were CIN III) was treated by diathermy in 1864 patients. The size of the lesion varied, and at times the lesion extended into the endocervical canal. Cervical intraepithelial neoplasia was eradicated in 97.3% of patients by a single diathermy treatment. Ninety-three percent of all patients under the age of 30 with CIN were treated by this method. Progression to invasive carcinoma after diathermy has not been demonstrated. A single treatment with electrocoagulation diathermy has proved consistently to be the most effective superficial ablative method for primary eradication of CIN whether deep, extensive, or of major severity. (Obstet Gynecol 61:673, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The medical records of 143 patients, hospitalized with a diagnosis of salpingitis over a five-year period were reviewed. Ninety-three patients had salpingitis without clinical evidence of a tuba-ovarian abscess. Seven (7.5%) of these women had surgical treatment; five of the seven were found to have tubo-ovarian abscesses which had not been detected clinically. Eighty-six of 93 (92.5%) patients with a clinical diagnosis of salpingitis and no abscess responded to medical management alone. Fifty patients had salpingitis and clinical evidence of a tubo-ovarian abscess(es); five of these patients had medical management only, 27 had medical treatment followed by surgery, and 18 had surgery initially before receiving antibiotics. There was a significant difference in age but not in parity between patients with evidence of a tubo-ovarian abscess that was managed medically and those who had surgery. There was no significant difference in surgical procedure performed, chronic symptoms, subsequent gynecologic surgery, or subsequent pregnancy among the groups with an abscess. There was a trend toward more surgical complications among women who had delayed surgical intervention for an abscess. Among women with a unilateral tubo-ovarian abscess, those who had a unilateral salpingo-oophorectomy had a higher pregnancy rate than those who received antibiotics alone. In this study, women with a tubo-ovarian abscess in association with salpingitis did not respond well to antibiotic treatment alone. This may be the most reliable way of distinguishing these patients from women with salpingitis alone or salpingitis in. association with a tubo-ovarian inflammatory complex, who, as a group, did respond well to medical management alone. (Obstet Gynecol 61:680, 1983)

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The records of 70 patients with a suburethral diverticulum were reviewed. Cases were classified according to their anatomic site of origin in an attempt to rationalize the appropriate therapeutic approach. It is suggested that suburethral diverticulum arising in the lower third of the urethra be preferably treated by marsupialization with tissue excision for histologic confirmation, and those diverticula arising in the upper two thirds of the urethra be treated by excision. In those cases in which multiple diverticula are suspected, an anterior vaginoplasty should be carried out in an attempt to reduce the morbidity associated with excision only.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Conventional microsurgical reanastomosis was compared with laser microsurgical reanastomosis of the ligated uterine horn in the rabbit. Fourteen virgin female New Zealand white rabbits had both uterine horns ligated and divided at laparotomy. Four weeks later, seven rabbits had conventional microsurgical reanastomosis of the divided uterine horns after the ligated stumps were excised (group 1). The ligated uterine horns of the other seven animals were incised with a carbon dioxide laser with a power density of 637 to 796 W/cm2 followed by conventional microsurgical reanastomosis using polyglactin (Vicryl) 8-0 sutures (group 2). After six weeks, a laparotomy was performed to determine adhesion formation and uterine horn patency by chromopertubation. Adhesion formation was graded 0 (no adhesions) through 3 (extensive, dense adhesions) for each uterine horn. Only one uterine horn in the control group was not patent. Laser microsurgery produced significantly less adhesion (mean ± SE, 0.79 ± 0.24) than conventional microsurgery (2.29 ± 0.13) (P < .001). The findings indicate that laser microsurgical tubal reanastomosis produces significantly better results with less adhesion than the conventional microsurgical technique.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The growth and rupture of the graafian follicle were studied in 23 women during 40 cycles (20 spontaneous, 20 clomiphene- induced) by the estimation of plasma estradiol levels and ultrasound scan. The mean preovulatory estradiol peak level was 415 pg/ml in spontaneous cycles and 626 pg/ml after clomiphene administration when one follicle was present. Ultrasonic examination revealed the presence of more than one developing follicle in one of 20 spontaneous cycles, and in 11 of 20 cycles after clomiphene treatment. The determination of follicle size and number by ultrasound scan during ovulatidn induction by the routinely used starting dosage of clomiphene has revealed a previously unrecognized incidence of ovarian overstimulation, and may allow the rationalization of ovulatibn induction regimens.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Between March 1972 and September 1981,154 patients with the diagnosis of ectopic pregnancy were treated at the University of Arizona. A retrospective review of these cases was performed to determine etiologic and demographic factors. Fertility follow-up was obtained in 58 women. Findings are discussed along with the presentation of various thoughts in an attempt to explain this proliferation of a surgical disease.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Patients with a laparoscopically verified first episode of acute salpingitis were offered a second-look laparoscopy to determine the effectiveness of the treatment regimen in terms of anatomic end result as well as to correlate the anatomic end result with future fertility. Until now, 13 women have been subjected to such relaparoscopy 16 to 33 weeks after the acute illness. At the acute stage of the disease, 11 of the women had serologic and/or cultural evidence of genital infection with Chlamydia trachomatis, three of whom also had Neisseria gonorrhoeae. All were culture-negative after treatment. In eight patients relaparoscopy showed that previously adherent adnexa were apparently normal, whereas in two patients a deterioration of the laparoscopic findings was found. Two patients had bilateral occluded tubes, for a preliminary infertility rate of 15%. These preliminary observations suggest that second-look laparoscopy after acute salpingitis might be a useful method for early objective evaluation of treatment results.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Little information is available concerning the effects of jogging during pregnancy on fetal and maternal outcomes. Through the use of a questionnaire, data were obtained on 67 experienced runners who continued to jog during pregnancy. The women had been running for an average of 3.8 years before the pregnancy, and ran an average of 470 miles during the pregnancy. The average number of miles run decreased as the pregnancy progressed (P < .05). There was no correlation between the number of miles run during the pregnancy, or in the third trimester alone, and either infant birth weight or gestational age. The incidence of maternal and fetal complications was low. Although there are limitations with questionnnaire retrospective studies, these data suggest that jogging during pregnancy by healthy women accustomed to such activity is not harmful to the infant.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The diagnosis of fetal hydrocephalus based on dilation of the ventricular system presents a broad range of management decisions. The options are presented and a case of Dandy-Walker syndrome managed by fetal ventriculoamniotic shunt placement is presented as an example. Under ultrasonic guidance, a shunt was placed at 30 weeks' gestation by later newborn Dubowitz examination. Delivery was delayed for five weeks, one to two weeks following probable shunt malfunction, after achieving fetal lung maturation. Follow-up six months after definitive neonatal ventricular shunting and three weeks after shunt revision revealed a socially active male infant with a motor development index of 87 and a psychomotor development index of 95. Potential advantages of fetal surgery including achievement of term gestation are presented. Proposed guidelines for determining the benefit of such procedures are also presented.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The outcome of delivery of infants weighing more than 4000 g born during two time periods 15 years apart was studied retrospectively. The increased use of cesarean section and other obstetric advances did not reduce the risk of fetal asphyxia and trauma associated with large fetal size. Maternal factors were identified for risk categorization of fetal macrosomia during pregnancy. Macrosomia was rare at 37 weeks and increasingly common thereafter. Fetal size assessment by ultrasound at 36 to 38 weeks' gestation would permit induction of labor for the macrosomic infant before the size became excessive or would make the accoucheur aware of the dangers that may arise during delivery.

ISSN:0029-7844    

出版商:OVID    

年代:1983

数据来源: OVID