Letrozole Pretreatment With Misoprostol Versus Misoprostol Alone For Induction of First Trimesteric Missed Miscarriage A Randomized Controlled Trial

Background Miscarriage or spontaneous abortion is the involuntary termination of pregnancy before 20 weeks of gestation or a fetus born weighting less than 500 grams. Objective To compare between the safety and efficacy of two treatment modalities in medical termination of first trimesteric missed miscarriage. Patients and Methods This study was conducted at outpatient Obstetric clinic of Ain Shams maternity hospital in the period between June 2017 and December 2018. The patients who were fulfilling the inclusion criteria, were recruited in the study, then an informed consent was taken before starting the trial. Results In the total of 88 patients who were recruited in the study, 3 patients dropped from the study, 2 patients from the first group and 1 patient from the second group, so 85 patients were analyzed, the complete abortion rate of the letrozole group was significantly higher than that of the misoprostol only group (83.72% compared to 64.29%). Conclusion The use of letrozole pretreatment followed by misoprostol for induction of abortion in the first trimester is associated with higher complete abortion rate than misoprostol only.

Tobacco and Alcohol as Factors for Male Infertility – a Public Health Approach

The study of reproductive characteristics of 430 male subjects of different age, fertility status and educational level who were covered by the program of extracorporeal fertilization at the Gynecological-Obstetric Clinic in Niš, examined knowledge, attitudes and behaviour regarding tobacco and alcohol consumption as predictors of infertility risk. The methodology consisted of analyses of spermiograms and a survey on the patients’ reactions to smoking and alcohol use. Results: Statistical analysis, expressed by Hi-square test and a unilateral regression analysis, yielded the following results: the proportion with higher tobacco consumption and more severe forms of infertility increased significantly with ageing (p<0.001); the highest consumption of daily doses of alcoholic beverages and the incidence of intoxication is with azoospermic patients; the level of awareness of tobacco harmfulness is highest in normozoospermic ones, and the most significant degree of determination to quit smoking in the future is with azoospermic subjects. The determination to quit alcohol in the future does not correspond to the most vulnerable categories of respondents. Belonging to educational groups does not coincide with their expected health behaviour. In all categories of subjects concerning fertility status, smoking was found to be a risk factor for its deterioration. Smokers are 12 times more likely to develop oligospermia than non-smokers (OR 12.331). Conclusion: appropriate use of health promotion activities in relation to alcohol and tobacco use is through specially designed programs.

Relationship between thyroid disfunction and fertility

Thyroid dysfunctions have been associated with maternal-fetal development abnormalities. The evidence about the influence that thyroid dysfunctions can have on delayed conception is not very numerous. However, the benefit of a systematic screening of such alterations is not well established. The main objective is to determine if thyroid dysfunctions are associated with delays in conception in patients treated in an obstetric clinic.

Seroprevalence rates of Toxoplasma gondii, Rubella, Cytomegalovirus among first trimester pregnant women in Istanbul

Background: Toxoplasma Gondii, Rubella, and Cytomegalovirus (CMV) are the most common causes of congenital infections worldwide. There is not a consensus on these infectious agents should be screened during pregnancy. The aim of this study is to determine the prevalence of toxoplasma, rubella, and CMV infections in order to know the need for antenatal screening.Methods: This retrospective cross-sectional study was performed on 1309 ambulatory pregnant patients who applied to the obstetric clinic of a university hospital between October 2016 and April 2018. Documents of patients in the first trimester were reviewed and serologic data of Toxoplasma gondii, CMV, Rubella infections were retrieved from the computer database.Results: Of 1309 pregnant women, positivity for anti-Toxoplasma IgG antibody was 352(26.9%), while 17(1.3%) of the subjects tested were positive for the anti-Toxoplasma IgM antibody. These positivities of the pregnant women for anti-Rubella IgG and IgM were 1147(87.6%) and (0.1%), respectively. These positivities of the pregnant women for anti-CMV IgG and IgM were 1163(88.8%) and 17(1.3%), respectively.Conclusions: We detected high rates of immunity against Rubella and CMV but low rates of immunity against Toxoplasma in this retrospective cohort of pregnant women. Due to high rates of seropositivity against Rubella and CMV, routine nationwide screening may not be necessary.

Split pelvis.

M.m. G.G.! Taz, which I have the opportunity to show you and which is one of the precious copies of the collection of pathological pelvises of the obstetric clinic of St. Vladimira, belongs to the patient K b, who came to the clinic for eversion of the urinary bladder (ectopia vesicae). This patient had already been demonstrated in our Society by Dr. V.N. Gogotsky in the spring semester of 1894. I intend to demonstrate to you only the pelvis of this patient, which is of significant scientific interest, as well as casuistic, as extremely rare encounter. The question of the treatment adopted in this case will be sorted out in another place).

Towards the treatment of postpartum uterine inversion

Eversion of the uterus after childbirth is extremely rare. So, according to Braun, for 250,000 births from the Vienna Obstetric Clinic there was not a single case of eversion, Winkel for 17,000 births, Benham for 100,000 births from the Dublin maternity hospital, Beckmann for 200,000 births from the St. Petersburg maternity hospital, not a single one was observed case of eversion. It depends on the fact that eversion with the correct management of childbirth and mainly the postpartum period occurs extremely rarely. Most authors at least consider the crude methods used during childbirth to isolate the placenta by poor midwives or, more often than not, simple midwives, as the most common causes of eversion. The etiology and symptomatology of postpartum inversion of the uterus have been sufficiently elucidated, while the treatment of especially old forms of it presents many controversial points, as a result of which I would allow myself here to cite one case of postpartum inversion of the uterus that I observed in the hospital of Mary Magdalene and is of some interest in relation.