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Focuses on perinatal infections cytomegalovirus and toxoplasmosis. Percentage of all congenital anomalies attributed to perinatal infections; Most common infections, including toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, varicella-zoster and parvovirus; Importance of the recognition of maternal disease and fetal monitoring; Discussion of cytomegalovirus and toxoplasmosis; Virology and epidemiology; Diagnosis.

Background/aims: The study aimed to assess whether the use of intrapartum transperineal ultrasound (US) can reduce the rate of failed vacuum extraction (VE).Methods: This is a retrospective cohort study including all women delivering at term with the diagnosis of protracted second stage of labor. The mode of delivery and rate of failed VE were compared between women who underwent a US examination prior to the decision on obstetrical interventions ("+US" group) and those in whom clinical decisions were based upon digital assessment only ("no-US" group).Results: The study included 635 women. Among the "no-US" group (536), there were 13 failed VE attempts (3.6%) vs. none in the "+US" group (99, p = 0.1). There was a significant difference between the groups regarding mode of delivery (p = 0.001), with a lower cesarean section (CS) rate (20.2 vs. 27.8%) among the "+US" group. Maternal age, body mass index, nulliparity, gestational age at delivery, and birth weight, as well as neonatal short-term outcome did not differ significantly between the 2 groups.Conclusions: We demonstrate that among women who had the addition of intrapartum US during the second stage of labor there was a trend toward a lower rate of failed VE (although not reaching statistical significance), with a lower rate of CS but not affecting neonatal outcome. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy and safety of oral misoprostol for labor induction in women with term premature rupture of membranes (PROM) and an unfavorable cervix. Methods: We randomized 130 women with PROM of ≤4 h to either oral misoprostol, 50 μg, or a placebo given every 4 h for up to three doses. Intravenous oxytocin was initiated if active labor did not begin within 12 h. Results: Sixty-four women received oral misoprostol and 66 received placebo. The PROM-to-delivery interval was shorter with misoprostol than with placebo (13.7±5.8 vs. 20.3±6.8 h, respectively, P<0.05). Misoprostol significantly reduced the need for oxytocin (28.1 vs. 72.7%, P<0.001) and antibiotics (25 vs. 69.7%, P<0.001). No significant differences in cesarean section or hyperstimulation rate were noted. Conclusion: Oral misoprostol given to women with unfavorable cervix soon after term PROM significantly reduces the induction-to-delivery time and the need for oxytocin and antibiotics. [ABSTRACT FROM AUTHOR]

In this paper, we describe a case of ovarian vein thrombosis following laparoscopic hysterectomy and obturator tension-free vaginal tape surgery. Clinical presentation included spiking fever and lower abdominal pain. The diagnosis was made using computed tomography scanning with contrast material. Therapy consisted of broad-spectrum intravenous antibiotics and subcutaneous low-molecular-weight heparin. This is a rare case of ovarian vein thrombosis following laparoscopic hysterectomy. We believe that such a thrombotic complication should be considered when evaluating a patient with spiking fevers and abdominal pain, even after minimally invasive procedures, such as laparoscopic hysterectomy. (J GYNECOL SURG 22:163) [ABSTRACT FROM AUTHOR]

Abstract: Objective: The objective of this study was to compare the intraoperative and short-term postoperative complications of laparoscopic hysterectomy and total abdominal hysterectomy. Study design: Retrospective study of 167 women who had laparoscopic hysterectomy and 119 women who had total abdominal hysterectomy. For assessing the learning curve, the laparoscopic hysterectomies were further subdivided to the first 30 hysterectomies and the later hysterectomies. For data analysis Student''s t-test, χ 2-test and Fisher''s exact test were used. Results: There were no statistically significant differences between the two groups for age, body mass index, previous abdominal surgery, uterine weight, first postoperative day hemoglobin drop, blood transfusion and major or minor complications rate. Operation time was significantly longer for laparoscopic than abdominal hysterectomy (156±40 and 91.2±33min, respectively; P <0.001) but the length of hospital stay was significantly shorter (3.9 and 6.55 days, respectively; P <0.001). The conversion rate of laparoscopic hysterectomy was 1.8% (three cases). Conclusions: Laparoscopic hysterectomy can be safely done even during the learning curve with a low and reasonable complication rate, and a shorter hospital stay but with longer operation time. As experience is gained the operation time, complication rate and hospital stay are decreased. [Copyright &y& Elsevier]

Abstract: Hydatidiform mole with co-existing live fetus is a rare entity. Two cases are reported. In the first, complete mole with a co-existing live fetus was suspected on ultrasound examination at 16 weeks of gestation. A termination of pregnancy was performed due to early onset of severe preeclampsia and thyrotoxicosis. In the second case, the patient was admitted at 26 weeks of gestation due to preeclampsia. Genetic amniocentesis at 19 weeks of gestation revealed a normal 46 XX karyotype. Ultrasound examination at 21 weeks of gestation demonstrated two cystic lesions in the fetal liver, wide multicystic placenta and polyhydramnious. Following deteriorating severe preeclampsia, a live female infant (730 g) along with a huge placenta (1350 g) was delivered by a cesarean section. Unfortunately, the newborn died after 35 days. Pathological examination in both cases was consistent with a complete mole co-existing with a viable fetus. During a 1 year follow up period, there was no evidence of persistent or metastatic disease in both cases. Review of literature discussing the diagnostic tools, clinical features, management and outcome of pregnancies with complete mole with a co-existing live fetus is presented. [Copyright &y& Elsevier]

Objectives: To determine the pre-malignant and malignant potential of endometrial polyps and to assess whether different clinical parameters are associated with malignancy in the polyps. Study design: Four hundred and thirty consecutive cases of hysteroscopic diagnosis of endometrial polyp were retrieved. The medical records, preoperative vaginal sonography results and histopathology findings were reviewed. Statistical analysis was performed. Results: Hysteroscopy truly identified endometrial polyps in 95.7% of the cases. In 11.4% cases, hyperplasia without atypia was found in the endometrial polyp. In 3.3 and 3.0% of women pre-malignant or malignant conditions were found in the polyp. Older age, menopause status and polyps larger than 1.5 cm were associated with significant pre-malignant or malignant changes, although the positive predictive value for malignancy was low. All the malignant polyps were diagnosed only in postmenopausal women. The presence of postmenopausal or irregular vaginal bleeding, was not a predictor of malignancy in the polyp. Conclusions: Postmenopausal women with endometrial polyps are at increased risk of malignancy in the polyp. Those patients, whether symptomatic or not should be evaluated by hysteroscopic resection of the polyps. Asymptomatic premenopausal patients with polyps smaller than 1.5 cm can be observed. [Copyright &y& Elsevier]

: ObjectivesRipening of the cervix with a Foley catheter commonly results in cervical dilatation without contractions. We examined the outcome of labour in women who underwent induction of labour using a Foley catheter, followed by either 1. early amniotomy, or 2. augmentation of labour by oxytocin and late amniotomy: DesignProspective randomised clinical trial: SettingLabour and delivery ward of a university teaching hospital: ParticipantsPregnant women ≥38 weeks of a singleton gestation, who had had no prior caesarean section: MethodsAll women underwent cervical ripening using a Foley catheter. Following removal of the catheter, women were randomly assigned to either early (n = 80) or late amniotomy (n = 88).Main outcome measures Comparison of mode of delivery and duration of labour between the two groups: ResultsThe rate of caesarean section was significantly higher in the early amniotomy group compared with the late amniotomy group (25% vs 7.9%; relative risk 1.74; 95% CI 1.3 – 2.34). The increase in caesarean section rate was due primarily to dystocia (15% vs 3.3%; relative risk 1.8; 95% CI 1.32 – 2.45). When excluding caesarean deliveries, no significant difference was found in duration of labour between the groups (8.3 hours (3.8) vs 7.7 hours (2.9)): ConclusionsIn women who undergo cervical ripening with a Foley catheter, augmentation of labour by oxytocin followed by amniotomy during active labour results in a lower rate of caesarean delivery for dystocia [ABSTRACT FROM AUTHOR]

Abstract: Objective:: To compare maternal and neonatal morbidity associated with two methods to extract the impacted fetal head during Cesarean delivery. Study design:: We retrospectively analyzed cases with difficult extraction of the impacted fetal head during Cesarean section. We compared maternal and neonatal outcomes between cases that were delivered by head extraction following pushing through the vagina (‘push’ method) and those that were delivered by the reverse breech technique (‘pull’ method). Results:: We reviewed 3105 Cesarean section reports. Difficult extraction necessitating the ‘push’ or ‘pull’ methods was noted in 48 (1.5%) instances. Women that were delivered by the ‘pull’ method had significantly lower rate of postpartum fever (5% versus 46%; odds ratios, 0.06; 95% confidence intervals, 0.007–0.51) and extensions of the uterine incision (15% versus 50%; odds ratio, 0.17; 95% CI, 0.04–0.74) compared to those that were delivered by the ‘push’ method. Neonatal outcomes were good in all cases. Conclusions:: In cases with difficult extraction of the impacted fetal head during Cesarean section, ‘pull’ method may result in lower maternal morbidity compared to the traditional ‘push’ method. [Copyright &y& Elsevier]

Green tea polyphenol extracts (GTE) are sold commercially as cholesterol-reducing agents and for weight reduction however, they have also been reported to be hepatotoxic. Our results from both in vitro and in vivo studies indicate that green tea polyphenols can potentiate liver injury after and during treatment with high cholesterol diet to induce experimental NASH. Eight week old male C57BL mice (n=32) were fed for 6 weeks with one of the following diets: Control diet (Con); Con +1% w/w polyphenols from green tea extract (Con+GTE); High cholesterol diet, Con+ 1% cholesterol+ 0.5% cholate w/w (HCD); HCD + 1 % polyphenols w/w (HCD+GTE). Hepatic steatosis, oxidative and inflammatory markers and bile acid synthesis pathways were measured. GTE enhanced hepatic steatosis but only in animals exposed to the high cholesterol diet. In HCD treated animals GTE elevated blood levels of liver enzymes SGOT, SGPT, and bile acids. Inflammatory and oxidative markers in the liver were also significantly increased including liver mRNA expression of TNF-alpha, IL-6, SAA1, SAA2, iNOS and levels of 4-hydroxynonenal protein adducts. The mechanism of action for GTE/cholesterol hepatotoxicity was found to be related to alteration in bile acids synthesis pathways. This study shows that liver injury in the presence of lipids could be the reason for weigh loss by high dose of polyphenols. [ABSTRACT FROM AUTHOR]

Presents information on placental site trophoblastic tumor (PSST). Description of two case reports of PSST patients; Symptoms of PSST; Treatment procedure.

Presents a case of two families with ovarian dermoid cysts. Medical history of the families; Role of the process of parthenogenesis in the occurrence of dermoids; Diagnosis of the disease.

No Abstract available [ABSTRACT FROM AUTHOR]