The objective of this paper is to evaluate the effect of mode of delivery on postpartum sexual functioning in primiparous women. A total of 248 primiparous women were recruited into this study. One hundred fifty-six delivered spontaneously with mediolateral episiotomy and 92 had elective cesarean section. Sexual function was evaluated by the Female Sexual Function Index, a validated questionnaire separately evaluating desire, lubrication, orgasm, satisfaction, and pain. Subjects were questioned relating their pre-pregnancy experiences during the first antenatal visit when the pregnancy was not more than six gestational weeks. The test was repeated 6 months postpartum. Statistical evaluation was carried out by SPSS for Windows v.11. In the vaginal delivery with mediolateral episiotomy group, there were significant decreases in the scores 6 months after delivery when compared to scores before pregnancy (p<0.001). In the cesarean section group, no difference was observed between pre-pregnancy and postpartum scores (p>0.05). When the two groups were compared, there was a significant difference between 6 months postpartum scores (p<0.001). Not only pain, but also other important aspects of sexual function, such as arousal, lubrication, orgasm, and satisfaction are affected by performing mediolateral episiotomy during vaginal delivery, well beyond the puerperal period. Concerning its effects on postpartum sexual functioning, a policy of restricting mediolateral episiotomy use should be adopted.

The imbalance between NO and ET-1 may play a significant role in the pathophysiology of preeclampsia.

No statistically significant difference existed between normotensive pregnant, and pre-eclamptic women, with regard to plasma lipoprotein(a) levels. It is improbable that high serum lipoprotein(a) levels are risk factors for the development of pre-eclampsia; however, elevated triglyceride-rich lipoproteins might cause endothelial damage leading to pre-eclampsia.

Imperforate Hymen (IH), an obstructive congenital anomaly of the female genital tract, is seen in 1 in 2000 female births. Treatment of IH is hymenotomy or hymenectomy. Different types of incisions are mentioned in the literature. We reported two cases of IH with different clinical presentations and described a simple virginity preserving and socially acceptable procedure to protect the virginity of the patient. In cultures and religions where the destruction of the hymen is a social problem in unmarried girls, virginity sparing surgery should be chosen in gynecological practice. Here we described a simple procedure without need for prophylactic antibiotic treatment and foley catheter application to form an intact annular hymen in two cases. Abstract ÖzetCase Report 278

A recurrence of ovarian mucinous cysts is very rare. Over a period of 21 months, a 20-year-old patient had three laparotomies resulting initially in the removal of one ovary with a mucinous cystadenoma and two cystectomies for the same pathology, but ultimately leading to hysterectomy and salphingo-oopherectomy. Because mucinous tumors are usually benign and most of the time multilocular, management of young patients is challenging, especially in the case of recurrence. Follow-up of these patients is very important and transvaginal ultrasound seems to be currently the most effective diagnostic tool for the follow-up of young patients treated with cystectomy for benign mucinous cystadenomas.