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3] Barmat LI, Chantilis SJ, Hurst BS, Dickey RP. A randomized prospective trial comparing gonadotropin-releasing hormone (GnRH) antagonist/recombinant follicle-stimulating hormone (rFSH) versus GnRH-agonist/rFSH in women pretreated with oral contraceptives before in vitro fertilization. Fertil Steril 2005;83(2): 321-30.[4] Fábregues F, Peñarrubia J, Creus M, Casamitjana R, Vanrell JA, Balasch J. Effect of halving the daily dose of triptorelin at the start of ovarian stimulation on hormone serum levels and the outcome of in vitro fertilization. Fertil Steril 2005;83(3): 785-8.In the assessment of fallopian tube patency for infertility, hysterosalpingo-contrast sonography (HyCoSy), using air, saline, and galactose microbubbles has been extensively studied over the last 15 years [1][2][3][4][5]. Most studies have compared the sensitivity and specificity of HyCoSy to the current "gold standard" techniques, but only a few have followed the patients and analyzed the outcome, i.e. pregnancy [2,4,5]. The aim of the present study was to assess the reliability, comparability, and efficiency of HyCoSy.Fifty consecutive infertile women presenting to one center with no acute genital infection were assessed for tubal patency using HyCoSy. We used a galactose-based microbubble contrast agent (Echovist-200; Schering, Berlin, Germany) and performed transvaginal ultrasound using a Toshiba Eccocee (Toshiba, Tokyo, Japan) with a 6-MHz vaginal probe as described elsewhere [1][2][3][4][5]. Repeat tubal patency assessment by X-ray hysterosalpingography or laparoscopy with dye chromopertubation was performed a few months later in women who did not conceive. The results of HyCoSy and the reference standard method were compared, along with the characteristics of women who conceived and those who did not. The study protocol was approved by the national medical ethics committee and the women provided informed consent.We used sensitivity, specificity, and positive and negative predictive values to compare the two diagnostic methods, and the χ 2 test and t test to compare the characteristics of the pregnant and nonpregnant women (SPSS version 13.0; SPSS, Chicago, IL, USA).Mean age of the women was 30.0 years (range, 21-40 years). Of the 50 women, 48% had primary infertility and 52% had secondary infertility. The mean duration of infertility was 3.2 years (range, 1-13 years). Of the 100 tubes assessed by HyCoSy, 63% were considered patent, 31% nonpatent, and in 6% although the contrast was not visualized, free fluid was detected in the posterior cul de sac.Of the 50 enrolled women, 25 (50%) underwent a repeat tubal assessment 1-24 months after the first procedure using X-ray hysterosalpingography or laparoscopy with dye chromopertubation, 17 (34%) conceived before undergoing additional investigation, and 8 (16%) did not pursue further investigation.In the 25 women who did not conceive after HyCoSy, tubal patency was reassessed using laparoscopy with dye chromopertubation in 21 cases, X-ray hysterosalpingography in 2 cases, both methods in 1 ca...

IzvlečekIzhodišča: Večino plodov v medenični vstavi ob predvidenem datumu poroda porodimo s carskim rezom. Strokovne smernice ob zagotovitvi določenih pogojev priporočajo poskus zunanjega obrata ploda v glavično vstavo in s tem zmanjšanje deleža carskih rezov. Želeli smo analizirati dejavnike uspešnosti zunanjega obrata in preveriti hipotezo, da se z izvajanjem zunanjega obrata izognemo znatnejšemu številu carskih rezov.Metode: V raziskavo smo vključili vse poskuse zunanjega obrata ploda na glavico pri enoplodni nosečnosti po dopolnjenem 36. tednu nosečnosti na Ginekološko-porodniškem oddelku Splošne bolnišnice Izola od leta 2002 do 2010.Rezultati: Od 143 poskusov zunanjega obrata je bil ta uspešen pri 68 nosečnicah ali v 47,6 %. Na uspešnost posega so najbolj vplivali večja količina plodovnice, visok položaj vodilnega plodovega dela v medenici ter prečna ali poševna lega ploda. S 100 poskusi zunanjih obratov se izognemo 32 carskim rezom oziroma enemu carskemu rezu s 3,1 poskusa.Zaključki: Raziskava je potrdila, da z zunanjim obratom na glavico lahko zmanjšamo število carskih rezov zaradi medenične vstave. Uspešnost posega je bila primerljiva z drugimi raziskavami kljub manjši uporabi zdravil. AbstractBackground: Almost all babies in breech presentation at term are delivered by caesarean section. Professional guidelines recommend an attempt of external cephalic version to reduce breech presentations at birth and thus the proportion of caesareans. Our aim was to analyse the clinical and ultrasound factors to predict the outcome of version and check the hypothesis, if the implementation of the external cephalic version helps to reduce the number of caesareans.