An evaluation of the outcome of pregnancies resulting from intracytoplasmic sperm injection for severe male factor infertility was conducted by analysing the data obtained from the patients and/or their obstetrician/gynaecologist on standardized questionnaires. The data from 424 pregnancies between April 1991 and September 1994 were analysed. Early pregnancy loss before 16 weeks occurred in 99 cases (23.3%), including 48 clinical abortions (11.3%), 47 subclinical pregnancies (11.1%) and four ectopic pregnancies (0.9%). Vanishing twins and triplets, which could be regarded as early embryonic wastage, were found in 36 cases (8.5%). One pregnancy was interrupted at week 15 of gestation because of anhydramnios, and four pregnancies (0.9%) ended in spontaneous late abortions before 26 weeks. A total of 320 pregnancies (75.5%) resulted in the birth of at least one child; 222 of these (69.3%) were singletons, 93 were twins (29.1%) and five were triplets (1.6%). The problems of prematurity and low birthweight were especially related to the multiplicity of pregnancies. Furthermore, from among the total of 423 babies born, we have observed three cases of stillbirth and five cases of neonatal mortality. The perinatal mortality rate was therefore 18.9 per 1000 births. The results of this study show that the obstetric outcome of these pregnancies was similar to that obtained after conventional in-vitro fertilization and other assisted reproduction techniques.

Purpose Gestational weight gain (GWG) is an important contributor to pregnancy outcomes in the general obstetric population and different subgroups. The corresponding information in women with thyroid conditions is limited. We aimed to evaluate the relationship between GWG according to Institute of Medicine (IOM) and pregnancy outcomes in women with thyroid disorders. Methods We performed a retrospective analysis of 620 pregnant women either treated with levothyroxine (N = 545) or attended because of hyperthyroidism during pregnancy (N = 75). Results The associations between GWG according to IOM and pregnancy outcomes were present both in women treated with thyroid hormone and women followed by hyperthyroidism, most of them related to the fetal outcomes. In women treated with levothyroxine, insufficient GWG was associated with gestational diabetes mellitus (GDM) (odds ratio (OR) 2.32, 95% confidence interval (CI) 1.18, 4.54), preterm birth (OR 2.31, 95% CI 1.22, 4.36), small-for-gestational age newborns (OR 2.38, 95% CI 1.09, 5.22) and respiratory distress (OR 6.89, 95% CI 1.46, 32.52). Excessive GWG was associated with cesarean delivery (OR 1.66, 95% CI 1.10, 2.51) and macrosomia (OR 2.75, 95% CI 1.38, 5.49). Large-for-gestational age newborns were associated with both insufficient GWG (OR 0.25, 95% CI 0.11, 0.58) and excessive GWG (OR 1.80, 95% CI 1.11, 2.92). In women followed by hyperthyroidism, excessive GWG was associated with large-for-gestational age newborns (OR 5.56, 95% CI 1.03, 29.96). Conclusion GWG according to IOM is associated with pregnancy outcomes both in women treated with thyroid hormone and women followed by hyperthyroidism.

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Spontaneous haemoperitoneum in pregnancy (SHiP) is a rare disease that is associated with adverse pregnancy outcome. The authors present a case of a 35-year-old pregnant woman who developed spontaneous haemoperitoneum at 33 weeks of gestation. An emergency laparotomy was performed, which revealed massive haemoperitoneum with active bleeding from the endometriotic lesions at the right back of uterus. The authors wish to highlight this uncommon but potentially life-threatening condition, which requires early recognition and prompt surgical intervention to reduce morbidity and mortality.

Objectives: This study established a regression model with the relative factors, evaluated its clinical applied value, and explored the diagnostic criterias of transvaginal Doppler ultrasonography (TDU) in predicting early ectopic pregnancy (EP). Methods: The thickness, symmetry, resonance, pattern, blood flow display of endometrial and artery RI value etc were analyzed and observed by TDU. The significant diadynamic criterias with multivariate Logistic regression analysis were selected in order to establish the multivariate predictive model for early EP diagnosis. Results: The multivariate analysis indicated that the final predictive model included three factors as follow: whether the endometrial thickness was more than 9 mm, whether the endometrial pattern was type A, and whether the endometrial spiral arteriae were detected by TDU. The area under the ROC curve of the TDU multivariate predictive model was 0.980. The coincidence rate was 94.5%, when this model was used to diagnose early EP. Conclusions:We conclude that the multivariate regressive predictive model established in this study has significant clinical value in the differential diagnosis of early EP. Objectives: The aim was to determine variables that are associated with a higher risk of miscarriage in the 1 st trimester in women with an intrauterine pregnancy of uncertain viability (IPUVI). Methods: Prospective observational study. Women in the 1 st trimester of pregnancy presenting to the Early Pregnancy Unit (EPU), between Nov 2006 and Dec 2010, underwent a transvaginal scan (TVS). Data was collected from women with an IPUVI at the first ultrasound (US). More than 40 historical, clinical and US end points were recorded for analysis. US measurements included gestational sac (GS) and yolk sac (YS) in three planes, crown-rump length (CRL) and fetal heart rate (FHR). Women were followed up until the outcome was established: viable or non-viable IUP at the end of the 1 st trimester. Univariate analysis to study the effect of the variables on the first trimester outcome was performed using ANOVA F-test and Fisher's exact test. Results: 346 pregnancies were included. 45.7% (158/346) were viable at the end of the 1 st trimester, 41.6% (144/346) were nonviable and 10.4% (36/346) did not have 1 st trimester outcomes available. The continuous variables that were significantly associated with a higher rate of miscarriage were: higher maternal age (mean maternal age for viable pregnancies 26.9 yrs vs. mean maternal age for miscarriages 30.7 yrs, P value = 3.33E-05), higher gestational age (GA) in days by LMP (mean GA for viable pregnancies 41.9 days vs. mean GA for miscarriages 52.7 days, P value = 1.78E-12), and higher CRL (mean CRL for viable pregnancies 0.22 mm vs. mean CRL for miscarriages 0.95 mm, P = 1.91E-05). The categorical variables that were associated with a higher rate of miscarriage were: previous miscarriage, history of vaginal bleeding with clots and the presence of a CRL at first scan. Conclusions: The rate of miscarriage in our IPUVI populati...