This study was designed to detect the relation between serum progesterone and viability of pregnancy during the first trimester. Prospective study carried out in Al-Rashid Maternity and Ahmadi Kuwait oil company hospitals, over three years from February 2009 to February 2012. Two hundred and Sixty (260) pregnant women were hospitalized due to vaginal bleeding and/or abdominal pain during the first trimester of their pregnancies and were included in this study. Women included in this study were; sure of dates, conceived spontaneously with no history of infertility and had a positive serum pregnancy test. 2 ml blood samples were taken for women included in this study for serum progesterone assay. Women included in this study were followed by ultrasound for the viability of the pregnancy till the end of first trimester and the outcome of their pregnancy were recorded, while women with exogenous progesterone support or multiple pregnancies or suspected ectopic pregnancy or Hydatiform mole were excluded from this study. Data were collected and statistically analyzed to detect the relationship between serum progesterone level and viability of pregnancy during the first trimester. The mean age of the studied population was 32.7 ± 5.1 years, the mean gestational age at progesterone assay was 9.7 ± 0.5 week and by the end of the first trimester, women included in this study were classified according to the viability of their pregnancies into; viable pregnancy group 178 (68.5%) cases and non-viable pregnancy group (ended by miscarriage) 82 (31.5%) cases. The mean serum progesterone of the studied population was significantly high in viable pregnancy group (46.5 ± 7.4 ng/ml) compared to non-viable pregnancy group (9.9 ± 4.8 ng/ml), (p <0.05). In this study; 6.7% of viable pregnancies had serum progesterone level <10 ng/ ml, while 20.7% of non-viable pregnancies had serum progesterone level >10 ng/ml, the serum progesterone at cut off level 10 ng/ml was 79.3% sensitive to diagnose non-viable pregnancy and was 93.3% specific to diagnose viable pregnancy. Also, in this study; 1.1% of viable pregnancies had serum progesterone level <20 ng/ ml, while 4.8% of non-viable pregnancies had serum progesterone level >20 ng/ml, the serum progesterone at cut off level 20 ng/ml was 95.1% sensitive to diagnose non-viable pregnancy and was 98.9% specific to diagnose viable pregnancy. Serum progesterone is a reliable marker for early pregnancy failure and single assay of its serum level can differentiate between viable and non-viable pregnancies.
Objective: This prospective study was designed to detect the role of magnetic resonance imaging (MRI) in refining the diagnosis of suspected fetal renal anomalies detected during screening sonography.Material and Methods: 54 pregnant women, with suspected fetal renal anomalies detected during routine ultrasound screening, were rescanned by MRI to refine the diagnosis of the suspected renal anomalies. The pregnancy outcome was examined externally and by postnatal ultrasonography.Results: Fifty-four cases of suspected renal anomalies detected during screening sonography of 8400 pregnant women (0.6%), were rescanned by MRI in this study. The MRI gave a similar diagnosis to postnatal ultrasound in 46 cases (16 cases of hydronephrosis, 14 cases of Polycystic Kidney Disease (PCKD), 9 cases of Multicystic Kidney Disease (MCKD), 2 cases of Renal Agensis (RA), 3 cases of single renal cyst and 2 cases of megacystis+hydroureter), while it gave a different diagnosis (false positive) in 6 cases (4 cases of hydronephrosis diagnosed by MRI confirmed to be PCKD by postnatal ultrasound, also, 1 case of MCKD diagnosed by MRI confirmed to be hydronephrosis by postnatal ultrasound and 1 case of RA diagnosed by MRI confirmed to be normal by postnatal ultrasound). The prenatal ultrasound gave a similar diagnosis to postnatal ultrasound in 43 cases (14 cases of hydronephrosis, 13 case of PCKD, 9 cases of MCKD, 2 cases of RA, 3 cases of single renal cyst and 2 case of megacystis+hydroureter), while it gave a different diagnosis (false positive) in 9 cases; 4 cases of hydronephrosis diagnosed by prenatal sonography confirmed to be PCKD by postnatal ultrasound, one case of PCKD+one case of MCKD, and one case of megacystis+hydroureter confirmed to be hydronephrosis by postnatal ultrasound, while one case of MCKD diagnosed by prenatal sonography was confirmed to be PCKD by postnatal ultrasound and one case of RA diagnosed by prenatal ultrasound was confirmed to be normal by postnatal ultrasound. Conclusion:The MRI can be used as a complementary adjunctive modality with excellent tissue contrast, especially in equivocal cases or inconclusive sonographic findings. (J Turkish-German Gynecol Assoc 2013; 14: 6-10) Key words: The magnetic resonance imaging (MRI), refining diagnosis, suspected, fetal, renal anomalies Received: 06 November, 2012 Accepted: 01 January, 2013 Amaç: Bu prospektif çalışma, tarama sonografisi sırasında saptanan şüpheli fetal renal anomali tanısını aydınlatmada manyetik rezonans görüntüleme (MRG)'nin rolünü saptamak için tasarlandı. Abstract Özet Gereç ve
ObjectiveThis prospective study was designed to evaluate the outcome and the changes in uterine artery blood flow after thermal balloon endometrial ablation (TBEA) in cases of menorrhagia. Study design Prospective study. Patients and methods Eighty-two premenopausal women with menorrhagia were included in this study.The TBEA was carried out on cycle days 3-8. Transvaginal color Doppler measurements were obtained from the uterine arteries on both sides before ablation and repeated on the first day, 3, 6, and 12 months after TBEA. ResultsOf 82 women, 78 (95.12%) were satisfied and experienced improvement after TBEA. The end-diastolic velocity was significantly decreased 6 and 12 months after TBEA (5.0 ± 2.5 and 4.6 ± 3.0; respectively); also, the time-averaged maximum velocity was significantly decreased 6 and 12 months after TBEA (14.8 ± 3.4 and 13.9 ± 3.4, respectively). The pulsatility index was significantly increased 6 and 12 months after TBEA (1.6 ± 0.9 and 1.63 ± 0.8, respectively); also, the resistance index was significantly increased 6 and 12 months after TBEA (0.89 ± 0.2 and 0.90 ± 0.3, respectively). Conclusion TBEA induces increase in impedance of the uterine blood flow because of fibrosis in the endometrium and subendometrial layers, with a subsequent reduction in the menstrual flow.
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