Search PubMed⌕ Search

Biomedical subjects

E Caspi

Publications and source records attributed to E Caspi.

At least 37 records · Page 2Linked to original sources
PubMed1994

Human decidua-associated protein 200 levels in uterine fluid at hysteroscopy.

Hysterosocpic intrauterine findings and levels of human decidua-associated protein 200 (hDP 200) in the uterine fluid were recorded in 116 women investigated for infertility or recurrent abortions. The levels of hDP 200 were significantly higher in the presence of submucous myomas or endometrial polyps, and lower in the presence of intrauterine adhesions in comparison to those in normal uterine cavities. hDP 200, an immunoglobin secreted by the endometrium, may be involved in implantation and placentation and its level in the uterine cavity is influenced by the presence of intrauterine pathology.

Abortion, Habitual↗
PubMed1994

A new colpo-needle suspension for the surgical treatment of stress incontinence: a 2-year follow-up.

Sixty-three patients with urinary stress incontinence underwent a new colpo-needle suspension procedure. It differs from the other transvaginal bladder neck suspension procedures by using the fixed and stable Cooper ligament as the fixation point for the suspension sutures rather than the unstable and compressible anterior abdominal wall. At 2-year follow-up we obtained a 90.5% cure rate of urinary stress incontinence. We consider the procedure suitable for all patients with genuine stress incontinence. Long-term follow-up is required for further evaluation of this new technique.

Adult↗
PubMed1994

Transvaginal aspiration of ovarian cysts: prognosis based on outcome over a 12-month period.

The success of transvaginal aspiration of ovarian cysts in terms of cyst dimensions, location, and content and the age of the women was evaluated in 35 women aged 17 to 76 years old. Three parameters proved important in predicting the outcome of aspiration: age of the woman (higher age = poorer prognosis for cure), maximum diameter of the cyst (larger diameter = poorer prognosis), and location (left-sided cysts have a poorer prognosis). Prognosis based on outcome indicates aspiration of large cysts should be avoided in older women.

Adult↗
PubMed1994

Endometrial carcinoma developing after cervical amputation: the influence of cervical stenosis on prognosis.

The clinical presentation, surgico-pathologic findings and the outcome are described of seven patients with carcinoma of the endometrium, which developed remote after cervical amputation as a treatment for cervical elongation. In six patients, cervical stenosis prevented early uterine bleeding. Four patients when diagnosed, were in advanced surgical stages of the disease (Stages II and III) and all died thereafter. Three patients with surgical Stage I, had no evidence of disease 33, 96, 151 months, after diagnosis and treatment. The role of cervical stenosis in delayed diagnosis and treatment, and therefore poor prognosis is discussed. When cervical stenosis is anticipated, periodic ultrasonographic evaluation of the endometrium is justified, in order to prevent a delay in making a diagnosis of endometrial carcinoma.

Adenocarcinoma↗
PubMed1993

The use of intravenous gammaglobulin, heparin and aspirin in the maintenance of pregnancy of freeze thawed embryo in a patient with lupus-type anticoagulant.

A case of lupus anticoagulant and repeated fetal loss with a successful delivery of a healthy baby after transfer of thawed frozen embryos and intravenous immunoglobulin administration is described. The repeated fetal loss was due to vascular disturbances caused by lupus anticoagulants. Early implantation was not affected. Anticoagulants and/or steroids did not help in further establishing pregnancy. Intravenous immunoglobulin combined with heparin and aspirin led to term pregnancy and the birth of a healthy child.

Adult↗
PubMed1993

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida following failed fertilization.

Cytogenetic analysis of the oocyte and embryo after removal of the zona pellucida provides a simple screening method for examining the oocyte and embryo and considering the morphological abnormalities of the zona and adjacent formations, cytoplasm and nucleus. Seventy-one unfertilized oocytes and 27 embryos with poor morphology or cleavage arrest were studied after fixation, staining and mechanical removal of the zona. Fixation was done with a glutaraldehyde solution (1%). The oocytes and embryos were then stained, causing weakening of the zona. A slight pressure on the cover slide led to rupture of the zona and the exposure of the oolema. The oocytes and embryos were analyzed for sperm attachment to and penetration through the zona, appearance of the polar bodies, differentiation of blastomeres from cytoplasmic fragments, nuclear status--pyknotic non-analyzable form, chromosomes or different degenerative appearances of DNA. Peeling of the zona is an easy and reliable screening technique needing only an ordinary light microscope. It provides the advantage of observing the whole structure of the oocyte-embryo, not just the chromosomes as in classical cytogenetic methods.

Female↗
PubMed1993

Current management of ruptured corpus luteum.

The objectives of the study are to assess current management of the rather frequent event of ruptured corpus luteum. Special emphasis is made on the value of ultrasonography, laparoscopy and culdocentesis in deciding appropriate treatment. A series of 70 patients with ruptured corpus luteum diagnosed and treated during a period of 6 years in one institution in Israel is reported. Eighteen patients with concurrent ruptured corpus luteum and ectopic pregnancy are included. Abdominal pain, the most prevalent presenting symptom, has no typical characteristics. The correlation between large amount of fluid as observed by ultrasound and the finding of > 250 ml of blood at laparotomy is very high. Culdocentesis was performed in only 21 patients. Surgical intervention (laparoscopy, laparotomy following laparoscopy or direct laparotomy) was carried out in 58 patients (83%). The remaining 12 cases were handled by observation only. Forty patients required laparotomy in whom 17 underwent wedge resection. We conclude that observation is sufficient treatment in hemodynamically stable patients, without severe abdominal pain and in the presence of a small amount of pelvic fluid demonstrated by ultrasound. When a large amount of fluid is observed and/or in the presence of severe abdominal pain laparoscopy should be performed on admission. Direct laparotomy is mandatory in case of circulatory collapse.

Abdominal Pain↗
PubMed1993

Dynamic ultrasonographic imaging of the third stage of labor: new perspectives into third-stage mechanisms.

OBJECTIVE: Dynamic ultrasonographic imaging of the third stage of labor was performed to document ultrasonographic findings and to present new perspectives into third-stage mechanisms. STUDY DESIGN: Twenty-five normal deliveries and five with prolonged third-stage labor were studied. RESULTS: Normal third-stage labor could be divided into four phases: (1) latent phase, characterized by thick, placenta-free wall and thin, placenta-site wall; (2) contraction phase, with thickening of placenta-site wall (from < 1 cm to > 2 cm); (3) detachment phase, in which the placenta completes its separation and detaches; and (4) expulsion phase, with a sliding movement of the placenta. Although oxytocic agents were routinely used, they do not seem to influence the findings. In five cases with retained placenta the placenta-site wall was initially thin. In four of them it became thick, and the placenta was removed by traction of the cord, whereas in the fifth case the placenta-site wall remained thin and the placenta had to be removed manually. CONCLUSION: Shearing forces seem to tear the decidual septae and thereby separate the placenta. This process is completed only when the placenta-site wall attains full thickness. In cases of prolonged third-stage labor, traction of the cord should be applied only when this phase is completed and the actual sliding movement of the placenta is observed.

Female↗
PubMed1993

Reproductive outcome after laparoscopic local methotrexate injection for tubal pregnancy.

OBJECTIVE: To evaluate reproductive outcome after laparoscopic local methotrexate (MTX) injection for tubal pregnancy. DESIGN: Follow-up was performed after 77 women were treated with local MTX injection between January 1, 1987 and December 31, 1990. SETTING: Department of Obstetrics and Gynecology in a university medical center. MAIN OUTCOME MEASURES: Concise patient details about tubal patency in hysterosalpingography, pelvic findings at laparoscopy or laparotomy performed after the treatment, and the intrauterine and extrauterine pregnancy rates (PRs) are given. RESULTS: Intrauterine PR of 67% and extrauterine PR of 13% were achieved. CONCLUSION: Local MTX injection does not modify tubal or pelvic anatomy and does not impair subsequent reproductive performance.

Adult↗
PubMed1993

Overstimulated cycles under low-dose gonadotrophins in patients with polycystic ovary syndrome: characterization and management.

Among 30 patients with polycystic ovary syndrome, treated with low-dose gonadotrophins, 75 cycles were analysed in order to characterize overstimulated cycles that were at increased risk of developing ovarian hyperstimulation. Optimal response (one or two follicles > or = 14 mm diameter) was observed in 59 cycles (79%). The remaining 16 cycles (21%) exhibited an overstimulated response characterized either by growing more than two follicles or having an oestradiol level > 850 pg/ml (2 SD above the mean observed in optimal cycles). Six of the latter were handled prospectively when oestradiol levels were found to be too high according to the size of the leading follicle. This stage was termed as developing overstimulation and its identification was based on objective criteria obtained from the optimal group. Following the withholding of gonadotrophin, the follicles continued to grow; however, the final oestradiol level was lower compared with six other matched overstimulated cycles. Overall, 14 patients conceived (47%) of whom three (21%) had multiple pregnancies. Mild or moderate ovarian hyperstimulation syndrome occurred in three cases; all of which involved overstimulated cycles. Low-dose gonadotrophin treatment is associated with a substantial degree of overstimulated response. All cycles should be monitored carefully in order to recognize the overstimulated response, which deserves cautious management.

Dose-Response Relationship, Drug↗
PubMed1993

Estimating fertility potential via semen analysis data.

The aim of this study was to evaluate diagnostic profiles for the assessment of semen analysis data with respect to male fertility potential. Semen samples taken from 208 patients of known fertility and suspected infertility were studied by conventional semen analysis methods. The data throw doubt upon the validity of an approach based on the number of deviations from the normal standard values defined by the World Health Organization. The alternative approach of a specific semen characteristic (particularly morphology) as the major predictor of fertility produced no beneficial results. However, the semen analysis index based on semen volume, sperm count, percentage motility and normal forms resulted in a high accuracy of classification but for only 44% of the cases, with 3% false negatives and 10% false positives using cut-off indices of > or = 0.6 and < or = -1.0 for defining 'fertile' and 'infertile' zones, respectively. In conclusion, it is emphasized that there are a number of specific semen analysis variables, each expressing a different aspect of male fertility potential which, when combined in correct proportion, do provide the optimal evaluation of the male fertility status. However, in order to increase the prognostic potential of the semen sample, new and meaningful parameters must be discovered.

Adult↗
PubMed1993

Pre-operative gonadotrophin-releasing hormone agonist treatment in surgery for uterine leiomyomata.

To determine whether pre-operative treatment with gonadotrophin-releasing hormone (GnRH) analogue may have a beneficial effect on surgery outcome, 53 patients with symptomatic fibroid uteri awaiting myomectomy or transabdominal hysterectomy (TAH), were randomly divided into a study group (n = 29) and a control group (n = 24). The study group of patients were treated by an i.m. injection of D-Trp6 LHRH microcapsules at 2 months and 1 month prior to surgery. The control group had no pre-operative treatment. Haemoglobin concentration and oestradiol, follicle-stimulating hormone and luteinizing hormone concentrations were measured at 2 months and 1 month prior to surgery, and at surgery. The duration of surgery was shorter in the study group (49 versus 70 min in the hysterectomy group) and intra-operative blood loss was less (208 versus 309 ml in the hysterectomies and 320 versus 476 ml in the myomectomies). Pre-operative treatment with GnRH-agonists which induces shrinkage of the uterus and fibroids is therefore efficient in shortening the duration of surgery, and diminishing the intra-operative blood loss in surgery for fibroid uteri. Such pre-operative treatment is therefore a useful addition to surgery in cases with symptomatic fibroid uteri.

Adult↗
PubMed1993

Human chorionic gonadotrophin is a better luteal support than progesterone in ultrashort gonadotrophin-releasing hormone agonist/menotrophin in-vitro fertilization cycles.

In an attempt to determine the best luteal support in in-vitro fertilization (IVF) cycles treated with gonadotrophin-releasing hormone agonist (GnRHa) and human menopausal gonadotrophin (HMG) by the ultrashort protocol, 60 patients were prospectively randomized for either i.m. progesterone or human chorionic gonadotrophin (HCG) luteal support. The two groups did not differ in the mean number of oocytes retrieved and embryos replaced, nor in the mean age of the patients and the amount of HMG used. HCG maintained higher levels of oestradiol and progesterone during the luteal phase. Conception rate was significantly higher in the HCG group. We conclude that HCG is superior to i.m. progesterone as luteal support in IVF cycles in which GnRHa is used in the ultrashort protocol.

Adult↗
PubMed1993

A simplified preinduction scoring method for the prediction of successful vaginal delivery based on multivariate analysis of pelvic and other obstetrical factors.

Most of the popular preinduction scoring methods were created three decades ago, applied to selected populations and based on analysis of each factor separately. In order to overcome these limitations and to try and create a simple and reliable scoring method, 401 inductions of labor were analyzed. Failure was defined as delivery by cesarean section, regardless the indication. Results of multivariate analysis demonstrated that only two of the five factors used by Bishop's method were included (cervical dilatation and fetal head station). Gestational age and parity also constituted important factors and thus the new method incorporates these four factors. The variables among each factor were scored according to their relative risk, obtained from the analysis; dilatation 3 cm or more = 2, dilatation 1-2 cm = 1, fetal head station -1 cm or lower = 1, multiparity = 1, term delivery = 1, closed cervix = 0, station -2 cm or higher = 0, primiparity = 0 and non-term delivery = 0. Comparison of the suggested scoring method and Bishop's method demonstrated that in the low score category our method predicted more accurately cesarean section rate (44.7% and 27.6%, respectively). No difference was noted among the middle or high score groups. More studies among other populations may clarify whether our proposed method really overcomes other methods concerning simplicity, universality and predictability.

Birth Weight↗
PubMed1992

Indomethacin and amniocentesis-induced changes in fetal flow velocity waveforms.

The effect of genetic amniocentesis on flow velocity waveforms in the fetal aorta and the umbilical artery, and fetal heart rate and their correlation with uterine contractions was examined in 75 pregnant women who underwent this procedure. Forty-three were untreated and 32 were pretreated with indomethacin. Median maternal age was 36 years and median gestational age was 18 weeks. The resistance index of waveforms from the fetal aorta was stable at 0.8 throughout the approximately 20-h study period in both groups, but the systolic/diastolic ratio in the umbilical artery increased significantly after amniocentesis in the untreated group, and remained stable in the treated group. Fetal heart rate remained at about 150 beats/min throughout all measurements in both groups. These findings indicate that genetic amniocentesis causes an increase in downstream resistance in the umbilical artery which, however, remains within normal limits. This mild fetoplacental response to amniocentesis can be suppressed by the administration of a potent prostaglandin inhibitor like indomethacin.

Journal Article↗