Biomedical subjects

L De Munck

Publications and source records attributed to L De Munck.

4 recordsLinked to original sources

PubMed1998

Hysteroscopic septum resection in patients with recurrent abortions or infertility.

Fifty-seven patients who underwent hysteroscopic septum resection between January 1991 and December 1996 were studied; nine patients presented with recurrent abortions, 46 with infertility (26 primary and 20 secondary), one with dysmenorrhoea and one with an asymptomatic complete septum. Their reproductive history included 78 pregnancies: 69 (88.4%) abortions, two (2.6%) ectopics, two (2.6%) preterm deliveries and five (6.4%) term deliveries. In patients with infertility, the incidence of unexplained infertility was 19.6% and the incidence of endometriosis was 26.1%. After hysteroscopic septum resection, 42 patients were interested in pregnancy. All patients with recurrent abortions conceived spontaneously. Twenty-one (63.6%) infertile patients achieved a pregnancy, 13 (61.9%) of them after treatment with various assisted reproduction techniques. The reproductive outcome after septum resection yielded 44 pregnancies, including three sets of twins and one set of triplets reduced to twins: 11 (25%) abortions, one (2.3%) ectopic pregnancy, two (4.5%) preterm deliveries (both twins), 28 (63.7%) term deliveries and two (4.5%) as-yet ongoing pregnancies. It seems that the hysteroscopic treatment of uterine septum has a beneficial effect on pregnancy outcome. A septate uterus does not seem to be an infertility factor. The achievement of pregnancy is normal in patients with recurrent abortions, while the chances of conception in patients with infertility seem to be similar to those for the general infertile population.

Abortion, Habitual↗

PubMed1993

Comparison of two local anaesthetics in transvaginal ultrasound-guided oocyte retrieval.

Transvaginal ultrasound-guided oocyte retrieval is an accepted procedure in most in-vitro fertilization programmes. In order to simplify the anaesthetic procedure into a minimally invasive one, we perform the oocyte retrieval under a modified para-cervical block combined with a standard pre-medication. In order to maximize the patient's comfort we evaluated two different local anaesthetics and their side-effects. Patients were allocated at random to receive a modified para-cervical block with mepivacaine 1% (n = 46) or with prilocaine 1% (n = 54). The patients were asked to fill in a visual analogue scale (VAS) including assessment of anxiety, pain and comfort concerning the procedure. The two local anaesthetics were both effective in reducing pain during transvaginal oocyte retrieval. The mean VAS scores were acceptable and were efficient as indicators of patient's comfort during the procedure. Mepivacaine was selected for routine use since prilocaine induced methaemoglobinaemia.

Adult↗

PubMed1992

Laparoscopic removal of benign mature teratoma.

Laparoscopic removal of benign mature teratoma is safe and effective in pre-menopausal patients. Fourteen patients underwent laparoscopic removal of such tumours. There were no operative complications. Post-operative hospitalization was short (average: 2 days). All patients undergoing a second-look laparoscopy had mild adhesions around the operated ovary. Two spontaneous and one in-vitro fertilization pregnancy occurred. If a teratoma is diagnosed during laparoscopy or oocyte retrieval, it should be promptly removed as malignant transformation is not excluded. In this case, the embryos should be frozen for later transfer.

Adult↗

PubMed1992

Laparoscopic application of interceed (TC7).

Interceed (TC7) is a surgical adjuvant which has been shown to be efficacious in reducing adhesion formation in gynaecological pelvic surgery by laparotomy. In view of the increasing number of laparoscopic interventions and the concern with reducing post-operative adhesions, we evaluated the possibility of Interceed delivery through the ancillary trocars. Twenty-four patients underwent operative laparoscopy followed by the application of Interceed. No difficulties were noticed. Material sized from 1.9 x 2.5 to 3.8 x 5 cm was successfully delivered into the peritoneal cavity, while the duration of the procedure ranged from 2.5 to 6 min for each piece. In conclusion, it is feasible to consider application of Interceed during laparoscopic interventions. This approach to delivery requires a short operative time, minimal instrumentation and enhanced ease of application.

Cellulose, Oxidized↗