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Biomedical subjects

S Lurie

Publications and source records attributed to S Lurie.

At least 91 records · Page 5Linked to original sources
PubMed1996

Beneficial effect of hysteroscopic metroplasty on the reproductive outcome in a 'T-shaped' uterus.

Eight women (aged 27-43) with reproductive dysfunction who were diagnosed by hysterosalpingogram and hysteroscopy as having a 'T-shaped' uterus were operated on using fiberoptic hysteroscopic guidance; the uterine side walls were incised until a normal uterine cavity was achieved. The women's gynecologic and obstetric records were compared before and after the operation. In all the 8 women the operation was without complications and resulted in a satisfactory uterine cavity. Before the operative procedure, the women had had 10 spontaneous abortions and 1 ectopic pregnancy. The postoperative performance available for 7 of the 8 women showed 4 term pregnancies in 3 women, 1 ectopic pregnancy, and no abortions. Our study suggests that hysteroscopic metroplasty in women with a T-shaped uterus improves the reproductive outcome, mainly in women with repeated abortions. We conclude that women with a T-shaped uterus who want to improve their reproductive function should be encouraged to undergo hysteroscopic metroplasty.

Abortion, Spontaneous↗
PubMed1996

Human chorionic gonadotropin: pharmacokinetics of subcutaneous administration.

The objective of the present study was to evaluate the pharmacokinetics of human chorionic gonadotropin (hCG) following different regimens of subcutaneous and intramuscular single-dose administration. Two hypogonadotropic hypogonadal volunteers received hCG injections without prior ovarian stimulation. The regimens included a single dose of 10,000 IU hCG either subcutaneously or intramuscularly, or 5000 IU hCG intramuscularly. Serum beta-hCG concentrations were measured periodically up to 13 days after hCG administration. Each of the three regimens exhibit a similar pharmacokinetic profile and the highest serum beta-hCG concentrations were achieved with a dose of 10,000 IU administered subcutaneously. Seven days after hCG administration beta-hCG was detectable only after subcutaneous or intramuscular administration of 10,000 IU, but not after a single intramuscular injection of 5000 IU. From the preliminary results of the study it is suggested that a single intramuscular dose of 5000 IU hCG might be sufficient to trigger ovulation, but for luteal-phase support a higher dose may be needed. Subcutaneous administration of hCG for the induction of ovulation or luteal-phase support in gonadotropin-induced cycles is feasible and might offer a better tolerance and cost-effectiveness of infertility treatments, leading to their further simplification.

Adult↗
PubMed1996

The perinatal emphasis of Segawa's syndrome.

Segawa's syndrome is a hereditary progressive dystonia with diurnal fluctuation, which in contrast to other chronic dystonia in childhood responds dramatically to levodopa therapy. Very little is known on how it affects pregnancy or how it is affected by the pregnancy. We present a case of pregnancy of a patient, suffering from Segawa's syndrome. The patient received levodopa throughout entire two consecutive pregnancies and gave birth to two healthy male infants. The only perinatal pathology was non-progressive labor. The safety of levodopa use in pregnancy is also discussed.

Adult↗
PubMed1995

Adnexal torsion in adolescents: prompt diagnosis and treatment may save the adnexa.

Adnexal torsion, although infrequent, may have a devastating effect on the future reproductive performance of adolescents and young women. However, clear variables predicting a favorable operative outcome have not yet been identified. In this retrospective study the authors analyzed the charts of 72 adolescent girls hospitalized for acute lower abdominal pain. In 13 cases (18%) torsion of the adnexa was found and six of them ended with reproductive compromise expressed by either adnexectomy or salpingectomy. We have found that in the cases of adnexal torsion, the time factor, from admission until final diagnosis and treatment, was the only significant variable affecting the operative results. A shorter time until the operation, resulted in less harm to the reproductive organs involved. Therefore, we conclude that whenever an adnexal torsion is suspected, a quick diagnostic laparoscopy followed by an operative procedure when needed, may contribute to better reproductive performance in the future.

Adnexal Diseases↗
PubMed1995

Comparison of sperm parameters, in vitro fertilization results, and subsequent pregnancy rates using sequential ejaculates, collected two hours apart, from oligoasthenozoospermic men.

OBJECTIVE: To evaluate the effect of second consecutive ejaculate collected 2 hours after the first one from infertile men on sperm quality and fertilization and pregnancy rates (PRs) in IVF. DESIGN: A prospective case-control study. SETTING: In vitro fertilization unit of a university hospital. PATIENTS: Thirty-nine consecutive infertile patients with oligoasthenozoospermia scheduled for IVF-ET. MAIN OUTCOME MEASURES: Two consecutive ejaculates were obtained 2 hours apart and were assessed for volume, sperm count, motility, morphology, and quality of swim-up fraction. The subsequent fertilization, cleavage, and PRs (as defined by the appearance of intrauterine gestational sac) were compared between the two ejaculates. RESULTS: In 28.2% of the individuals the semen analysis of the first ejaculate precluded proceeding with IVF. A statistically significant improvement was shown in sperm cell motility (31.9% +/- 20.7% versus 15.6% +/- 15.3%) and in motile count after swim-up (4.9 +/- 4.5 versus 2.6 +/- 3.1 x 10(6) sperm). No improvement could be demonstrated in sperm density or morphology. The volume of the second ejaculate was decreased significantly as compared with the first one. The fertilization rate, the cleavage rate, and PR were all increased when oocytes were exposed to sperm from the second ejaculate compared with oocytes exposed to sperm from the first ejaculate. The overall PR in our series was 25.6%. CONCLUSIONS: We suggest that in the group of infertile men with oligoasthenozoospermia, whose partners are scheduled for IVF-ET, if on the day of retrieved oocytes insemination, the ejaculate is of unacceptable quality, a second ejaculate collected 2 hours after collection of the initial ejaculate may produce a sample that exhibits improvements in both semen parameters and reproductive potential.

Adult↗
PubMed1995

Continuous wave Doppler velocimetry of the main-stem uterine arteries: the transvaginal approach.

The purpose of the study was (1) to establish the efficacy of the transvaginal approach for continuous wave Doppler velocimetry of the main-stem uterine arteries in normal pregnancy and (2) to provide reference values for the flow velocity waveform indices of the main-stem uterine arteries in normal pregnancy. In a cross-sectional study from 16 to 40 weeks of pregnancy, 201 healthy normal women were examined by transvaginal continuous wave Doppler, and flow velocity waveforms were obtained from the main branch of the uterine artery on both sides. Nomograms were compiled for the systolic: diastolic ratio, pulsatility index and resistance index. Values for all variables declined during the course of pregnancy until 22 weeks' gestation, and then remained stable to term. Intra- and interobserver variations were 5% and 8%, respectively, and the examination time was < 5 min. Flow velocity waveform indices declined during pregnancy, indicating a decrease of resistance in the uteroplacental circulation. Our results are comparable to those obtained transvaginally by pulsed wave Doppler, previously reported in the literature. The transvaginal approach for continuous wave Doppler velocimetry of the main-stem uterine arteries is a simple, quick, accurate, safe, cheap and highly reproducible method, and is therefore suitable for evaluating the uteroplacental circulation.

Adolescent↗
PubMed1995

Shoulder dystocia: could it be deduced from the labor partogram?

The study was undertaken to test the hypothesis that shoulder dystocia might be suspected and reliably identified from the labor partogram. A retrospective analysis of 52 consecutive patients with shoulder dystocia was performed. The 52 controls were the next consecutive parturient matched for maternal age, gestational age at delivery, parity, presentation, and infants weight at delivery. The mean dilation rate was 2.1 +/- 1.9 cm/hr in shoulder dystocia group compared to 2.4 +/- 1.5 cm/hr in the control group. The incidence of protracted rate of less than 1 cm/hr was 14.3% in shoulder dystocia group and 13.5% in the control group. The mean duration of second stage was 38.3 +/- 30.7 minutes in the shoulder dystocia group compared to 35.5 +/- 32.5 minutes in the control group. Only 1.9% have had a prolonged second stage (more than 2 hours) in the shoulder dystocia group compared to 1.9% in the control group. The difference between the groups regarding the length of labor was not statistically significant. We conclude that protracted labor does not seem to be a risk factor for shoulder dystocia.

Adult↗
PubMed1995

The evaluation of accelerated fetal growth.

The timely recognition of fetal macrosomia may reduce the complications associated with vaginal delivery of a macrosomic fetus. Today, the most frequently used tool for identification of fetal macrosomia is ultrasound. Although many different calculations have been applied, the most commonly used is the estimation of fetal weight. Generally, the detection rate of fetal macrosomia is 33-82%, with a specificity of 70-100%, a positive predictive value of 40-83%, and negative predictive value of 66-92%. Adding amniotic fluid volume, cheek-to-cheek diameter or fetal subcutaneous tissue: femur length ratio may improve the accuracy of the diagnosis. Other promising diagnostic tools include the echo-planar imaging and the neural network. Despite the progress that has been achieved since the use of Nagele's rule, our ability to fetal macrosomia remains limited.

Body Weight↗
PubMed1995

Positive serology for chlamydia: is it always for Chlamydia trachomatis?

In this study we tried to determine the factual prevalence of Chlamydia trachomatis seropositive women. Sera of 174 sexually active women of reproductive age who attended the emergency room in our gynecology department were tested by both a species-specific solid-phase enzyme immunoassay (SPEIA, ImmunoComb, Orgenics, Israel) and by an immunoperoxidase assay (IPA). One-hundred and twenty-two of 174 women (70.1%) tested were found positive for C. trachomatis by the IPA test. The SPEIA test identified 41 (33.6%) of those as positive for C. trachomatis and 81 (66.4%) positive for C. pneumoniae. We conclude that the currently used IPA method for chlamydia diagnosis overestimates C. trachomatis infection and its specificity for the diagnosis of C. trachomatis is limited. By using the SPEIA test, it is possible to distinguish between C. trachomatis and C. pneumoniae seropositivity.

Antibodies, Bacterial↗
PubMed1995

Hemoglobin levels during twin vs. singleton pregnancies. Parity makes the difference.

A retrospective, case-control study of 200 consecutive twin and singleton gestations matched for parity was conducted to challenge the hypothesis that lower hemoglobin values appear more often during twin gestations. The database consisted of hemoglobin levels recorded during each trimester. Comparisons were made between the mean hemoglobin levels and incidence of values > 11, 9-11 and < 9 g/dL. Significantly lower mean (+/- SD) hemoglobin values were observed during the first (11.94 +/- 1.1 vs. 12.17 +/- 1.0, P = .026) and second (11.1 +/- 1.0 vs. 11.48 +/- 0.9, P = .00001) trimesters in twin vs. singleton pregnancies, respectively. The differences resulted from lower values in multiparas with twins as compared with their singleton-pregnancy controls (11.8 +/- 1.2 vs. 12.2 +/- 0.9, P = .015, for the first trimester and 11.0 +/- 1.0 vs. 11.5 +/- 0.9, P = .0001, for the second trimester). During the second trimester, the lower incidence of values > 11 g/dL (P = .005, odds ratio = .475, 95% confidence interval = .31-.73) and higher incidence of values between 9 and 11 g/dL (P = .0008, odds ratio = 2.06, 95% confidence interval = 1.34-3.19) may account for the significant differences in mean values. There were no differences between third-trimester values, between nulliparas in both groups or between nulliparas and multiparas in each group. We conclude that the lower hemoglobin levels in twin gestations were associated with multiparity and were statistically significant during the first and second trimesters. This subgroup of twin pregnancies may benefit from further research and possibly from closer hematologic care and monitored iron supplementation.

Adult↗
PubMed1994

Expectant management of suspected ectopic pregnancies even with rising beta-subunit human chorionic gonadotropin levels. A clinical prospective study.

A prospective study was undertaken to evaluate possibility of expectant management of ectopic pregnancy in a selected group of patients with few symptoms, no gestational sac on sonography, and rising but low beta hCG levels. Using the above mentioned criteria, 26 patients were enrolled during prospective study period of 24 month. Five patients (19.2%) had a ruptured tubal pregnancy during the period of observation. Ten patients (38.5%) underwent laparoscopy with subsequent surgery for tubal pregnancy. The indication for laparoscopy in all 10 cases was abdominal pain. In all these 10 patients the pregnancy was unruptured. The remaining 11 patients (42.3%) escaped surgical intervention. Three had intrauterine pregnancies. In the remaining 8 patients the diagnosis remained presumed ectopic. The mean interval from admission of beta hCG level of < 5 mIU/ml in these 8 patients was 19.2 +/- 8.4 days. They were inpatients until the beta hCG level begun to decline. Thereafter, the patients were observed as outpatients. We conclude that in carefully selected cases of suspected ectopic pregnancies with rising but low beta hCG levels, expectant management is appropriate as long as the patient remains relatively asymptomatic.

Adult↗
PubMed1994

The influence of midtrimester termination of pregnancy on subsequent fertility: four to five years follow-up.

A four to five years follow-up upon subsequent fertility was performed on 46 women who underwent a midtrimester termination of pregnancy. Thirty out of 31 (96.8%) women who wanted to conceive became pregnant. Of those, term delivery rate was 73.3%. Only one woman who desired to conceive could not become pregnant. Her infertility workup revealed bilateral occlusion of tubes. We conclude that termination of pregnancy in midtrimester possibly has little, if any, impact upon subsequent fertility.

Abortion, Induced↗