SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Clinical experience with soft synthetic pessary in the conservative treatment of genital prolapse is discussed. No local inflammation or laceration of the vagina, or cervix was seen.
A silicone Gellhorn pessary, 3 inches in diameter, neglected for several years in an elderly woman, eroded through the anterior vaginal wall, ultimately to lie entirely within the bladder. General anesthesia and bilateral deep full-length Schuchardt's incisions were required to remove it. A Latzko procedure was done at a later date to close the large vesicovaginal fistula; similar Schuhardt's incisions were again used.
Objective: To evaluate the role of dinoprostone vaginal pessary (DVP) for induction of labor in preeclampsia.Methods: This is a prospective review of 94 patients with preeclampsia, who delivered from July 1995 to December 1996 at a university center. Of these, 25 received DVP, 22 oxytocin, 11 intracervical prostaglandin E(2), and 36 received no pharmacologic agents. Patients receiving DVP and oxytocin induction were compared for outcome of pregnancy and cesarean section rate. Statistical analysis was carried out by Student t test, chi(2) test with Yates correction.Results: The two groups were comparable with respect to parity and 5-minute Apgar scores.Three patients in the DVP group developed complications-one episode of seizure, one atonic postpartum hemorrhage, and one cervical laceration. One patient in the oxytocin group developed HELLP syndrome.Conclusion: DVP is at least as effective as oxytocin in achieving vaginal delivery in preeclampsia, despite lower Bishop scores. Future larger studies are needed to better assess DVP in patients with preeclampsia.
The plasma kinetics and residual depletion in milk of cows treated by the intrauterine route with pessaries containing oxytetracycline (OTC) were evaluated. The antibiotic was administered to five healthy Friesian cows at a dosage of 3g/head in the early post partum phase. Blood samples were collected before and at different time intervals (3, 6, 12, 24, 48, 72, 84, and 96 h) after treatment. Milk was drawn before treatment and at 12-h intervals for 4 consecutive days. Samples were analysed by a high-performance liquid chromatography method and the pharmacokinetic parameters were processed using the minimum Akaike information criterion estimation (MAICE) test. The mean values obtained indicated a relatively low area under the concentration time curve (25.19+/-12.61 microg/mg per h) and maximum plasma concentration (Cmax) (0.549+/-0.278 microg/mL) with delayed time to Cmax (11.71+/-4.15 h) and elimination half-life (21.96+/-4.42 h). A similar pattern could be shown for milk, in which measurable residual levels are found in two out of five animals until the 72nd hour after treatment. Data obtained demonstrate that OTC administered as a solid form is poorly and slowly absorbed from the uterus of cows.
Ehlers-Danlos syndrome (EDS) is a heterogeneous group of inherited connective tissue disorders with at least ten distinct types. We report a case of EDS complicated by cervical incompetence. Treatment was undertaken after confirmation that the patient's EDS was not type IV, hence not associated with potentially serious vascular complications. Because of concern about stretching or tearing of the hyperextensible connective tissue associated with EDS, cerclage was not performed. The cervical incompetence due to defective connective tissue was treated with a Smith-Hodge pessary.
A new prostaglandin analogue, 16,16-dimethyl=trans-delta 2-PGE1 methyl ester (16 me E1) was used for preoperative cervical dilatation in 23 pregnant women who had abortion induced for socio-economical reasons in the first trimester of pregnancy. A single vaginal pessary containing 1 mg 16 me E1 was inserted into the posterior fornix at 3-hour intervals. Thirteen (56.5 per cent) of the 23 patients had complete abortions and two patients (8.7 percent) had incomplete abortions. In six patients (26.1 per cent) the cervix was dilated to at least 10 mm and the remaining two patients (8.7 per cent) required mechanical dilatation at the time of vacuum evacuation. Apart from mild gastrointestinal symptoms, no serious side effects were noted. It is concluded that the new prostaglandin analogue, 16 me E1, could be used safely and effectively for preoperative dilatation of the cervix before surgical abortion in early pregnancy.
The Foley catheter and a 3 mg dinoprostone pessary (Prostin E2) were compared as methods for cervical preparation before second trimester dilatation and evacuation. The catheter was well tolerated and provided significantly greater change in cervical dilatation and improved cervical compliance. The Foley catheter would seem to provide a readily available and efficacious means of cervical preparation.
Fenticonazole is an imidazole derivative with a broad spectrum of antimycotic activity. The therapeutic activity and tolerability of 600 mg fenticonazole versus 500 mg clotrimazole were evaluated in an investigator-blind trial in 80 patients with mycologically confirmed vaginal candidiasis. Fenticonazole was administered as an ovule and clotrimazole as a vaginal pessary, both in a single administration. Therapeutic efficacy was assessed by microbiological and clinical criteria 7 days after the start of treatment. Patients cured at the end of the trial were rechecked 4-5 weeks after the start of therapy in order to identify and evaluate possible relapse. Both treatments resulted in a statistically significant reduction in vaginal symptoms (erythema, itching, discharge and oedema) and in elimination of Candida albicans in about 90% of patients. The tolerance of both treatments was excellent since no local or systemic signs or symptoms of toxicity were reported. An equally high efficacy and safety for both drugs in the elimination of symptoms and objective evidence of vaginal candidiasis was indicated.
Vaginal pessaries, up to a maximum of 5, each containing 1 mg of 16,16-dimethyl-trans-delta squared-prostaglandin E1, ester (Gemeprost) were inserted as high as possible into the posterior fornix of the vagina at 3 hourly intervals in 459 women with abnormal intrauterine pregnancies presenting for termination of the pregnancy. There were 145 missed abortions (31.6%), 207 intrauterine fetal deaths (45.1%), 86 molar pregnancies (18.7%), 5 anencephalics (1.1%), and 16 others (3.5%). The study was conducted from July 1981-March 1982. 402 women (87.6%) underwent abortion within the 30 hour observation period, including 139 women (30.3%) who required additional procedures to complete evacuation of the uterus. Expulsion of the uterine contents failed to occur within 30 hours in 57 women (12.4%) and alternative procedures were employed. These failures consisted of 37 missed abortions, 17 intrauterine fetal deaths, 2 molar pregnancies, and 1 pregnancy with an IUD in situ. Side effects caused by the drug were basically tolerable. 234 women (51.0%) had 1 or more side effects, gastrointestinal tract disturbances (nausea, vomiting, and diarrhea) being the most frequently observed, and moderate fever the next most frequent. There was 1 ruptured uterus.
This study presents 4 cases of perforation of the uterus caused by intrauterine devices. The marked complications and frequent difficulty in relocating the I.U.D. are also described. Three devices had to be removed by laparotomy because adhesions made non-invasive removal impossible. In these three cases, the intestine was perforated spontaneously. The last pessary is still within the uterine wall at the present time. To lower the complication rate, intrauterine devices should only be inserted by physicians experienced in gynecological techniques.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.