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At least 595 records · Page 33Linked to original sources
PubMed1991

Does prostaglandin confer significant advantage over oxytocin infusion for nulliparas with pre-labor rupture of membranes at term?

Ninety-four nulliparous women with a poor cervical score (less than 6) who had premature rupture of membranes at term were randomized by sealed envelope into two groups. One group received immediate stimulation of labor with oxytocin infusion. The second group received two prostaglandin E2 (PGE2) 3-mg pessaries 4 hours apart, followed by oxytocin infusion, if necessary. The interval between initiation of therapy to onset of labor was significantly longer in the PG group, but the length of labor was similar in both groups. The maximum dose of oxytocin needed was significantly higher in the oxytocin group. The cesarean delivery rate in the oxytocin group was 14.9%, compared with 19.1% in the PG group (not significantly different). All seven cesareans in the oxytocin group and seven of nine in the PG group were for failed stimulation of labor. Neonatal Apgar scores at 1 and 5 minutes and admission to the neonatal intensive care unit were similar in the two groups. The incidence of maternal and neonatal infection was small and was not different in the two groups. The use of PGE2 3-mg pessaries 4 hours apart, followed by oxytocin infusion if necessary, did not confer any benefit over the use of intravenous oxytocin in obstetric or neonatal outcome when both agents were started a few hours after admission.

Administration, Intravaginal↗
PubMed1989

[Use of mifepristone in the termination of early pregnancy. The experience in France].

Are reported the results obtained with mifepristone, administered alone or followed by a low dose of prostaglandin derivative, as an alternative to endometrial aspiration for termination of early pregnancy. Mifepristone was first used alone in doses of 600 mg in 1,841 women. Subsequently, 703 other women received, 36 to 48 hours after mifepristone, either sulprostone (a prostaglandin E2 analogue) 0.25 mg intramuscularly, or gemeprost (a prostaglandin E1 analogue) 1 mg as pessary, or meteneprost (a prostaglandin E2 analogue) 10 mg as pessary. Mifepristone administered alone was successful in 80 per cent of pregnant women with less than 42 days of amenorrhoea. The mifepristone-prostaglandin combination was successful in more than 95 per cent of pregnant women with less than 50 days of amenorrhoea. Expulsion of the ovum was difficult to date when mifepristone was used alone; it occurred within 24 hours of prostaglandin dosing in more than 80 per cent of the other women. Uterine bleeding was almost constant. It was more copious than the usual menses in the majority of women, with or without prostaglandin, and it sometimes required aspiration or curettage (mifepristone alone 1.3 per cent, with prostaglandin 0.28 per cent) and/or blood transfusion (mifepristone alone 0.4 per cent, with prostaglandin 0.14 per cent). Administered alone, mifepristone was very well tolerated. When prostaglandin analogues were added the women complained of lower abdominal pain which required a minor antalgic treatment in 30 to 50 per cent of the cases. Gastrointestinal side-effects were mild, probably due to the low doses of prostaglandin administered.

Abortifacient Agents↗
PubMed1986

Superovulation and embryo transfer in the dairy goat.

Eighteen mature, purebred (Saanen, Alpine, Nubian, La Mancha) dairy does were estrus-regulated with progesterone-impregnated vaginal pessaries. On treatment days 16 to 18, superovulation of 6 does was attempted with pregnant mare's serum gonadotropin (PMSG), and of 12 does with follicle stimulating hormone (FSH). Estrus was induced by progesterone withdrawal on days 18 to 20 and the does were mated to bucks of proven fertility. Embryos were recovered from oviduct flushings on the fourth day after mating. The yield of 4- to 12-cell embryos with FSH superovulation was 17(+/- 2), significantly greater (P less than 0.001) than with PMSG, which was 2(+/- 2). Thirty-six embryos from 3 FSH donor does were transferred to 14 recipients that were estrus-regulated to the donor cycles with the same progesterone pessary regimen. Eleven (78%) of the recipients became pregnant and delivered 21 (70%) kids from 40 embryos, a mean of 7(+/- 2)/donor.

Animals↗
PubMed1979

[Clinical experiences with clotrimazole in treating vaginal candidiasis].

The results of a clinical trial using Clotrimazole (Canesten) vaginal pessaries in the treatment of mycologically confirmed cases of vaginal candidiasis are presented. Treatment schedule consisted in the application of vaginal pessaries each containing 100 mg Clotramizole at bedtime on 6 successive days. In 68 patients who adhered to the treatment schedule and completed the observation and follow-up periods an overall cure-rate of 78.4% was recorded. There were no adverse reactions. Treatment schedules would vary from case to case and in instances of reinfection a repeated course of treatment is recommended.

Adult↗
PubMed1984

[A new prostaglandin E1 analog in late interruption of pregnancy, in utero deaths and very premature ruptures of the membranes. Apropos of 117 cases].

The authors have used suppositories containing 1 mg of an analogue of PGE1 in 117 cases. The indication was fetal abnormality or fetal disease in 85 cases, fetal death in utero in 24 cases and very premature rupture of the membranes in 8 cases. The pessaries have a number of advantages over the techniques that were employed previously; intra-amniotic injection and intra-cervical perfusion of PGF2. The method is very efficacious: 98.3% successes. There was no failure in the series of intra-uterine fetal deaths. Placing the pessaries in the posterior vaginal fornix is easy and the technique does not consist of any manipulation. Not having to put any laminary tents in and no early rupture of the membranes has made it possible to avoid infection except in 1.7% of cases. The incidence of heavy bleeding was exceptionally low: 0.8%. As far as the dangers of rupture of the uterus or of tears in the cervix, this was minimal. Picking cases for correct indications, using doses adapted to each patient and careful observation by a team who are used to dealing with terminations of pregnancy and their techniques should lower the risk. The time spent in hospital is lessened: on an average 3 days. The fetus that is expelled is never macerated, which is important in order to be able to find out all the facts necessary to give good genetic counselling to a couple who have been profoundly traumatised.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗
PubMed1978

Controlled breeding of sheep for studies in fetal physiology.

A supply of fetal sheep of known gestational age was ensured after synchronizing estrus in the ewes, by means of an intravaginal pessary impregnated with a progestagen. Estrus occurred approximately 2 days after the pessary was removed. Conception rates at different times of the year and for a period of 4 years were described.

Animals↗
PubMed1981

[Recent studies into conductivity of oviduct (author's transl)].

A modern functional test of tubal activity is based on the fundamental activity of the oviduct. A glass pessary is applied to the portio, before iodine-containing contrast medium is injected into the Douglas pouch. The blue colour of genital secretion which accumulates in the pessary during iodine-starch reaction will indicate not only tubal patency but also conform tubal function. The functional test is easy to perform and does not imply any risk to the patient. It can thus be carried out in any hospital, but iodine allergy of the patient concerned should be ruled out beforehand.

Adolescent↗
PubMed1995

[Induction of cervical maturation using vaginal administration of estrogens].

During the period between September 1, 1993 and September 1, 1994 the authors preinduced 38 pregnant women in term by oestrogen administered by the vaginal route. The group comprised patients with a single pregnancy, PPH, CS 5n and reactive NST. For preinduction 150 mg oestradiol in a viscous gel were used which along with a pessary was inserted 24 hours before the planned induction of delivery by the vaginal route on the portio uteri. After removal of the pessary the CS was evaluated and then delivery was induced by intracervically administered prostaglandin. The preinduction was successful in 32 patients (84.3%), in 6 patients uterine contractions started during preinduction, delivery by forceps was used twice (5.3%) and Caesarean section six time (15.8%). In the course of preinduction there were no side-effects, no irregularities in the course of parturition were observed. The described method can be recommended as the method of choice for the treatment of an immature portio uteri before planned induction of delivery.

Administration, Intravaginal↗
PubMed1997

Vaginectomy: Profile of Success in Treating Vaginal Prolapse.

Treatment of procidentia and vaginal inversion in older women either with pessaries or surgery commonly brings poor results. Women are unable to retain the pessary; they develop vaginitis and vaginal ulcerations; and surgical "correction" fails due to age-induced genital atrophy or previous obstetrical trauma. We performed a retrospective chart review to assess results of our own technique of vaginectomy/hysterectomy and pelvic floor closure for vaginal vault prolapse and procidentia in 26 aged sexually inactive women seen in our practice. The women ranged from 63 to 83 years of age and had borne 0 to 9 children. Where possible, an estrogen-containing medication was introduced into the vagina preoperatively to stimulate thickening of the vaginal mucosa. A standard Heaney or Doderlein vaginal hysterectomy was performed. Operative time averaged 100 minutes, blood loss averaged 278mL, and 5 patients required a blood transfusion. All patients were discharged in good condition after an average stay of 4.67 days, although 9 of the 24 patients had complications. Since body-cavity invasion was minimal, postoperative care was simple, consisting of hydration with intravenous fluids, urine drainage utilizing an indwelling catheter, (while preventing bladder distension), early ambulation, and prophylaxis against infection and thromboembolism.

Journal Article↗
PubMed2001

Posthysterectomy vault eversion with a large retroperitoneal mass.

A woman with complete vaginal eversion was found to have a large pelvic mass, extending from the rectovaginal septum to the presacral space. This 66-year-old woman with posthysterectomy vaginal eversion complained of pelvic fullness. A pessary provided relief of the prolapse, but the symptom of fullness persisted. Physical examination did not identify a pelvic mass. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a 9 cm tumor of the rectovaginal septum, extending to the presacral space. At laparotomy the patient had a massive neurofibroma arising from the anterior rectal wall. This case is of interest because the complete vaginal prolapse obscured the diagnosis of this large pelvic tumor. CT and MRI were useful in identifying and characterizing the mass. To our knowledge, this is the first reported case of vaginal prolapse with a large pelvic mass.

Aged↗
PubMed2003

Vaginal wind - a new pelvic symptom.

The aim of this study was to evaluate the risk factors, investigations and treatments for vaginal wind. A prospective longitudinal study was carried out at a tertiary care referral centre at St George's Hospital, London. Six consecutive women with symptomatic vaginal air were enrolled in the study, which used a comprehensive questionnaire for vaginal air, prolapse, urinary, bowel and sexual symptoms, vaginal examination following the Standardized ICS Scoring System for prolapse, physiotherapist evaluation, and analysis of the treatment. Main outcome measures were the effect of the patient's age, weight, parity, mode of delivery, fetal weight, and the treatment (conservative and surgical) on the frequency of vaginal wind. The mean age of the six women was 32.8+/-9.9 years (range 21-52), the mean BMI was 23.1+/-5.5 (range 15.2-32.2), all women were premenopausal and five were parous. The mean estimated frequency of the symptoms was 20.0+/-8.1 per day (range 10-40). All the patients completed a course of pelvic floor physiotherapy and one patient had a posterior repair and later a Fenton operation without improvement. A modified 'Bard' pessary was the main form of treatment and resolved the symptoms in two women. Vaginal wind causes significant distress and embarrassment to sufferers. Further information on risk factors, evaluation and treatment modalities should be obtained.

Adult↗
PubMed1990

Laparoscopic ventrosuspensions. A review of 72 cases.

Laparoscopic ventrosuspension is simple to perform after diagnostic laparoscopy. Serious postoperative complication is unlikely. However, patient follow-up over 6 months has not confirmed the usefulness of laparoscopic ventrosuspension in the management of deep dyspareunia or pelvic pain in association with a retroverted uterus. The success rate of laparoscopic ventrosuspension at 6 months varies from 18.6% to 46.5%. The prior use of a Hodge pessary does not predict the success of laparoscopic ventrosuspension.

Adult↗
PubMed1989

Oral versus local treatment of vaginal candidosis.

A comparative study was conducted to compare the results of the use of oral and local vaginal therapy in the treatment of vaginal candidosis. Forty-five patients with clinical and mycological evidence of vaginal candidosis were recruited and were randomly allocated to one of the treatment groups. Twenty-four patients received ketoconazole orally (400 mg/day for 5 days) and 21 patients received nystatin vaginal pessaries (100,000 units twice/day for 7 days). Seven out of 20 rectal swabs (35%) were positive for Candida albicans. Both drugs were significantly effective in relieving patients symptoms and physical signs. The mycological cure rates were 87.5% and 81%, and the relapsing rates were 0% and 5.9% for the ketoconazole and nystatin groups, respectively. Ketoconazole oral therapy had generally slightly higher results than local nystatin therapy in the treatment of vaginal candidosis, yet the difference was statistically insignificant.

Administration, Oral↗
PubMed1985

Progesterone treatment of premenstrual tension--a double blind study.

Fifteen women with moderate to severe premenstrual symptoms, defined and graded according to a recently developed scoring system, took part in a double blind study of the effect of progesterone on premenstrual symptoms. The dosage was 100 mg progesterone twice daily delivered in vaginal pessaries. The women were improved with a statistically significant decrease in their scores by progesterone as well as by placebo treatment. There was no statistically significant difference between the two regimes.

Adult↗
PubMed1979

A new treatment of vaginal candidiasis: three-day treatment with econazole.

From an open comparative multicentric trial it became clear that econazole was an active and well-tolerated agent for the treatment of vulvo-vaginal mycoses. Combined treatment with pessaries and econazole cream seems to be worthwhile in order to isolate the vagina from possible Candida reservoirs or to hasten symptomatic relief.

Adolescent↗
PubMed1992

Preoperative treatment with oestradiol in women scheduled for vaginal operation for genital prolapse. A randomised, double-blind trial.

OBJECTIVE: To disclose a clinical and histopathological effect of local low-dose oestradiol treatment on the vagina. DESIGN: A randomised, double-blind trial. SETTING: Two gynaecological departments at University Hospitals. SUBJECTS: Forty-eight postmenopausal women scheduled for surgery because of genital prolapse. INTERVENTION: 25 micrograms oestradiol or placebo, administered as vaginal pessaries daily, 3 weeks prior to surgery. MAIN OUTCOME MEASURES: Cytological, histological and clinical changes of the vaginal mucosa. RESULTS: The thickness of the vaginal wall increased as did the oestrogenic index. No clinical effect was seen apart from decreased incidence of recurrent cystitis postoperatively. CONCLUSIONS: Preoperative oestrogen treatment has been shown to reduce the incidence of recurrent cystitis and may be needed for stimulation of vaginal mucosa; the short-term clinical effect is not convincing, however.

Administration, Intravaginal↗
PubMed2006

Cryopreserved-thawed embryo transfer in natural or down-regulated hormonally controlled cycles: a retrospective study.

OBJECTIVE: To assess the implantation, pregnancy, and live birth rates after the transfer of frozen-thawed embryos (FET) in a natural or hormonal control cycle. DESIGN: Retrospective study. SETTING: National Health Service tertiary referral center for reproductive medicine in Manchester, United Kingdom. PATIENT(S): Two comparable groups of women with regular menstrual cycles: Group A (n = 212) had FET in a natural cycle after spontaneous ovulation; group B (n = 205) had FET in a pituitary-desensitized hormonally controlled cycle. INTERVENTION(S): In group B, GnRH agonist was commenced in the midluteal phase of the previous cycle and discontinued 3 days before embryo transfer. Oral estradiol valerate and vaginal progesterone pessary were used to prepare the endometrium. Embryo transfer was carried out 3 days after detection of the endogenous LH surge in group A and on day 3 of progesterone administration in group B. MAIN OUTCOME MEASURE(S): Implantation, pregnancy, and live birth rates per cycle and per embryo transfer (ET). RESULT(S): In the 212 women who had natural-cycle FET, 172 ETs were performed and 247 embryos replaced. The implantation rate was 14.1% (35/247). Twenty clinical pregnancies (20/172, 11.6%) were achieved. In the 205 women who had down-regulated hormone replacement-cycle FET, 173 embryo transfers were performed and 243 embryos replaced. The implantation rate was 13.5% (33/243). Eighteen clinical pregnancies (18/173, 10.2%) were achieved. There were no significant differences between the two groups with regard to the implantation, clinical pregnancy, or live birth rates per cycle or per ET. CONCLUSION(S): These findings suggest that both FET protocols are equally effective in terms of implantation rate and pregnancy outcome in women with regular menstrual cycles.

Administration, Intravaginal↗
PubMed1991

Vaginal cancer: the role of infectious and environmental factors.

Primary cancers of the vagina are rare. They comprise 1% to 2% of all gynecologic malignancies and occur predominantly in older women. The diagnosis of primary carcinoma of the vagina requires that the cervix and vulva be intact and that no clinical evidence of other primary tumors exist. Approximately 90% of all vaginal tumors are squamous cell in type on histologic examination. Adenocarcinoma, which is much less common (2% to 4%), is seen primarily in younger women with in utero exposure to diethylstilbestrol. In addition to exposure to diethylstilbestrol, other environmental factors have been associated with the development of vaginal tumors, including chronic irritation from pessaries, previous hysterectomy for benign disease, immunosuppression therapy, cervical irradiation, and endometriosis. Infectious causes seem to play an even more pernicious role in vaginal cancer. The two agents most often implicated are herpes simplex virus and human papillomavirus. These viruses appear to serve as cofactors in the inducement of various genital cancers, working together or with environmental agents such as diethylstilbestrol and host-related genetic abnormalities. The prognosis of vaginal cancer depends on the stage of the disease, with an overall 5-year survival rate of 80% to 90% for early stages.

Adenocarcinoma↗