77 research outputs found
Acquired factor XII deficiency in a woman with recurrent pregnancy loss: working on a differential diagnosis in a single case
No full textAbstract Background Antiphospholipid syndrome (APS) has been often associated to RPL since 1980 and some reports in the Literature rarely described antibodies to factor XII in patients with APS. Case history We report the case history of 34-year-old caucasian women with recurrent fetal loss and persistent prolonged activated partial thromboplastin time. Haemostatic tests revealed persistent light decrease of clotting factor XII with normal values of IgG and IgM anticardiolipin antibodies and transient positivity for lupus anticoagulant (LA). Few reports in the Literature described antibodies to factor XII in patient with antiphospholipid syndrome (APS) and transient LA. So, once other causes of RPL were excluded, the patient was diagnosed an unusual form of APS associated to antibodies to factor XII, reduced factor XII plasma levels, transient LA and prolonged activated partial thromboplastin time. Discussion We suggest to consider also antibodies directed to clotting factors (e.g. factor XII in our case) as second step of thrombophilia screening in RPL, in particular if a persistent prolonged aPTT is present without an apparent cause.</p
Hyperhomocysteinemia in women with unexplained sterility or recurrent early pregnancy loss from Southern Italy: a preliminary report
No full textAbstract Background Hyperhomocysteinemia has been described as a risk factor for unexplained recurrent pregnancy loss. Increased levels of homocysteine may be due to inadequate dietary intake of folate and vitamin B12 and inherited defects within the methionine-homocysteine pathway such as MTHFR C677T gene polymorphism. However, the association between hyperhomocysteinemia and sterility problems have been underlined only for recurrent pregnancy loss while a relationship between hyperhomocysteinemia and female sterility is still matter of discussion. Aim This study sought to find out a possible relationship between sterility (primary sterility or secondary sterility due to recurrent pregnancy loss) and homocysteine metabolism. Patients and Methods We selected 20 patients with recurrent pregnancy loss, 20 patients with unexplained female sterility and 20 healthy women as control group. Several whole blood samples were collected by venipuncture. Firstly homocysteinemia and other related variables were tested (i.e. folate and vitamin B12 levels); thereafter DNA was extracted by a further whole blood sample collected in EDTA in order to screen MTHFR C677T gene polymorphism. Statistical analysis was performed by chi square test; differences were considered to be significant if p Results The median fasting total plasma homocysteine concentration was 19.2 ± 6.14 μM for patients with recurrent pregnancy loss, while was 21.05 ± 8.78 μM for patients with unexplained sterility, vs 7.85 ± 3.31 μM of control group (p Discussion MTHFR C677T gene polymorphism is frequent in the studied populations. These data raise questions on the role of the homocysteine metabolism in sterility problems. Even though increased homocysteine (i.e. > 15 μM) and MTHFR C677T homozigosity have already been described as risk factors for recurrent pregnancy loss, few studies evaluated their role in women with unexplained sterility. Further studies on larger series are needed to better understand the role of homocysteine metabolism, including folate metabolism, in this clinical setting.</p
Techniques to reduce blood loss during open myomectomy: a qualitative review of literature.
No full textTechniques to reduce blood loss during open myomectomy: a qualitative review of literature.
No full textAcquired factor XII deficiency in a woman with recurrent pregnancy loss: working on a differential diagnosis in a single case.
No full textGonadotropin-releasing hormone (GnRH) antagonist plus recombinant luteinizing hormone vs. a standard GnRH agonist short protocol in patients at risk for poor ovarian response.
No full textVarious studies have compared the efficacy of GnRH agonists (GnRH-a) and antagonists (GnRH-ant) for controlled ovarian stimulation (COS) in women undergoing IVF. Nevertheless, few data are available about the use of GnRH-ant in poor responders. Here, a flexible protocol providing a gradual increase in the dose of GnRH-ant in association with recombinant LH (rec-LH) administration is compared with the standard GnRH-a flare-up protocol in 133 women at risk for poor ovarian response. The mean number of metaphase 2 oocytes (primary end point) was significantly higher in the antagonist group (5.73 +/- 3.57 vs. 4.64 +/- 2.23, respectively; P<.05)
Impaired multiple follicular growth in carriers of the Trp8Arg and Ile15Thr LH-beta variant undergoing controlled ovarian stimulation
No full textAbstracts of the 21st Annual Meeting of the European Society of Human Reproduction and Embryology, Copenhagen, Denmark 19-22 June 200
Maternal and perinatal complications according to maternal age: A systematic review and meta‐analysis
No full textObjective: To evaluate the risk levels for maternal and perinatal complications at >=40, >=45, >50 years old compared to younger controls METHODS: Electronic databases were searched from their inception until March 2021. We included studies reporting pregnancy outcome in pregnant women 40, 45 and 50 years or older compared with controls at the time of delivery. Case reports, and case series were excluded. The primary outcome was the incidence of stillbirth. Meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary treatment effects in terms of either a relative risk (RR) with 95% confidence interval (CI). Heterogeneity was measured using I-squared (Higgins I2 ). Subgroup analyses in women older than 45 years and in those older than 50 years were performed. Results: 27 studies, including 31,090,631, were included in the meta-analysis. The overall quality of the included studies was moderate to high. The vast majority of the included studies were retrospective cohort studies (21/27), four were population-based studies, and two were cross sectional studies. Women ≥ 40 years had significantly higher risk of stillbirth (RR 2.16, 95% CI 1.86 to 2.51), perinatal mortality, IUGR, neonatal death, admission to NICU, preeclampsia, preterm delivery, cesarean delivery, and maternal mortality compared to 45 years compared to those aged 40-45, and in those >50 years compared to those aged 45-50. The risk of maternal mortality was significantly higher in women >50 years compared to those aged 40-45 (RR 60.40, 95% CI 13.28 to 274.74). Conclusions: The risk of stillbirth, cesarean delivery, and maternal mortality increases with advancing maternal age. The risk ratio for maternal mortality was 3.18, 11.60, and 42.76 in women older than 40, older than 45, and older than 50 years, respectively. These data should be used when women with advanced maternal age are counselled regarding their risk in pregnancy
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