Publications by authors named "Guirgis R"

Objectives: Image-guided surgery of the paranasal sinuses has become a valuable tool in endoscopic sinus surgery. Optical image-guided systems using infrared tracking technology are widely used. We present our experience with new angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery.

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Objective: To examine the effect of pre-induction cervical length, parity, gestational age at induction, maternal age and body mass index (BMI) on the possibility of successful delivery in women undergoing induction of labor.

Methods: In 822 singleton pregnancies, induction of labor was carried out at 35 to 42(+6) weeks of gestation. The cervical length was measured by transvaginal sonography before induction.

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This report describes the case of a 28 year old woman with virilisation occurring in two successive pregnancies. Recurrent maternal virilisation is rare (seven previous reports) and this case is unique in its severity. Differential diagnoses include ovarian disease and fetal aromatase deficiency.

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Objectives: To examine the value of pre-induction sonographic assessment of cervical length, posterior cervical angle and occipital position in the prediction of the induction-to-delivery interval within 24 h, the likelihood of vaginal delivery within 24 h, the likelihood of Cesarean section and to compare sonographic assessment with the Bishop score.

Methods: In 604 singleton pregnancies, induction of labor was carried out at 35-42 weeks of gestation. Immediately before induction, transvaginal sonography was performed for measurement of cervical length and posterior cervical angle and a transabdominal scan was carried out to determine the position of the fetal occiput.

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Objective: To examine the effect of parity on the relationship between pre-induction cervical length and the risk of Cesarean section in women undergoing induction of labor for prolonged pregnancy.

Methods: In 382 singleton pregnancies, induction of labor was carried out at 41 + 3 to 42 + 1 weeks of gestation. The cervical length was measured by transvaginal sonography before induction.

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Objective: To examine the effect of parity on the relationship between pre-induction cervical length and the induction-to-delivery interval and rate of vaginal delivery within 24 h in women undergoing induction of labor for prolonged pregnancy.

Methods: In 382 singleton pregnancies, induction of labor was carried out at 41 + 3 to 42 + 1 weeks of gestation. The cervical length was measured by transvaginal sonography before induction.

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A comparison was made between the progress of labour and its outcome after an uncomplicated pregnancy, in 400 smokers and 400 non-smokers. Strict selection criteria were applied to eliminate, as far as possible, the variables which might have influenced labour in both groups and to ensure that the two groups of women were matched. The duration of labour was longer in smokers, who also had a higher incidence of caesarean sections.

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The crown-rump lengths (CRL) of 224 pregnancies which resulted from gamete intra-Fallopian transfer (GIFT) or in-vitro fertilization (IVF) were assessed two to four times in the first trimester. The results were compared with some of the published articles which assessed CRL in spontaneous and induced pregnancies. The range of CRL measurements from this study was generally smaller than the previously published data, although all women went on to deliver normal fetuses at full term weighing > 2.

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A total of 350 women due to undergo gamete intrafallopian transfer were scanned vaginally on the operation day and the findings were compared with those recorded 2 days previously when human chorionic gonadotropin was administered. The aim was to assess the clinical value of ultrasound assessment on the operation day, especially from a prognostic point of view. Seven women (2%) were found to have already ovulated and evidence of imminent ovulation was detected in another 27 cases (7.

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Fecundity declines with increasing age in women. The pregnancy rate is lower in in-vitro fertilization/embryo transfer (IVF/ET) in women aged greater than or equal to 40 years. We analysed 349 consecutive gamete intra-Fallopian transfer (GIFT) cycles in women aged greater than or equal to 40 years to identify factors which affected the outcome.

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Two cases of ovarian torsion after gamete intra-Fallopian transfer are described and the roles of ovarian manipulation during the procedure, ovarian hyperstimulation and pregnancy as predisposing factors are discussed. The relevant literature is reviewed.

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Eighty-seven women who had previously had ectopic pregnancy underwent 111 gamete intrafallopian transfers (GIFT). Forty-one women had moderate or severe pelvic adhesions, eight had mild pelvic adhesions, and 18 had had the fallopian tubes surgically repaired. The remaining 20 women had no obvious pelvic abnormality except for the absence of one fallopian tube.

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Forty-five cases of ectopic pregnancy occurred after gamete intrafallopian transfer (32 cases) or in vitro fertilization (13 cases). Ultrasonography positively identified ectopic pregnancy in 33 cases (73.4%) and suggested the presence of one in 7 cases (15.

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A retrospective analysis was carried out to assess the outcome of gamete intrafallopian transfer (GIFT) in cycles when more than 10 oocytes were retrieved (superhigh responders) from October 1987 through June 1989. There were 276 (13%) cycles with more than 10 oocytes retrieved among all GIFT cycles initiated during the period. Clomiphene citrate and gonadotropin were employed for ovarian stimulation in 105 (38%) cycles, and gonadotropin releasing hormone agonist in the remaining 171 (62%) cycles, employing either the flare (104 cycles) or the pituitary down-regulation (67 cycles) protocol.

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Two cases are reported in which GIFT was performed into the right Fallopian tube, both resulting in ectopic pregnancy in the left Fallopian tube. The possible aetiological factors for the occurrence of contralateral ectopic pregnancy are discussed.

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Fourteen women with bicornuate uteri underwent a total of 30 gamete intrafallopian transfer procedures. All patients responded adequately to ovarian stimulation. Eight women conceived, two of them twice.

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This paper reports nine cases of simultaneous intrauterine and ectopic pregnancies which followed in-vitro fertilization (three cases) and gamete intra-Fallopian transfer (six cases). The ectopic pregnancies were treated by aspiration and injection of potassium chloride and methotrexate (five cases), salpingectomy (three cases) or laparoscopic evacuation (one case). In five of the nine patients the intrauterine pregnancies continued until after the 35th week and the patients delivered live infants.

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