Leiomyomatosis peritonealis disseminata presenting with intravascular extension and coexisting with endometriosis: a case report.

Background: Leiomyomatosis peritonealis disseminata is a benign disease of women of reproductive age. Female gonadal steroids play the major role in pathogenesis, but reported cases in postmenopausal women suggests other factors. A few cases in the literature with coexisting endometriosis confirm the hypothesis that both originate in submesothelial multipotential mesenchymal cells.

Predictors of methotrexate treatment failure in ectopic pregnancy.

Objective: To determine the possible predictors of methotrexate treatment failure in ectopic pregnancy.

Study Design: Fifty-eight patients diagnosed with ectopic pregnancy were treated with methotrexate (50 mg/m2). Selected variables in the history of the patients, the signs and symptoms at the time of admission, transvaginal ultrasound findings and serum beta-human chorionic gonadotropin (beta-hCG) levels on day 1 and 3 were evaluated in a logistic regression model to predict treatmentfailure, defined as tubal rupture.

Vesical calculus formation around a migrated copper-T 380-A.

The authors report a case of intravesical migration of an intrauterine contraceptive device (IUD) with secondary stone formation in a 28-year-old woman who presented with recurrent urinary tract infections. After incomplete removal of the migrated copper-T 380-A from the pelvic cavity by laparoscopy, cystoscopy was performed and the arms of the IUD with the calculus formed around them were removed via the cystoscope. Intravesical migration of an IUD should be suspected in any woman with an unretrieved device and with recurrent urinary symptoms.

Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures.

Aim: To report 11 cases of incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. The diagnostic approaches and therapies for incisional endometriosis are also evaluated.

Methods: Eleven patients who presented with a painful nodule that was increasing in size during menstruation on the scar of a previous gynecologic procedure were examined retrospectively.

Adjusted leptin level (ALL) is a predictor for hyperemesis gravidarum.

Objective: To compare the maternal serum leptin level according to the gestational week and to assess the relationship between the adjusted serum leptin level and thyroid hormones. In order to obtain this objective a new parameter is developed: adjusted leptin level (ALL: maternal serum leptin level/gestational week).

Study Design: A prospective study was carried out at the early prenatal care unit, SSK Ankara Women's Health and Teaching Hospital.

Lipid peroxidation and antioxidant activity in patients in labor with nonreassuring fetal status.

Objective: The aim of our study was to evaluate lipid peroxidation products and antioxidant enzyme activity in placental tissue and umbilical cord blood, as a marker for fetal hypoxia in patients in labor with nonreassuring fetal status.

Study Design: Umbilical cord arterial blood and placental tissue samples were collected from 24 patients with term pregnancies in labor and nonreassuring fetal heart rate (FHR) patterns (study) and 24 women with normal pregnancies in labor and normal FHR tracings (controls) for determination of malondialdehyde (MDA) as a marker for lipid peroxidation and superoxide dismutase (SOD) for the antioxidant activity. Measured values were compared statistically between two groups using independent samples t-test or Mann-Whitney U-test.

Induction of labor with three different techniques at 41 weeks of gestation or spontaneous follow-up until 42 weeks in women with definitely unfavorable cervical scores.

Objective: To compare the obstetric outcome of induction of labor at 41 weeks and of follow-up until 42 weeks and induction if the patient has still not given birth at 42 weeks.

Study Design: Six hundred women at 287+/-1 days of gestation with definitely unfavorable cervical scores were randomized to labor induction (N=300) or spontaneous follow-up (N=300) with twice-weekly nonstress testing and amniotic fluid measurement and once-weekly biophysical scoring. The treatments used in the induction group were (1) vaginal administration of 50 microg misoprostol (n=100), (2) oxytocin induction (n=100), and (3) transcervical insertion of a Foley balloon (n=100).

Actinomyces infection in female genital tract.

Objectives: To analyze clinical and laboratory characteristics of patients with pelvic actinomyces.

Study Design: We studied five patients with pelvic actinomyces who were admitted between January 1, 2002 and December 31, 2002. The initial complaints, diagnostic methods, therapeutic alternatives and results of the therapies were examined.

Primary fallopian tube carcinoma: a retrospective multicenter study.

Purpose: This retrospective multicenter study aimed to assess the survival and prognostic factors of primary fallopian tube carcinoma.

Methods: The medical records of 29 patients with fallopian tube carcinoma from two centers were reviewed for age, stage, surgical intervention, relapse and survival.

Results: The mean age of the patients was 56 years (range, 37-76).

Smooth muscle fraction of the round ligament in women with pelvic organ prolapse: a computer-based morphometric analysis.

Our objective was to compare the collagen and muscle content of the round ligament of uteri in women with pelvic organ prolapse. We evaluated the tissue samples obtained from the round ligaments of 22 patients with uterine prolapse who underwent vaginal hysterectomy (group A, study) and from 26 patients with no pelvic relaxation in whom total abdominal hysterectomy was performed for benign reasons (group B, controls). Morphometric analysis was performed on histologic cross-sections of the round ligament.

Frequent low-dose misoprostol for termination of second-trimester pregnancy.

Objectives: To determine the efficacy of an application regimen of low-dose frequent misoprostol for second-trimester pregnancy termination.

Methods: A total of 250 women between 12 and 20 weeks of gestation who were scheduled for second-trimester pregnancy termination received 200 microg vaginal misoprostol followed by 100 microg oral misoprostol every 2 h until expulsion of the fetus. Mechanical cervical dilatation with a 16-French Foley balloon catheter was performed if no cervical dilatation was observed after 24 h.

Angiomyolipoma of the uterus associated with tuberous sclerosis: case report and review of the literature.

Background: Angiomyolipoma (AML) is a rare benign tumor that occurs most commonly in the kidney. Only a few cases have been described in the uterus.

Case: We describe a 32-year-old woman with tuberous sclerosis who presented with irregular bleeding.

Chylous ascites following para-aortic lymphadenectomy: a case report.

Background: Chylous ascites is an uncommon complication following para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options are serial paracentesis, medium-chain triglyceride diet, total parenteral nutrition and somatostatin as conservative management and peritoneovenous shunting, and surgical exploration for refractory cases.

Case: A 31-year-old female patient developed chylous ascites following para-aortic lymph node dissection for borderline mucinous tumor of the ovary.

A population-based risk factor scoring will decrease unnecessary testing for the diagnosis of gestational diabetes mellitus.

Background: To determine the effectiveness of a population-based risk factor scoring to decrease unnecessary testing for the diagnosis of gestational diabetes mellitus (GDM).

Methods: We formed a risk factor scoring over five, which questions maternal age, body mass index and first-degree relatives with a diagnosis of diabetes mellitus, a prior macrosomic fetus and adverse outcome during the previous pregnancies. All participants underwent a 50-g glucose challenge test (GCT) followed by a 100-g oral glucose tolerence test (OGTT).

Pregnancy outcomes and menstrual function after fertility sparing surgery for pure ovarian dysgerminomas.

Materials And Methods: The medical records of 23 patients with pure ovarian dysgerminoma treated by conservative surgery at SSK Ankara Maternity Hospital between 1991 and 2001 were reviewed retrospectively. Pregnancy outcomes and menstrual function after conservative surgery were analyzed.

Results: Seven patients (30%) were incompletely staged and were assumed to be stage IA due to intraoperative findings.

Comparison of hepatocyte growth factor levels of epithelial ovarian cancer cyst fluids with benign ovarian cysts.

Hepatocyte growth factor (HGF) is known to take role in oncogenesis and tumoral behavior of the tumors of the organs that contain mesenchymal and epithelial cells together. This study aims to compare HGF levels in cyst fluids of epithelial ovarian cancer and benign ovarian cysts and look for the role of HGF in ovarian carcinogenesis. Twenty-four consecutive patients with ovarian cancer and 34 with benign cysts of ovary were recruited prospectively at Gynecologic Oncology Departments of SSK Ankara Maternity Hospital and Hacettepe University School of Medicine between 2001 and 2002.

Misoprostol for cervical ripening and labor induction in pregnancies with oligohydramnios.

The efficacy and safety of misoprostol for cervical ripening and labor induction in patients with oligohydramnios was investigated. 57 pregnancies with oligohydramnios and 58 cases with a normal amniotic fluid volume (controls) were enrolled in this prospective trial. All patients received 50 microg of intravaginal misoprostol every 5 h.

Comparison of HGF (hepatocyte growth factor) levels of epithelial ovarian cancer cyst fluids with benign ovarian cysts.

Hepatocyte growth factor (HGF) is known to take a role in oncogenesis and tumoral behavior of the tumors of the organs that contain both mesenchymal and epithelial cells. This study compares HGF levels in cyst fluids of epithelial ovarian cancer and benign ovarian cysts to look for the role of HGF in ovarian carcinogenesis. Twenty-four consecutive patients with ovarian cancer and 34 with benign ovarian cysts were recruited prospectively at the Gynecologic Oncology Departments of SSK Ankara Maternity Hospital and Hacettepe University School of Medicine between 2001 and 2002.

Analysis of risk factors associated with uterine perforation by intrauterine devices.

Objective: To determine the risk factors for intrauterine devices (IUDs) being displaced into the abdominal cavity.

Methods: This prospective follow-up study was conducted between 1996 and 2002, at the family planning clinic of a referral hospital. All 8343 women who had a copper T-380A IUD inserted underwent ultrasound examination after 1 year.

Placenta previa percreta with urinary bladder and ureter invasion.

A 26-year-old woman, with one previous cesarean delivery and two uterine curettage due to incomplete abortion, was admitted to the labor ward with the diagnosis of partial placenta previa at 35 weeks of gestation. Repeat cesarean section was performed due to profuse vaginal bleeding. Placenta previa percreta invading the bladder trigone was confirmed with cystotomy.

Laparoscopic conservation of the ovaries in cases with massive ovarian oedema.

Two women, one 27 years old (case 1) and the other 20 years old (case 2), were evaluated due to right lower quadrant pain. The lactate dehydrogenase level was increased in case 1 and the dihydroepiandostrone level was increased in both cases. Preoperative transvaginal ultrasonography revealed solid masses, but the tumour markers were within normal limits.

Metformin therapy improves ovulatory rates, cervical scores, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome.

Objective: To evaluate the effect of metformin therapy on hyperandrogenism, insulin resistance, cervical scores, ovulation, and pregnancy rates in clomiphene citrate-resistant women with polycystic ovary syndrome (PCOS).

Design: Prospective, randomized, double-blind, placebo-controlled study.

Setting: Infertility clinic of a tertiary referral center.