The Experts below are selected from a list of 309 Experts worldwide ranked by ideXlab platform
Eyal Sheiner - One of the best experts on this subject based on the ideXlab platform.
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pregnancy outcome in women with an Intrauterine contraceptive device
American Journal of Obstetrics and Gynecology, 2009Co-Authors: Hadas Ganer, Amalia Levy, Iris Ohel, Eyal SheinerAbstract:Objective To investigate pregnancy outcome in patients who conceived with an Intrauterine contraceptive device. Study Design A retrospective study comparing the pregnancy outcome of women with retained Intrauterine device (n = 98), patients after Intrauterine device removal in early pregnancy (n = 194), and pregnancies without an Intrauterine device (n = 141,191) was performed. Results A significant linear association was documented among the 3 groups and adverse outcomes such as preterm delivery (18.4% in the retained Intrauterine device, 14.4 % in removed Intrauterine device, and 7.3% in the no-Intrauterine device group; P P Conclusion Women conceiving with an Intrauterine device are at increased risk for adverse obstetric outcomes, whereas the risk is higher for pregnancies with retained Intrauterine device compared with early Intrauterine device removal.
Sandra Orgeig - One of the best experts on this subject based on the ideXlab platform.
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Antenatal Glucocorticoid Treatment of The Growth-restricted Fetus: Benefit or Cost?
Reproductive Sciences, 2009Co-Authors: Janna L. Morrison, Sandra OrgeigAbstract:Women at risk of preterm labor are commonly treated with antenatal glucocorticoids to reduce neonatal complications, including respiratory distress syndrome. Despite the benefits of antenatal glucocorticoid for neonatal lung function, they are associated with negative cardiovascular outcomes. Among this population, there is a group of Intrauterine growth-restricted fetuses in which substrate supply is reduced and these fetuses must undergo a range of cardiovascular adaptations to survive. Interestingly, the cardiovascular changes caused by antenatal glucocorticoid in normally grown fetuses are contrary to the cardiovascular adaptations that the Intrauterine growth-restricted fetus must make to survive. Hence, the possibility exists that antenatal glucocorticoid in Intrauterine growth-restricted infants may compromise cardiovascular development. This review first provides an overview of general antenatal glucocorticoid effects, before outlining the effects on cardiorespiratory development in normally grown fetuses, the cardiovascular adaptations that occur in the Intrauterine growth-restricted fetus and finally integrating this with the very limited evidence for the effect of antenatal glucocorticoid in Intrauterine growth-restricted infants.
Ashok Agarwal - One of the best experts on this subject based on the ideXlab platform.
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varicocelectomy improves Intrauterine insemination success rates in men with varicocele
The Journal of Urology, 2001Co-Authors: James A Daitch, Mohamed A Bedaiwy, Eleonora Bedin Pasqualotto, Benjamin N Hendin, Jorge Hallak, Tommaso Falcone, J Anthony J R Thomas, David R Nelson, Ashok AgarwalAbstract:Purpose: We determined whether varicocele treatment before Intrauterine insemination significantly affects Intrauterine insemination success rates.Materials and Methods: A total of 58 infertile couples, of whom the women had normal evaluations and men had abnormal semen analyses and a history of varicocele, were included in this study. They were identified after reviewing the charts of all women undergoing Intrauterine insemination for male factor infertility at our center. Of the men 24 participated in 63 Intrauterine insemination cycles without varicocele treatment, while in the remaining 34 varicocele was treated before a total of 101 Intrauterine insemination cycles. Variables associated with pregnancy or live birth were analyzed using repeat measures logistic regression with generalized estimating equation techniques. An initial stepwise generalized estimating equation was performed without including varicocele treatment status. Subsequently varicocele treatment status and the significant associated ...
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Relationship of Total Motile Sperm Count and Percentage Motile Sperm to Successful Pregnancy Rates Following Intrauterine Insemination
Journal of Assisted Reproduction and Genetics, 1999Co-Authors: Eleonora B. Pasqualotto, James A Daitch, Benjamin N Hendin, Tommaso Falcone, David R Nelson, Anthony J. Thomas, Ashok AgarwalAbstract:Purpose: This study sought (i) to investigate the relationship between postwash total motile sperm count and postwash percentage motile sperm in predicting successful Intrauterine insemination and (ii) to determine the minimal postwash total motile sperm count required to achieve pregnancy with Intrauterine insemination. Methods: Five hundred four women, who underwent 1636 Intrauterine insemination cycles with their partner's sperm for infertility treatment from 1993 through 1995, were included in this retrospective study. All patient charts were reviewed for age, infertility etiology, ovarian stimulation regimens, semen characteristics, and treatment outcome. To determine the relationship between total motile sperm count and Intrauterine insemination outcome, patients were grouped as (1) less than 0.5 million, (2) 0.5 to 1 million, (3) 1 to 5 million, (4) greater than 5 million, and (5) greater than 20 million. Results: Similar live birth rates (per cycle) were seen among the postwash total motile sperm count groups: group 1, 3.5%; group 2, 2.4%; group 3, 7.0%; group 4, 6.9%; and group 5, 7.0% (P = 0.37). However, regardless of the postwash total motile sperm count, the postwash motility predicted Intrauterine insemination success at a cutoff value of 40%. Conclusions: The percentage of postwash sperm motility, and not the postwash total motile sperm count, can predict successful Intrauterine insemination outcome. Such information can be useful in counseling patients regarding their chance of success with Intrauterine insemination and in determining when alternate methods of assisted reproduction may be a better approach.
David K Turok - One of the best experts on this subject based on the ideXlab platform.
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immediate postpartum levonorgestrel Intrauterine device insertion and breast feeding outcomes a noninferiority randomized controlled trial
American Journal of Obstetrics and Gynecology, 2017Co-Authors: David K Turok, Jennifer L Eggebroten, Jessica N Sanders, Lauren Thaxton, Nicole Yonke, Holly Bullock, Rameet H Singh, Lori M Gawron, Lawrence Leeman, Eve EspeyAbstract:Background Immediate postpartum levonorgestrel Intrauterine device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. Objective This study examined the effect of immediate vs delayed postpartum levonorgestrel Intrauterine device insertion on breast-feeding outcomes. Study Design We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel Intrauterine device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery Results We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate group (79%; 95% confidence interval, 70–86%) was noninferior to that of the delayed group (84%; 95% confidence interval, 76–91%). The 5% difference in breast-feeding continuation at 8 weeks between the groups fell within the noninferiority margin (95% confidence interval, –5.6 to 15%). Time to lactogenesis (mean ± SD) in the immediate group, 65.3 ± 25.7 hours, was noninferior to that of the delayed group, 63.6 ± 21.6 hours. The mean difference between groups was 1.7 hours (95% confidence interval, –4.8 to 8.2 hours), noninferior by log-rank test. A total of 24 Intrauterine device expulsions occurred in the immediate group compared to 2 in the delayed group (19% vs 2%, P Conclusion Our results of noninferior breast-feeding outcomes between women with immediate and delayed postpartum levonorgestrel Intrauterine device insertion suggest that immediate postpartum Intrauterine device insertion is an acceptable option for women planning to breast-feed and use the levonorgestrel Intrauterine device. Expulsion rates are higher with immediate postpartum levonorgestrel Intrauterine device insertion compared to delayed insertion, but this disadvantage may be outweighed by the advantages of immediate initiation of contraception. Providers should offer immediate postpartum Intrauterine device insertion to breast-feeding women planning to use the levonorgestrel Intrauterine device.
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immediate postpartum Intrauterine device and implant program outcomes a prospective analysis
American Journal of Obstetrics and Gynecology, 2017Co-Authors: Jennifer L Eggebroten, Jessica N Sanders, David K TurokAbstract:Background In-hospital placement of Intrauterine devices and contraceptive implants following vaginal and cesarean delivery is increasingly popular and responds to maternal motivation for highly effective postpartum contraception. Immediate postpartum Intrauterine device insertion is associated with higher expulsion than interval placement, but emerging evidence suggests that the levonorgestrel Intrauterine device may have a higher expulsion rate than the copper Intrauterine device. Objective This study evaluated in-hospital provision, expulsion, and 6-month continuation of immediate postpartum copper T380 Intrauterine devices, levonorgestrel Intrauterine devices, and contraceptive implants. Study Design We offered enrollment in this prospective observational trial to women presenting to the University of Utah labor and delivery unit from October 2013 through February 2016 who requested an Intrauterine device or implant for postpartum contraception during prenatal care or hospitalization at the time of delivery. Following informed consent, participants completed questionnaires prior to hospital discharge and at 3 and 6 months postpartum. Data on expulsions at 6 months were validated by chart abstraction. Results During the study period, 639 patients requested a postpartum Intrauterine device or implant and 350 patients enrolled in prospective follow-up prior to discharge from the hospital. Among enrollees, 325 (93%) received their preferred contraceptive device prior to hospital discharge: 88 (27%) copper Intrauterine device users, 123 (38%) levonorgestrel Intrauterine device users, and 114 (35%) implant users. Participants predominantly were Hispanic (90%), were multiparous (87%), reported a household income Conclusion An immediate postpartum long-acting reversible contraception program effectively provides women who desire highly effective reversible contraceptive devices with their method of choice prior to hospital discharge. Immediate postplacental levonorgestrel Intrauterine device users have higher expulsion rates than copper Intrauterine device users, but >8 of 10 women initiating an Intrauterine device or implant continue use at 6 months postpartum.
Humphrey H H Kanhai - One of the best experts on this subject based on the ideXlab platform.
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complications of Intrauterine intravascular transfusion for fetal anemia due to maternal red cell alloimmunization
American Journal of Obstetrics and Gynecology, 2005Co-Authors: Inge L Van Kamp, F J Klumper, Dick Oepkes, Robertjan H Meerman, Sicco A Scherjon, Frank P H A Vandenbussche, Humphrey H H KanhaiAbstract:Objective The purpose of this study was to establish the true procedure-related complication rate of Intrauterine transfusion therapy. Study design A cohort study of 254 fetuses treated with 740 Intrauterine blood transfusions for red-cell alloimmunization in a single center in the years 1988 to 2001. Our database was searched for perinatal deaths, emergency deliveries, infections, and preterm rupture of membranes associated with Intrauterine blood transfusion. Complications were categorized by two independent obstetricians as procedure-related (PR) or not procedure-related (NPR). Logistic regression analysis was used to identify risk factors for complications. Results Overall survival was 225/254 (89%). Fetal death occurred in 19 cases (7 PR) and neonatal death in 10 cases (5 PR). There were two cases of Intrauterine infection with Escherichia coli (both PR) and two other cases of preterm premature rupture of membranes (1 PR) within a week of a procedure. Emergency delivery after a transfusion was performed in 18 pregnancies (15 PR). The total PR complication rate was 3.1%, resulting in an overall PR loss rate of 1.6% per procedure. Arterial puncture, transamniotic cord puncture, refraining from fetal paralysis, and advancing gestational age were associated with the occurrence of PR complications. Conclusion Our study shows that Intrauterine transfusion is a safe procedure, with a relatively low PR perinatal loss rate. Arterial puncture and transamniotic cord needling carry a high risk for serious complications, whereas fetal paralysis improves the safety of the procedure. This information on risks of Intrauterine transfusion therapy may help to further improve the safety of Intrauterine transfusions. Data on complication rates of Intrauterine transfusions are essential in counseling patients.