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O1024 Clomiphene citrate and dexamethazone in treatment of polycystic ovary syndrome and infertility
S384
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
O1021 The maternal bone mineral density at second trimester of pregnancy can reflect the fetal growth at birth J. Yang, S. Lee, M. Kim, H. Ryu, J. Chung, J. Choi. Cheil General Hospital and Women’s Healthcare center, Dept. of Ob&Gyn Introduction: The BMD during pregnancy was known to decrease because of increased bone resorption for the mineralization of fetal skeleton. Accordingly, it is likely that the BMD during pregnancy have a relationship with fetal growth, but this relationship has not been well elucidated. Method: We conducted a prospective study between February 2004 and February 2005. 41 healthy singleton pregnant women were included. We used quantitative USG for BMD measurement. We measured marker of bone resorption (b-Crosslaps), bone formation (total alkaline phosphatase (ALP), osteocalcin (OC)), total calcium, phosphorus and parathyroid hormone (PTH) during pregnancy. Results: During pregnancy, BMD slightly decreased in the third trimester. Both markers of bone resorption (b-Crosslaps) and formation (ALP, osteocalcin) showed increase during pregnancy especially in late pregnancy. The birth weight is well correlated with the BMD of 2nd trimester (R = 0.568, p = 0.002), delta BMD (2nd − 1st trimester) (R = 0.578, p = 0.001), gestational age (GA) (R = 0.578, p < 0.001) and weight gain during pregnancy (0.458, p = 0.006). Moreover, in stepwise multiple linear regression, the BMD of 2nd trimester was an independent predictor of fetal birth weight. In contrast, maternal height, BMI, BMD of 1st and 2nd trimester and various bone turnover markers were not correlated with birth weight. Conclusion: After considering all the factors that affects the fetal bodyweight, the BMD of 2nd trimester were independent predictors of fetal birth weight. O1022 Study on emergency cervical cerclage combined with tocolytic for intervention of early preterm labor Z. Yang, Y. Guo. Dept. Ob and Gyn, Peking University Third Hospital Objective: The purpose of this study was to evaluate the approach of emergency cervical cerclage combined with tocolytic in preterm labour and seek for the optimal opportunity and approaches for intervention of early preterm labor. Methods: Seventy three cases with preterm labor were enrolled in this study before 34 gestational weeks. 39 cases out of 73 with cervical dilatation <5 cm received emergency cervical cerclage combined with tocolytic (study group) and 34 cases out of 73 with cervical dilatation <5 cm received tocolytic alone (control group). The clinical outcomes were compared between two groups using univariate analysis and multivariate logistic regression analysis. Results: The average prolongation of gestation in group received emergency cervical cerclage combined with tocolytic were significantly higher than that accepted single tocolytic in control group (45 days versus 8.47 days, p < 0.01). The rate of deliver at >34 weeks gestation was significantly higher in study group than that in control group (66.7%, versus 35.3%, P < 0.01). Logistic regression analysis showed that the major factors affecting preterm delivery were emergency cervical cerclage (OR 0.271, 95%CI 0.100– 0.737) and elevated leukocyte count (OR 7.256, 95%CI 1.836– 28.682). Conclusions: This study showed that tocolytic prolonged pregnancy for 2–7 days in pregnant women with symptoms of preterm labor. This delay was sufficient to allow treatment with antenatal steroids. Intervention of emergency cervical cerclage combined with tocolytic was not only prolonged gestational weeks but also increased the delivery rate after 34 gestational weeks in preterm labor cases with advanced cervical dilatation <5 cm.
O1023 Analysis of clinical warning signs before preeclampsia onset Z. Yang, J. Shi, J. Wang. Dept. Ob and Gyn, Peking University Third Hospital Objective: The aim of this study was to identify the warning signs before severe preeclampsia onset for explore the series monitoring. Methods: A case control observational study was conducted. Study group contained 47 cases meeting the criteria of severe preeclampsia between Jan. 2002 and Dec. 2007 in the Peking university Third hospital with regular antenatal care. The case control group contained 94 normal pregnant women at the same stage. Clinical data were analyzed. Results: The BMI increasing in study group before preeclampsia onset was different from the control group significantly (P = 0.045), and so was the velocity of increase of BMI in the second and the third trimester (P = 0.000). The ROC curve showed that the area was 0.912, if 0.385 kg/m2 as the cut point, the sensitivity was 84.2% and the specificity was 81.2%between IVF-ET and; if 0.395 kg/m2 as the cut point, the sensitivity was 81.6%, and the specificity was 86.0%; if 0.41 kg/m2 as the cut point, the sensitivity was 78.9%the specificity was 90.7%. In the third trimester, comparing the degree of the over-gain of weight between study and control groups, significant difference was found (P = 0.000), but no significant difference of the incidence rate between two groups. In study group, 53.2% developed edema as the first clinic sign before preeclampsia diagnosed. Only 18.1% developed edema in control group (P = 0.000). In study group, 17.0% had hypoproteinmia in the third trimester before preeclampsia onset, significant difference was found when compared with the control group (P < 0.05). The logistic regression analysis showed the risk factors including the velocity of increase of BMI, edema and gain of weight (>0.85 kg/w). Conclusion: This study showed that edema, over-gain of weight, pre-hypertension and hypoproteinmia may be the warning clinic signs of the severe preeclampsia. For some patients with warning signs needed more intensive prenatal care. O1024 Clomiphene citrate and dexamethazone in treatment of polycystic ovary syndrome and infertility F. Yari1 , M. Ghafarzadeh, A. Khadish1 , S. Vahabi1 , A. Yari. 1 Lorestan University of Medical Sciences Background: This study was to evaluate the effect of dexamethazone and clomiphene citrate in treatment of polycystic ovary syndrome (PCOS) and infertility. Material and Methods: In this clinical trial study 120 infertile women with PCOS were randomly selected into two groups. Group 1 were treated with Clomiphene citrate 100 mg/day that was given from day 5 to day 9 of the cycle and DEX 2 mg/day from day 5 to day 14 of the cycle. Group 2 were treated with placebo that was given from day 5 to day 14 of the cycle. The goal of the study was ovulation and pregnancy. Results: There were no significant differences between groups in age, duration of infertility, BMI, menstrual pattern, hirsutism and serum DHEAS. The mean number of follicles >18 mm was significantly higher in the DEX and clomiphen group than in the placebo group (P < 0.05). In this study there were significantly higher rates of ovulation and pregnancy in the DEX and clomiphen group. Conclusion: Using by DEX and clomiphen in treatment infertile women by PCOS is significantly efficient in Induction of ovulation and pregnancy.
Free communication (oral) presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S93–S396
O1021 The maternal bone mineral density at second trimester of pregnancy can reflect the fetal growth at birth J. Yang, S. Lee, M. Kim, H. Ryu, J. Chung, J. Choi. Cheil General Hospital and Women’s Healthcare center, Dept. of Ob&Gyn Introduction: The BMD during pregnancy was known to decrease because of increased bone resorption for the mineralization of fetal skeleton. Accordingly, it is likely that the BMD during pregnancy have a relationship with fetal growth, but this relationship has not been well elucidated. Method: We conducted a prospective study between February 2004 and February 2005. 41 healthy singleton pregnant women were included. We used quantitative USG for BMD measurement. We measured marker of bone resorption (b-Crosslaps), bone formation (total alkaline phosphatase (ALP), osteocalcin (OC)), total calcium, phosphorus and parathyroid hormone (PTH) during pregnancy. Results: During pregnancy, BMD slightly decreased in the third trimester. Both markers of bone resorption (b-Crosslaps) and formation (ALP, osteocalcin) showed increase during pregnancy especially in late pregnancy. The birth weight is well correlated with the BMD of 2nd trimester (R = 0.568, p = 0.002), delta BMD (2nd − 1st trimester) (R = 0.578, p = 0.001), gestational age (GA) (R = 0.578, p < 0.001) and weight gain during pregnancy (0.458, p = 0.006). Moreover, in stepwise multiple linear regression, the BMD of 2nd trimester was an independent predictor of fetal birth weight. In contrast, maternal height, BMI, BMD of 1st and 2nd trimester and various bone turnover markers were not correlated with birth weight. Conclusion: After considering all the factors that affects the fetal bodyweight, the BMD of 2nd trimester were independent predictors of fetal birth weight. O1022 Study on emergency cervical cerclage combined with tocolytic for intervention of early preterm labor Z. Yang, Y. Guo. Dept. Ob and Gyn, Peking University Third Hospital Objective: The purpose of this study was to evaluate the approach of emergency cervical cerclage combined with tocolytic in preterm labour and seek for the optimal opportunity and approaches for intervention of early preterm labor. Methods: Seventy three cases with preterm labor were enrolled in this study before 34 gestational weeks. 39 cases out of 73 with cervical dilatation <5 cm received emergency cervical cerclage combined with tocolytic (study group) and 34 cases out of 73 with cervical dilatation <5 cm received tocolytic alone (control group). The clinical outcomes were compared between two groups using univariate analysis and multivariate logistic regression analysis. Results: The average prolongation of gestation in group received emergency cervical cerclage combined with tocolytic were significantly higher than that accepted single tocolytic in control group (45 days versus 8.47 days, p < 0.01). The rate of deliver at >34 weeks gestation was significantly higher in study group than that in control group (66.7%, versus 35.3%, P < 0.01). Logistic regression analysis showed that the major factors affecting preterm delivery were emergency cervical cerclage (OR 0.271, 95%CI 0.100– 0.737) and elevated leukocyte count (OR 7.256, 95%CI 1.836– 28.682). Conclusions: This study showed that tocolytic prolonged pregnancy for 2–7 days in pregnant women with symptoms of preterm labor. This delay was sufficient to allow treatment with antenatal steroids. Intervention of emergency cervical cerclage combined with tocolytic was not only prolonged gestational weeks but also increased the delivery rate after 34 gestational weeks in preterm labor cases with advanced cervical dilatation <5 cm.
O1023 Analysis of clinical warning signs before preeclampsia onset Z. Yang, J. Shi, J. Wang. Dept. Ob and Gyn, Peking University Third Hospital Objective: The aim of this study was to identify the warning signs before severe preeclampsia onset for explore the series monitoring. Methods: A case control observational study was conducted. Study group contained 47 cases meeting the criteria of severe preeclampsia between Jan. 2002 and Dec. 2007 in the Peking university Third hospital with regular antenatal care. The case control group contained 94 normal pregnant women at the same stage. Clinical data were analyzed. Results: The BMI increasing in study group before preeclampsia onset was different from the control group significantly (P = 0.045), and so was the velocity of increase of BMI in the second and the third trimester (P = 0.000). The ROC curve showed that the area was 0.912, if 0.385 kg/m2 as the cut point, the sensitivity was 84.2% and the specificity was 81.2%between IVF-ET and; if 0.395 kg/m2 as the cut point, the sensitivity was 81.6%, and the specificity was 86.0%; if 0.41 kg/m2 as the cut point, the sensitivity was 78.9%the specificity was 90.7%. In the third trimester, comparing the degree of the over-gain of weight between study and control groups, significant difference was found (P = 0.000), but no significant difference of the incidence rate between two groups. In study group, 53.2% developed edema as the first clinic sign before preeclampsia diagnosed. Only 18.1% developed edema in control group (P = 0.000). In study group, 17.0% had hypoproteinmia in the third trimester before preeclampsia onset, significant difference was found when compared with the control group (P < 0.05). The logistic regression analysis showed the risk factors including the velocity of increase of BMI, edema and gain of weight (>0.85 kg/w). Conclusion: This study showed that edema, over-gain of weight, pre-hypertension and hypoproteinmia may be the warning clinic signs of the severe preeclampsia. For some patients with warning signs needed more intensive prenatal care. O1024 Clomiphene citrate and dexamethazone in treatment of polycystic ovary syndrome and infertility F. Yari1 , M. Ghafarzadeh, A. Khadish1 , S. Vahabi1 , A. Yari. 1 Lorestan University of Medical Sciences Background: This study was to evaluate the effect of dexamethazone and clomiphene citrate in treatment of polycystic ovary syndrome (PCOS) and infertility. Material and Methods: In this clinical trial study 120 infertile women with PCOS were randomly selected into two groups. Group 1 were treated with Clomiphene citrate 100 mg/day that was given from day 5 to day 9 of the cycle and DEX 2 mg/day from day 5 to day 14 of the cycle. Group 2 were treated with placebo that was given from day 5 to day 14 of the cycle. The goal of the study was ovulation and pregnancy. Results: There were no significant differences between groups in age, duration of infertility, BMI, menstrual pattern, hirsutism and serum DHEAS. The mean number of follicles >18 mm was significantly higher in the DEX and clomiphen group than in the placebo group (P < 0.05). In this study there were significantly higher rates of ovulation and pregnancy in the DEX and clomiphen group. Conclusion: Using by DEX and clomiphen in treatment infertile women by PCOS is significantly efficient in Induction of ovulation and pregnancy.