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Selective embryo reduction in multiple pregnancies' resulting from assisted conception
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Citations from the Chinese literature/International
group and 21.4% in the 4500 gm group, compared with 4.4% in the normal birthweight group. No birth trauma occurred in the macrosomic infants delivered by Cesarean section. Of those microsomic infants delivered vaginally, the frequency of clavicle fracture was II .80/uin the 4 000-4499 gm group and 18.2% in the s 4500 gm group, compared with 1.2% in the normal birthweight group. Two infants (18.2%) weighing greater than 4500 gm sustained brachial plexus injury. Conclusions. Effective Cesarean section on macrosomic infants to prevent dystocia is not recommended because most of them can be delivered vaginally. For the very macrosomic infants ( L 4500 gm), elective Cesarean section is suggested to prevent birth trauma. Transvaginal color flow imaging in the follow-up of invasive gestational trophoblastic disease: A Case Report Jenn-Ming Yang; Kuo-Gon Wang CHIN MED J TAIPEI 1993 51/3 (231-234) A case of invasive gestational trophoblastic disease after partial hydatidiform mole was presented in this study in which the diagnosis was made along with the treatment being monitored by means of transvaginal color Doppler ultrasound. In this case, the appearance or disappearance of vascular changes induced by invasive mole corresponded with serum beta human chorionic gonadotropin @-hCG) titer. Vascular changes displayed on color Doppler scanning may thus complement the application of HCG in postmolar pregnancy surveillance. Selective embryo reduction in multiple pregnancies’ resulting from assisted conception Su-Chee Chen; Fa-Kung Lee; Sheng-Ping Chang; Loy-Lan Too; Li-Ping Shu; Heung-Tat Ng CHIN MED J TAIPEI 1993 5113 (231-234) Background. Assisted conception not only raises the pregnancy rate by treating infertility, but also increases the chance of obstetrical complication of multiple pregnancy. So it is important to develop a means by which the number of developing embryos can be reduced. Methods. Eight multiple pregnant women (from triplets to octuplets) asked to have the number of viable fetuses reduced. By means of sonar guided puncture, a mixture of demerol and xylocaine was injected to the fetal thorax until the fetal heart ceased to beat. The procedures were done between the 7th and I Ith week of gestational age. Repeated scans were done for three consecutive days to confirm the viability of the remaining fetuses. Results. Except for vanishing twins, no serious complication was noted. For six of the women, 10 healthy births have resulted: the remaining two have ongoing pregnancies Conclusions. The procedure described is an easy, safe and effective method to diminish obstetrical morbidity of multiple pregnancy. Effect of peritoneal fluid and serum from patients with endometriosis on mouse embryo in vitro development Chii-Ruey Tzeng; Li-Wei Chien; Shu-Ru Chang; An-Chiun Chen CHIN MED J TAIPEI 1993 51 13 (231-234) Background. The adverse effects on early embryo development as caused by peritoneal fluid exudate and serum from en-
Journul of Gynecology & Obstetrics 48
(1995J
137- 14i
dometriosis patients have been shown, but the underlying mechanism and clinical significance remain unknown. Methods. Peritoneal fluid (PF) and serum (S) from patients with minimal to mild endometriosis (Group A, n = 12), moderate to severe endometriosis (Group B, n = 6). and others including tubal ligation and uterine myoma (Group C. controls, n =6), were obtained during laparoscopy. 5% CO,. 95% air with Two-cell mouse embryos were cultured at 37°C in 5% CO,, 95% air with supplementation of lO%PF+ I’%BS A, loo/OSand IOU/IS+IO%PF in HTF medium. The percentage of progression to the blastocyst stage at 72 and 96 h was observed and compared among the three groups. Result. Serum and peritoneal fluid from infertile patients with moderate to severe endometriosis appeared to be=embryotoxic to the in vitro development of two-cell mouse embryos, but no significant differences were found between minimal to mild endometriosis and group C patients. Conclusions. These data suggest that the production of embryotoxic factor(s) is related to the clinical stage, and may be derived from endometriotic implants. The correlation of the embryotoxic effect of the peritoneal fluid with that of the serum indicated that embryotoxic factor(s) may enter the systemic circulation and impede early embryogenesis in the reproductive tract. The nature and mechanism of this result demand further study. Electroejaculation for the treatment of idiopathic anejaculation: a case report Yin-Chin Ho; Hsiang-Tai Chao; Chuan-Chien Pan; HueiShing Hsu; Sheng-Ping Chang; Heung-Tat Ng CHIN MED J TAIPEI 1993 51/3 (231-234) Electroejaculation to produce semen from anejaculated males has been employed successfully in conjunction with intrauterine insemination (IUI), in vitro fertilization/embryo transfer, and gamete intrafall opian transfer. We herein report the use of IUI to achieve pregnancy following electroejaculation in a patient with primary idiopathic anejaculation. This 30year-old patient had a history of anejaculation that was noted after marriage, but had normal sexual potency and occasional nocturnal emission. Electroejaculation was successfully used to obtain semen. The highly motile sperm was recovered from swing up procedure and used for IUI. The 25-year-old wife was given clomiphene citrate and Pergonal for ovulation induction. A triplet pregnancy was achieved. At 26 weeks of gestation. the first triplet was delivered after spontaneous rupture of membrane. We tried to delay delivery of this retained twin pregnancy. Thirty-two days later, the remaining two fetuses were delivered weighing 1100 gm and 900 gm. Ninety-three days after delivery, these two babies were discharged. putting on weight to 3564 gm and 3264 gm. This case represents the first success of using electroejaculation to achieve pregnancy from anejaculated patient in Taiwan. A case report of repeated paroxysmal supraventricular tachycardia at immediate postpartum Ruey-Jien Chen; Su-Cheng Huang: Song-Nan Chow; DawYuan Chang; Men-Luh Yen; Yuan-Teh Lee J Obstet Gynecol ROC 1993 51!3 (231-234)
Citations from the Chinese literature/International
group and 21.4% in the 4500 gm group, compared with 4.4% in the normal birthweight group. No birth trauma occurred in the macrosomic infants delivered by Cesarean section. Of those microsomic infants delivered vaginally, the frequency of clavicle fracture was II .80/uin the 4 000-4499 gm group and 18.2% in the s 4500 gm group, compared with 1.2% in the normal birthweight group. Two infants (18.2%) weighing greater than 4500 gm sustained brachial plexus injury. Conclusions. Effective Cesarean section on macrosomic infants to prevent dystocia is not recommended because most of them can be delivered vaginally. For the very macrosomic infants ( L 4500 gm), elective Cesarean section is suggested to prevent birth trauma. Transvaginal color flow imaging in the follow-up of invasive gestational trophoblastic disease: A Case Report Jenn-Ming Yang; Kuo-Gon Wang CHIN MED J TAIPEI 1993 51/3 (231-234) A case of invasive gestational trophoblastic disease after partial hydatidiform mole was presented in this study in which the diagnosis was made along with the treatment being monitored by means of transvaginal color Doppler ultrasound. In this case, the appearance or disappearance of vascular changes induced by invasive mole corresponded with serum beta human chorionic gonadotropin @-hCG) titer. Vascular changes displayed on color Doppler scanning may thus complement the application of HCG in postmolar pregnancy surveillance. Selective embryo reduction in multiple pregnancies’ resulting from assisted conception Su-Chee Chen; Fa-Kung Lee; Sheng-Ping Chang; Loy-Lan Too; Li-Ping Shu; Heung-Tat Ng CHIN MED J TAIPEI 1993 5113 (231-234) Background. Assisted conception not only raises the pregnancy rate by treating infertility, but also increases the chance of obstetrical complication of multiple pregnancy. So it is important to develop a means by which the number of developing embryos can be reduced. Methods. Eight multiple pregnant women (from triplets to octuplets) asked to have the number of viable fetuses reduced. By means of sonar guided puncture, a mixture of demerol and xylocaine was injected to the fetal thorax until the fetal heart ceased to beat. The procedures were done between the 7th and I Ith week of gestational age. Repeated scans were done for three consecutive days to confirm the viability of the remaining fetuses. Results. Except for vanishing twins, no serious complication was noted. For six of the women, 10 healthy births have resulted: the remaining two have ongoing pregnancies Conclusions. The procedure described is an easy, safe and effective method to diminish obstetrical morbidity of multiple pregnancy. Effect of peritoneal fluid and serum from patients with endometriosis on mouse embryo in vitro development Chii-Ruey Tzeng; Li-Wei Chien; Shu-Ru Chang; An-Chiun Chen CHIN MED J TAIPEI 1993 51 13 (231-234) Background. The adverse effects on early embryo development as caused by peritoneal fluid exudate and serum from en-
Journul of Gynecology & Obstetrics 48
(1995J
137- 14i
dometriosis patients have been shown, but the underlying mechanism and clinical significance remain unknown. Methods. Peritoneal fluid (PF) and serum (S) from patients with minimal to mild endometriosis (Group A, n = 12), moderate to severe endometriosis (Group B, n = 6). and others including tubal ligation and uterine myoma (Group C. controls, n =6), were obtained during laparoscopy. 5% CO,. 95% air with Two-cell mouse embryos were cultured at 37°C in 5% CO,, 95% air with supplementation of lO%PF+ I’%BS A, loo/OSand IOU/IS+IO%PF in HTF medium. The percentage of progression to the blastocyst stage at 72 and 96 h was observed and compared among the three groups. Result. Serum and peritoneal fluid from infertile patients with moderate to severe endometriosis appeared to be=embryotoxic to the in vitro development of two-cell mouse embryos, but no significant differences were found between minimal to mild endometriosis and group C patients. Conclusions. These data suggest that the production of embryotoxic factor(s) is related to the clinical stage, and may be derived from endometriotic implants. The correlation of the embryotoxic effect of the peritoneal fluid with that of the serum indicated that embryotoxic factor(s) may enter the systemic circulation and impede early embryogenesis in the reproductive tract. The nature and mechanism of this result demand further study. Electroejaculation for the treatment of idiopathic anejaculation: a case report Yin-Chin Ho; Hsiang-Tai Chao; Chuan-Chien Pan; HueiShing Hsu; Sheng-Ping Chang; Heung-Tat Ng CHIN MED J TAIPEI 1993 51/3 (231-234) Electroejaculation to produce semen from anejaculated males has been employed successfully in conjunction with intrauterine insemination (IUI), in vitro fertilization/embryo transfer, and gamete intrafall opian transfer. We herein report the use of IUI to achieve pregnancy following electroejaculation in a patient with primary idiopathic anejaculation. This 30year-old patient had a history of anejaculation that was noted after marriage, but had normal sexual potency and occasional nocturnal emission. Electroejaculation was successfully used to obtain semen. The highly motile sperm was recovered from swing up procedure and used for IUI. The 25-year-old wife was given clomiphene citrate and Pergonal for ovulation induction. A triplet pregnancy was achieved. At 26 weeks of gestation. the first triplet was delivered after spontaneous rupture of membrane. We tried to delay delivery of this retained twin pregnancy. Thirty-two days later, the remaining two fetuses were delivered weighing 1100 gm and 900 gm. Ninety-three days after delivery, these two babies were discharged. putting on weight to 3564 gm and 3264 gm. This case represents the first success of using electroejaculation to achieve pregnancy from anejaculated patient in Taiwan. A case report of repeated paroxysmal supraventricular tachycardia at immediate postpartum Ruey-Jien Chen; Su-Cheng Huang: Song-Nan Chow; DawYuan Chang; Men-Luh Yen; Yuan-Teh Lee J Obstet Gynecol ROC 1993 51!3 (231-234)