We sought to determine whether neonatal complications are less frequent in gestational diabetes mellitus (GDM) than in overt maternal diabetes (DM), and whether these complications are related to degree of maternal glycemic control during pregnancy. Obstetric and diabetic management was provided at a university hospital. Maternal glycemic control was monitored with hemoglobin (Hb) A lc determinations. Neonatal complications were somewhat more frequent in the DM group than in the GDM group, but except for congenital anomalies the difference was not statistically significant. Maternal HbA lc levels ≥6 % were associated with some apparent excess of neonatal complications, again falling short of statistical significance. In conclusions, glycemic control in born GDM and DM is likely to be important in minimizing risk of neonatal complications, since occurrence rates were similarly high in GDM and DM.
Ovarian hyperstimulation syndrome (OHSS) is almost cases an iatrogenic complication. Severe OHSS is characterised by ovarian enlargement, ascites, electrolyte imbalance, hypovolemia, and hemoconcentration. The pathophysiologic factors of this syndrome are not well known. It has been observed that paracentesis is efficacious, provided that care is taken to reinfuse protein lost in the peritoneal exudate. For this reason, in two patients with severe OHSS, we used a dialytic technique of reinfusing concentrated ascitic fluid. Here, we report two cases of severe OHSS following IVF with massive ascites in which we reinfused concentrated ascites by ultrafiltration. Through sonography-guided paracentesis, the ascitic fluid was concentrated by ultrafiltration and reinfused. The concentrated fluid was returned to the peripheral vein. In these patients, a progressive increase of diuresis was evident during treatment and subjective improvement was almost immediate. After treatment, hematologic and biochemical parameters had returned to normal limits. In treating severe OHSS, we have used the technique of reinfusing of concentrated ascitic fluid to avoid protein depletion induced by paracentesis. We were able to successfully restore to normal the hematological and biochemical imbalance with one treatment. Treatment of OHSS with this ultrafiltration and reinfusion method may help to resolve serious cases of OHSS and to treat severe OHSS.
Extracorporeal shock wave lithotripsy (ESWL) is one of the treatments for sialolithiasis without surgical excision. ESWL applies for a patient who is in primary condition of sialolith internal submandibular gland. As the device of ESWL, there are EDAP LT-01 and EDAP LT-02. LT-01 is a former device and LT-02 is a improved device. These device like LT-01 and LT-02 make ESWL treatment more effective, especially, a improved device LT-02. LT-02 has been already used in urology, but there are not many reported about using LT-02 in silolithiasis case. However, LT-02 gives the operation promptly, makes the angle of focusing exactly, and shows a precise of echo imaging. All the reasons have proven that LT-02 has better effectual device on the lithotripsy than LT-01 in the field of urology. This report is our experiment about ESWL for sialolith internal submandibular gland using LT-02. We experience with a client who is 26 year-old female. She complains of the pain for swelling in the left side of digastric triangle. She has the treatment of ESWL and is recovered from her chief complain. As a result of our experiment, we think that ESWL using LT-02 has more effectual device for the treatment of sialolith internal submandibular gland than a former device LT-01.