Luca Bocciolone

Antiphospholipid antibodies and risk of intrauterine late fetal death

Study objective. Goal of the study was to analyze the relationship between anticardiolipin antibodies lupus anticoagulant and the risk of intrauterine late fetal death. Design. A case‐control study was conducted in a network of general and teaching hospitals in northern Italy. Cases studied were 99 women (median age 27 years), without clinical evidence of systemic lupus erythematosus or other immunological disorders who had an ‘unexplained’ intrauterine fetal death at or after the 20 weeks of gestation. The control subjects tiere 85 women (median age 28 years) who gave birth at term (> 37 weeks gestation) to healthy infants on randomly selected days at the same hospitals where cases had been identified.

Gonadotropin releasing hormone agonist treatment before hysterectomy for menorrhagia and uterine leiomyomas

Objective. To investigate the effect of gonadotropin releasing hormone agonist (goserelin) treatment before hysterectomy for leiomyomata‐associated menorrhagia.

Relief of dysmenorrhea associated with septate uteri after abdominal or hysteroscopic metroplasty

We analyzed the postoperative modifications of dysmenorrhea in 90 patients with septate or subseptate uterus, but no other genital or pelvic disorders, who underwent metroplasty according to Tompkins (n = 28) or hysteroscopic metroplasty (n = 62). The frequency of dysmenorrhea fell from 50% to 32.1% after the Tompkins procedure and from 54.8% to 17.7% after hysteroscopic metroplasty. The severity of dysmenorrhea evaluated with two scales, one linear and one multidimensional, showed a significant postoperative decrease in both the groups. In view of the limited cost and low risks of hysteroscopic metroplasty, primary dysmenorrhea associated with septate or subseptate uterus may be considered an indication for this intervention.

Timing of ovulation in spontaneous and induced cycles

We studied 30 spontaneous cycles, 30 cycles induced with clomiphene citrate, and 30 cycles induced with human menopausal gonadotropin‐human chorionic gonadotropin to evaluate the pattern of the following parameters and their predictive value in timing ovulation: basal body temperature; cervical mucus; mean follicular diameter; serum LH and 17‐β‐estradiol; and urinary LH. Compared with the spontaneous cycles, in the cycles induced with clomiphene citrate the cervical score was significantfy lower on the 4 days preceding ovulation, serum LH was higher in the early follicular phase, and serum 17‐β‐estradiol was significantly higher in the pharmacologically treated cycles. The highest predictive values in all groups of cycles were obtained by considering the following combinations of parameters: serum 17‐β‐estradiol and LH concentrations; mean follicular diameter as shown by ultrasonography and urinary LH as determined by a rapid method.