Abstract Objectives: To study the correlation between Doppler blood flow and beta-human chorionic gonadotropin (hCG), to assess the course of the disease and the follow up evaluation. Setting: This study was conducted in Assiut University Hospital, Department of Obstetrics and Gynecology. Design: Longitudinal study. Subjects and methods: Fifteen cases of vesicular mole were recruited and followed up. The patients were evaluated the day before evacuation of the uterus. This included clinical assessment, Doppler uterine artery blood flow velocity waveforms using the Doppler indices and assessment of the serum level of beta-hCG. These cases were followed up every 2 weeks in the first 2 months, and every month thereafter until the 6 month. Results: Twelve patients showed continuous decrease in beta-hCG level from 1192+/-697 to 6+/-11 IU/ml by the end of the second month. Systolic-diastolic (S/D) increased from (2.57+/-1.13) to (15.9+/-2.07) (P0.0001), RI increased from 0.55+/-0.15 to 1.0+/-0.26(P0.0001) and PI increased from 1.02+/-0.47 to 6.12+/-2.34 (P0.0001). One patient showed a fluctuating level of beta-hCG around the same level, and two showed a slowed decrease. Doppler indices showed similar results. There is a strong correlation between beta-hCG and all Doppler indices throughout the course of follow up: beta-hCG and S/D r0.01, beta-hCG and RI r0.01 and beta-hCG and PI r0.01. Conclusion: Doppler ultrasound can be used as an adjuvant tool in the follow up of cases of vesicular mole and can predict the progress in the course of the disease.

Abstract Objectives: To study the correlation between Doppler blood flow and beta-human chorionic gonadotropin (hCG), to assess the course of the disease and the follow up evaluation. Setting: This study was conducted in Assiut University Hospital, Department of Obstetrics and Gynecology. Design: Longitudinal study. Subjects and methods: Fifteen cases of vesicular mole were recruited and followed up. The patients were evaluated the day before evacuation of the uterus. This included clinical assessment, Doppler uterine artery blood flow velocity waveforms using the Doppler indices and assessment of the serum level of beta-hCG. These cases were followed up every 2 weeks in the first 2 months, and every month thereafter until the 6 month. Results: Twelve patients showed continuous decrease in beta-hCG level from 1192+/-697 to 6+/-11 IU/ml by the end of the second month. Systolic-diastolic (S/D) increased from (2.57+/-1.13) to (15.9+/-2.07) (P0.0001), RI increased from 0.55+/-0.15 to 1.0+/-0.26(P0.0001) and PI increased from 1.02+/-0.47 to 6.12+/-2.34 (P0.0001). One patient showed a fluctuating level of beta-hCG around the same level, and two showed a slowed decrease. Doppler indices showed similar results. There is a strong correlation between beta-hCG and all Doppler indices throughout the course of follow up: beta-hCG and S/D r0.01, beta-hCG and RI r0.01 and beta-hCG and PI r0.01. Conclusion: Doppler ultrasound can be used as an adjuvant tool in the follow up of cases of vesicular mole and can predict the progress in the course of the disease.

Abstract Objectives: To study the correlation between Doppler blood flow and beta-human chorionic gonadotropin (hCG), to assess the course of the disease and the follow up evaluation. Setting: This study was conducted in Assiut University Hospital, Department of Obstetrics and Gynecology. Design: Longitudinal study. Subjects and methods: Fifteen cases of vesicular mole were recruited and followed up. The patients were evaluated the day before evacuation of the uterus. This included clinical assessment, Doppler uterine artery blood flow velocity waveforms using the Doppler indices and assessment of the serum level of beta-hCG. These cases were followed up every 2 weeks in the first 2 months, and every month thereafter until the 6 month. Results: Twelve patients showed continuous decrease in beta-hCG level from 1192+/-697 to 6+/-11 IU/ml by the end of the second month. Systolic-diastolic (S/D) increased from (2.57+/-1.13) to (15.9+/-2.07) (P0.0001), RI increased from 0.55+/-0.15 to 1.0+/-0.26(P0.0001) and PI increased from 1.02+/-0.47 to 6.12+/-2.34 (P0.0001). One patient showed a fluctuating level of beta-hCG around the same level, and two showed a slowed decrease. Doppler indices showed similar results. There is a strong correlation between beta-hCG and all Doppler indices throughout the course of follow up: beta-hCG and S/D r0.01, beta-hCG and RI r0.01 and beta-hCG and PI r0.01. Conclusion: Doppler ultrasound can be used as an adjuvant tool in the follow up of cases of vesicular mole and can predict the progress in the course of the disease.

Abstract Objectives: To study the correlation between Doppler blood flow and beta-human chorionic gonadotropin (hCG), to assess the course of the disease and the follow up evaluation. Setting: This study was conducted in Assiut University Hospital, Department of Obstetrics and Gynecology. Design: Longitudinal study. Subjects and methods: Fifteen cases of vesicular mole were recruited and followed up. The patients were evaluated the day before evacuation of the uterus. This included clinical assessment, Doppler uterine artery blood flow velocity waveforms using the Doppler indices and assessment of the serum level of beta-hCG. These cases were followed up every 2 weeks in the first 2 months, and every month thereafter until the 6 month. Results: Twelve patients showed continuous decrease in beta-hCG level from 1192+/-697 to 6+/-11 IU/ml by the end of the second month. Systolic-diastolic (S/D) increased from (2.57+/-1.13) to (15.9+/-2.07) (P0.0001), RI increased from 0.55+/-0.15 to 1.0+/-0.26(P0.0001) and PI increased from 1.02+/-0.47 to 6.12+/-2.34 (P0.0001). One patient showed a fluctuating level of beta-hCG around the same level, and two showed a slowed decrease. Doppler indices showed similar results. There is a strong correlation between beta-hCG and all Doppler indices throughout the course of follow up: beta-hCG and S/D r0.01, beta-hCG and RI r0.01 and beta-hCG and PI r0.01. Conclusion: Doppler ultrasound can be used as an adjuvant tool in the follow up of cases of vesicular mole and can predict the progress in the course of the disease.

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Abstract Objectives: To present a series of women with recurrent molar pregnancies, including rare familial cases, and discuss etiology and treatment options. Methods: We performed a detailed clinical evaluation and pedigree analysis of five Egyptian women with recurrent pregnancy loss due to molar pregnancy. Results: The women had a history of four to nine consecutive hydatidiform moles but of no viable pregnancies. Two of the women had molar pregnancies with different husbands who themselves had viable offspring from previous wives; and three of them, who belonged to a family with extensive intermarriage, had a pedigree consistent with an autosomal recessive maternal-effect mutation. Conclusions: Recurrent pregnancy loss due to habitual molar pregnancy is uncommon and familial cases are extremely rare. The etiology of this disorder is not well understood but likely results from a maternal-effect mutation. Management options are limited, especially for couples who desire to have their own genetic offspring.

Abstract Objectives: To present a series of women with recurrent molar pregnancies, including rare familial cases, and discuss etiology and treatment options. Methods: We performed a detailed clinical evaluation and pedigree analysis of five Egyptian women with recurrent pregnancy loss due to molar pregnancy. Results: The women had a history of four to nine consecutive hydatidiform moles but of no viable pregnancies. Two of the women had molar pregnancies with different husbands who themselves had viable offspring from previous wives; and three of them, who belonged to a family with extensive intermarriage, had a pedigree consistent with an autosomal recessive maternal-effect mutation. Conclusions: Recurrent pregnancy loss due to habitual molar pregnancy is uncommon and familial cases are extremely rare. The etiology of this disorder is not well understood but likely results from a maternal-effect mutation. Management options are limited, especially for couples who desire to have their own genetic offspring.

Abstract Objective: To study the serum levels and correlation of vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF-1), hormonal profile, and Doppler blood flow changes within the ovarian stroma before and after laparoscopic ovarian drilling (LOD) in women with clomiphene-resistant polycystic ovary syndrome (PCOS). Design: Prospective controlled study. Setting: University teaching hospital. Patient(s): Twenty-five women with clomiphene-resistant PCOS (group 1) and 20 women with regular menstrual cycles as a comparison group (group 2). Intervention(s): Laparoscopic ovarian drilling. Main outcome measure(s): Serum levels of VEGF, IGF-1, and Doppler indices of ovarian stromal blood flow. Result(s): The serum levels of VEGF, IGF-1, T, and LH were significantly higher in group 1 before LOD than in group 2. The Doppler indices (pulsatility index and resistance index) of ovarian stromal blood flow were also significantly lower in group 1 before LOD than in group 2. The serum levels of VEGF, T, and LH were significantly reduced in group 1 after LOD compared with in group 1 before LOD. Doppler indices (pulsatility index and resistance index) of ovarian stromal blood flow were significantly increased after LOD. The VEGF levels before LOD were positively correlated with IGF-1, LH, and T. After LOD, the VEGF levels were positively correlated with LH and T. Conclusion(s): Higher serum levels of VEGF and IGF-1 may explain the increased vascularity that was demonstrated by Doppler blood flow measurements in PCOS. Laparoscopic ovarian drilling reduced serum VEGF, IGF-1, T, and LH and reduced ovarian blood flow velocities, which may explain the reduction of ovarian hyperstimulation syndrome in women with PCOS after LOD.