Pub Date : 2024-07-05DOI: 10.21608/ebwhj.2024.301613.1339
Ayman Dawood, M. Elnamoury, Mahmoud Gehad
{"title":"Nuchal translucency in pregnant women beyond 35 years and its relation to congenital cardiac abnormalities: A cross-section study","authors":"Ayman Dawood, M. Elnamoury, Mahmoud Gehad","doi":"10.21608/ebwhj.2024.301613.1339","DOIUrl":"https://doi.org/10.21608/ebwhj.2024.301613.1339","url":null,"abstract":"","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":" 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2023.241804.1265
Ali Yousef, Tarek Al-Hussaini, mohammed hashem, Dalia Badary
Background and study aims: Fetal histopathology testing is an essential and common part of care for women experiencing miscarriage in the early stages of pregnancy. The study is being carried out to find out the prevalence of chronic histiocytic intervillositis among sporadic & recurrent miscarriage, as well as to evaluate the histological characteristics of products of conception in both types of miscarriage. Materials and Methods: This was a cross-sectional study had been conducted at Women Health Hospital of Assiut University. A total of 300 womens were recruited. Results: Histopathological diagnosis in the current study was product of conception, no product of conception, partial mole and complete mole in 245 (81.7%), 45 (15%), 8 (2.7%) and 2 (0.70%) patients, respectively. Conclusion : The prevelance of CHIV in the current study was rare. So, the need for histopathological evaluation of product of conception for CHIV is controversial. Multiple centers studies with cost analysis are warranted to assess the benefit of this issue.
{"title":"Histopathological evaluation of products of conception in sporadic and recurrent abortions","authors":"Ali Yousef, Tarek Al-Hussaini, mohammed hashem, Dalia Badary","doi":"10.21608/ebwhj.2023.241804.1265","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.241804.1265","url":null,"abstract":"Background and study aims: Fetal histopathology testing is an essential and common part of care for women experiencing miscarriage in the early stages of pregnancy. The study is being carried out to find out the prevalence of chronic histiocytic intervillositis among sporadic & recurrent miscarriage, as well as to evaluate the histological characteristics of products of conception in both types of miscarriage. Materials and Methods: This was a cross-sectional study had been conducted at Women Health Hospital of Assiut University. A total of 300 womens were recruited. Results: Histopathological diagnosis in the current study was product of conception, no product of conception, partial mole and complete mole in 245 (81.7%), 45 (15%), 8 (2.7%) and 2 (0.70%) patients, respectively. Conclusion : The prevelance of CHIV in the current study was rare. So, the need for histopathological evaluation of product of conception for CHIV is controversial. Multiple centers studies with cost analysis are warranted to assess the benefit of this issue.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"67 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2023.244148.1267
suzan el sharkawy, omar khalil, abdulmoniem fawzy, ibrahim elmakhzangy
Background: Cervical cerclage is a commonly performed intervention in the care of women at risk of preterm birth or second-trimester fetal loss to prevent preterm cervical dilatation. Aim: To compare the second trimester trans-vaginal cervical cerclage with conservative management on duration of pregnancy and perinatal outcome. Materials and Methods: This was a randomized controlled clinical trial that included (40) pregnant females attending El-Shatby Maternity University Hospital antenatal care clinic. All cases of group A were subjected to planned cervical cerclage (McDonald) after the 14 th week of gestation by the same surgeon. All cases of group B were subjected to observational management. Both groups did urinalysis and high vaginal swab to detect and treat infection. All cases were subjected to trans-vaginal ultrasound scans at 14, 16 and 18 weeks then every month till delivery to assess viability, internal os diameter, cervical dilatation and length of the cervical canal. Also the time of delivery, process of labor, complications, and fetal outcome were recorded. Results: There was no statistically significant difference in cervical length measurements between the two groups at the gestational ages of 14, 16, 18 and 36 weeks, while at 24, 28 and 32 weeks gestation, the cervical length was longer in group A than group B and this was statistically significant. Also, no statistically significant difference was found between groups regarding timing, termination mode, specific complications observed during pregnancy and labor. Conclusion : There is no evident role for a second trimester trans-vaginal cervical cerclage over conservative management on the duration of pregnancy and perinatal outcome.
{"title":"A Randomized Comparative Study between Second Trimester Cervical Cerclage and Observational Management on Duration of Pregnancy and Perinatal Outcome","authors":"suzan el sharkawy, omar khalil, abdulmoniem fawzy, ibrahim elmakhzangy","doi":"10.21608/ebwhj.2023.244148.1267","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.244148.1267","url":null,"abstract":"Background: Cervical cerclage is a commonly performed intervention in the care of women at risk of preterm birth or second-trimester fetal loss to prevent preterm cervical dilatation. Aim: To compare the second trimester trans-vaginal cervical cerclage with conservative management on duration of pregnancy and perinatal outcome. Materials and Methods: This was a randomized controlled clinical trial that included (40) pregnant females attending El-Shatby Maternity University Hospital antenatal care clinic. All cases of group A were subjected to planned cervical cerclage (McDonald) after the 14 th week of gestation by the same surgeon. All cases of group B were subjected to observational management. Both groups did urinalysis and high vaginal swab to detect and treat infection. All cases were subjected to trans-vaginal ultrasound scans at 14, 16 and 18 weeks then every month till delivery to assess viability, internal os diameter, cervical dilatation and length of the cervical canal. Also the time of delivery, process of labor, complications, and fetal outcome were recorded. Results: There was no statistically significant difference in cervical length measurements between the two groups at the gestational ages of 14, 16, 18 and 36 weeks, while at 24, 28 and 32 weeks gestation, the cervical length was longer in group A than group B and this was statistically significant. Also, no statistically significant difference was found between groups regarding timing, termination mode, specific complications observed during pregnancy and labor. Conclusion : There is no evident role for a second trimester trans-vaginal cervical cerclage over conservative management on the duration of pregnancy and perinatal outcome.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"1625 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2023.243760.1266
Khaled Ismael, Osama Warda, M. Elshamy, Mohamed Abdelhafez
Objective: To describe an Egyptian single tertiary care center experience regarding the incidence, etiology and maternal and perinatal outcomes of pregnancy-related acute kidney injury (PR-AKI). Materials and Methods: This was a retrospective analysis of prospectively collected data of women with AKI admitted to Mansoura University Hospital (MUH) during pregnancy or two weeks postpartum for a pregnancy-or delivery-related cause. All patients were followed up for 3 months from the time of AKI diagnosis in order to assess the maternal outcome (recovery, non-recovery or mortality). Patients who did not require dialysis were compared with those who required dialysis. Results: Over the 1.5-year study period, 18 patients with PR-AKI were admitted to MUH, representing a cumulative incidence of 4.1 per 1000 deliveries. Out of these patients, 10 patients (55.6%) required dialysis while the other 8 patients (44.4%) did not require dialysis. The commonest cause of AKI was severe preeclampsia (50%) and other causes included AFLP (16.7%), hemorrhage (16.7%) and sepsis (16.7%). Thirteen cases (72.2%) had complete recovery of kidney function while 2 cases (11.1%) did not have complete recovery after the 3-months follow up period. Maternal mortality occurred in 3 cases (16.7%) who had sepsis and hemorrhage. Conclusion : Preeclampsia, represent the commonest cause of PR-AKI, and although it has a favorable maternal outcome, the perinatal outcome is very poor. Obstetric hemorrhage had not become the leading cause of PR-AKI, but delayed referral of cases with severe peripartum bleeding, especially when associated with sepsis, is responsible for most of the maternal mortalities.
{"title":"Pregnancy Related Acute Kidney Injury: A Single Tertiary Care Center Experience","authors":"Khaled Ismael, Osama Warda, M. Elshamy, Mohamed Abdelhafez","doi":"10.21608/ebwhj.2023.243760.1266","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.243760.1266","url":null,"abstract":"Objective: To describe an Egyptian single tertiary care center experience regarding the incidence, etiology and maternal and perinatal outcomes of pregnancy-related acute kidney injury (PR-AKI). Materials and Methods: This was a retrospective analysis of prospectively collected data of women with AKI admitted to Mansoura University Hospital (MUH) during pregnancy or two weeks postpartum for a pregnancy-or delivery-related cause. All patients were followed up for 3 months from the time of AKI diagnosis in order to assess the maternal outcome (recovery, non-recovery or mortality). Patients who did not require dialysis were compared with those who required dialysis. Results: Over the 1.5-year study period, 18 patients with PR-AKI were admitted to MUH, representing a cumulative incidence of 4.1 per 1000 deliveries. Out of these patients, 10 patients (55.6%) required dialysis while the other 8 patients (44.4%) did not require dialysis. The commonest cause of AKI was severe preeclampsia (50%) and other causes included AFLP (16.7%), hemorrhage (16.7%) and sepsis (16.7%). Thirteen cases (72.2%) had complete recovery of kidney function while 2 cases (11.1%) did not have complete recovery after the 3-months follow up period. Maternal mortality occurred in 3 cases (16.7%) who had sepsis and hemorrhage. Conclusion : Preeclampsia, represent the commonest cause of PR-AKI, and although it has a favorable maternal outcome, the perinatal outcome is very poor. Obstetric hemorrhage had not become the leading cause of PR-AKI, but delayed referral of cases with severe peripartum bleeding, especially when associated with sepsis, is responsible for most of the maternal mortalities.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"16 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140468185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2024.81715.1143
Abd ELsamie Abd ELsamie, Sahar ElBaradie, Ayman Abd El Wahab, Howaida Abd Elrasoul, Mohamed Bakry
. ABSTRACT Background: Diabetes raises the risk of maternal and neonatal morbidity and mortality. Fetal macrosomia is one of the most common perinatal problems in diabetes pregnancy, particularly in women with poor glycemic control. Aim: Determine the association between maternal serum lipid levels, particularly TG and TC levels, and newborn BW. Also, the ability of TG and TC levels was tested to predict macrosomia. Materials and Methods: This observational cohort study was conducted on 150 pregnant women divided into two groups 75 pregnant women with type2 DM and 75 pregnant women with GDM at 3 rd trimester GA of 29-40 week. The following lipid parameters were measured. Results: There is no statistically significant difference between the type 2DM group compared to GDM group regarding age, height, weight, BMI, F.B.G, 2HPP.BG, HbA1c, parity LDL, neonatal weight and gestational age ( p > 0.05 ). On the other hand, there was a statistically significant difference between the type 2DM and GDM groups regarding TC, TG, and HDL. By applying Spearman’s correlation test, there was a statistically significant positive correlation between neonatal weight and age, TC, TG, and parity in the type 2DM group. Regression analysis defined Neonatal weight development among the type 2DM group as the persistently significant positive predictor for TG. Conclusion: This research demonstrated the utility of measuring fasting serum TG and TC levels measured at third-trimester pregnancy correlated positively with neonatal BW and may be considered an independent predictor of fetal macrosomia at term in type 2DM and GDM.
{"title":"Association Between Maternal Lipid Profile and Fetal Birth Weight in Type 2 Diabetes Mellitus and Gestational Diabetes Mellitus Pregnancies","authors":"Abd ELsamie Abd ELsamie, Sahar ElBaradie, Ayman Abd El Wahab, Howaida Abd Elrasoul, Mohamed Bakry","doi":"10.21608/ebwhj.2024.81715.1143","DOIUrl":"https://doi.org/10.21608/ebwhj.2024.81715.1143","url":null,"abstract":". ABSTRACT Background: Diabetes raises the risk of maternal and neonatal morbidity and mortality. Fetal macrosomia is one of the most common perinatal problems in diabetes pregnancy, particularly in women with poor glycemic control. Aim: Determine the association between maternal serum lipid levels, particularly TG and TC levels, and newborn BW. Also, the ability of TG and TC levels was tested to predict macrosomia. Materials and Methods: This observational cohort study was conducted on 150 pregnant women divided into two groups 75 pregnant women with type2 DM and 75 pregnant women with GDM at 3 rd trimester GA of 29-40 week. The following lipid parameters were measured. Results: There is no statistically significant difference between the type 2DM group compared to GDM group regarding age, height, weight, BMI, F.B.G, 2HPP.BG, HbA1c, parity LDL, neonatal weight and gestational age ( p > 0.05 ). On the other hand, there was a statistically significant difference between the type 2DM and GDM groups regarding TC, TG, and HDL. By applying Spearman’s correlation test, there was a statistically significant positive correlation between neonatal weight and age, TC, TG, and parity in the type 2DM group. Regression analysis defined Neonatal weight development among the type 2DM group as the persistently significant positive predictor for TG. Conclusion: This research demonstrated the utility of measuring fasting serum TG and TC levels measured at third-trimester pregnancy correlated positively with neonatal BW and may be considered an independent predictor of fetal macrosomia at term in type 2DM and GDM.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"822 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2024.268894.1298
Hatem Elgendy, Ali A. Bendary, Samar Mohamed
. ABSTRACT Introduction: An abnormal uterine bleeding condition accounts for one-third of all gynaecological consultations (AUB). Both diagnostic and straightforward surgical hysteroscopies can typically be performed in an office environment. Hysteroscopic surgery can be carried out without the use of anaesthetic or analgesia. Obesity has long been recognised as a major risk factor for the onset of many chronic illnesses, including heart disease, hypertension, type 2 diabetes, stroke, osteoarthritis, and some types of cancer, as well as abnormal uterine bleeding including endometrial cancer, polycystic ovary dysfunctional uterine bleeding. Materials and Methods: The study included 120 cases undergoing hysteroscopic examination and icrrelation of finding to obesity. Results: We found that the correlation between complaint and BMI was as follow: Menorrhagia, polymenorrhagia, metromenorrhagia and premenstrual spots were significant complaint in obese women, while polymenorrhagia was higher but insignificant statically. Fibroid, endometrial polyp, unknown (DUB) and malignancy were significant findings in obese women.endometrial thickness (1-4.9 mm), (10-14.9 mm), (15-19.9 mm) and (more than 20mm) were significant in obese women, while endometrial thickness (5-9.9 mm) was higher but insignificant statically. Simple hyperplasia without atypia, complex hyperplasia without atypia, complex hyperplasia with atypia, atrophic changes and carcinoma were significant in the obese patients, while proliferative, secretory and disorder proliferation were higher in obese patients but insignificant statically. Conclusion : Obesity is strong predisposing factor for abnormal uterine bleeding as there is strong relation between obesity and abnormal uterine bleeding as approved by our study.
{"title":"Hysteroscopic Study in Cases of Peri-menopausal Bleeding and its Correlation with Obesity","authors":"Hatem Elgendy, Ali A. Bendary, Samar Mohamed","doi":"10.21608/ebwhj.2024.268894.1298","DOIUrl":"https://doi.org/10.21608/ebwhj.2024.268894.1298","url":null,"abstract":". ABSTRACT Introduction: An abnormal uterine bleeding condition accounts for one-third of all gynaecological consultations (AUB). Both diagnostic and straightforward surgical hysteroscopies can typically be performed in an office environment. Hysteroscopic surgery can be carried out without the use of anaesthetic or analgesia. Obesity has long been recognised as a major risk factor for the onset of many chronic illnesses, including heart disease, hypertension, type 2 diabetes, stroke, osteoarthritis, and some types of cancer, as well as abnormal uterine bleeding including endometrial cancer, polycystic ovary dysfunctional uterine bleeding. Materials and Methods: The study included 120 cases undergoing hysteroscopic examination and icrrelation of finding to obesity. Results: We found that the correlation between complaint and BMI was as follow: Menorrhagia, polymenorrhagia, metromenorrhagia and premenstrual spots were significant complaint in obese women, while polymenorrhagia was higher but insignificant statically. Fibroid, endometrial polyp, unknown (DUB) and malignancy were significant findings in obese women.endometrial thickness (1-4.9 mm), (10-14.9 mm), (15-19.9 mm) and (more than 20mm) were significant in obese women, while endometrial thickness (5-9.9 mm) was higher but insignificant statically. Simple hyperplasia without atypia, complex hyperplasia without atypia, complex hyperplasia with atypia, atrophic changes and carcinoma were significant in the obese patients, while proliferative, secretory and disorder proliferation were higher in obese patients but insignificant statically. Conclusion : Obesity is strong predisposing factor for abnormal uterine bleeding as there is strong relation between obesity and abnormal uterine bleeding as approved by our study.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"75 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140470060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2023.245173.1269
Sara Hamed, Ayman Shedid, Ghada Abdel-Halim, Ahmed Zainel-Din
Background: Recurrent pregnancy loss (RPL) is a distressing condition affecting women of childbearing age, often with unexplained causes. Pulsatility Index (PI) in uterine arteries has been proposed as a potential diagnostic marker. Objectives: To assess disparities in uterine artery PI between women experiencing recurrent unexplained first-trimester miscarriages and those with no prior history of miscarriage. Study Design: A case-control study. Materials and Methods: A cohort of 100 non-pregnant women was the focus of this research. They were categorized into two distinct groups: the RPL group, denoted as Group A, and the control group, identified as Group B. All participants underwent comprehensive clinical evaluations, including an exhaustive medical history, general health, abdominal and pelvic examinations, in addition to two-dimensional ultrasound assessments and Doppler studies aimed at quantifying the PI of the uterine arteries. Results: A statistically significant variance was observed in PI of the right uterine artery between the RPL group and the control group. The mean PI values were 2.000 (±0.451) and 2.248 (±0.322), respectively. A notable distinction in the PI of the left uterine artery between the RPL group and the control group was also detected ( P-value < 0.05 ). Furthermore, PI values of both the right and left uterine arteries exhibited a statistically significant difference between the RPL and control groups ( P-value < 0.05 ). Conclusion : The mean uterine artery PI value was greater in RPL group in contrast to control group. This suggests an elevated resistance to blood flow within uterine arteries among women who have experienced RPL.
背景：复发性妊娠失败（RPL）是一种影响育龄妇女的令人痛苦的情况，通常原因不明。子宫动脉脉动指数（PI）被认为是一种潜在的诊断指标。研究目的评估复发性不明原因头胎流产妇女与无流产史妇女之间子宫动脉脉动指数的差异。研究设计：病例对照研究。材料与方法：本研究以 100 名非怀孕妇女为研究对象。所有参与者都接受了全面的临床评估，包括详尽的病史、一般健康状况、腹部和盆腔检查，以及旨在量化子宫动脉 PI 的二维超声评估和多普勒研究。结果在统计学上，RPL 组和对照组的右侧子宫动脉 PI 存在明显差异。平均 PI 值分别为 2.000（±0.451）和 2.248（±0.322）。RPL 组与对照组之间子宫左动脉的 PI 值也有显著差异（P 值 < 0.05）。此外，右侧和左侧子宫动脉的 PI 值在 RPL 组和对照组之间也有显著差异（P 值 < 0.05）。结论：与对照组相比，RPL 组的平均子宫动脉 PI 值更高。这表明经历过 RPL 的妇女的子宫动脉血流阻力增大。
{"title":"Study of the Changes of Pulsatility Index (PI) in Uterine Artery in Patients with Recurrent Pregnancy Loss","authors":"Sara Hamed, Ayman Shedid, Ghada Abdel-Halim, Ahmed Zainel-Din","doi":"10.21608/ebwhj.2023.245173.1269","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.245173.1269","url":null,"abstract":"Background: Recurrent pregnancy loss (RPL) is a distressing condition affecting women of childbearing age, often with unexplained causes. Pulsatility Index (PI) in uterine arteries has been proposed as a potential diagnostic marker. Objectives: To assess disparities in uterine artery PI between women experiencing recurrent unexplained first-trimester miscarriages and those with no prior history of miscarriage. Study Design: A case-control study. Materials and Methods: A cohort of 100 non-pregnant women was the focus of this research. They were categorized into two distinct groups: the RPL group, denoted as Group A, and the control group, identified as Group B. All participants underwent comprehensive clinical evaluations, including an exhaustive medical history, general health, abdominal and pelvic examinations, in addition to two-dimensional ultrasound assessments and Doppler studies aimed at quantifying the PI of the uterine arteries. Results: A statistically significant variance was observed in PI of the right uterine artery between the RPL group and the control group. The mean PI values were 2.000 (±0.451) and 2.248 (±0.322), respectively. A notable distinction in the PI of the left uterine artery between the RPL group and the control group was also detected ( P-value < 0.05 ). Furthermore, PI values of both the right and left uterine arteries exhibited a statistically significant difference between the RPL and control groups ( P-value < 0.05 ). Conclusion : The mean uterine artery PI value was greater in RPL group in contrast to control group. This suggests an elevated resistance to blood flow within uterine arteries among women who have experienced RPL.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"153 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2023.245005.1268
Mohamed Ali, Mostafa Hussein, Reham Ali, A. Sobh, Abdelrahman Mahmoud
Aim: To investigate the effectiveness of adding vaginal progesterone to oral omega-3 fatty acids on the birth weight of constitutionally small for gestational age fetuses (SGA). Materials and Methods: The study was a randomized clinical trial conducted from May 2020 to June 2022 at Assiut Woman's Health Hospital, Egypt including pregnant women in singleton fetuses (26-28 weeks) whose pregnancy was associated with constitutionally SGA fetuses. The eligible women were randomized to either group I (oral omega-3 fatty acids group) or group II (vaginal progesterone plus oral omega-3 fatty acids group); given daily till delivery. The primary outcome was the mean birth weight (gm) at the time of delivery. The data were analyzed using an unpaired t-test and the Chi-square test. Results: Eighty women were divided equally into two groups. There was a statistically significant increase in the mean birth weight (gm) at the time of delivery in group II in comparison to group I (1762.74 ± 80.06 vs. 1852.94 ± 71.71, receptively; p=0.000 ). The mean of uterine artery resistant index (RI) has a statistically significant decrease at 32 weeks and 36 weeks ( p value=0.000 ) and the mean of umbilical artery RI has a statistically significant decrease at 36 weeks ( p value=0.001 ) in group II. Conclusion : Adding vaginal progesterone to oral omega-3 fatty acids is superior to oral omega-3 fatty acids alone in increasing the birth weight of constitutionally SGA fetuses when given from 26-28 weeks gestation till delivery. The improvement of the feto-maternal blood flow may be behind the treatment result.
{"title":"The Effect of Adding Vaginal Progesterone to Oral Omega-3 Fatty Acids on the Birth Weight of Constitutionally Small for Gestational Age Fetuses: A Randomized Clinical Trial","authors":"Mohamed Ali, Mostafa Hussein, Reham Ali, A. Sobh, Abdelrahman Mahmoud","doi":"10.21608/ebwhj.2023.245005.1268","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.245005.1268","url":null,"abstract":"Aim: To investigate the effectiveness of adding vaginal progesterone to oral omega-3 fatty acids on the birth weight of constitutionally small for gestational age fetuses (SGA). Materials and Methods: The study was a randomized clinical trial conducted from May 2020 to June 2022 at Assiut Woman's Health Hospital, Egypt including pregnant women in singleton fetuses (26-28 weeks) whose pregnancy was associated with constitutionally SGA fetuses. The eligible women were randomized to either group I (oral omega-3 fatty acids group) or group II (vaginal progesterone plus oral omega-3 fatty acids group); given daily till delivery. The primary outcome was the mean birth weight (gm) at the time of delivery. The data were analyzed using an unpaired t-test and the Chi-square test. Results: Eighty women were divided equally into two groups. There was a statistically significant increase in the mean birth weight (gm) at the time of delivery in group II in comparison to group I (1762.74 ± 80.06 vs. 1852.94 ± 71.71, receptively; p=0.000 ). The mean of uterine artery resistant index (RI) has a statistically significant decrease at 32 weeks and 36 weeks ( p value=0.000 ) and the mean of umbilical artery RI has a statistically significant decrease at 36 weeks ( p value=0.001 ) in group II. Conclusion : Adding vaginal progesterone to oral omega-3 fatty acids is superior to oral omega-3 fatty acids alone in increasing the birth weight of constitutionally SGA fetuses when given from 26-28 weeks gestation till delivery. The improvement of the feto-maternal blood flow may be behind the treatment result.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"149 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.21608/ebwhj.2022.41546.1104
Ahmed Abd El Hamid, Abd El Megeed Abd El Megeed, Rawhia Elsayed, Ahmed Hussein
Background: The CBC is easy tool for pregnant women predicting placental invasion anomalies, Numerous studies proposed that cancer cell invasion has several common features with the trophoblast invasion [1] . The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are recent popular markers for inflammatory response and have been applied as predictive markers and prognostic factors in various gynecological cancers [2] . We found in placenta accreta increasing Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio, decreasing Red cell Distribution Width (RDW), Platelet's count. Aim of the Work: Aim of our study is to assess the relationship between complete blood count parameters and placental invasion anomalies. Materials and Methods: Our study is Prospective cohort study done in Labour ward of Ain Shams University Maternity Hospital. From January 2019 to December 2019. On Pregnant women attended Ain Shams University Maternity Hospital with a placenta previa. This study was done after approval of the ethical committee of the department of obstetrics and gynecology, Faculty of Medicine, Ain Shams University. Informed consent was taken from all participants before recruitment in the study, and after explaining the purpose and procedures of the study. The investigator obtained the written, signed informed consent of each subject prior to performing any study specific procedures on the subject. The investigator retained the original signed informed consent form. All laboratory specimens, evaluation forms, reports, video recordings and other records that left the site did not include unique personal to maintain subject confidentiality. The study was based on the investigator self-funding. The main object was presence of significant differences between groups with and without placental invasion anomaly in terms of age, platelet count, mean platelet volume, red cell distribution width and neutrophil to lymphocyte ratio P<0.05 . Conclusion : There are changes in CBC parameters which can predict placental invasion anomalies such as increase in Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio and decrease in Red cell Distribution Width (RDW), Platelet's count. The cut point's in predicting placenta accreta by complete blood count are. Mean platelet Volume(MPV) ≥ 8,1fl had the highest diagnostic characteristics. Neutrophil / lymphocyte (N/L) ratio ≥4.1. Red cell Distribution Width (RDW) ≤ 16.6%. Platelet's count ≤ 264.0(x103/mL). Recommendations: In suspected cases of placenta accrete by ultrasound, We recommend to evaluate every change in CBC parameters which can predict placental invasion anomalies eg. Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio and Red cell Distribution Width (RDW), Platelet's count.
{"title":"Predictive Value of Complete Blood Countparameters in Placenta Accreta","authors":"Ahmed Abd El Hamid, Abd El Megeed Abd El Megeed, Rawhia Elsayed, Ahmed Hussein","doi":"10.21608/ebwhj.2022.41546.1104","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.41546.1104","url":null,"abstract":"Background: The CBC is easy tool for pregnant women predicting placental invasion anomalies, Numerous studies proposed that cancer cell invasion has several common features with the trophoblast invasion [1] . The neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios are recent popular markers for inflammatory response and have been applied as predictive markers and prognostic factors in various gynecological cancers [2] . We found in placenta accreta increasing Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio, decreasing Red cell Distribution Width (RDW), Platelet's count. Aim of the Work: Aim of our study is to assess the relationship between complete blood count parameters and placental invasion anomalies. Materials and Methods: Our study is Prospective cohort study done in Labour ward of Ain Shams University Maternity Hospital. From January 2019 to December 2019. On Pregnant women attended Ain Shams University Maternity Hospital with a placenta previa. This study was done after approval of the ethical committee of the department of obstetrics and gynecology, Faculty of Medicine, Ain Shams University. Informed consent was taken from all participants before recruitment in the study, and after explaining the purpose and procedures of the study. The investigator obtained the written, signed informed consent of each subject prior to performing any study specific procedures on the subject. The investigator retained the original signed informed consent form. All laboratory specimens, evaluation forms, reports, video recordings and other records that left the site did not include unique personal to maintain subject confidentiality. The study was based on the investigator self-funding. The main object was presence of significant differences between groups with and without placental invasion anomaly in terms of age, platelet count, mean platelet volume, red cell distribution width and neutrophil to lymphocyte ratio P<0.05 . Conclusion : There are changes in CBC parameters which can predict placental invasion anomalies such as increase in Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio and decrease in Red cell Distribution Width (RDW), Platelet's count. The cut point's in predicting placenta accreta by complete blood count are. Mean platelet Volume(MPV) ≥ 8,1fl had the highest diagnostic characteristics. Neutrophil / lymphocyte (N/L) ratio ≥4.1. Red cell Distribution Width (RDW) ≤ 16.6%. Platelet's count ≤ 264.0(x103/mL). Recommendations: In suspected cases of placenta accrete by ultrasound, We recommend to evaluate every change in CBC parameters which can predict placental invasion anomalies eg. Mean platelet Volume(MPV), Neutrophil / lymphocyte (N/L) ratio and Red cell Distribution Width (RDW), Platelet's count.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"343 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
. ABSTRACT Background: Obstetric blood loss is a significant cause of maternal mortality, and it is frequently underestimated and thus inadequately replaced. The most common major operation performed on women worldwide is a caesarean section. Cesarean section (C.S) is mainly linked to varying levels of blood loss. Aim of the Work: Evaluate the effects of intravenous Tranexamic acid (TXA) and sublingual Misoprostol on reducing bleeding during C.S. Materials and Methods: This was a prospective comparative study that was conducted at the obstetrics & gynecology department of Mansoura University Hospital and included one hundred patients with the following inclusion criteria: Elective CS, full-term birth (38-41 weeks), singleton pregnancy, and no medical disorders. Patients with severe medical and surgical conditions associated with pregnancy were excluded. Subjects included in the study were divided into two equal groups as follows: group A included 50 patients who received 400 µg sublingual misοprοѕtol, and Group B included 50 patients who received 1 g Tranexamic acid. Follow up of vital signs, vaginal blood loss, and uterine tone every 30 minutes for 2 hours, then every hour up to 24 h. blood loss was calculated from the suction apparatus that collects blood after delivery of the placenta to exclude parietal blood loss and amniotic fluid, in addition to the surgical towels and mats below patients. A complete blood count was done before and 2 hours post-operative to calculate the haemoglobin and hematocrit deficit. Results: Regarding the vital data, both systolic & diastolic blood pressure of Tranexamic acid were slightly lower than the misοprοѕtol group either after delivery of the placenta or 2 hrs post-operative, but this difference was not statistically significant. Also, the post-operative heart beats were higher in the Tranexamic acid group than in the misοprοѕtol group. The amount of sucked blood from Towels (Blood loss from placental delivery till end of operation) was higher in the Tranexamic Acid group (400.6 ± 37.8 ml) than misοprοѕtol group (389.1 ± 45.7 ml). Also, the weight of the disposable mat (Blood loss from the end of operation till 24 h post-operative) in the Tranexamic Acid group was heavier than in the misοprοѕtol group (641.3 ± 46.7 ml & 510.8 ± 58.8 ml respectively). The difference was statistically significant between both groups regarding the amount of sucked blood from Towels & the Weight of disposable mat ( P= 0.00 & 0.022 respectively). Conclusion : Sublingual 400 µg of Misoprostol before elective cesarean section is a safe, easily administered medication that is associated with decreasing the incidence of PPH without causing complications
{"title":"Sublingual Misoprostol and Intravenous Tranexamic Acid for Reducing Blood Loss during Elective Cesarean Section","authors":"mona ibrahem, lofty sherif, mahmoud thabet, Maher Elesawi","doi":"10.21608/ebwhj.2023.239652.1263","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.239652.1263","url":null,"abstract":". ABSTRACT Background: Obstetric blood loss is a significant cause of maternal mortality, and it is frequently underestimated and thus inadequately replaced. The most common major operation performed on women worldwide is a caesarean section. Cesarean section (C.S) is mainly linked to varying levels of blood loss. Aim of the Work: Evaluate the effects of intravenous Tranexamic acid (TXA) and sublingual Misoprostol on reducing bleeding during C.S. Materials and Methods: This was a prospective comparative study that was conducted at the obstetrics & gynecology department of Mansoura University Hospital and included one hundred patients with the following inclusion criteria: Elective CS, full-term birth (38-41 weeks), singleton pregnancy, and no medical disorders. Patients with severe medical and surgical conditions associated with pregnancy were excluded. Subjects included in the study were divided into two equal groups as follows: group A included 50 patients who received 400 µg sublingual misοprοѕtol, and Group B included 50 patients who received 1 g Tranexamic acid. Follow up of vital signs, vaginal blood loss, and uterine tone every 30 minutes for 2 hours, then every hour up to 24 h. blood loss was calculated from the suction apparatus that collects blood after delivery of the placenta to exclude parietal blood loss and amniotic fluid, in addition to the surgical towels and mats below patients. A complete blood count was done before and 2 hours post-operative to calculate the haemoglobin and hematocrit deficit. Results: Regarding the vital data, both systolic & diastolic blood pressure of Tranexamic acid were slightly lower than the misοprοѕtol group either after delivery of the placenta or 2 hrs post-operative, but this difference was not statistically significant. Also, the post-operative heart beats were higher in the Tranexamic acid group than in the misοprοѕtol group. The amount of sucked blood from Towels (Blood loss from placental delivery till end of operation) was higher in the Tranexamic Acid group (400.6 ± 37.8 ml) than misοprοѕtol group (389.1 ± 45.7 ml). Also, the weight of the disposable mat (Blood loss from the end of operation till 24 h post-operative) in the Tranexamic Acid group was heavier than in the misοprοѕtol group (641.3 ± 46.7 ml & 510.8 ± 58.8 ml respectively). The difference was statistically significant between both groups regarding the amount of sucked blood from Towels & the Weight of disposable mat ( P= 0.00 & 0.022 respectively). Conclusion : Sublingual 400 µg of Misoprostol before elective cesarean section is a safe, easily administered medication that is associated with decreasing the incidence of PPH without causing complications","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"509 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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