Pub Date : 2023-11-01DOI: 10.21608/ebwhj.2023.240939.1264
sherwat shawky, ashraf samir, Amira Elgamel, abd elgany hassan
Introduction: Abnormal placentation leading to obstetric haemorrhage is a major obstetric emergency. Due to an increase in the number of cesarean sections over the past few years, the Incidence of placenta accreta spectrum has considerably grown. We aimed at evaluation of the predictability of simple ultrasound staging system in the women at high risk for placenta accreta spectrum through a prospective observational study. Materials and Methods: The study was a prospective observational cohort. It was conducted in Beni-Suef University Hospitals. It included one hundred and twenty-one pregnant women in 3rd pregnancy trimester and at high risk for placenta accreta spectrum. The examination of all women by transvaginal or transabdominal ultrasound was based on a staging system according to the American Institute of Ultrasound in Medicine “AIUM” developed in 2015. This staging system used simple ultrasound parameters of myometrial placental invasion. Ultrasound staging was done among the participating women. The surgical team documented intraoperative findings and complications in patients’ files postoperatively. The simple descriptive analysis in the form of numbers, percentages & arithmetic means was used for qualitative data. The Student t-Test was used to compare measurements of two independent groups for quantitative parametric data. Results: The placenta was inseparable intraoperatively in 35 women (28.9%). The number of past caesarean sections & gestational age at time of caesarean delivery were associated with intra-operative placental invasion ( p value 0.0001 and 0.01 respectively). Ultrasound staging prediction for placental invasion was 100%. Conclusion: Ultrasound staging of the women at risk of placenta accreta spectrum has a very high predictability and strongly avoids adverse maternal and fetal outcomes through antepartum multidisciplinary delivery planning.
{"title":"Efficacy of Simple Ultrasound Staging System in Prediction of Placenta Accreta Spectrum","authors":"sherwat shawky, ashraf samir, Amira Elgamel, abd elgany hassan","doi":"10.21608/ebwhj.2023.240939.1264","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.240939.1264","url":null,"abstract":"Introduction: Abnormal placentation leading to obstetric haemorrhage is a major obstetric emergency. Due to an increase in the number of cesarean sections over the past few years, the Incidence of placenta accreta spectrum has considerably grown. We aimed at evaluation of the predictability of simple ultrasound staging system in the women at high risk for placenta accreta spectrum through a prospective observational study. Materials and Methods: The study was a prospective observational cohort. It was conducted in Beni-Suef University Hospitals. It included one hundred and twenty-one pregnant women in 3rd pregnancy trimester and at high risk for placenta accreta spectrum. The examination of all women by transvaginal or transabdominal ultrasound was based on a staging system according to the American Institute of Ultrasound in Medicine “AIUM” developed in 2015. This staging system used simple ultrasound parameters of myometrial placental invasion. Ultrasound staging was done among the participating women. The surgical team documented intraoperative findings and complications in patients’ files postoperatively. The simple descriptive analysis in the form of numbers, percentages & arithmetic means was used for qualitative data. The Student t-Test was used to compare measurements of two independent groups for quantitative parametric data. Results: The placenta was inseparable intraoperatively in 35 women (28.9%). The number of past caesarean sections & gestational age at time of caesarean delivery were associated with intra-operative placental invasion ( p value 0.0001 and 0.01 respectively). Ultrasound staging prediction for placental invasion was 100%. Conclusion: Ultrasound staging of the women at risk of placenta accreta spectrum has a very high predictability and strongly avoids adverse maternal and fetal outcomes through antepartum multidisciplinary delivery planning.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139297584","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 : 2023-11-01DOI: 10.21608/ebwhj.2023.196608.1238
Andrew Samy, Ahmed Abd El Aleem, Ahmed Abu-El Hassan
Aim of Work: To investigate the maternal and neonatal outcomes after using metformin among obese non diabetic Egyptian women. Study design: A case control, open label randomized controlled trial. Methods: A case control, open label randomized controlled trial study was conducted on 178 pregnant – 11 to 16 weeks – obese (Body mass index ≥ 30 kg/m 2 ) non diabetic females. Our populations` cohort were equally randomized into 2 groups, cases – who were subjected to receive metformin from the date of recruitment till termination of pregnancy – and controls – who received nothing – with follow up of the maternal glucose levels and documenting the maternal and fetal outcomes. Results: Metformin appeared to have a good patient acceptability with a less weight gain during enrollment of the trial among the pregnant females with a better glycemic control. There is no difference between the 2 groups regarding incidence of developing GDM, gestational hypertension and fetal macrosomia. Conclusion: Using metformin for obese non diabetic females, from the second trimester of pregnancy can reduce the maternal weight gain during pregnancy and provide a better glycemic control with no increase in perinatal and maternal complications.
{"title":"Maternal and Fetal Outcomes with Metformin Therapy for Obese Pregnant Women A Randomized Control Trial","authors":"Andrew Samy, Ahmed Abd El Aleem, Ahmed Abu-El Hassan","doi":"10.21608/ebwhj.2023.196608.1238","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.196608.1238","url":null,"abstract":"Aim of Work: To investigate the maternal and neonatal outcomes after using metformin among obese non diabetic Egyptian women. Study design: A case control, open label randomized controlled trial. Methods: A case control, open label randomized controlled trial study was conducted on 178 pregnant – 11 to 16 weeks – obese (Body mass index ≥ 30 kg/m 2 ) non diabetic females. Our populations` cohort were equally randomized into 2 groups, cases – who were subjected to receive metformin from the date of recruitment till termination of pregnancy – and controls – who received nothing – with follow up of the maternal glucose levels and documenting the maternal and fetal outcomes. Results: Metformin appeared to have a good patient acceptability with a less weight gain during enrollment of the trial among the pregnant females with a better glycemic control. There is no difference between the 2 groups regarding incidence of developing GDM, gestational hypertension and fetal macrosomia. Conclusion: Using metformin for obese non diabetic females, from the second trimester of pregnancy can reduce the maternal weight gain during pregnancy and provide a better glycemic control with no increase in perinatal and maternal complications.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139298353","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 : 2023-11-01DOI: 10.21608/ebwhj.2023.43351.1111
Sara Eldessouky, Rana Abdella, Hassan Gaafar, Mona Fouad, Sherin Sobh, Maha Eid, Ebtesam Abdalla, Alaa Na Ebrashy, Dalia Zolfokar
Objective: To describe the prenatal findings, associated anomalies, chromosomal abnormalities of fetuses with ventral wall defects (VWDs). Methods: Detailed fetal anomaly scan, postnatal assessment, and chromosomal analysis were performed in 200 fetuses with VWDs. Results: The omphalocele subtype was the most frequently encountered with 121 cases (60%), among them Pentalogy of Cantrell (POC) and OEIS complex (omphalocele, exstrophy of bladder, imperforate anus, spinal defects) were presented in 6 cases and 5 cases, respectively. The second most common variety was gastroschisis in 63 cases (31.5%). Additionally, 12 fetuses were found to have body stalk anomaly, while ectopia cordis and bladder exstrophy each were detected in 2 fetuses. Abnormal karyotype was found in 93 cases (49.4 %); the most frequently was trisomy 18(64.5%) followed by trisomy 13 (22.5%), trisomy 21(5.37%) and 45,X (4.3%). One case of POC had ring chromosome 13 karyotyping, one case with ectopia cordis had 45,X and a case of body stalk anomaly with sacrocooygeal teratoma was associated with monosmy 21. Major structural anomalies were detected in 104 cases (86%) with omphalocele and 22 cases (34.9%) with gastroschisis. Conclusion: Our study highlights the clinical and genetic heterogeneity of VWD especially the severe forms.
{"title":"Prenatal Diagnosis of Fetal Ventral Wall Defects: Associated Anomalies and Chromosomal Aberrations","authors":"Sara Eldessouky, Rana Abdella, Hassan Gaafar, Mona Fouad, Sherin Sobh, Maha Eid, Ebtesam Abdalla, Alaa Na Ebrashy, Dalia Zolfokar","doi":"10.21608/ebwhj.2023.43351.1111","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.43351.1111","url":null,"abstract":"Objective: To describe the prenatal findings, associated anomalies, chromosomal abnormalities of fetuses with ventral wall defects (VWDs). Methods: Detailed fetal anomaly scan, postnatal assessment, and chromosomal analysis were performed in 200 fetuses with VWDs. Results: The omphalocele subtype was the most frequently encountered with 121 cases (60%), among them Pentalogy of Cantrell (POC) and OEIS complex (omphalocele, exstrophy of bladder, imperforate anus, spinal defects) were presented in 6 cases and 5 cases, respectively. The second most common variety was gastroschisis in 63 cases (31.5%). Additionally, 12 fetuses were found to have body stalk anomaly, while ectopia cordis and bladder exstrophy each were detected in 2 fetuses. Abnormal karyotype was found in 93 cases (49.4 %); the most frequently was trisomy 18(64.5%) followed by trisomy 13 (22.5%), trisomy 21(5.37%) and 45,X (4.3%). One case of POC had ring chromosome 13 karyotyping, one case with ectopia cordis had 45,X and a case of body stalk anomaly with sacrocooygeal teratoma was associated with monosmy 21. Major structural anomalies were detected in 104 cases (86%) with omphalocele and 22 cases (34.9%) with gastroschisis. Conclusion: Our study highlights the clinical and genetic heterogeneity of VWD especially the severe forms.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139303843","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 : 2023-11-01DOI: 10.21608/ebwhj.2023.211176.1249
Ahmed Ramy, Tarek Rafaat, Ahmed Abdel Hameed, Ikran Haji
Background: The causes of female infertility are different and include genetic and anatomic abnormalities as well as endocrine and autoimmune disorders (ADs). Vitamin D might influence steroidogenesis of both estradiol and progesterone in healthy women where low levels of 25(OH)D levels might be associated with infertility. Aim of the Work: To elucidate if there is relationship between vitamin D and unexplained infertility and if it more prevalent in them. Patients and Methods: This case-control study was conducted at Ain Shams University Maternity Hospital during the period between October 2018-april 2019. A total of 70 women with prior history of unexplained infertility were included as group A (study group). A Second set of 70 fertile control group were included as group B (control group). Results: Our study indicated that 25(OH) vitamin-D was significant lower in unexplained infertility group than control group (according to vitamin D level 39 out of 70 in unexplained infertility patient (55.7) had deficiency, while 30(42.9%) had insufficiency and 1(1.4) had sufficiency, in comparison to control group 21(30.0%) had deficiency, while 43(61.4) had insufficiency and 6(8.6%) had sufficiency), there were no significant correlation between 25(OH) vitamin D and age and BMI. Conclusion: Vitamin-D deficiency had a role in unexplained infertility, nevertheless it is not a good diagnostic test.
背景：导致女性不孕的原因多种多样，包括遗传和解剖异常以及内分泌和自身免疫性疾病（ADs）。维生素 D 可能会影响健康女性体内雌二醇和孕酮的类固醇生成，而 25(OH)D 水平过低可能与不孕症有关。工作目的阐明维生素 D 与不明原因不孕症之间是否存在关系，以及这种关系是否在不明原因不孕症中更为普遍。患者和方法：这项病例对照研究于 2018 年 10 月至 2019 年 4 月期间在艾因夏姆斯大学妇产医院进行。共纳入 70 名曾有不明原因不孕史的妇女作为 A 组（研究组）。第二组 70 名可育对照组被列为 B 组（对照组）。研究结果我们的研究表明，不明原因不孕症组的 25（OH）维生素-D 水平明显低于对照组（根据维生素 D 水平，70 名不明原因不孕症患者中有 39 人（55.7%）缺乏维生素 D，30 人（42.9%）不足，1（1.4）充足；与对照组相比，21（30.0%）不足，43（61.4）不足，6（8.6%）充足。结论维生素 D 缺乏在不明原因的不孕症中起着一定的作用，但它并不是一个很好的诊断测试。
{"title":"Association Between Vitamin D Deficiency and Unexplained Infertility","authors":"Ahmed Ramy, Tarek Rafaat, Ahmed Abdel Hameed, Ikran Haji","doi":"10.21608/ebwhj.2023.211176.1249","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.211176.1249","url":null,"abstract":"Background: The causes of female infertility are different and include genetic and anatomic abnormalities as well as endocrine and autoimmune disorders (ADs). Vitamin D might influence steroidogenesis of both estradiol and progesterone in healthy women where low levels of 25(OH)D levels might be associated with infertility. Aim of the Work: To elucidate if there is relationship between vitamin D and unexplained infertility and if it more prevalent in them. Patients and Methods: This case-control study was conducted at Ain Shams University Maternity Hospital during the period between October 2018-april 2019. A total of 70 women with prior history of unexplained infertility were included as group A (study group). A Second set of 70 fertile control group were included as group B (control group). Results: Our study indicated that 25(OH) vitamin-D was significant lower in unexplained infertility group than control group (according to vitamin D level 39 out of 70 in unexplained infertility patient (55.7) had deficiency, while 30(42.9%) had insufficiency and 1(1.4) had sufficiency, in comparison to control group 21(30.0%) had deficiency, while 43(61.4) had insufficiency and 6(8.6%) had sufficiency), there were no significant correlation between 25(OH) vitamin D and age and BMI. Conclusion: Vitamin-D deficiency had a role in unexplained infertility, nevertheless it is not a good diagnostic test.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302387","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 : 2023-11-01DOI: 10.21608/ebwhj.2023.223472.1257
hany elbehery, maher hassan, mohamed elgareeb, Emad Ahmed Fyala Fyala
Objective: Evaluation of the effect of uterine cooling during caesarean section on both, amount of blood loss and incidence of uterine atony. Method: This prospective randomized controlled study was conducted at Mansoura University Hospital, Obstetrics and Gynecology Department in the period from June 2017 to June 2018, included 220 patients who underwent delivery by caesarean section. All women included in the study were randomized into two equal groups; half of these patients were randomly assigned to uterine cooling after delivery of the fetus and placenta using cold saline. The other half of these patients, caesarean section was done in the usual manner. The amounts of blood loss were calculated for all patients during and after caesarean section. Also the occurrences of uterine atony were noticed on both groups. Data was regestrated for statistical analyses. Results: There were no significant difference between both groups as regard of age, gravidity, parity, gestational age, no of previous caesarean section, preoperative hemoglobin level and hematocrit values . The total amounts of blood loss during and after caesarean section was significantly low in cooling group P value (<0.001). Although atonic postpartum hemorrhage was lower in cooling group (3 cases 2.7 %) versus (10 cases 9.1%) in non-cooling group, it was not statistically significant P value (0.53). Conclusions: Uterine cooling by iced saline decrease total blood loss and decrease incidence of atonic PPH.
{"title":"Uterine Cooling During Cesarean Section an Attempt to Reduce Blood Loss and Atonic Post-Partum Hemorrhage","authors":"hany elbehery, maher hassan, mohamed elgareeb, Emad Ahmed Fyala Fyala","doi":"10.21608/ebwhj.2023.223472.1257","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.223472.1257","url":null,"abstract":"Objective: Evaluation of the effect of uterine cooling during caesarean section on both, amount of blood loss and incidence of uterine atony. Method: This prospective randomized controlled study was conducted at Mansoura University Hospital, Obstetrics and Gynecology Department in the period from June 2017 to June 2018, included 220 patients who underwent delivery by caesarean section. All women included in the study were randomized into two equal groups; half of these patients were randomly assigned to uterine cooling after delivery of the fetus and placenta using cold saline. The other half of these patients, caesarean section was done in the usual manner. The amounts of blood loss were calculated for all patients during and after caesarean section. Also the occurrences of uterine atony were noticed on both groups. Data was regestrated for statistical analyses. Results: There were no significant difference between both groups as regard of age, gravidity, parity, gestational age, no of previous caesarean section, preoperative hemoglobin level and hematocrit values . The total amounts of blood loss during and after caesarean section was significantly low in cooling group P value (<0.001). Although atonic postpartum hemorrhage was lower in cooling group (3 cases 2.7 %) versus (10 cases 9.1%) in non-cooling group, it was not statistically significant P value (0.53). Conclusions: Uterine cooling by iced saline decrease total blood loss and decrease incidence of atonic PPH.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139292022","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 : 2023-11-01DOI: 10.21608/ebwhj.2023.44462.1112
Abd El-Haseib Saad, Said Saleh, Asmaa Mahmoud El-Melih, Mohamed Sayer Dayer
Objectives: To compare the effects of Letrozole and Tamoxifen for induction of ovulation in clomiphene citrate resistant women with Polycystic Ovarian syndrome. Patients and Methods: A prospective randomized study was conducted in the Department of Obstetrics & Gynecology of Menoufia University Hospital. The study was carried out on 80 clomiphene citrate resistant women with polycystic ovary syndrome divided into Group (1): received letrozole 2,5 mg tab orally twice per day from day 3 to day 7 of the menstrual cycle for three successive cycles (40 women, odd numbers). Group (2): received Tamoxifen 20 mg tab once per day from day 3 to day 7 of the menstrual cycle for three successive cycles (40 women, even numbers). In both groups, 10000 IU hCG was administrated when at least one mature follicle more than 18mm was observed during folliculometry. Results: The mean number of follicles (≥18 mm) was higher in letrozole than tamoxifen group. Ovulation rate was significantly higher in letrozole than tamoxifen group (52.5% vs 20% ) .There were no statistically significant differences between both groups regarding pregnancy rate. Conclusion: Letrozole was eminent than tamoxifen in achieving a higher ovulation rate and should be considered for clomiphene
{"title":"Letrozole Versus Tomoxifen in Infertile Woman with Clomiphene Citrate Resistant Polycystic Ovarian Syndrome","authors":"Abd El-Haseib Saad, Said Saleh, Asmaa Mahmoud El-Melih, Mohamed Sayer Dayer","doi":"10.21608/ebwhj.2023.44462.1112","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.44462.1112","url":null,"abstract":"Objectives: To compare the effects of Letrozole and Tamoxifen for induction of ovulation in clomiphene citrate resistant women with Polycystic Ovarian syndrome. Patients and Methods: A prospective randomized study was conducted in the Department of Obstetrics & Gynecology of Menoufia University Hospital. The study was carried out on 80 clomiphene citrate resistant women with polycystic ovary syndrome divided into Group (1): received letrozole 2,5 mg tab orally twice per day from day 3 to day 7 of the menstrual cycle for three successive cycles (40 women, odd numbers). Group (2): received Tamoxifen 20 mg tab once per day from day 3 to day 7 of the menstrual cycle for three successive cycles (40 women, even numbers). In both groups, 10000 IU hCG was administrated when at least one mature follicle more than 18mm was observed during folliculometry. Results: The mean number of follicles (≥18 mm) was higher in letrozole than tamoxifen group. Ovulation rate was significantly higher in letrozole than tamoxifen group (52.5% vs 20% ) .There were no statistically significant differences between both groups regarding pregnancy rate. Conclusion: Letrozole was eminent than tamoxifen in achieving a higher ovulation rate and should be considered for clomiphene","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139296260","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}
Background: Emerging data identifies critical roles for vitamin D and many areas of medicine are involved: regulation of cellular growth, immunity, central nervous system, cardiovascular diseases, and reproduction. Objective: To determine the impact of serum vitamin D level on ICSI cycle outcome. Design: A prospective cohort study. Methods: Patients who will undergo ICSI cycle with age ≤ 38 years , adequate ovarian reserve were included in this study., women with poor ovarian reserve and patients with freeze all cycles were excluded. Vitamin D Serum samples were obtained On the day of the ovum pick-up, participants were divided into 2 groups :Deficiency: (serum vitamin D ≤30ng/ml), Sufficiency: (serum vitamin D≥30ng/ml ).Quantitative B-hCG was done 14 days after emberyo transfer Result : A total of 135 women were included in the study after undergoing ICSI , women were divided into two groups as following :Group A:(n = 68) with serum vitamin D level ≥30 ng/ml and Group B:(n = 67) with serum vitamin D level < 30 ng/ml at day of ovum pick-up.. pregnancy was significantly higher in group A (76.5 %) compared to group B (58.2 %) with P-value < 0.05. With regards to pregnancy continuation there was significant increase in ongoing pregnancy among group A (88.5 %) compared to group B (61.5 %) and significant decrease in the number of aborted cases among group A (11.5 %) compared to group B (38.5 %) with P-value < 0.05. Conclusions: Vitamin D serum level may play a role in ICSI cycle out come . and it seems to valuable to adjust its level in patients with deficiency before starting their ICSI cycle.
背景：新的数据表明，维生素 D 具有重要作用，涉及许多医学领域：细胞生长调节、免疫、中枢神经系统、心血管疾病和生殖。目的确定血清维生素 D 水平对 ICSI 周期结果的影响。设计：前瞻性队列研究。研究方法：采用前瞻性队列研究：将年龄小于 38 岁、卵巢储备充足、将接受卵胞浆内单精子显微注射（ICSI）周期的患者纳入本研究。获取维生素 D 血清样本 取卵当天，参与者被分为两组：缺乏组（血清维生素 D≤30ng/ml ）和充足组（血清维生素 D≥30ng/ml ）。结果：共有 135 名妇女接受了卵胞浆内单精子显微注射（ICSI），并被分为以下两组：A 组：（n = 68）取卵当天血清维生素 D 水平≥30 毫微克/毫升；B 组：（n = 67）取卵当天血清维生素 D 水平＜30 毫微克/毫升。 A 组的妊娠率（76.5%）明显高于 B 组（58.2%），P 值＜0.05。在继续妊娠方面，与 B 组（61.5%）相比，A 组（88.5%）的继续妊娠率明显增加；与 B 组（38.5%）相比，A 组（11.5%）的流产率明显下降，P 值小于 0.05。结论维生素 D 血清水平可能对卵胞浆内单精子显微注射周期的结果有影响，因此在卵胞浆内单精子显微注射周期开始前调整维生素 D 缺乏症患者的血清水平似乎很有价值。
{"title":"Impact of Vitamin D Deficiency on ICSI cycle Outcome","authors":"Amany Abdel Ghany, Shahenda Saleh, Abeer Omran, Samar Sharaf, Amr Aboelfath","doi":"10.21608/ebwhj.2023.177236.1225","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.177236.1225","url":null,"abstract":"Background: Emerging data identifies critical roles for vitamin D and many areas of medicine are involved: regulation of cellular growth, immunity, central nervous system, cardiovascular diseases, and reproduction. Objective: To determine the impact of serum vitamin D level on ICSI cycle outcome. Design: A prospective cohort study. Methods: Patients who will undergo ICSI cycle with age ≤ 38 years , adequate ovarian reserve were included in this study., women with poor ovarian reserve and patients with freeze all cycles were excluded. Vitamin D Serum samples were obtained On the day of the ovum pick-up, participants were divided into 2 groups :Deficiency: (serum vitamin D ≤30ng/ml), Sufficiency: (serum vitamin D≥30ng/ml ).Quantitative B-hCG was done 14 days after emberyo transfer Result : A total of 135 women were included in the study after undergoing ICSI , women were divided into two groups as following :Group A:(n = 68) with serum vitamin D level ≥30 ng/ml and Group B:(n = 67) with serum vitamin D level < 30 ng/ml at day of ovum pick-up.. pregnancy was significantly higher in group A (76.5 %) compared to group B (58.2 %) with P-value < 0.05. With regards to pregnancy continuation there was significant increase in ongoing pregnancy among group A (88.5 %) compared to group B (61.5 %) and significant decrease in the number of aborted cases among group A (11.5 %) compared to group B (38.5 %) with P-value < 0.05. Conclusions: Vitamin D serum level may play a role in ICSI cycle out come . and it seems to valuable to adjust its level in patients with deficiency before starting their ICSI cycle.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139296677","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 : 2023-11-01DOI: 10.21608/ebwhj.2023.237700.1262
Ashraf Ahmed Elkashef, Muhammad Abolkheir, Ashraf Ghanem, Khaled Ismael
Objective: To assess the prevalence and investigate possible risk factors of cesarean scar niche after one cesarean delivery using three-dimensional ultrasonography. Methods: A descriptive cross-sectional study conducted on 250 non pregnant women attended to outpatient clinic in Mansoura university hospital. Patients with only one cesarean delivery done from 6 to 12 months prior to time of examination were evaluated by three-dimensional trans-vaginal ultrasonography to detect possible cesarean scar niche. The main outcome measure was the presence of cesarean scar niche. Women with cesarean scar niche were compared with those with intact scar (control group). Maternal demographic variables, obstetric and peri-operative variables were analyzed in both groups to detect possible risk factors of cesarean scar niche. Results: Cesarean scar niche was found in 77.2% of study group, with 58.4% of all study group having large defect. The most common shape of cesarean scar niche was triangular (71.6%). The following variables were more detected in cesarean scar defect group than in control group; advanced maternal BMI (as mean BMI in cesarean scar defect group was 27.15 ± 4.17 versus 25.28 ± 2.90 in control group; P value 0.001), presence of active labor (45,6% of women in cesarean scar defect group had active labor versus only 17.5% in the control group; P value ≤ 0.001), peripartum fever (34.2% of cesarean scar defect group had peripartum fever versus only 17.5% in the control group; P value 0.016), and uterine retroversion (uterus was retro flexed in 26.4% in the cesarean scar defect group versus only 12.3% in the control group; P value 0.016). Gestational age at time of delivery and fetal weight were not found to affect the risk of cesarean scar niche formation. Conclusion: Based on ultrasound examination, increased maternal BMI, presence of active labor, peripartum fever, and uterine retroversion were found to be associated with increased risk of cesarean scar niche. Reduced distance between cesarean section scar or niche and cervical internal os was associated with large defects.
{"title":"Cesarean Section Scar Niche Evaluation in Non-Pregnant Women Using Three-Dimensional Ultrasound","authors":"Ashraf Ahmed Elkashef, Muhammad Abolkheir, Ashraf Ghanem, Khaled Ismael","doi":"10.21608/ebwhj.2023.237700.1262","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.237700.1262","url":null,"abstract":"Objective: To assess the prevalence and investigate possible risk factors of cesarean scar niche after one cesarean delivery using three-dimensional ultrasonography. Methods: A descriptive cross-sectional study conducted on 250 non pregnant women attended to outpatient clinic in Mansoura university hospital. Patients with only one cesarean delivery done from 6 to 12 months prior to time of examination were evaluated by three-dimensional trans-vaginal ultrasonography to detect possible cesarean scar niche. The main outcome measure was the presence of cesarean scar niche. Women with cesarean scar niche were compared with those with intact scar (control group). Maternal demographic variables, obstetric and peri-operative variables were analyzed in both groups to detect possible risk factors of cesarean scar niche. Results: Cesarean scar niche was found in 77.2% of study group, with 58.4% of all study group having large defect. The most common shape of cesarean scar niche was triangular (71.6%). The following variables were more detected in cesarean scar defect group than in control group; advanced maternal BMI (as mean BMI in cesarean scar defect group was 27.15 ± 4.17 versus 25.28 ± 2.90 in control group; P value 0.001), presence of active labor (45,6% of women in cesarean scar defect group had active labor versus only 17.5% in the control group; P value ≤ 0.001), peripartum fever (34.2% of cesarean scar defect group had peripartum fever versus only 17.5% in the control group; P value 0.016), and uterine retroversion (uterus was retro flexed in 26.4% in the cesarean scar defect group versus only 12.3% in the control group; P value 0.016). Gestational age at time of delivery and fetal weight were not found to affect the risk of cesarean scar niche formation. Conclusion: Based on ultrasound examination, increased maternal BMI, presence of active labor, peripartum fever, and uterine retroversion were found to be associated with increased risk of cesarean scar niche. Reduced distance between cesarean section scar or niche and cervical internal os was associated with large defects.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302719","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 : 2023-11-01DOI: 10.21608/ebwhj.2023.217484.1256
Aml Aljaml, Mohamed Elnegery, Nermeen Shams-Eldien, Khalid Samir, Mohamed Abdelhafez
Objective: To assess the efficacy of intramuscular (IM) neostigmine administration for acceleration of urinary bladder (UB) emptying and prevention of postoperative urine retention (POUR) following cesarean section (CS) performed under spinal anesthesia. Patients and Methods: Randomized controlled trial conducted on pregnant women who were planned to undergo elective CS under spinal anesthesia. All participants were randomly allocated after surgery into 2 groups; neostigmine group who received 0.5 mg IM neostigmine, and placebo group who received IM NaCl 0.9%. The primary outcome measures were time to first voiding after treatment and time to first voiding after catheter removal, and the secondary outcome measures were volume of excreted urine, postvoid residual bladder volume (PVRBV) and catheterization rate. Results: A total of 100 women (50 women in each group) were subjected to final analysis. Time to first voiding after treatment was significantly lower in neostigmine group than in placebo group (266.94 ± 77.53 vs 303.72 ± 64.07 min; P = 0.027). Also, time to first voiding after catheter removal was significantly lower in neostigmine group than in placebo group (214.90 ± 66.53 vs 241.60 ± 61.73 min; P = 0.036). However, there were no significant difference between both groups in volume of excreted urine, PVRBV and catheterization rate. Conclusion:
目的评估在脊髓麻醉下进行剖宫产术（CS）后，肌肉注射（IM）新斯的明对加速膀胱（UB）排空和预防术后尿潴留（POUR）的疗效。患者和方法：随机对照试验针对计划在脊柱麻醉下接受择期剖腹产手术的孕妇。所有参与者在手术后被随机分为两组：新斯的明组接受 0.5 毫克 IM 新斯的明，安慰剂组接受 0.9% NaCl IM。主要结果指标为治疗后首次排尿时间和拔除导尿管后首次排尿时间，次要结果指标为排出尿量、排尿后残余膀胱容量（PVRBV）和导尿率。结果共有 100 名妇女（每组 50 人）接受了最终分析。新斯的明组治疗后首次排尿的时间明显低于安慰剂组（266.94 ± 77.53 vs 303.72 ± 64.07 min; P = 0.027）。此外，新斯的明组拔除导管后首次排尿的时间也明显低于安慰剂组（214.90 ± 66.53 vs 241.60 ± 61.73 分钟；P = 0.036）。然而，两组在排尿量、PVRBV 和导尿率方面没有明显差异。结论
{"title":"Intramuscular Neostigmine for Accelerating Bladder Emptying after Cesarean Section by Spinal Anesthesia","authors":"Aml Aljaml, Mohamed Elnegery, Nermeen Shams-Eldien, Khalid Samir, Mohamed Abdelhafez","doi":"10.21608/ebwhj.2023.217484.1256","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.217484.1256","url":null,"abstract":"Objective: To assess the efficacy of intramuscular (IM) neostigmine administration for acceleration of urinary bladder (UB) emptying and prevention of postoperative urine retention (POUR) following cesarean section (CS) performed under spinal anesthesia. Patients and Methods: Randomized controlled trial conducted on pregnant women who were planned to undergo elective CS under spinal anesthesia. All participants were randomly allocated after surgery into 2 groups; neostigmine group who received 0.5 mg IM neostigmine, and placebo group who received IM NaCl 0.9%. The primary outcome measures were time to first voiding after treatment and time to first voiding after catheter removal, and the secondary outcome measures were volume of excreted urine, postvoid residual bladder volume (PVRBV) and catheterization rate. Results: A total of 100 women (50 women in each group) were subjected to final analysis. Time to first voiding after treatment was significantly lower in neostigmine group than in placebo group (266.94 ± 77.53 vs 303.72 ± 64.07 min; P = 0.027). Also, time to first voiding after catheter removal was significantly lower in neostigmine group than in placebo group (214.90 ± 66.53 vs 241.60 ± 61.73 min; P = 0.036). However, there were no significant difference between both groups in volume of excreted urine, PVRBV and catheterization rate. Conclusion:","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302856","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}
Background: Quality is the most important issue and the main predictor variable in developing as well as developed countries to achieve the Sustainable Development Goals (SDGs) and antenatal care. Objective: Determination of the quality of antenatal care service and associated factors at Ain Shams University Hospital, using longitudinal study design and questionnaire form. Methods: A total of 520 pregnant women were enrolled, after consenting each of them. Women were asked to fill the online questionnaire form give a clear answer to each item. This questionnaire defined three interconnected components of quality: structure, process, and outcomes. Deliveries outcomes were compared after the end of study. Primary outcome was assessment of the overall level quality of antenatal care service provision at Ain Shams University in comparison with other hospitals, private/public clinics and health offices. Secondary outcome was identification of the determinant factors for quality of antenatal care. Results: No differences between study groups regarding the three components of quality of ANC. However, our study revealed that other governmental and private healthcare settings were better than Ain Shams University Maternity Hospital regarding frequency of maternal weight and blood pressure measuring during ANC, fetal assessment using ultrasound, counseling about iron and calcium intake. Conclusion: Educational level (secondary and above) and attending regular ANC during pregnancy were significant factors associated with higher total ANC score. Caesarean section rate was higher among cases delivered at Ain Shams University Maternity Hospital that could be explained by Ain Shams Maternity University Hospital is a tertiary hospital and almost all cases delivered at it were complicated cases required urgent interventions.
{"title":"Assessment of Quality of Antenatal Care in Pregnant Women Delivered in Ain Shams University Hospitals","authors":"Salma Nassar, Alaa Hassanin, Youstina Ramzy, Mahmoud Abdallah","doi":"10.21608/ebwhj.2023.233575.1261","DOIUrl":"https://doi.org/10.21608/ebwhj.2023.233575.1261","url":null,"abstract":"Background: Quality is the most important issue and the main predictor variable in developing as well as developed countries to achieve the Sustainable Development Goals (SDGs) and antenatal care. Objective: Determination of the quality of antenatal care service and associated factors at Ain Shams University Hospital, using longitudinal study design and questionnaire form. Methods: A total of 520 pregnant women were enrolled, after consenting each of them. Women were asked to fill the online questionnaire form give a clear answer to each item. This questionnaire defined three interconnected components of quality: structure, process, and outcomes. Deliveries outcomes were compared after the end of study. Primary outcome was assessment of the overall level quality of antenatal care service provision at Ain Shams University in comparison with other hospitals, private/public clinics and health offices. Secondary outcome was identification of the determinant factors for quality of antenatal care. Results: No differences between study groups regarding the three components of quality of ANC. However, our study revealed that other governmental and private healthcare settings were better than Ain Shams University Maternity Hospital regarding frequency of maternal weight and blood pressure measuring during ANC, fetal assessment using ultrasound, counseling about iron and calcium intake. Conclusion: Educational level (secondary and above) and attending regular ANC during pregnancy were significant factors associated with higher total ANC score. Caesarean section rate was higher among cases delivered at Ain Shams University Maternity Hospital that could be explained by Ain Shams Maternity University Hospital is a tertiary hospital and almost all cases delivered at it were complicated cases required urgent interventions.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139304019","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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