Pub Date : 2022-08-01DOI: 10.21608/ebwhj.2022.143871.1180
Magdy Abd El- Gawad, Alaa Elsewafy, L. Farid
{"title":"Effect of Single Course Versus Repeated Single Course of Antenatal Corticosteroid (Dexamethasone) in Preterm Premature Rupture of Membranes on Neonatal Respiratory Outcome \"Randomized Control Trials\"","authors":"Magdy Abd El- Gawad, Alaa Elsewafy, L. Farid","doi":"10.21608/ebwhj.2022.143871.1180","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.143871.1180","url":null,"abstract":"","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73181034","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 : 2022-08-01DOI: 10.21608/ebwhj.2022.128004.1174
Tarek El Azizi, Doaa Alaa Eldin
Aim: This monocentric retrospective study aimed at the evaluation of outcome of the parturients with intractable postpartum haemorrhage (P.P.H.) after the administration of recombinant activated factor VII (rFVIIa) to preserve the uterus. Materials and Methods : this is a retrospective study conducted in a tertiary hospital . 41 patients were selected based on the inclusion criteria of both suffering from postpartum hemorrhage and received recombinant activated factor VII (rFVIIa). Patients were divided into group A who were managed by senior staff and group B who had started their management by junior staff and senior staff was called later for the case. Data was retrieved from patients’ records during 2019. All patients had a preliminary evaluation and classic management measures for postpartum hemorrhage either in the emergency department or during planned cesarean section. If are still bleeding, patients were infused with rFVIIa. If the uterine bleeding didn't stop, conservative management was cancelled, and abdominal hysterectomy was done. In all cases, postpartum mortality was determined. Results: The study included 41 parturient with P.P.H. with a mean age of 30.8±5.4 years. Eighteen patients had a cesarean section (C.S.), of whom 8 had successfully conserved the uterus, and 10 patients had a lifesaving hysterectomy using rFVIIa. On the other hand, 23 patients had been complicated with intractable postpartum haemorrhage. Twenty patients successfully had conservative management after using rFVIIa, and 3 patients had failed conservative management after using rFVIIa, and hysterectomy was lifesaving. Regarding 7-day postpartum mortality, one patient died with an intractable haemorrhage with delayed hysterectomy. Conclusion: The operator seniority and experience is more important than the use of rFVIIa to achieve conservative management of cases suffering from or at great risk of postpartum hemorrhage and to reduce patients mortality.
{"title":"Recombinant Factor VII for the Conservative Management Trials of Intractable Postpartum Haemorrhage: Is it a Drug Effect, Operator Experience or Inherent Result of the Aetiology","authors":"Tarek El Azizi, Doaa Alaa Eldin","doi":"10.21608/ebwhj.2022.128004.1174","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.128004.1174","url":null,"abstract":"Aim: This monocentric retrospective study aimed at the evaluation of outcome of the parturients with intractable postpartum haemorrhage (P.P.H.) after the administration of recombinant activated factor VII (rFVIIa) to preserve the uterus. Materials and Methods : this is a retrospective study conducted in a tertiary hospital . 41 patients were selected based on the inclusion criteria of both suffering from postpartum hemorrhage and received recombinant activated factor VII (rFVIIa). Patients were divided into group A who were managed by senior staff and group B who had started their management by junior staff and senior staff was called later for the case. Data was retrieved from patients’ records during 2019. All patients had a preliminary evaluation and classic management measures for postpartum hemorrhage either in the emergency department or during planned cesarean section. If are still bleeding, patients were infused with rFVIIa. If the uterine bleeding didn't stop, conservative management was cancelled, and abdominal hysterectomy was done. In all cases, postpartum mortality was determined. Results: The study included 41 parturient with P.P.H. with a mean age of 30.8±5.4 years. Eighteen patients had a cesarean section (C.S.), of whom 8 had successfully conserved the uterus, and 10 patients had a lifesaving hysterectomy using rFVIIa. On the other hand, 23 patients had been complicated with intractable postpartum haemorrhage. Twenty patients successfully had conservative management after using rFVIIa, and 3 patients had failed conservative management after using rFVIIa, and hysterectomy was lifesaving. Regarding 7-day postpartum mortality, one patient died with an intractable haemorrhage with delayed hysterectomy. Conclusion: The operator seniority and experience is more important than the use of rFVIIa to achieve conservative management of cases suffering from or at great risk of postpartum hemorrhage and to reduce patients mortality.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74038641","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 : 2022-08-01DOI: 10.21608/ebwhj.2022.140071.1177
suzan el sharkawy, Mohamed Amin, A. Mansy
{"title":"A Study of the Effect of Preoperative Vaginal Antiseptic on Occurrence of Postoperative Infection in Cesarean Section","authors":"suzan el sharkawy, Mohamed Amin, A. Mansy","doi":"10.21608/ebwhj.2022.140071.1177","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.140071.1177","url":null,"abstract":"","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78165032","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 : 2022-05-24DOI: 10.21608/ebwhj.2022.127684.1173
K. Hammam, A. Ali, Esraa Ayman, Shymaa Abdel Hamid, Hussien Seeda, S. Elsayed, Ahmad Tareq Anwar, Fatma Saad, A. Ali, M. Ramadan, A. Hussein
{"title":"Early versus delayed removal of urinary catheter after Pelvic organ prolapse surgery and vaginal hysterectomy: A systematic review and meta-analysis of randomized controlled trials","authors":"K. Hammam, A. Ali, Esraa Ayman, Shymaa Abdel Hamid, Hussien Seeda, S. Elsayed, Ahmad Tareq Anwar, Fatma Saad, A. Ali, M. Ramadan, A. Hussein","doi":"10.21608/ebwhj.2022.127684.1173","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.127684.1173","url":null,"abstract":"","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84422653","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 : 2022-05-01DOI: 10.21608/ebwhj.2021.109258.1159
A. Hassan, N. Mahmoud, M. Elhawary
Background: Delivery by elective caesarean section at a gestational age of less than 39 weeks increases the risk of various respiratory morbidities in the newborn including respiratory distress syndrome. Prostaglandins are substances that have beneficial effects on the neonatal lungs as it promote surfactant secretion by inducing the catecholamine surge. However on clinical practice, the effectiveness of the antenatal prophylactic administration prostaglandin is still not clear. Aim: This study aimed to evaluate the efficacy of vaginal Misoprostol before ECS in pregnant women with gestational age less than 38 weeks for preventing the occurrence of neonatal respiratory morbidity. Materials and Methods: Study sample included 159 participants were randomly assigned into 2 groups: Group (A): misoprostol group who administered 1/2 tablet of Cytotec (R) 200 g one hour before elective caesarean section and Group (B): included women received no treatment before elective caesarean section . Results: A significant decrease in respiratory rate among the Misoprostol group and decrease in neonatal respiratory morbidity especially RDS type 2, 3 and TTN, also misoprostol causes significant decrease in the rate of NICU admissions and none of the neonates required mechanical ventilation. Conclusion: Prophylactic misoprostol before elective caesarean at a gestational age of less than 39 weeks reduces the rate of neonatal respiratory morbidity and may prevent neonatal RDS type 2 and 3.
{"title":"Vaginal Misoprostol before Elective Caesarean Section for Preventing Neonatal Respiratory Morbidity","authors":"A. Hassan, N. Mahmoud, M. Elhawary","doi":"10.21608/ebwhj.2021.109258.1159","DOIUrl":"https://doi.org/10.21608/ebwhj.2021.109258.1159","url":null,"abstract":"Background: Delivery by elective caesarean section at a gestational age of less than 39 weeks increases the risk of various respiratory morbidities in the newborn including respiratory distress syndrome. Prostaglandins are substances that have beneficial effects on the neonatal lungs as it promote surfactant secretion by inducing the catecholamine surge. However on clinical practice, the effectiveness of the antenatal prophylactic administration prostaglandin is still not clear. Aim: This study aimed to evaluate the efficacy of vaginal Misoprostol before ECS in pregnant women with gestational age less than 38 weeks for preventing the occurrence of neonatal respiratory morbidity. Materials and Methods: Study sample included 159 participants were randomly assigned into 2 groups: Group (A): misoprostol group who administered 1/2 tablet of Cytotec (R) 200 g one hour before elective caesarean section and Group (B): included women received no treatment before elective caesarean section . Results: A significant decrease in respiratory rate among the Misoprostol group and decrease in neonatal respiratory morbidity especially RDS type 2, 3 and TTN, also misoprostol causes significant decrease in the rate of NICU admissions and none of the neonates required mechanical ventilation. Conclusion: Prophylactic misoprostol before elective caesarean at a gestational age of less than 39 weeks reduces the rate of neonatal respiratory morbidity and may prevent neonatal RDS type 2 and 3.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83497561","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 : 2022-05-01DOI: 10.21608/ebwhj.2022.117548.1166
Shaemaa Belal, Manal Alsayed, Hany Abdel Hamid, Ashraf ElBaz
Aim: The purpose of this study is to determine placental volume and vascular flow indices during the first trimester and their values as predictors of developing preeclampsia. Materials and Methods: A prospective analysis for standard antenatal follow up at 11 to 13 weeks of gestation was performed on 177 singleton pregnant women visiting the antenatal care outpatient clinic at Al-Sahel Teaching Hospital between June 2018 and June 2019. Transabdominal 3D ultrasonography ('placental biopsy') to determine placental volume and power Doppler assessment of placental vascularization were done for all cases. Results: Comparative analysis of placental volumes between the normal pregnancy and preeclamptic pregnancies groups revealed a statistically high significant difference ( P value < 0.001 ). The mean volume in the two groups was 84.9 ± 22 and 45.6 ± 11.4 cm3, respectively. In the normal pregnancy group, the volume of placenta was larger than preeclamptic pregnancies group. Also, comparative analysis of placental vascularization index (VI), flow index (FI), and vascularization flow index (VFI) between the normal pregnancy group and pregnancies group that developed preeclampsia revealed a statistically high significant difference ( P value <0.001 ). The mean values of (VI), (FI), and (VFI) in the two groups were (24.7±8.1, 95.4±9.1, 13.1±3. 7) and (16.2±5.8, 54.6±10.9, 8.1±2.1) respectively. Conclusion: Quantitative assessment of placental volume and vasculature using 3D power doppler VOCAL TM techniques can be used in the 1st trimester to predict preeclampsia. Placentas of pregnancy complicated with preeclampsia have smaller volume, fewer blood vessels (reduced VI) and decreased blood flow (reduced FI).
{"title":"Value of 3D Ultrasonographic Assessment of Placental Volume and Perfusion Indices in The First Trimester As Predictors to The Occurrence of Preeclampsia","authors":"Shaemaa Belal, Manal Alsayed, Hany Abdel Hamid, Ashraf ElBaz","doi":"10.21608/ebwhj.2022.117548.1166","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.117548.1166","url":null,"abstract":"Aim: The purpose of this study is to determine placental volume and vascular flow indices during the first trimester and their values as predictors of developing preeclampsia. Materials and Methods: A prospective analysis for standard antenatal follow up at 11 to 13 weeks of gestation was performed on 177 singleton pregnant women visiting the antenatal care outpatient clinic at Al-Sahel Teaching Hospital between June 2018 and June 2019. Transabdominal 3D ultrasonography ('placental biopsy') to determine placental volume and power Doppler assessment of placental vascularization were done for all cases. Results: Comparative analysis of placental volumes between the normal pregnancy and preeclamptic pregnancies groups revealed a statistically high significant difference ( P value < 0.001 ). The mean volume in the two groups was 84.9 ± 22 and 45.6 ± 11.4 cm3, respectively. In the normal pregnancy group, the volume of placenta was larger than preeclamptic pregnancies group. Also, comparative analysis of placental vascularization index (VI), flow index (FI), and vascularization flow index (VFI) between the normal pregnancy group and pregnancies group that developed preeclampsia revealed a statistically high significant difference ( P value <0.001 ). The mean values of (VI), (FI), and (VFI) in the two groups were (24.7±8.1, 95.4±9.1, 13.1±3. 7) and (16.2±5.8, 54.6±10.9, 8.1±2.1) respectively. Conclusion: Quantitative assessment of placental volume and vasculature using 3D power doppler VOCAL TM techniques can be used in the 1st trimester to predict preeclampsia. Placentas of pregnancy complicated with preeclampsia have smaller volume, fewer blood vessels (reduced VI) and decreased blood flow (reduced FI).","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88546028","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 : 2022-05-01DOI: 10.21608/ebwhj.2021.113640.1164
H. Ashry, T. Aly, A. Ragab
Background: We developed a multicenter randomized observational trial to assess the effectiveness of letrozole monotherapy and the co-therapy of letrozole and gonadotropins on pregnancy outcomes including the ovulation induction, pregnancy rate, estradiol (E2) levels and endometrial thickness in infertile women with polycystic ovarian syndrome (PCOS). Materials and Methods: At three in vitro fertilization (IVF) centers in Egypt, we conducted our study since May 2019 until we have recruited the planned number of patients. Infertile PCOS patients were recruited after they met our criteria. We had two intervention groups based on the treatment regimen. Moreover, baseline parameters, outcomes, and hormonal assessment were conducted throughout the study period. Results: We included 90 patients in this study and were equally randomized into two groups; the letrozole monotherapy (Group A) and the letrozole with gonadotropins (Group B) groups. The mean age was significantly higher in group A [26 (±3.5)] than group B [24.2 (±3.1)] ( P= 0.015 ). Both groups showed resulted in similar pregnancy rates (31.1%) ( P= 0.079 ). Moreover, group B [2.4 (±0.8)] resulted in a significantly higher ( P= 0.023 ) mean number of follicles than group A [2.0 (±0.7)]. On the other hand, no statistical significance was estimated in terms of estradiol levels and endometrial thickness ( P= 0.209 and 0.485, respectively). Conclusion: We concluded that letrozole monotherapy and in combination with gonadotropins obtain better pregnancy rates in PCOS patients. Moreover, the combination may be useful in reducing gonadotropin adverse events with the same acceptable rates.
{"title":"Comparison Between Letrozole With and Without Gonadotropins Injection on Pregnancy Rates in Infertile PCOS Patients : A Multicenter Randomized Observational Trial","authors":"H. Ashry, T. Aly, A. Ragab","doi":"10.21608/ebwhj.2021.113640.1164","DOIUrl":"https://doi.org/10.21608/ebwhj.2021.113640.1164","url":null,"abstract":"Background: We developed a multicenter randomized observational trial to assess the effectiveness of letrozole monotherapy and the co-therapy of letrozole and gonadotropins on pregnancy outcomes including the ovulation induction, pregnancy rate, estradiol (E2) levels and endometrial thickness in infertile women with polycystic ovarian syndrome (PCOS). Materials and Methods: At three in vitro fertilization (IVF) centers in Egypt, we conducted our study since May 2019 until we have recruited the planned number of patients. Infertile PCOS patients were recruited after they met our criteria. We had two intervention groups based on the treatment regimen. Moreover, baseline parameters, outcomes, and hormonal assessment were conducted throughout the study period. Results: We included 90 patients in this study and were equally randomized into two groups; the letrozole monotherapy (Group A) and the letrozole with gonadotropins (Group B) groups. The mean age was significantly higher in group A [26 (±3.5)] than group B [24.2 (±3.1)] ( P= 0.015 ). Both groups showed resulted in similar pregnancy rates (31.1%) ( P= 0.079 ). Moreover, group B [2.4 (±0.8)] resulted in a significantly higher ( P= 0.023 ) mean number of follicles than group A [2.0 (±0.7)]. On the other hand, no statistical significance was estimated in terms of estradiol levels and endometrial thickness ( P= 0.209 and 0.485, respectively). Conclusion: We concluded that letrozole monotherapy and in combination with gonadotropins obtain better pregnancy rates in PCOS patients. Moreover, the combination may be useful in reducing gonadotropin adverse events with the same acceptable rates.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81196365","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 : 2022-05-01DOI: 10.21608/ebwhj.2022.126327.1168
Mohamed Elsafty, Sherif Abdel Khalek, A. Farid, Haitham Gad Elkarem
Aim: The present study aimed to evaluate using thalamic echogenicity by ultrasound as a predictor of fetal lung maturity in comparison with other ultrasound markers. Methods: This was a prospective study performed in Ain shams Maternity Hospital, Cairo, Egypt from August, 2020 until April 2021. Two hundred and thirty-eight pregnant women (36 to 40 weeks of gestation) who were admitted for elective cesarean section were recruited. An obstetric ultrasound scan was done at the same day of their elective cesarean section to evaluate echogenicity of the thalamus, to measure presence of ossification centers of distal femur epiphysis (DFE) and proximal tibia epiphysis (PTE), to measure biparietal diameter, to detect placental changes and amniotic fluid vernix. The outcome measures were APGAR scores at 1 minute and 5 minutes, admission to neonatal intensive care unit, duration of hospitalization and signs of respiratory distress syndrome (RDS). Results: The presence of echogenic thalamus as a sign of fetal lung maturity had a specificity of 77.2% which was lower than specificity of presence of PTE (90.4%) and measurement of BPD (82.6%). Diagnostic accuracy was 77.3% which was also lower than PTE (90.8%) and BPD (81.5%), respectively. Sensitivity was 78.9% which was lower than PTE (99.5%) and BPD (82.6%), respectively. Negative predictive value for thalamic echogenicity, PTE and DFE were 97.7%, 99.5% and 99.2%, respectively. Conclusion: Evaluation of echogenic thalamus could be an accurate method to predict fetal lung maturity. However, further studies are required to strengthen such idea.
{"title":"Can Thalamic Echogenicity by Ultrasound Be Used as a Predictor of Fetal Lung Maturity?","authors":"Mohamed Elsafty, Sherif Abdel Khalek, A. Farid, Haitham Gad Elkarem","doi":"10.21608/ebwhj.2022.126327.1168","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.126327.1168","url":null,"abstract":"Aim: The present study aimed to evaluate using thalamic echogenicity by ultrasound as a predictor of fetal lung maturity in comparison with other ultrasound markers. Methods: This was a prospective study performed in Ain shams Maternity Hospital, Cairo, Egypt from August, 2020 until April 2021. Two hundred and thirty-eight pregnant women (36 to 40 weeks of gestation) who were admitted for elective cesarean section were recruited. An obstetric ultrasound scan was done at the same day of their elective cesarean section to evaluate echogenicity of the thalamus, to measure presence of ossification centers of distal femur epiphysis (DFE) and proximal tibia epiphysis (PTE), to measure biparietal diameter, to detect placental changes and amniotic fluid vernix. The outcome measures were APGAR scores at 1 minute and 5 minutes, admission to neonatal intensive care unit, duration of hospitalization and signs of respiratory distress syndrome (RDS). Results: The presence of echogenic thalamus as a sign of fetal lung maturity had a specificity of 77.2% which was lower than specificity of presence of PTE (90.4%) and measurement of BPD (82.6%). Diagnostic accuracy was 77.3% which was also lower than PTE (90.8%) and BPD (81.5%), respectively. Sensitivity was 78.9% which was lower than PTE (99.5%) and BPD (82.6%), respectively. Negative predictive value for thalamic echogenicity, PTE and DFE were 97.7%, 99.5% and 99.2%, respectively. Conclusion: Evaluation of echogenic thalamus could be an accurate method to predict fetal lung maturity. However, further studies are required to strengthen such idea.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80144297","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 : 2022-05-01DOI: 10.21608/ebwhj.2022.107310.1158
Ahmed Mohamed, A. Ahmed, Ali H. Yosef, Diaa Eldeen Abd El Aal El Nashar
Aim: To assess the effect of rectus muscle re-approximation by two different techniques during Cesarean Section on postoperative pain. Study Design: A prospective, single-blinded, randomized clinical trial. Patients and Methods: It included (n=156) primigravida who underwent Cesarean section. They were randomly allocated into three groups; Group (A): non-closure of rectus muscle, Group (B): re-approximation by three simple interrupted sutures, and Group (C) re-approximation by three vertical mattress sutures. Postoperative pain was assessed by visual analogue scale during hospital stay. Postoperative analgesia, amount of blood loss and occurrence of postoperative complications were also investigated. Results: Women with non-closure technique had significantly lower visual analogue score (VAS) at the end of 1 st 48 hours postoperative (2.86 ± 1.61) in comparison to other groups. Women who underwent re-approximation either with simple interrupted sutures or vertical mattress sutures had no difference as regard VAS (4.26 ± 2.19 vs. 4.80 ± 2.36; P value = 0.19). Regarding to postoperative analgesia intake, women with non-re-approximation had significant lower intake of analgesic drugs (170.76 ± 30.85 mg) in comparison to other two groups. Both techniques of muscle closure showed no difference in analgesic requirements postoperative. Conclusion: Rectus muscle approximation is associated with significant increase in postoperative pain and analgesia.
{"title":"Assessment of the Effect of Rectus Muscle Re-Approximation by Two Techniques Versus Non Re-Approximation During Caesarean Section on Postoperative Pain: A Randomized Controlled Trial","authors":"Ahmed Mohamed, A. Ahmed, Ali H. Yosef, Diaa Eldeen Abd El Aal El Nashar","doi":"10.21608/ebwhj.2022.107310.1158","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.107310.1158","url":null,"abstract":"Aim: To assess the effect of rectus muscle re-approximation by two different techniques during Cesarean Section on postoperative pain. Study Design: A prospective, single-blinded, randomized clinical trial. Patients and Methods: It included (n=156) primigravida who underwent Cesarean section. They were randomly allocated into three groups; Group (A): non-closure of rectus muscle, Group (B): re-approximation by three simple interrupted sutures, and Group (C) re-approximation by three vertical mattress sutures. Postoperative pain was assessed by visual analogue scale during hospital stay. Postoperative analgesia, amount of blood loss and occurrence of postoperative complications were also investigated. Results: Women with non-closure technique had significantly lower visual analogue score (VAS) at the end of 1 st 48 hours postoperative (2.86 ± 1.61) in comparison to other groups. Women who underwent re-approximation either with simple interrupted sutures or vertical mattress sutures had no difference as regard VAS (4.26 ± 2.19 vs. 4.80 ± 2.36; P value = 0.19). Regarding to postoperative analgesia intake, women with non-re-approximation had significant lower intake of analgesic drugs (170.76 ± 30.85 mg) in comparison to other two groups. Both techniques of muscle closure showed no difference in analgesic requirements postoperative. Conclusion: Rectus muscle approximation is associated with significant increase in postoperative pain and analgesia.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89912930","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 : 2022-05-01DOI: 10.21608/ebwhj.2022.127316.1169
M. Eid, R. Omar, Ahmed Mohamed, Khaled Abdel Maqsood
Aim: To estimate whether the cervical length and can be used as a method to predict peripartum complications as antepartum haemorrhage and preterm delivery in cases of complete placenta previa. Methods: Between October 2013 and April 2014, transvaginal measurement of cervical length was done for 30 cases of complete placenta previa identified between 28 weeks and 36 weeks of gestation. This was correlated to the clinical outcome of pregnancy with recordings for the gestational age at time of delivery, occurrence if any complications as antepartum haemorrhage ,blood transfusion, caesarean hysterectomy , preterm delivery and the need for NICU admission and whether the caesarean section was elective or emergency caesarean section was needed before 36 weeks due to massive haemorrhage. Results: Antepartum haemorrhage necessitating emergency cesarean section was observed in 17 patients (56.7%). This was the basis of grouping the patients into two outcome groups: Emergency CS group and elective delivery group. Using receiver-operating characteristic (ROC) curve analysis we found that a cervical length ≤ 33 mm at 28 weeks was predictive of antepartum haemorrhage necessitating emergency caesarean section with a sensitivity of 88.2% and specificity of 61.5% positive predictive value of 75.0% and negative predicative value of 80.0% and accuracy of 76.7%. Area under the curve (AUC) was 0.760. with P-value < 0.01 Conclusion: Short cervical length measurements at cut-off value ≤33mm may predict increased risk of hemorrhage and emergency caesarean section in patients with complete placenta previa.
{"title":"The Efficacy of Third Trimester Cervical Length Measurement as A Predictor of Ante-Partum Haemorrhage Among Pregnancies Complicated with Placenta Previa","authors":"M. Eid, R. Omar, Ahmed Mohamed, Khaled Abdel Maqsood","doi":"10.21608/ebwhj.2022.127316.1169","DOIUrl":"https://doi.org/10.21608/ebwhj.2022.127316.1169","url":null,"abstract":"Aim: To estimate whether the cervical length and can be used as a method to predict peripartum complications as antepartum haemorrhage and preterm delivery in cases of complete placenta previa. Methods: Between October 2013 and April 2014, transvaginal measurement of cervical length was done for 30 cases of complete placenta previa identified between 28 weeks and 36 weeks of gestation. This was correlated to the clinical outcome of pregnancy with recordings for the gestational age at time of delivery, occurrence if any complications as antepartum haemorrhage ,blood transfusion, caesarean hysterectomy , preterm delivery and the need for NICU admission and whether the caesarean section was elective or emergency caesarean section was needed before 36 weeks due to massive haemorrhage. Results: Antepartum haemorrhage necessitating emergency cesarean section was observed in 17 patients (56.7%). This was the basis of grouping the patients into two outcome groups: Emergency CS group and elective delivery group. Using receiver-operating characteristic (ROC) curve analysis we found that a cervical length ≤ 33 mm at 28 weeks was predictive of antepartum haemorrhage necessitating emergency caesarean section with a sensitivity of 88.2% and specificity of 61.5% positive predictive value of 75.0% and negative predicative value of 80.0% and accuracy of 76.7%. Area under the curve (AUC) was 0.760. with P-value < 0.01 Conclusion: Short cervical length measurements at cut-off value ≤33mm may predict increased risk of hemorrhage and emergency caesarean section in patients with complete placenta previa.","PeriodicalId":12080,"journal":{"name":"Evidence Based Women's Health Journal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78902838","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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