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Hysteroscopy as a diagnostic tool in women with recurrent pregnancy loss, a prospective randomized controlled study 宫腔镜作为复发性流产妇女的诊断工具,一项前瞻性随机对照研究
Pub Date : 2021-05-04 DOI: 10.21608/EBWHJ.2021.66147.1129
Attia Mohammed, Kamal Rageh, Amr Habib, A. Shaaban, Mohamed Rushdy
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引用次数: 0
Serum Soluble Endoglin Versus Serum Placental Growth Factor for Early Prediction of Preeclampsia 血清可溶性内啡肽与血清胎盘生长因子早期预测子痫前期
Pub Date : 2021-05-01 DOI: 10.21608/EBWHJ.2021.74864.1134
Ali Bendary, M. Elgazzar, L. Mohamed
Aim: Evaluation of the predictive ability of serum soluble endoglin (sEng) and placental growth factor (PLGF) levels estimated at the 12th gestational week (GW) for discrimination of women liable to develop preeclampsia (PE).Materials and Methods: 102 PE women were diagnosed according to the American Society of Hypertension and categorized according to guidelines of American College of Obstetricians and Gynecologists. The severity of PE was judged by the difference between blood pressure (ΔBP) measures at time of PE diagnosis and at time of enrolment. Blood samples were obtained at the 12th GW for ELISA estimation of serum sEng and PLGF. Study outcomes included the predictive ability of these markers for development of PE and the relation between age, body mass index (BMI) and serum levels of studied biomarkers and ΔSBP and ΔDBP.Results: 29 and 73 women developed early- and late-onset PE, respectively and 18 women had severe, while 84 women had mild PE. At time of PE diagnosis, BP measures were increased significantly in PE women in comparison to enrolment measures and to control measures. Serum levels of sEng were significantly higher, while serum PLGF levels were significantly lower in PE women than in controls. Development of PE was positively correlated with serum sEng, while was negatively correlated with serum PLGF levels. Also, there was positive significant correlation between ΔBP and BMI and serum levels of sEng, and negative significant correlation with at enrolment BP and serum levels of PLGF. ROC curve analysis defined ΔSBP and ΔDBP by 33 and 10 mmHg as a cutoff point for diagnosis of PE and defined high serum sEng as the significant sensitive predictor for development of PE at both cutoff points.Conclusion: At 12th GW, estimated levels of sEng and PLGF could discriminate pregnant women vulnerable for development of PE. Statistical analyses defined high serum sEng levels estimated at the 12th GW as the significant early predictor for upcoming PE. Maternal obesity and old age are also related to PE severity and must be considered for prediction.
目的:评价血清可溶性内素(sEng)和胎盘生长因子(PLGF)水平在妊娠第12周(GW)时的预测能力,以鉴别易患先兆子痫(PE)的妇女。材料与方法:102例PE妇女根据美国高血压学会诊断,并根据美国妇产科医师学会指南进行分类。通过PE诊断时和入组时血压(ΔBP)测量值的差异来判断PE的严重程度。在12 GW时采集血样用于ELISA测定血清sEng和PLGF。研究结果包括这些标志物对PE发展的预测能力,以及年龄、体重指数(BMI)和所研究生物标志物与ΔSBP和ΔDBP的血清水平之间的关系。结果:早发性PE 29例,晚发性PE 73例,重度PE 18例,轻度PE 84例。在PE诊断时,与入组和对照组相比,PE女性的血压测量明显增加。PE女性的血清sEng水平显著高于对照组,而血清PLGF水平显著低于对照组。PE的发展与血清sEng呈正相关,而与血清PLGF水平负相关。此外,ΔBP与BMI和血清sEng水平呈正相关,与入组时BP和血清PLGF水平呈负相关。ROC曲线分析将ΔSBP和ΔDBP的33和10 mmHg定义为PE诊断的截止点,并将高血清sEng定义为两个截止点上PE发展的重要敏感预测因子。结论:在第12 GW时,估计的sEng和PLGF水平可以区分易患PE的孕妇。统计分析将12 GW时估计的高血清sEng水平定义为即将到来的PE的重要早期预测因子。产妇肥胖和老年也与PE严重程度有关,必须考虑预测。
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引用次数: 0
New ultrasound signs for prediction of early placental Insufficiency 预测早期胎盘功能不全的新超声征象
Pub Date : 2021-05-01 DOI: 10.21608/EBWHJ.2021.75491.1135
T. Said, Y. El-Kassar, Gehan Shehata
Background: Chronic placental insufficiency is a common condition that affects fetal growth and wellbeing. The response of the fetus to such stress depends on time and degree of placental affection. The acute placental insufficiency rapidly affects the fetal movements, amount of liquor and might lead to fetal demise while the chronic placental insufficiency is more deciduous and affects fetal weight and develops fetal growth restriction more slowly. The prophylaxis against the development of chronic placental insufficiency is more effective to protect growth and avoid perinatal morbidities and moralities.Aim: Evaluation of 2 new ultrasound signs (tent like placenta and turbid liquor) to predict early placental insufficiencyMaterials and Methods: One hundred pregnant women with gestational age between 16 weeks till 28 weeks were included in the study. This cohort of women with singleton pregnancy was evaluated by detailed ultrasound scanning to document gestational age, amniotic fluid index, cerebroplacental ratio (CPR), exclusion of congenital anomalies and other routine ultrasound scanning items. This cohort was divided into two groups, group one was the group with placental tenting and/or turbid liquor while group two was the group with no evidence of placental tenting or turbid liquor.Results: Documentation of all relevant demographic data was done. The follow up was done every two weeks in all cases unless patients complained of decreased or absent fetal movement, passage of liquor, passage of blood. Spontaneous labour was allowed in primigravidae and elective cesarean section in Cases with previous c-section at completed 38 weeks of gestation was done unless one or more of the following signs had appeared that indicated the need for emergency delivery which were : abnormal low CPR less than 0.76, severe oligohydramnios, biophysical profile equal to or less than 4/8, abnormal cardiotocogram and fetal distress. The duration from the beginning of the study and documentation of the new studied signs in the placenta and turbid liquor till the development of placental insufficiency was calculated in weeks. All complications or adverse events were documented in both groups.Conclusions: Both new signs were associated with increased risk for development of chronic placental insufficiency and can be used as predictors for evaluation of all pregnant women in the second trimester.
背景:慢性胎盘功能不全是一种影响胎儿生长和健康的常见疾病。胎儿对这种压力的反应取决于胎盘受影响的时间和程度。急性胎盘功能不全迅速影响胎动、产液量,可能导致胎儿死亡,而慢性胎盘功能不全更严重,影响胎儿体重,胎儿生长受限发展较慢。预防慢性胎盘功能不全的发展是更有效的保护生长和避免围产期发病率和死亡率。目的:评价两种新的超声征象(帐篷状胎盘和浑浊液)对早期胎盘功能不全的预测。材料与方法:选取100例胎龄在16 ~ 28周的孕妇。通过详细的超声扫描记录胎龄、羊水指数、脑胎盘比(CPR)、排除先天性异常和其他常规超声扫描项目,对单胎妊娠妇女进行评估。该队列被分为两组,第一组是有胎盘帐篷和/或浑浊液的组,而第二组是没有胎盘帐篷或浑浊液的组。结果:完成了所有相关人口统计资料的记录。所有病例均每两周随访一次,除非患者主诉胎动减少或不胎动、胎液通过、胎血通过。初产妇允许自然分娩,妊娠满38周有剖腹产史的可选择剖宫产,除非出现以下一种或多种迹象表明需要紧急分娩:异常低CPR小于0.76,严重羊水过少,生物物理特征等于或小于4/8,异常心电图和胎儿窘迫。从研究开始并记录胎盘和浑浊液的新研究迹象到发展为胎盘功能不全的时间以周为单位计算。两组均记录了所有并发症或不良事件。结论:这两个新体征与慢性胎盘功能不全的风险增加有关,可作为评估妊娠中期所有孕妇的预测指标。
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引用次数: 0
Cervical cerclage for Pregnant Women at High-risk of Recurrent Preterm Birth can act beyond its Mechanical Action 宫颈环扎术对复发性早产高危孕妇的作用可以超越其机械作用
Pub Date : 2021-05-01 DOI: 10.21608/EBWHJ.2021.75518.1136
W. Amer, Ali A. Morsi, Hamasat A Alnoury
Aim: Evaluation of predictive value of levels of cervicovaginal fluid (CVF) interleukin (IL)-6 and 8, and matrix metalloproteinases (MMP) estimated at time of performing cervical cerclage (CC) in women with history of spontaneous preterm birth (SPTB) for pregnancy duration.Materials and Methods: 59 women had history of SPTB (Study group) and 25 women with no history of SPTB (Control group). Two CVF samples were obtained for ELISA estimation of IL-6, IL-8, MMP8 and MMP9 levels at 14-18 gestational weeks (GW), S1 sampling time, and at time of removal of CC suture, S2 sampling time. CC was applied 4-days after S1 sampling.Results: S1-CVF levels were significantly higher in study versus control women. S2-CVF levels were significantly higher in control, while were significantly lower in study women compared to S1 levels. S2-CVF IL-6 and IL-8 levels were non-significantly higher, while levels of MMP were significantly lower in study than control women. Percentages of change in cytokines' levels showed significant differences between study and control groups. Nineteen study women had PTD at 37 GW. Study women had significantly shorter CL and pregnancy duration compared to control women. Pregnancy duration was negatively correlated with percentage of CL change, while positively correlated with percentage of decrease of cytokines levels.Conclusion: CC induced significant decrease of CVF cytokines' levels and allowed prolongation of pregnancy duration for >37 GW in 67.8% of studied women at high risk of SPTB
目的:评价自发性早产(SPTB)妇女妊娠期行宫颈环切术(CC)时宫颈阴道液(CVF)、白细胞介素(IL)-6、IL - 8和基质金属蛋白酶(MMP)水平的预测价值。材料与方法:有SPTB病史的女性59例(研究组),无SPTB病史的女性25例(对照组)。取两份CVF样本,用ELISA法测定14-18孕周(GW)、S1取样时间和拆除CC缝线时、S2取样时间的IL-6、IL-8、MMP8和MMP9水平。S1取样后4天施用CC。结果:研究女性的S1-CVF水平明显高于对照组。对照组的S2-CVF水平明显较高,而研究女性的S1水平则明显较低。S2-CVF IL-6和IL-8水平无显著性升高,而MMP水平显著低于对照组。细胞因子水平的变化百分比在实验组和对照组之间显示出显著差异。19名研究女性在37 GW时患有PTD。与对照组妇女相比,研究妇女的CL和妊娠期明显缩短。妊娠期与CL变化百分比呈负相关,与细胞因子水平下降百分比呈正相关。结论:在67.8%的SPTB高危妇女中,CC诱导CVF细胞因子水平显著降低,并使>37 GW的妊娠期延长
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引用次数: 0
Efficacy and Safety of Preoperative Intravenous Tranexamic Acid to Reduce Blood Loss During and After Elective Lower‐Segment Cesarean Delivery 术前静脉注射氨甲环酸减少选择性下节段剖宫产术中和术后出血量的有效性和安全性
Pub Date : 2021-05-01 DOI: 10.21608/EBWHJ.2021.74846.1133
Dalia Nour, Tarek El Husseiny, N. Osman
Aim: This work aimed to study the efficacy and safety of preoperative intravenous tranexamic acid to reduce blood loss during and after elective lower‐segment cesarean delivery.Materials and Methods: A double‐blind, randomized placebo‐controlled study was undertaken of women undergoing elective lower‐segment cesarean delivery of a full‐term singleton pregnancy at a center in tertiary referral hospital , Egypt, between December, 2019 and March, 2020. Patients were randomly assigned (1:1) using computer‐generated random numbers to receive either 1 g tranexamic acid(TXA) or 5% glucose 15 minutes before surgery. Preoperative and postoperative complete blood count, hematocrit values, and maternal weight were used to calculate the estimated blood loss (EBL) during cesarean section, which was the primary outcome. Analyses included women who received their assigned treatment, whose surgery was 90 minutes or less, and who completed follow‐up.Results: Eighty women in each group.There was no statistical difference found between women subjected to TXA and those subjected to placebo regarding maternal age, weight, gestational age or mode of previous delivery. Mean EBL was significantly higher in the placebo group (896.81 ± 519.6mL mL) than in the tranexamic acid group (583.23 ± 379.62mL; P < 0.001).Conclusion: Preoperative administration of tranexamic acid safely reduces blood loss during elective lower‐segment cesarean delivery
目的:本研究旨在研究术前静脉注射氨甲环酸减少选择性下段剖宫产术中和术后出血量的有效性和安全性。材料和方法:2019年12月至2020年3月,在埃及三级转诊医院的一个中心进行了一项双盲、随机安慰剂对照研究,研究对象是接受选择性下段剖宫产的足月单胎妊娠妇女。手术前15分钟,使用计算机生成的随机数随机分配患者(1:1),接受1g氨甲环酸(TXA)或5%葡萄糖。术前和术后全血细胞计数、红细胞压积值和产妇体重被用来计算剖宫产术中估计的失血量(EBL),这是主要结局。分析包括接受指定治疗的妇女,手术时间为90分钟或更短,并完成随访。结果:每组80例。在产妇年龄、体重、胎龄或分娩方式方面,服用TXA的妇女与服用安慰剂的妇女之间没有统计学差异。安慰剂组平均EBL(896.81±519.6mL mL)显著高于氨甲环酸组(583.23±379.62mL;P < 0.001)。结论:术前给予氨甲环酸可安全减少选择性下节段剖宫产的出血量
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引用次数: 2
The association between vitamin D level and Endometriosis 维生素D水平与子宫内膜异位症之间的关系
Pub Date : 2021-03-30 DOI: 10.21608/EBWHJ.2019.16346.1018
A. Okasha
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引用次数: 0
Assessment of the efficacy of uterine artery Doppler in predicting the response to Mefenamic Acid during treatment of women having IUCD associated menorrhagia 子宫动脉多普勒预测宫内节育器相关月经过多治疗期间甲芬那酸疗效的评估
Pub Date : 2021-03-30 DOI: 10.21608/EBWHJ.2019.19364.1054
H. Sammour, S. Ashoush, O. Ibrahim, Y. Essam
Background: Bleeding with IUCDs is considered iatrogenic dysfunctional uterine bleeding. The bleeding associated with IUCD use may either occur during menstruation (heavy and/or prolonged) or in the form of intermenstrual bleeding and spotting.Patients and Methods:This study was carried out on 156 women attended the family planning out-patient clinic in the Obstetrics and Gynecology Department, Ain-Shams University Hospitals, during the period from May 2017 to May 2018. Patients were divided according to the response to treatment into two groups: Group (I): Responders to treatment with Mefenamic acid and Group (II): Non-responders to treatment with Mefenamic acid. Response to treatment was evaluated according to: Pictorial blood loss assessment chart.Results: Interpretation of the results of this work showed that uterine artery mean value of the PI of the women who responded to treatment with Mefenamic acid (group I) (1.54±0.42) were significantly higher than mean value of PI of women who didn’t respond to treatment with Mefenamic acid (group II) (0.96±0.28), also showed that uterine artery mean value of the RI of the who responded to treatment with Mefenamic acid (group I) (1.01±0.25) were significantly higher than mean values of RI of women who didn’t respond to treatment with Mefenamic acid (group II) (0.71±0.21). Doppler indices showed that pulsatility index ≥ 1.27 had moderate sensitivity (75.3%) and NPV (75.3%) but high specificity (90.1%) and PPV (90.1%) in prediction of responders. Resistive index ≥ 0.93 had low sensitivity (69.4%) and NPV (70.8%) but moderate specificity (88.7%) and PPV (88.1%) in prediction of responders.Conclusion:There is a strong relationship between uterine artery Doppler indices and prediction of response to Mefenamic acid.
背景:宫内节育器出血被认为是医源性失调性子宫出血。与使用宫内节育器相关的出血可能发生在月经期间(大量和/或延长),也可能以月经间出血和点滴出血的形式出现。患者与方法:本研究选取2017年5月至2018年5月在Ain-Shams大学附属医院妇产科计划生育门诊就诊的156名妇女为研究对象。根据对治疗的反应将患者分为两组:组(I):甲非那酸治疗有反应,组(II):甲非那酸治疗无反应。治疗效果根据:失血评估图进行评估。结果:对本研究结果的解释表明,甲非那酸治疗有效组(I组)的子宫动脉PI均值(1.54±0.42)显著高于甲非那酸治疗无效组(II组)的PI均值(0.96±0.28);甲非那酸治疗有效组(I组)子宫动脉RI均值(1.01±0.25)显著高于甲非那酸治疗无效组(II组)(0.71±0.21)。多普勒指标显示,脉搏指数≥1.27预测应答者的灵敏度(75.3%)和NPV(75.3%)中等,但特异性(90.1%)和PPV(90.1%)较高。耐药指数≥0.93预测应答者的敏感性(69.4%)和NPV(70.8%)较低,特异性(88.7%)和PPV(88.1%)中等。结论:子宫动脉多普勒指数与预测甲氧胺酸反应有密切关系。
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引用次数: 1
Correlation between Serum Anti-Müllerian Hormone Levels and Antral follicle count in prediction of clinical pregnancy in women with unexplained infertility undergoing ICSI cycles 血清抗<s:1>勒氏激素水平与窦卵泡计数在预测不明原因不孕症行ICSI周期妇女临床妊娠中的相关性
Pub Date : 2021-03-30 DOI: 10.21608/EBWHJ.2020.19205.1049
Wafaa Taha, M. E. M. Mohamed, D. Mansour, A. Awad
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引用次数: 0
The Effect of Increased Maternal Body Mass Index on Pregnancy Outcome A Comparative, Prospective Study 孕妇体重指数增加对妊娠结局的影响:一项比较、前瞻性研究
Pub Date : 2021-03-30 DOI: 10.21608/EBWHJ.2021.42917.1107
M. Eweis, E. Farid, Ahmed Gawain, R. Ramadan
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引用次数: 0
Effect of intramyometrial injection of epinephrine during abdominal myomectomy 子宫肌瘤切除术中肌内注射肾上腺素的效果
Pub Date : 2021-03-30 DOI: 10.21608/EBWHJ.2018.5540.1007
Z. Abouzeid
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引用次数: 0
期刊
Evidence Based Womenʼs Health Journal
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