Pub Date : 2018-02-01DOI: 10.21608/EBWHJ.2018.5642
F. Moiety, Osama Saied El Ashkar, A. Agameya
Introduction: Huge ovarian cystic lesions are rarely encountered in modern practice due to the marked development in health care services and technology on both the diagnostic and therapeutic levels, in addition to the continuous rise of awareness of women's health issues. Laparoscopic management seems to be the ideal line of intervention.Case Report: An 18-year-old, virgin female, was presented with abdominal distension. Physical examination and ultrasonography revealed a huge pelvi-abdominal cystic mass. A laparoscopic ovarian cystectomy was performed. A follow up for 12 months and was unremarkable. The technique of the operation as well as tips in such a heroic surgery were described.Conclusion: Huge ovarian cysts might be successfully and safely treated by laparoscopic excision. There seem to be no size-related limits for laparoscopic intervention for ovarian cysts; however, experience is a crucial factor.
{"title":"Laparoscopic ovarian cystecomy for a huge ovarian cystic mass : A case report and review of literature","authors":"F. Moiety, Osama Saied El Ashkar, A. Agameya","doi":"10.21608/EBWHJ.2018.5642","DOIUrl":"https://doi.org/10.21608/EBWHJ.2018.5642","url":null,"abstract":"Introduction: Huge ovarian cystic lesions are rarely encountered in modern practice due to the marked development in health care services and technology on both the diagnostic and therapeutic levels, in addition to the continuous rise of awareness of women's health issues. Laparoscopic management seems to be the ideal line of intervention.Case Report: An 18-year-old, virgin female, was presented with abdominal distension. Physical examination and ultrasonography revealed a huge pelvi-abdominal cystic mass. A laparoscopic ovarian cystectomy was performed. A follow up for 12 months and was unremarkable. The technique of the operation as well as tips in such a heroic surgery were described.Conclusion: Huge ovarian cysts might be successfully and safely treated by laparoscopic excision. There seem to be no size-related limits for laparoscopic intervention for ovarian cysts; however, experience is a crucial factor.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132068952","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 : 2017-11-01DOI: 10.21608/EBWHJ.2017.5576
M. Eid, A. Abdallah, Ahmed S. El-Halwagy
Background: Induction of labor is a widely used intervention in modern labor. Bishop score, the gold standard for assessing favourability for induction of labor is very subjective with a poor predictive value.Objective: To compare the transvaginal ultrasonography and the score proposed by Kepansereel in prediction of success of labor induction.Patients and Methods: A prospective study involved 50 women subjected to induction of labor. Preinduction assessment of Bishop score and ultrasound measurement of cervical length, posterior cervical angle and cervical funnelling was done.Results: 35 and 15 cases had successful and unsuccessful induction .Cervical length was significantly longer and posterior cervical angle was significantly larger in cases of failed induction (p < 0.001 for both). The Bishop score and Keepanasseril core were significantly lower in association with induction failure (p < 0.001 for both).Conclusion: Successful induction correlated significantly with the Bishop score and ultrasonographic cervical length and posterior cervical angle.
{"title":"Value of transvaginal ultrasonography versus Bishop Score in predicting successful induction of labor","authors":"M. Eid, A. Abdallah, Ahmed S. El-Halwagy","doi":"10.21608/EBWHJ.2017.5576","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.5576","url":null,"abstract":"Background: Induction of labor is a widely used intervention in modern labor. Bishop score, the gold standard for assessing favourability for induction of labor is very subjective with a poor predictive value.Objective: To compare the transvaginal ultrasonography and the score proposed by Kepansereel in prediction of success of labor induction.Patients and Methods: A prospective study involved 50 women subjected to induction of labor. Preinduction assessment of Bishop score and ultrasound measurement of cervical length, posterior cervical angle and cervical funnelling was done.Results: 35 and 15 cases had successful and unsuccessful induction .Cervical length was significantly longer and posterior cervical angle was significantly larger in cases of failed induction (p < 0.001 for both). The Bishop score and Keepanasseril core were significantly lower in association with induction failure (p < 0.001 for both).Conclusion: Successful induction correlated significantly with the Bishop score and ultrasonographic cervical length and posterior cervical angle.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127732614","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 : 2017-02-01DOI: 10.21608/EBWHJ.2017.3224
A. Mahran
Objectives: To investigate the effect of body mass index (BMI) on outcome of IVF/ICSI in Egyptian women withPCOS.Study design: Retrospective cohort study.Patients And Methods: The study included including 253 women with PCOS (study group) and 253 women with tubalor unexplained infertility (control group) that underwent IVF/ICSI treatment at Minia IVF Center in Egypt in the periodbetween January 2013 and December 2015.Results: The number of retrieved oocytes and the total number of embryos were significantly higher in women withPCOS compared to the control group (P=0.003 and 0.002 respectively). There was no significant difference betweenthe two groups as regards the clinical pregnancy rate (CPR), live birth rate and miscarriage rate. More cases of ovarianhyperstimulation syndrome (OHSS) were diagnosed in the PCOS group (24 vs. 5. P=0.3). When stratified for BMI,lean PCOS women (BMI< 25) had higher CPR (35% vs. 28.2, P=0.01), live birth rate (32% vs. 26.1%, P =0.01). Therewere more cases of OHSS in lean as compared with overweight and obese PCOS women (19% vs. 3.3%, P = 0.05).Conclusion: Lean PCOS women achieved higher CPR and live birth rate in IVF/ICSI compared to overweight andobese PCOS women in Egyptian population.
目的:探讨体重指数(BMI)对埃及多囊卵巢综合征(pcos)患者体外受精/ICSI结果的影响。研究设计:回顾性队列研究。患者和方法:研究纳入2013年1月至2015年12月在埃及Minia IVF中心接受IVF/ICSI治疗的多囊卵巢综合征(PCOS)妇女253例(研究组)和输卵管或不明原因性不孕症妇女253例(对照组)。结果:pcos患者取卵数和胚胎总数明显高于对照组(P=0.003和0.002)。两组临床妊娠率(CPR)、活产率、流产率比较，差异均无统计学意义。多囊卵巢综合征(PCOS)组出现卵巢过度刺激综合征(OHSS)的病例较多(24例对5例)。P = 0.3)。当BMI分层时，瘦弱PCOS女性(BMI< 25)有更高的CPR (35% vs. 28.2, P=0.01)和活产率(32% vs. 26.1%， P=0.01)。与超重和肥胖的PCOS女性相比，瘦子女性的OHSS发生率更高(19% vs. 3.3%， P = 0.05)。结论:在埃及人群中，与超重和肥胖PCOS妇女相比，瘦弱PCOS妇女在IVF/ICSI中获得了更高的CPR和活产率。
{"title":"Useeffect of Body Mass Index on in Vitro Fertilization/Intra-Cytoplasmic Sperm Injection Outcome in Egyptian Women with Polycystic Ovary Syndrome","authors":"A. Mahran","doi":"10.21608/EBWHJ.2017.3224","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.3224","url":null,"abstract":"Objectives: To investigate the effect of body mass index (BMI) on outcome of IVF/ICSI in Egyptian women withPCOS.Study design: Retrospective cohort study.Patients And Methods: The study included including 253 women with PCOS (study group) and 253 women with tubalor unexplained infertility (control group) that underwent IVF/ICSI treatment at Minia IVF Center in Egypt in the periodbetween January 2013 and December 2015.Results: The number of retrieved oocytes and the total number of embryos were significantly higher in women withPCOS compared to the control group (P=0.003 and 0.002 respectively). There was no significant difference betweenthe two groups as regards the clinical pregnancy rate (CPR), live birth rate and miscarriage rate. More cases of ovarianhyperstimulation syndrome (OHSS) were diagnosed in the PCOS group (24 vs. 5. P=0.3). When stratified for BMI,lean PCOS women (BMI< 25) had higher CPR (35% vs. 28.2, P=0.01), live birth rate (32% vs. 26.1%, P =0.01). Therewere more cases of OHSS in lean as compared with overweight and obese PCOS women (19% vs. 3.3%, P = 0.05).Conclusion: Lean PCOS women achieved higher CPR and live birth rate in IVF/ICSI compared to overweight andobese PCOS women in Egyptian population.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123744261","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 : 2017-02-01DOI: 10.21608/EBWHJ.2017.3225
E. A. E. Fattah
Background: Polycystic ovarian syndrome is associated with high LH related to infertility.Objectives: We aim at detecting the effect of day 1 LH on the outcome of controlled ovarian stimulationin slim PCOScases to determine a cut- off value for LH.Study design: We retrospectively analysed the out- come of stimulated cycles in PCOS cases with a body mass index 18-29 kg/m2 visiting the reproductive medicine clinic in El Shatby university hospital, Egypt. They were divided into two groups: Group A( LH less than or equal to 6IU/dl ) and Group B ( LH more than 6).Recombinent FEH was started day 2 and ovarian responce was monitored by folllicular scanning and serum estradiol (E2). HCG trigger was considered when the leading follicle is at least 18 mm, luteal phase was supported by vaginal micronised progesterone. Prenancy test in blood was done 16 days later.Results: significant difference was found in gonadotrophin dose and in pregnancy rate.Conclusion: Day 1 LH had a negative predictive value better than a positive predictive value for occurrence of pregnancy.
{"title":"Usefulness of Measuring Serum LH Concentration on Day 1 Before Ovarian Stimulation in Non- Obese Polycystic Cases","authors":"E. A. E. Fattah","doi":"10.21608/EBWHJ.2017.3225","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.3225","url":null,"abstract":"Background: Polycystic ovarian syndrome is associated with high LH related to infertility.Objectives: We aim at detecting the effect of day 1 LH on the outcome of controlled ovarian stimulationin slim PCOScases to determine a cut- off value for LH.Study design: We retrospectively analysed the out- come of stimulated cycles in PCOS cases with a body mass index 18-29 kg/m2 visiting the reproductive medicine clinic in El Shatby university hospital, Egypt. They were divided into two groups: Group A( LH less than or equal to 6IU/dl ) and Group B ( LH more than 6).Recombinent FEH was started day 2 and ovarian responce was monitored by folllicular scanning and serum estradiol (E2). HCG trigger was considered when the leading follicle is at least 18 mm, luteal phase was supported by vaginal micronised progesterone. Prenancy test in blood was done 16 days later.Results: significant difference was found in gonadotrophin dose and in pregnancy rate.Conclusion: Day 1 LH had a negative predictive value better than a positive predictive value for occurrence of pregnancy.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132262533","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 : 2017-02-01DOI: 10.21608/EBWHJ.2017.3218
M. Ahmed, A. Elsayed, A. Soliman
Objective: The aim of this research is to detect the role of eradication of Helicobacter pylori in pregnant women withhyperemesis gravidarum (HG) using modified, high dose, non-teratogenic dual therapy.Study design: Randomized controlled trial.Patients and methods: The study included 156 pregnant women suffering from HG with positive fecal antigen test forHelicobacter pylori. Participants were divided randomly into two groups: group A that received the traditional management for HG (diet instructions, intravenous fluids, electrolyte replacement, antiemetics and vitamins supplementation), and group B that received the previous management for HG plus adding eradication dual therapy for Helicobacter pylori in form of Lansoprazole 30 mg TID + Amoxicillin 1 g TID for 2 weeks and the clinical response to both lines of management was evaluated in both groups two weeks after the start of management.Results: There is a statistically significant difference between both groups as regard clinical response to the used regimen with more clinical improvement in group B.Conclusion: There is an association between Helicobacter pylori infection and hyperemesis gravidarum, allowing us toconclude that Helicobacter pylori should be considered as one of the risk factors of HG. Screening for Helicobacter pylorishould be added to the investigations of HG, especially if prolonged or refractory to the traditional management. Modified, high dose, non-teratogenic dual therapy for eradication of Helicobacter pylori could be considered to relieve HG in intractable cases with negligible side effects.
目的:探讨改良、大剂量、非致畸双重治疗在妊娠剧吐(HG)孕妇中根除幽门螺杆菌的作用。研究设计:随机对照试验。患者和方法:本研究纳入156例幽门螺杆菌粪便抗原检测阳性的HG孕妇。参与者被随机分为两组:A组采用传统的HG治疗方法(饮食指导、静脉输液、电解质补充、止吐药和维生素补充)，B组采用原有的HG治疗方法加幽门螺杆菌根除双重治疗，即兰索拉唑30mg TID +阿莫西林1g TID，疗程2周，两组在治疗开始2周后评价两种治疗方法的临床疗效。结果:两组患者对使用方案的临床反应差异有统计学意义，b组临床改善较多。幽门螺杆菌感染与妊娠剧吐之间存在一定的相关性，提示幽门螺杆菌是HG的危险因素之一。在对HG的调查中应增加幽门螺杆菌的筛查，特别是在传统治疗方法长期或难治的情况下。改良的、高剂量的、无致畸性的根除幽门螺杆菌的双重治疗可以考虑缓解顽固性病例的HG，副作用可以忽略不计。
{"title":"Role of Helicobacter Pylori Eradication in Pregnant Women with Hyperemesis Gravidarum","authors":"M. Ahmed, A. Elsayed, A. Soliman","doi":"10.21608/EBWHJ.2017.3218","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.3218","url":null,"abstract":"Objective: The aim of this research is to detect the role of eradication of Helicobacter pylori in pregnant women withhyperemesis gravidarum (HG) using modified, high dose, non-teratogenic dual therapy.Study design: Randomized controlled trial.Patients and methods: The study included 156 pregnant women suffering from HG with positive fecal antigen test forHelicobacter pylori. Participants were divided randomly into two groups: group A that received the traditional management for HG (diet instructions, intravenous fluids, electrolyte replacement, antiemetics and vitamins supplementation), and group B that received the previous management for HG plus adding eradication dual therapy for Helicobacter pylori in form of Lansoprazole 30 mg TID + Amoxicillin 1 g TID for 2 weeks and the clinical response to both lines of management was evaluated in both groups two weeks after the start of management.Results: There is a statistically significant difference between both groups as regard clinical response to the used regimen with more clinical improvement in group B.Conclusion: There is an association between Helicobacter pylori infection and hyperemesis gravidarum, allowing us toconclude that Helicobacter pylori should be considered as one of the risk factors of HG. Screening for Helicobacter pylorishould be added to the investigations of HG, especially if prolonged or refractory to the traditional management. Modified, high dose, non-teratogenic dual therapy for eradication of Helicobacter pylori could be considered to relieve HG in intractable cases with negligible side effects.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127679338","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 : 2017-02-01DOI: 10.21608/EBWHJ.2017.3220
Youssef Mohamed Wahby, Ayman N. Raslan, H. E. Ghazaly, A. E. Kateb
Objective: To evaluate the effect of Dexamethasone on the daily foetal movement count and whether this affectshaemodynamics.Study Design: This is a cohort study involving pregnant women with a history of preterm labour, to follow up theirdaily foetal movement count for 5 days. Meanwhile, the non-stress test, middle cerebral and umbilical arteries Dopplerindices were recorded before and after taking a designated Dexamethasone course. Each woman’s data was consideredas her control.Patients and Methods: A total of 50 women with low risk, except a history of previous 1 or more preterm labour, wereassigned to receive four separate injections of 6 mg Dexamethasone, each given 12 hours apart. Doppler studies andcardiotocography traces were done before and after administration. Foetal movements were counted by mothers usingSadovsky method since the first dose and 5 days later. Paired T, McNemar’s and Pearson’s correlation coefficient testswere used.Results: There were decrease in the MCA PI and RI (PI p <0.001, RI p = 0.002), increase in foetal heart rate short termvariability (p = 0.016) and decrease in the foetal movement count on Day 2 (p < 0.001).Conclusion: Dexamethasone therapy affects the heart rate, haemodynamics and decreases daily foetal movement count.
目的:探讨地塞米松对日胎动数的影响及其对血流动力学的影响。研究设计:这是一项队列研究，涉及有早产史的孕妇，随访她们每天的胎动数5天。同时记录服药前后非应激试验、大脑中动脉和脐动脉多普勒指数。每个妇女的数据都被认为是她的对照。患者和方法:共有50名低风险妇女，除有1次或1次以上早产史外，被分配接受4次6毫克地塞米松注射，每次注射间隔12小时。在给药前后分别进行多普勒检查和心脏造影。自第一次给药后及给药后5天，采用萨多夫斯基法统计胎儿运动。采用配对T、McNemar和Pearson相关系数检验。结果:MCA PI和RI降低(PI p <0.001, RI p = 0.002)，胎儿心率短期变异性增加(p = 0.016)，第2天胎动计数减少(p <0.001)。结论:地塞米松治疗影响心率、血流动力学，降低日胎动数。
{"title":"Effects of Maternal Dexamethasone Administration on Daily Foetal Movement Count and its Correlation with Doppler Studies and Non-Stress Test","authors":"Youssef Mohamed Wahby, Ayman N. Raslan, H. E. Ghazaly, A. E. Kateb","doi":"10.21608/EBWHJ.2017.3220","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.3220","url":null,"abstract":"Objective: To evaluate the effect of Dexamethasone on the daily foetal movement count and whether this affectshaemodynamics.Study Design: This is a cohort study involving pregnant women with a history of preterm labour, to follow up theirdaily foetal movement count for 5 days. Meanwhile, the non-stress test, middle cerebral and umbilical arteries Dopplerindices were recorded before and after taking a designated Dexamethasone course. Each woman’s data was consideredas her control.Patients and Methods: A total of 50 women with low risk, except a history of previous 1 or more preterm labour, wereassigned to receive four separate injections of 6 mg Dexamethasone, each given 12 hours apart. Doppler studies andcardiotocography traces were done before and after administration. Foetal movements were counted by mothers usingSadovsky method since the first dose and 5 days later. Paired T, McNemar’s and Pearson’s correlation coefficient testswere used.Results: There were decrease in the MCA PI and RI (PI p <0.001, RI p = 0.002), increase in foetal heart rate short termvariability (p = 0.016) and decrease in the foetal movement count on Day 2 (p < 0.001).Conclusion: Dexamethasone therapy affects the heart rate, haemodynamics and decreases daily foetal movement count.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124362344","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 : 2017-02-01DOI: 10.21608/EBWHJ.2017.3223
A. Saman, A. Abbas, M. Ali, E. Othman, Ibrahim S I Mohamed, M. Khalaf, Mustafa Bahloul, Dina A. El Saman
Objectives: To assess the safety and feasibility of a novel technique, External Pop-out (EPO), for supporting the loweruterine segment during fetal head extraction in cesarean section (CS).Study design: Prospective cohort study.Patients and Methods: The current research is a registered (NCT02755168) study compassing the new technique, EPO,for head extraction during CS. The technique was performed on single, living, cephalic, elective cesarean deliveries atWomen's Health Hospital, Assiut University, Egypt. The primary study outcomes were; the feasibility and the rate ofincision extensions with the External Pop-out technique. The secondary outcomes included the easiness score and thelearning curve of this technique on five senior obstetricians’ trainee.Results: The EPO technique was successful in 845/877 cases (96.3%) but impossible in the remaining 32 case because ofextensive pelvic adhesions. The rate of occurrence of minor extensions associated with EPO was 8/845 (0.95%) with nomajor extensions in succeeded cases. There was a statistically significant difference between the mean of easiness score in the early 5 cases and the next 5 cases in 4 out of 5 trainees. The remaining trainee reported a higher easiness score earlier from his 4th case. The mean of total scores in the late cases was also significantly higher than the early cases (p=0.0001).Conclusions: External Pop-out technique is feasible with low rates of uterine incisions extensions. Moreover; thistechnique is easily learned and performed by obstetricians
{"title":"External Pop-out Cesarean Section: A Novel Technique for Supporting the Lower Uterine Segment During Fetal Head Extraction","authors":"A. Saman, A. Abbas, M. Ali, E. Othman, Ibrahim S I Mohamed, M. Khalaf, Mustafa Bahloul, Dina A. El Saman","doi":"10.21608/EBWHJ.2017.3223","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.3223","url":null,"abstract":"Objectives: To assess the safety and feasibility of a novel technique, External Pop-out (EPO), for supporting the loweruterine segment during fetal head extraction in cesarean section (CS).Study design: Prospective cohort study.Patients and Methods: The current research is a registered (NCT02755168) study compassing the new technique, EPO,for head extraction during CS. The technique was performed on single, living, cephalic, elective cesarean deliveries atWomen's Health Hospital, Assiut University, Egypt. The primary study outcomes were; the feasibility and the rate ofincision extensions with the External Pop-out technique. The secondary outcomes included the easiness score and thelearning curve of this technique on five senior obstetricians’ trainee.Results: The EPO technique was successful in 845/877 cases (96.3%) but impossible in the remaining 32 case because ofextensive pelvic adhesions. The rate of occurrence of minor extensions associated with EPO was 8/845 (0.95%) with nomajor extensions in succeeded cases. There was a statistically significant difference between the mean of easiness score in the early 5 cases and the next 5 cases in 4 out of 5 trainees. The remaining trainee reported a higher easiness score earlier from his 4th case. The mean of total scores in the late cases was also significantly higher than the early cases (p=0.0001).Conclusions: External Pop-out technique is feasible with low rates of uterine incisions extensions. Moreover; thistechnique is easily learned and performed by obstetricians","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130149663","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 : 2017-02-01DOI: 10.21608/EBWHJ.2017.3279
A. Mahran
Objectives: To compare the AMH based protocol and the traditional protocol in patients undergoing IVF/ICSI.Study Design: Randomized controlled trial. Patients and Methods: Two hundred patients candidate for IVF/ICSI were randomized intro two group; AMH-basedprotocol group (n = 100) and traditional protocol group (n = 100).Results: There two groups were similar as regards the demographic features and baseline hormones. The antagonistprotocol was used more frequently in the AMH group compared to the traditional protocol group (62% vs. 19%, P = 0.03).The duration of stimulation was shorter and the total dose of gonadotropins was lower in the AMH group (10.2 ± 2.8 vs.11.7 ± 2.7, P = 0.05 and 2133.4 ± 432.5 vs. 2875.4 ± 465.7, P = 0.04, respectively). The clinical pregnancy rate (CPR)and live birth rate were higher in the AMH group compared to the control group (49.5% vs.30.7%, P = 0.001 and 43.3%vs.23.9%, P =0.001 respectively). In the AMH group, two cases were cancelled due to poor response and one case wascancelled due to moderate ovarian hyperstimulation syndrome (OHSS) with freeze all embryos, while in the traditionalprotocol group, five cases were cancelled due to poor response and seven cases were cancelled due to moderate / severeOHSS (2% vs. 5%, P =0.002 and 1% vs. 7%, P = 0.001 respectively).Conclusion: AMH based protocol was significantly associated with improvement of CPR and live birth rate whilereducing the adverse outcomes such as OHSS and cycle cancellation rate in patients undergoing IVF/ICSI.
目的:比较基于AMH的方案与传统方案在IVF/ICSI患者中的应用。研究设计:随机对照试验。患者与方法:将200例拟体外受精/ICSI患者随机分为两组;基于amh的协议组(n = 100)和传统协议组(n = 100)。结果:两组在人口学特征和基线激素方面相似。与传统方案组相比，AMH组使用拮抗剂方案的频率更高(62%对19%，P = 0.03)。AMH组刺激时间较短，促性腺激素总剂量较低(分别为10.2±2.8比11.7±2.7,P = 0.05; 2133.4±432.5比2875.4±465.7,P = 0.04)。AMH组临床妊娠率(CPR)和活产率(活产率)分别高于对照组(49.5% vs.30.7%， P =0.001和43.3%vs.23.9%， P =0.001)。AMH组因反应差取消2例，因中度卵巢过度刺激综合征(OHSS)取消1例，冻结全胚，而传统方案组因反应差取消5例，因中/重度卵巢过度刺激综合征取消7例(分别为2%对5%，P =0.002和1%对7%，P = 0.001)。结论:基于AMH的方案可显著改善IVF/ICSI患者的CPR和活产率，同时降低OHSS和周期取消率等不良结局。
{"title":"Anti-Müllerian Hormone Based Protocol Versus The Traditional Protocol For in-Vitro Fertilization/ Intracytoplasmic Sperm Injection: A Randomized Controlled Trial","authors":"A. Mahran","doi":"10.21608/EBWHJ.2017.3279","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.3279","url":null,"abstract":"Objectives: To compare the AMH based protocol and the traditional protocol in patients undergoing IVF/ICSI.Study Design: Randomized controlled trial. Patients and Methods: Two hundred patients candidate for IVF/ICSI were randomized intro two group; AMH-basedprotocol group (n = 100) and traditional protocol group (n = 100).Results: There two groups were similar as regards the demographic features and baseline hormones. The antagonistprotocol was used more frequently in the AMH group compared to the traditional protocol group (62% vs. 19%, P = 0.03).The duration of stimulation was shorter and the total dose of gonadotropins was lower in the AMH group (10.2 ± 2.8 vs.11.7 ± 2.7, P = 0.05 and 2133.4 ± 432.5 vs. 2875.4 ± 465.7, P = 0.04, respectively). The clinical pregnancy rate (CPR)and live birth rate were higher in the AMH group compared to the control group (49.5% vs.30.7%, P = 0.001 and 43.3%vs.23.9%, P =0.001 respectively). In the AMH group, two cases were cancelled due to poor response and one case wascancelled due to moderate ovarian hyperstimulation syndrome (OHSS) with freeze all embryos, while in the traditionalprotocol group, five cases were cancelled due to poor response and seven cases were cancelled due to moderate / severeOHSS (2% vs. 5%, P =0.002 and 1% vs. 7%, P = 0.001 respectively).Conclusion: AMH based protocol was significantly associated with improvement of CPR and live birth rate whilereducing the adverse outcomes such as OHSS and cycle cancellation rate in patients undergoing IVF/ICSI.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129318420","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 : 2017-02-01DOI: 10.21608/EBWHJ.2017.3221
Walid Attalla, Tarek Abd Elhamidb
Objective: To evaluate the effect of the aromatase inhibitor letrozole in the prevention of ovarian hyperstimulationsyndrome (OHSS) in patients at risk during controlled ovarian hyperstimul (COH).Design: This is a prospective, randomized, double-blind study on women at risk of the development of OHSS during COHusing gonadotropin-releasing hormone (GnRH) antagonist protocolPatients and Methods: This research was conducted at the Center of Assisted Reproduction, Om El-kora Hospital,Tanta, Egypt. Sixty patients, who were considered at risk of the development of OHSS during COH were enrolled in thisstudy. Ovarian stimulation was performed using GnRH, whereas cabergoline (0.25 mg) given twice daily or letrozole(2.5 mg) twice daily from the day of oocyte retrieval for one week.Results: In the cabergoline group, two cases (6.6%) developed mild OHSS and one case (3.3%) developed moderateOHSS versus 8 (26.6%) mild OHSS and 6 (20%) moderate OHSS in the letrozole group. On the other hand, there was nostatistically significant difference in the number of cases that developed severe OHSS in both groups where only one case(3.3%) developed severe OHSS in the cabergoline group vs. two (6.6%) cases in the letrozole group.Conclusion: Although letrozle administration during the luteal phase of ART cycles can reduce the high E2 level inhyper-responding patients, but it cannot prevent the development of early OHSS. On the contrary, Cabergoline caneffectively prevent the development of early OHSS.
{"title":"Aromatase Inhibitors Versus Cabergoline for the Prevention of Ovarian Hyperstimulation Syndrome: a Prospective, Randomized, Double-Blind Study","authors":"Walid Attalla, Tarek Abd Elhamidb","doi":"10.21608/EBWHJ.2017.3221","DOIUrl":"https://doi.org/10.21608/EBWHJ.2017.3221","url":null,"abstract":"Objective: To evaluate the effect of the aromatase inhibitor letrozole in the prevention of ovarian hyperstimulationsyndrome (OHSS) in patients at risk during controlled ovarian hyperstimul (COH).Design: This is a prospective, randomized, double-blind study on women at risk of the development of OHSS during COHusing gonadotropin-releasing hormone (GnRH) antagonist protocolPatients and Methods: This research was conducted at the Center of Assisted Reproduction, Om El-kora Hospital,Tanta, Egypt. Sixty patients, who were considered at risk of the development of OHSS during COH were enrolled in thisstudy. Ovarian stimulation was performed using GnRH, whereas cabergoline (0.25 mg) given twice daily or letrozole(2.5 mg) twice daily from the day of oocyte retrieval for one week.Results: In the cabergoline group, two cases (6.6%) developed mild OHSS and one case (3.3%) developed moderateOHSS versus 8 (26.6%) mild OHSS and 6 (20%) moderate OHSS in the letrozole group. On the other hand, there was nostatistically significant difference in the number of cases that developed severe OHSS in both groups where only one case(3.3%) developed severe OHSS in the cabergoline group vs. two (6.6%) cases in the letrozole group.Conclusion: Although letrozle administration during the luteal phase of ART cycles can reduce the high E2 level inhyper-responding patients, but it cannot prevent the development of early OHSS. On the contrary, Cabergoline caneffectively prevent the development of early OHSS.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122543529","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 : 2016-11-01DOI: 10.1097/01.EBX.0000508306.21837.16
Hossam Hassan Aly Hassan El Sokkary, R. Haleem
Evidence Based Women’s Health Journal 2016, 6:149–152 Objective The aim of this study was to correlate the level of CA125 in different stages, histopathological types, and grades of endometrial cancer. Patients and methods Prospective study was conducted on 120 endometrial cancer patients who underwent full surgical staging, preoperative measurement of CA125, histopathological examination, and grading of uterus and pelvic lymph nodes. Results Histopathology of the cases revealed the following: 102 cases were endometrioid adenocarcinoma, 17 cases were serous papillary adenocarcinoma, and one case was clear cell carcinoma. All 25 (100%) cases with advanced-stage disease had a CA-125 level of at least 35 Uml, compared with 52 of 95 (54.7%) cases with early-stage disease (Po0.001). In relation to histopathological type and CA-125 serum level, all the 18 (100%) nonendometrioid-type cases had a CA-125 level of greater than or equal to 35 Uml in comparison with 59 of 102 (57.8%) endometriod cases (P = 0.001). In contrast to histopathological grading, there was no positive correlation (P = 0.36). Conclusion Preoperative CA125 serum levels of at least 35 Uml in uterine adenocarcinoma can predict advanced disease stages (III or IV), regional lymph nodes metastasis, and high risk patients who need regional lymphadenectomy and complete surgical staging.
{"title":"Studying CA-125 tumor marker level in different stages, histopathological types, and grades of endometrial cancer","authors":"Hossam Hassan Aly Hassan El Sokkary, R. Haleem","doi":"10.1097/01.EBX.0000508306.21837.16","DOIUrl":"https://doi.org/10.1097/01.EBX.0000508306.21837.16","url":null,"abstract":"Evidence Based Women’s Health Journal 2016, 6:149–152 Objective The aim of this study was to correlate the level of CA125 in different stages, histopathological types, and grades of endometrial cancer. Patients and methods Prospective study was conducted on 120 endometrial cancer patients who underwent full surgical staging, preoperative measurement of CA125, histopathological examination, and grading of uterus and pelvic lymph nodes. Results Histopathology of the cases revealed the following: 102 cases were endometrioid adenocarcinoma, 17 cases were serous papillary adenocarcinoma, and one case was clear cell carcinoma. All 25 (100%) cases with advanced-stage disease had a CA-125 level of at least 35 Uml, compared with 52 of 95 (54.7%) cases with early-stage disease (Po0.001). In relation to histopathological type and CA-125 serum level, all the 18 (100%) nonendometrioid-type cases had a CA-125 level of greater than or equal to 35 Uml in comparison with 59 of 102 (57.8%) endometriod cases (P = 0.001). In contrast to histopathological grading, there was no positive correlation (P = 0.36). Conclusion Preoperative CA125 serum levels of at least 35 Uml in uterine adenocarcinoma can predict advanced disease stages (III or IV), regional lymph nodes metastasis, and high risk patients who need regional lymphadenectomy and complete surgical staging.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"134 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127027132","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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