Pub Date : 2021-03-30DOI: 10.21608/EBWHJ.2019.19066.1047
M. Shaban
{"title":"The Role of Gum Chewing in Regaining Bowel Motility in Patients Undergoing Caesarean Section: a randomized controlled trial","authors":"M. Shaban","doi":"10.21608/EBWHJ.2019.19066.1047","DOIUrl":"https://doi.org/10.21608/EBWHJ.2019.19066.1047","url":null,"abstract":"","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124169378","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 : 2021-03-30DOI: 10.21608/EBWHJ.2019.16436.1017
Mai All ansary, A. Megeed
Background: Uterine fibroid are the most common benign pelvic tumors among women in reproductive age group that has multifactorial pathogenesis. Vitamin D has become one of the key elements of modern theories of uterine fibroid pathogenesis. Aim: This work aim to investigate the association between vitamin D3 status and uterine leiomyoma. Materials and Methods: This observational case control study was conducted on 150 women in their reproductive age (20-45 years) at Ain-Shams University Hospital in the department of Obstetrics and Gynecology from March 2019 till August 2019. They were divided into two groups. 75 women with at least one uterine fibroid detected by transvaginal ultrasound to be considered as case group and the other 75 women with normal uterine examination and transvaginal ultrasound representing the control group. Results: In the current study, there was a statistically significant difference between cases group and control group as regard 25(OH) D level (P=0.001), the mean vitamin D level in the case group was 13.39±7.93 ng/ml and in the control group was 21.71±8.95 ng/ml. There was no statistical significant difference between the size of fibroid and vitamin D level. The mean serum vitamin D level in patients with small fibroid (size less than 5 cm) was 14.11ng/ml and 12.76 ng/ml for women with large fibroid (size more than 5 cm) (P=0.457). Conclusion: There is a significant association between vitamin D deficiency in reproductive age women and uterine fibroid. There is no correlation between vitamin D level and the size of uterine fibroid.
{"title":"Level of Vitamin D3 in Women who have Uterine Fibroids","authors":"Mai All ansary, A. Megeed","doi":"10.21608/EBWHJ.2019.16436.1017","DOIUrl":"https://doi.org/10.21608/EBWHJ.2019.16436.1017","url":null,"abstract":"Background: Uterine fibroid are the most common benign pelvic tumors among women in reproductive age group that has multifactorial pathogenesis. Vitamin D has become one of the key elements of modern theories of uterine fibroid pathogenesis. Aim: This work aim to investigate the association between vitamin D3 status and uterine leiomyoma. Materials and Methods: This observational case control study was conducted on 150 women in their reproductive age (20-45 years) at Ain-Shams University Hospital in the department of Obstetrics and Gynecology from March 2019 till August 2019. They were divided into two groups. 75 women with at least one uterine fibroid detected by transvaginal ultrasound to be considered as case group and the other 75 women with normal uterine examination and transvaginal ultrasound representing the control group. Results: In the current study, there was a statistically significant difference between cases group and control group as regard 25(OH) D level (P=0.001), the mean vitamin D level in the case group was 13.39±7.93 ng/ml and in the control group was 21.71±8.95 ng/ml. There was no statistical significant difference between the size of fibroid and vitamin D level. The mean serum vitamin D level in patients with small fibroid (size less than 5 cm) was 14.11ng/ml and 12.76 ng/ml for women with large fibroid (size more than 5 cm) (P=0.457). Conclusion: There is a significant association between vitamin D deficiency in reproductive age women and uterine fibroid. There is no correlation between vitamin D level and the size of uterine fibroid.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131174766","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 : 2021-03-30DOI: 10.21608/EBWHJ.2019.6533.1011
Sitthanan Thanintranon, O. Chinthakanan
{"title":"Teenage pregnancy and dropout rate from school after delivery in Northern Thailand","authors":"Sitthanan Thanintranon, O. Chinthakanan","doi":"10.21608/EBWHJ.2019.6533.1011","DOIUrl":"https://doi.org/10.21608/EBWHJ.2019.6533.1011","url":null,"abstract":"","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116231206","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 : 2021-03-30DOI: 10.21608/EBWHJ.2021.61911.1128
Hatem Elgendy, S. Mohamed
Aim: Estimation of blood glycated hemoglobin A (HbA1c) level in newly pregnant women at time of pregnancy diagnosis (T0) and 3-monthly thereafter to detect any relation between these levels and the change in maternal blood glucose (BG) levels during pregnancy. Material and Methods: 304 newly pregnant women gave fasting blood samples for estimation of T0 HbA1c level and then underwent the 75-Oral glucose tolerance test (OGTT) and were asked to re-attend the clinic overnight fasting at the start of the 12th and at the 24th-28th gestational week (GW) for estimation of HbA1c levels and to repeat the 75-OGTT. ΔHbA1c was calculated as the difference between HbA1c levels estimated at 12th GW minus T0 levels. The results of the 75-OGTT were interpreted for diagnosis of gestational diabetes mellitus (GDM) and HbA1c at range of 4-6% indicates non-diabetic state. Study outcome is the ability of T0 levels of HbA1c to discriminate women vulnerable to develop GDM around the 24th to the 28th GW. Results: 38 women developed GDM, while 286 women completed their pregnancy free of GDM. GDM women had significantly higher T0 body mass index (BMI) and HbA1c levels than Non-GDM women. Moreover, the 12th and 24th GW HbA1c levels and ΔHbA1c were significantly higher in GDM women. The 24th GW 2hr-postprandial BG (PPBG) levels showed significant positive correlation with T0 BMI, fasting BG and 2hr-PPBG and with T0 and 12th GW levels of HbA1c and ΔHbA1c. Regression analysis defined T0 level of HbA1c, ΔHbA1c, 12th GW HbA1c level and T0 BMI as the significant positive predictor for the 24th GW 2hr-PPBG level. ROC curve analysis defined T0 level of HbA1c and ΔHbA1c as the significant predictors for the 24th GW 2hr-PPBG level which is diagnostic for GDM. Conclusion: Development and severity of GDM could be predicted at time of pregnancy diagnosis by high HbA1c level and assured by calculation of the extent of change in HbA1c level at the 12th GW.
{"title":"Estimation of Glycated Hemoglobin A (HbA1c) at time of Pregnancy Diagnosis as a discriminative Early test for Women vulnerable to develop Gestational Diabetes Mellitus at the 24th Gestational Week","authors":"Hatem Elgendy, S. Mohamed","doi":"10.21608/EBWHJ.2021.61911.1128","DOIUrl":"https://doi.org/10.21608/EBWHJ.2021.61911.1128","url":null,"abstract":"Aim: Estimation of blood glycated hemoglobin A (HbA1c) level in newly pregnant women at time of pregnancy diagnosis (T0) and 3-monthly thereafter to detect any relation between these levels and the change in maternal blood glucose (BG) levels during pregnancy. Material and Methods: 304 newly pregnant women gave fasting blood samples for estimation of T0 HbA1c level and then underwent the 75-Oral glucose tolerance test (OGTT) and were asked to re-attend the clinic overnight fasting at the start of the 12th and at the 24th-28th gestational week (GW) for estimation of HbA1c levels and to repeat the 75-OGTT. ΔHbA1c was calculated as the difference between HbA1c levels estimated at 12th GW minus T0 levels. The results of the 75-OGTT were interpreted for diagnosis of gestational diabetes mellitus (GDM) and HbA1c at range of 4-6% indicates non-diabetic state. Study outcome is the ability of T0 levels of HbA1c to discriminate women vulnerable to develop GDM around the 24th to the 28th GW. Results: 38 women developed GDM, while 286 women completed their pregnancy free of GDM. GDM women had significantly higher T0 body mass index (BMI) and HbA1c levels than Non-GDM women. Moreover, the 12th and 24th GW HbA1c levels and ΔHbA1c were significantly higher in GDM women. The 24th GW 2hr-postprandial BG (PPBG) levels showed significant positive correlation with T0 BMI, fasting BG and 2hr-PPBG and with T0 and 12th GW levels of HbA1c and ΔHbA1c. Regression analysis defined T0 level of HbA1c, ΔHbA1c, 12th GW HbA1c level and T0 BMI as the significant positive predictor for the 24th GW 2hr-PPBG level. ROC curve analysis defined T0 level of HbA1c and ΔHbA1c as the significant predictors for the 24th GW 2hr-PPBG level which is diagnostic for GDM. Conclusion: Development and severity of GDM could be predicted at time of pregnancy diagnosis by high HbA1c level and assured by calculation of the extent of change in HbA1c level at the 12th GW.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"258263 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123287793","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 : 2021-03-16DOI: 10.21608/EBWHJ.2021.58921.1119
H. S. Kamel, Diaa Eldeen M. Abd El Aal, Mohammed Nagy Elammary, Mohammed Twfik
Aim: The objective of this prospective cohort study is to create a scoring model for prediction of placenta accreta in early pregnancy by two-dimensional ultrasound and color Doppler. Materials and Methods: In our study, we investigated 146 Patients at high risk of PAS using two dimensional and color Doppler ultrasound for findings suggestive of placenta accreta in early pregnancy. At time of delivery, diagnosis of placenta accreta was confirmed clinically. Results: Significant Doppler and 2D ultrasound findings for prediction for PAS in early pregnancy were; low implantation of the gestational sac, presence of placental lacunae and gestational sac or placenta overlapping uterine scar by 2D transvaginal ultrasound and Intraplacental dilated vessels by Doppler ultrasound. A scoring model for prediction of PAS in early pregnancy was created using these significant findings in addition to the number of previous CS deliveries. A cut-off point of 4.5 (out of 7.5 total score value) was used for prediction of cases at high risk of placenta accreta with sensitivity 77% and specificity 95%. Conclusion: A standardized risk assessment scoring model based on number of previous cesarean deliveries, 2Dultrasound and Doppler findings can predict women at highest risk for morbidly adherent placenta in early pregnancy with relatively high specificity.
{"title":"Scoring Model for Prediction of Placenta Accreta Spectrum (PAS) in Early Pregnancy","authors":"H. S. Kamel, Diaa Eldeen M. Abd El Aal, Mohammed Nagy Elammary, Mohammed Twfik","doi":"10.21608/EBWHJ.2021.58921.1119","DOIUrl":"https://doi.org/10.21608/EBWHJ.2021.58921.1119","url":null,"abstract":"Aim: The objective of this prospective cohort study is to create a scoring model for prediction of placenta accreta in early pregnancy by two-dimensional ultrasound and color Doppler. Materials and Methods: In our study, we investigated 146 Patients at high risk of PAS using two dimensional and color Doppler ultrasound for findings suggestive of placenta accreta in early pregnancy. At time of delivery, diagnosis of placenta accreta was confirmed clinically. Results: Significant Doppler and 2D ultrasound findings for prediction for PAS in early pregnancy were; low implantation of the gestational sac, presence of placental lacunae and gestational sac or placenta overlapping uterine scar by 2D transvaginal ultrasound and Intraplacental dilated vessels by Doppler ultrasound. A scoring model for prediction of PAS in early pregnancy was created using these significant findings in addition to the number of previous CS deliveries. A cut-off point of 4.5 (out of 7.5 total score value) was used for prediction of cases at high risk of placenta accreta with sensitivity 77% and specificity 95%. Conclusion: A standardized risk assessment scoring model based on number of previous cesarean deliveries, 2Dultrasound and Doppler findings can predict women at highest risk for morbidly adherent placenta in early pregnancy with relatively high specificity.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131225463","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 : 2021-02-18DOI: 10.21608/EBWHJ.2021.59821.1122
T. Abdeldayem, Y. El-Kassar
Background: RhD isoimmunization is a life threatening condition for affected fetuses. It is currently treated only by intrauterine transfusion of packed red blood cells. This procedure required special skill and has potential complications. Aim : The aim of the present study was to evaluate the role of corticosteroids in prevention of fetal anemia due to RhD isoimmunization. Material and Methods: The study was conducted on 15 pregnant patients with RH isoimmunization in Shatby Maternity University Hospital, Alexandria, Egypt, during the period from July 30th 2016 to July 30th 2019. Recruited women received 40 mg oral prednisolone starting from 10th week of gestation. Follow up of Anti-Rh antibodies titer and-from 18 weeks gestationmiddle cerebral artery peak systolic velocity (MSA-PSV) was done every 2 weeks. Patients were delivered at 34 weeks gestation by elective caesarean section after receiving 4 doses of dexamethasone to enhance fetal lung maturity. Results: 12 patients continued the trial. Significant reduction was achieved in anti-Rh antibodies titer. Reduction in MSAPSV was achieved and maintained below 1.5 MOM. Gestational age at delivery ranged from30.3-34 weeks (33.18±1.2 weeks). Fetal eight at delivery ranged from 1550-2270 grams (1978.5±232.5 gm). 9 newborns required NICU admission, only 2 newborns underwent exchange transfusion therapy. Conclusion: In Rh iso-immunization, oral prednisolone proved to have a good rule in preventing fetal anemia and introducing its use should be considered. More studies with bigger sample size are needed to confirm its efficacy.
{"title":"Corticosteroids for management of Rh-isoimmunization, extended study in a tertiary referral centre.","authors":"T. Abdeldayem, Y. El-Kassar","doi":"10.21608/EBWHJ.2021.59821.1122","DOIUrl":"https://doi.org/10.21608/EBWHJ.2021.59821.1122","url":null,"abstract":"Background: RhD isoimmunization is a life threatening condition for affected fetuses. It is currently treated only by intrauterine transfusion of packed red blood cells. This procedure required special skill and has potential complications. Aim : The aim of the present study was to evaluate the role of corticosteroids in prevention of fetal anemia due to RhD isoimmunization. Material and Methods: The study was conducted on 15 pregnant patients with RH isoimmunization in Shatby Maternity University Hospital, Alexandria, Egypt, during the period from July 30th 2016 to July 30th 2019. Recruited women received 40 mg oral prednisolone starting from 10th week of gestation. Follow up of Anti-Rh antibodies titer and-from 18 weeks gestationmiddle cerebral artery peak systolic velocity (MSA-PSV) was done every 2 weeks. Patients were delivered at 34 weeks gestation by elective caesarean section after receiving 4 doses of dexamethasone to enhance fetal lung maturity. Results: 12 patients continued the trial. Significant reduction was achieved in anti-Rh antibodies titer. Reduction in MSAPSV was achieved and maintained below 1.5 MOM. Gestational age at delivery ranged from30.3-34 weeks (33.18±1.2 weeks). Fetal eight at delivery ranged from 1550-2270 grams (1978.5±232.5 gm). 9 newborns required NICU admission, only 2 newborns underwent exchange transfusion therapy. Conclusion: In Rh iso-immunization, oral prednisolone proved to have a good rule in preventing fetal anemia and introducing its use should be considered. More studies with bigger sample size are needed to confirm its efficacy.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124356354","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 : 2020-12-06DOI: 10.21608/ebwhj.2020.45846.1114
A. Morad, T. Assar
Objectives: To explore the efficacy of intrauterine infusion of autologous platelet-rich plasma (PRP) in infertile ladies as an adjuvant to clomiphene citrate (CC) in ladies with previous CC failure attributed to a thin endometrium (≤ 7 mm). Design: A pilot prospective self-controlled trial. Patients and methods: The study included thirty anovulatory PCOS women with CC failure for 3 cycles with a thin endometrium (7 mm). All patients underwent ovarian stimulations for 2 cycles; 1) Control cycle: 30 women received CC alone and one got pregnant and 2) Study cycle;29 women received CC plus an intrauterine infusion of PRP. Main endpoints included the comparison of the endometrial thickness (ET) and endometrial vascularity pattern by power Doppler on the day of hCG injection between both treatment cycles. Results: There was a statistically significant increase in the endometrial thickness on the day of hCG injection with CC plus PRP compared to CC alone (8.98 ±1.31 vs, 5.8 ±1.2; p < 0.0001). There was a significant improvement in the endometrial blood flow with the use of PRP (p= 0.00004). The pregnancy rate is significantly higher in the PRP cycles compared to control cycles (7 pregnancies (24.14%) vs. one pregnancy (3.3%) respectively; p = 0.0257) Conclusion: Intrauterine infusion PRP seems to be a promising adjuvant to increase endometrial thickness and endometrial blood flow with subsequent improvement in clinical pregnancy rate in ladies with CC failure due to thin endometrium
{"title":"Autologous platelet-rich plasma to prevent a thin endometrium in patients undergoing clomiphene citrate therapy: a pilot prospective self-controlled trial","authors":"A. Morad, T. Assar","doi":"10.21608/ebwhj.2020.45846.1114","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.45846.1114","url":null,"abstract":"Objectives: To explore the efficacy of intrauterine infusion of autologous platelet-rich plasma (PRP) in infertile ladies as an adjuvant to clomiphene citrate (CC) in ladies with previous CC failure attributed to a thin endometrium (≤ 7 mm). Design: A pilot prospective self-controlled trial. Patients and methods: The study included thirty anovulatory PCOS women with CC failure for 3 cycles with a thin endometrium (7 mm). All patients underwent ovarian stimulations for 2 cycles; 1) Control cycle: 30 women received CC alone and one got pregnant and 2) Study cycle;29 women received CC plus an intrauterine infusion of PRP. Main endpoints included the comparison of the endometrial thickness (ET) and endometrial vascularity pattern by power Doppler on the day of hCG injection between both treatment cycles. Results: There was a statistically significant increase in the endometrial thickness on the day of hCG injection with CC plus PRP compared to CC alone (8.98 ±1.31 vs, 5.8 ±1.2; p < 0.0001). There was a significant improvement in the endometrial blood flow with the use of PRP (p= 0.00004). The pregnancy rate is significantly higher in the PRP cycles compared to control cycles (7 pregnancies (24.14%) vs. one pregnancy (3.3%) respectively; p = 0.0257) Conclusion: Intrauterine infusion PRP seems to be a promising adjuvant to increase endometrial thickness and endometrial blood flow with subsequent improvement in clinical pregnancy rate in ladies with CC failure due to thin endometrium","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129599326","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 : 2020-12-06DOI: 10.21608/ebwhj.2020.28154.1092
A. Elsayed, A. Ibrahim, Mona Elkafrawy, Iman AbdRabou
Background: neonatal asphyxia is a significant cause of neonatall morbidity and mortality worldwide. Aim of the work: This study aims to is to evaluate the significance of the cord blood ischemia-modified albumin (IMA) level as a diagnostic marker for neonatal asphyxia and to determine the associations of IMA levels with doppler findings in diagnosis of neonatal asphyxia in high risk pregnancy. Patients and Methods: This is a prospective case control study that will be performed at obstetrics and gynecology department at Al-zahraa University Hospital. The study was carried out on 90 pregnant women who are attend the obstetrics department for labour and divided into two groups: Group A:(control group)it was include 30 healthy pregnant women. Group B:(study group) it was include 60 pregnant women with high risk pregnancy. Doppler measurements were obtained from umbilical and middle cerebral arteries,C/P ratio.IMA was measured by ELISA kits and expressed as picomole per milliliter. Results: Ischemia-modified albumin levels were significantly higher in neonates of complicated pregnancies as compared to uncomplicated pregnancies (P
{"title":"Correlation Between Umblical Artery Doppler Indices With Neonatal Cord Blood Ischemic Modified Albumin In Diagnosis Of Neonatal Asphyxia In High Risk Pregnancy","authors":"A. Elsayed, A. Ibrahim, Mona Elkafrawy, Iman AbdRabou","doi":"10.21608/ebwhj.2020.28154.1092","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.28154.1092","url":null,"abstract":"Background: neonatal asphyxia is a significant cause of neonatall morbidity and mortality worldwide. Aim of the work: This study aims to is to evaluate the significance of the cord blood ischemia-modified albumin (IMA) level as a diagnostic marker for neonatal asphyxia and to determine the associations of IMA levels with doppler findings in diagnosis of neonatal asphyxia in high risk pregnancy. Patients and Methods: This is a prospective case control study that will be performed at obstetrics and gynecology department at Al-zahraa University Hospital. The study was carried out on 90 pregnant women who are attend the obstetrics department for labour and divided into two groups: Group A:(control group)it was include 30 healthy pregnant women. Group B:(study group) it was include 60 pregnant women with high risk pregnancy. Doppler measurements were obtained from umbilical and middle cerebral arteries,C/P ratio.IMA was measured by ELISA kits and expressed as picomole per milliliter. Results: Ischemia-modified albumin levels were significantly higher in neonates of complicated pregnancies as compared to uncomplicated pregnancies (P","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123357076","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 : 2020-12-06DOI: 10.21608/ebwhj.2019.17455.1025
A. Elsalam, E. S. Hussien
ABSTRACTBackground: Morbidly adherent placenta (MAP) is now a significant obstetric challenge results in significant maternal morbidity and mortality (it is responsible for 7-10% of maternal mortality). The incidence of MAP have increased over the past few decades, this is mainly because of the increasing caesarean delivery rate. Risk factors for MAP include placenta previa, cesarean delivery, high maternal age and high parity.Objective: To investigate patient characteristics and neonatal and maternal outcomes of placenta accreta in Ain Shams from 2012 to 2017.Methods: This is a retrospective study which was carried out in Ain Shams University Maternity Hospital (a major tertiary referral hospital in Egypt) during the period from January 2012 to December 2017 (6 years), the archives of the hospital were examined for hospital records fulfilling the criteria of the study population during the study period. Results: The results revealed that morbidly adherent placenta was recorded during the studied period in 467 cases with an incidence of 6.6/1000 deliveries (0.66%). Conclusion: Early antenatal diagnosis of morbidly adherent placenta through imaging (ultrasound colour doppler and MRI) allows for multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality. Also, proper counselling of patients regarding associated risks reduce maternal morbidity and mortality.
{"title":"Maternal and neonatal outcomes of morbidly adherent placenta in Ain Shams University Maternity Hospital from 2012 to 2017","authors":"A. Elsalam, E. S. Hussien","doi":"10.21608/ebwhj.2019.17455.1025","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17455.1025","url":null,"abstract":"ABSTRACTBackground: Morbidly adherent placenta (MAP) is now a significant obstetric challenge results in significant maternal morbidity and mortality (it is responsible for 7-10% of maternal mortality). The incidence of MAP have increased over the past few decades, this is mainly because of the increasing caesarean delivery rate. Risk factors for MAP include placenta previa, cesarean delivery, high maternal age and high parity.Objective: To investigate patient characteristics and neonatal and maternal outcomes of placenta accreta in Ain Shams from 2012 to 2017.Methods: This is a retrospective study which was carried out in Ain Shams University Maternity Hospital (a major tertiary referral hospital in Egypt) during the period from January 2012 to December 2017 (6 years), the archives of the hospital were examined for hospital records fulfilling the criteria of the study population during the study period. Results: The results revealed that morbidly adherent placenta was recorded during the studied period in 467 cases with an incidence of 6.6/1000 deliveries (0.66%). Conclusion: Early antenatal diagnosis of morbidly adherent placenta through imaging (ultrasound colour doppler and MRI) allows for multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality. Also, proper counselling of patients regarding associated risks reduce maternal morbidity and mortality.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121450395","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 : 2020-12-06DOI: 10.21608/ebwhj.2020.19086.1048
S. Ghaly, Mohamed S. Ali, A. Abdel-Hamid
Objective: The study`s objective was to assess the accuracy of prenatal 3-dimensional power Doppler analysis of vascular and flow placental indices to predict the morbidly adherent placenta objectively.Background: Traditionally, 2D ultrasound have been used for the diagnosis of a suspected morbidly adherent placenta previa. Recently ,3D power Doppler technique was introduced to diagnose morbidly adherent placenta (MAP).Study Design: A prospective study executed among women with placenta previa between 28 and 32 weeks of gestation. Patients were examined by 2D ultrasounds which was used in management decisions. 3D Power Doppler vascular, flow and vascular flow indices were measured during the same examination after tracing of maximum placental thickness; data were blinded to obstetricians. Histopathology was used to confirm MAP. Severe morbidly adherent placenta was described as increta/percreta on histopathology, blood loss >2L, and >2 units of PRBC transfused. Sensitivities, specificities, predictive values, and likelihood ratios were calculated.Results: Our results showed that the 3D Doppler VI ≥ 16 predicted MAP with a 100% sensitivity ,100% specificity which are better than those of 2D ultrasound (60.0% and 89.1% respectively).Sever MAP occurred in 51.2% of MAP and 3D Doppler of VI > 33.1 predicted sever MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound.Conclusion: In placenta previa patients, the vascular index accurately predicts the morbidly adherent placenta. Furthermore, vascular and vascular flow indices of 3D power Doppler were more predictive of severe cases of morbidly adherent placenta compared to 2D ultrasound.
{"title":"Detecting the accuracy of three dimensional power Doppler (3DPD) vascular indices for prenatal diagnosis of morbidly adherent placenta in patients with placenta previa","authors":"S. Ghaly, Mohamed S. Ali, A. Abdel-Hamid","doi":"10.21608/ebwhj.2020.19086.1048","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.19086.1048","url":null,"abstract":"Objective: The study`s objective was to assess the accuracy of prenatal 3-dimensional power Doppler analysis of vascular and flow placental indices to predict the morbidly adherent placenta objectively.Background: Traditionally, 2D ultrasound have been used for the diagnosis of a suspected morbidly adherent placenta previa. Recently ,3D power Doppler technique was introduced to diagnose morbidly adherent placenta (MAP).Study Design: A prospective study executed among women with placenta previa between 28 and 32 weeks of gestation. Patients were examined by 2D ultrasounds which was used in management decisions. 3D Power Doppler vascular, flow and vascular flow indices were measured during the same examination after tracing of maximum placental thickness; data were blinded to obstetricians. Histopathology was used to confirm MAP. Severe morbidly adherent placenta was described as increta/percreta on histopathology, blood loss >2L, and >2 units of PRBC transfused. Sensitivities, specificities, predictive values, and likelihood ratios were calculated.Results: Our results showed that the 3D Doppler VI ≥ 16 predicted MAP with a 100% sensitivity ,100% specificity which are better than those of 2D ultrasound (60.0% and 89.1% respectively).Sever MAP occurred in 51.2% of MAP and 3D Doppler of VI > 33.1 predicted sever MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound.Conclusion: In placenta previa patients, the vascular index accurately predicts the morbidly adherent placenta. Furthermore, vascular and vascular flow indices of 3D power Doppler were more predictive of severe cases of morbidly adherent placenta compared to 2D ultrasound.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"158 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124442115","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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