Pub Date : 2020-09-01DOI: 10.21608/ebwhj.2020.29798.1096
A. Moustafa, S. Elhady, H. Shalaby, W. Elrefaie
Aim: This study aimed to compare the use of misoprostol to carbetocin in reducing blood loss during cesarean section in low risk patients.Materials and Methods: This randomized controlled study enrolled 300 patients who were eligible. 150 women received carbetocin100ug i.v intra-operative immediately after extraction of the fetus during cesarean section (group A). They were compared to 150 women who received misoprostol 600ug rectally immediately before sterilization during caesarean section (group B).Results: There is significant difference in intraoperative uterine atony [3 (2.0%) vs 11 (7.3%) P 0.018] and surgical hemostatic measures as uterine artery ligation and uterine compression sutures [0.00 vs 3.00 (2%) P < 0.00 and 0.00 vs 12.00 (8%) P < 0.00] were higher in misopristol group. Also, the need for other uterotonic drugs was significantly higher in misopristol group (10.0 ± 0.0 vs 13.15 ± 5.28, P < 0.001 and the difference in hemoglobin and hematocrit values before and after delivery were slightly higher in misopristol group with no statistical significance (10.71 ± 0.98 vs 10.86 ± 0.84, P < 0.15 and 33.86 ± 2.8 vs 34.29 ± 2.7, P < 0.17).Conclusion: Intravenous therapy infusion of 100 ug carbetocin reduced but no significantly blood loss during cesarean section than 600ug rectal misoprostol.
目的:本研究旨在比较米索前列醇与卡贝菌素在低危患者剖宫产术中减少出血量的作用。材料和方法:本随机对照研究纳入了300例符合条件的患者。剖宫产术中取出胎儿后立即静脉滴注卡贝霉素100ug (A组)，与剖宫产术中绝育前立即直肠滴注米索前列醇600ug (B组)进行比较。米索里斯醇组术中子宫张力[3(2.0%)比11 (7.3%)P 0.018]和手术止血措施(子宫动脉结扎和子宫压迫缝合)[0.00比3.00 (2%)P < 0.00和0.00比12.00 (8%)P < 0.00]差异有统计学意义。米索里斯醇组对其他子宫强直药物的需求明显高于对照组(10.0±0.0 vs 13.15±5.28,P < 0.001);米索里斯醇组分娩前后血红蛋白和红细胞压积值差异略高于对照组(10.71±0.98 vs 10.86±0.84,P < 0.15; 33.86±2.8 vs 34.29±2.7,P < 0.17)，差异无统计学意义。结论:子宫剖宫产术中静脉输注100 ug卡贝菌素比直肠输注600ug米索前列醇可减少剖宫产术中出血量，但无显著性。
{"title":"Carbetocin versus Misoprostol in Reducing Blood Loss during Cesarean Section in low risk patients. A Randomized Controlled Trial","authors":"A. Moustafa, S. Elhady, H. Shalaby, W. Elrefaie","doi":"10.21608/ebwhj.2020.29798.1096","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.29798.1096","url":null,"abstract":"Aim: This study aimed to compare the use of misoprostol to carbetocin in reducing blood loss during cesarean section in low risk patients.Materials and Methods: This randomized controlled study enrolled 300 patients who were eligible. 150 women received carbetocin100ug i.v intra-operative immediately after extraction of the fetus during cesarean section (group A). They were compared to 150 women who received misoprostol 600ug rectally immediately before sterilization during caesarean section (group B).Results: There is significant difference in intraoperative uterine atony [3 (2.0%) vs 11 (7.3%) P 0.018] and surgical hemostatic measures as uterine artery ligation and uterine compression sutures [0.00 vs 3.00 (2%) P < 0.00 and 0.00 vs 12.00 (8%) P < 0.00] were higher in misopristol group. Also, the need for other uterotonic drugs was significantly higher in misopristol group (10.0 ± 0.0 vs 13.15 ± 5.28, P < 0.001 and the difference in hemoglobin and hematocrit values before and after delivery were slightly higher in misopristol group with no statistical significance (10.71 ± 0.98 vs 10.86 ± 0.84, P < 0.15 and 33.86 ± 2.8 vs 34.29 ± 2.7, P < 0.17).Conclusion: Intravenous therapy infusion of 100 ug carbetocin reduced but no significantly blood loss during cesarean section than 600ug rectal misoprostol.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123777307","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 : 2020-09-01DOI: 10.21608/ebwhj.2020.25596.1079
Hossam Abdou, M. Ismail, Haitham O. Elboraie, Yasser Mohamed Abou Talib
Background: Chronic pelvic pain has been described in a variety of ways, it is most commonly defined as non-menstrual pelvic pain of 6 months or more duration, that is severe enough to cause functional disability or require medical or surgical treatment. Adhesions are diagnosed in approximately 25% of women with chronic pelvic pain.Aim: The aim of the present study was to compare between quality of life before and after laparoscopic adhesiolysis in the management of chronic pelvic pain.Materials and Methods: This study was prospective cohort study which included 20 patients and carried out at Helwan University Hospitals between December 2018 and December 2019 over 12 months. All of the patients completed general health questionnaire (GHQ) preoperatively. All laparoscopies were done by the same operator. Complete adequate laparoscopic adheseolysis was the aim of laparoscopy. All patients completed the questionnaire again 2 weeks and 3 months postoperatively.Results: Fifteen patients improved after 2 weeks and 18 patients after 3 months 2 patients has no improvement and quality of life for these patients has significant improvement after laparoscopic adhesiolysis.Conclusion: Laparoscopic adhesiolysis seems to be effective regarding improvement of quality of life in patient with chronic pelvic pain.
{"title":"Effect of Laparoscopic Adhesiolysis of Pelvic Adhesions in Management of Chronic Pelvic Pain on Quality of Life","authors":"Hossam Abdou, M. Ismail, Haitham O. Elboraie, Yasser Mohamed Abou Talib","doi":"10.21608/ebwhj.2020.25596.1079","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.25596.1079","url":null,"abstract":"Background: Chronic pelvic pain has been described in a variety of ways, it is most commonly defined as non-menstrual pelvic pain of 6 months or more duration, that is severe enough to cause functional disability or require medical or surgical treatment. Adhesions are diagnosed in approximately 25% of women with chronic pelvic pain.Aim: The aim of the present study was to compare between quality of life before and after laparoscopic adhesiolysis in the management of chronic pelvic pain.Materials and Methods: This study was prospective cohort study which included 20 patients and carried out at Helwan University Hospitals between December 2018 and December 2019 over 12 months. All of the patients completed general health questionnaire (GHQ) preoperatively. All laparoscopies were done by the same operator. Complete adequate laparoscopic adheseolysis was the aim of laparoscopy. All patients completed the questionnaire again 2 weeks and 3 months postoperatively.Results: Fifteen patients improved after 2 weeks and 18 patients after 3 months 2 patients has no improvement and quality of life for these patients has significant improvement after laparoscopic adhesiolysis.Conclusion: Laparoscopic adhesiolysis seems to be effective regarding improvement of quality of life in patient with chronic pelvic pain.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"53 82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115183285","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 : 2020-09-01DOI: 10.21608/ebwhj.2020.21885.1070
A. S. El-Houssieny, H. A. Sabba, H. Allam, M. Abozeid
Background: Outpatient hysteroscopy is a clinical procedure that is used for several diagnostic and therapeutic purposes. However, the most common adverse event and reason for procedure failure is pain. Several strategies were developed to manage pain during outpatient hysteroscopy.Aim: The aim of the present study is to compare the efficacy of intrauterine lidocaine instillation and rectal diclofenac in reducing pain associated with outpatient hysteroscopy.Materials and Methods: The present study was a randomized, comparative, trial that included. 200 female patients who underwent outpatient hysteroscopy at office hysteroscopy room at early cancer detection unit of Ain-Shams Maternity Hospital. The patients were randomly allocated to receive transcervical intrauterine instillation of 5 ml 2% lidocaine or 100 mg rectal diclofenac.Results: The most common cause for undergoing infertility, followed by menorrhagia and irregular uterine bleeding. In addition, the most common findings were submucous fibroid, endometrial polyp, and intrauterine adhesion. Regarding the primary outcome of the present study, it was found that the 100 mg rectal diclofenac was more effective than intrauterine instillation of 5 ml 2% lidocaine for pain relief during outpatient hysteroscopy. Both drugs were tolerable with no observed adverse events.Conclusion: Rectal diclofenac was more effective than local anesthetic in pain relief during outpatient hysteroscopy. This technique may be ideal for outpatient diagnostic hysteroscopy. However, further well-designed studies are still needed to confirm this finding.
背景:门诊宫腔镜是一种用于多种诊断和治疗目的的临床程序。然而，最常见的不良事件和手术失败的原因是疼痛。制定了几种策略来管理门诊宫腔镜检查期间的疼痛。目的:本研究的目的是比较子宫内滴注利多卡因和直肠双氯芬酸对减轻门诊宫腔镜相关疼痛的疗效。材料和方法:本研究是一项随机比较试验，包括。在艾因沙姆斯妇产医院早期癌症检测部宫腔镜室行门诊宫腔镜检查的200例女性患者。患者被随机分配接受经宫颈子宫内滴注5 ml 2%利多卡因或100 mg直肠双氯芬酸。结果:不孕症最常见的原因是月经过多和不规则子宫出血。此外，最常见的表现是粘膜下肌瘤、子宫内膜息肉和宫内粘连。关于本研究的主要结局，我们发现100mg直肠双氯芬酸比5ml 2%利多卡因宫腔内滴注在门诊宫腔镜下缓解疼痛更有效。两种药物均可耐受，未见不良反应。结论:直肠双氯芬酸对门诊宫腔镜疼痛的缓解效果优于局麻药。这项技术可能是理想的门诊诊断宫腔镜。然而，还需要进一步精心设计的研究来证实这一发现。
{"title":"Comparing Transcervical Intrauterine Lidocaine Instillation with Rectal Diclofenac for Pain Relief During Outpatient Hysteroscopy: A Randomized Controlled Trial","authors":"A. S. El-Houssieny, H. A. Sabba, H. Allam, M. Abozeid","doi":"10.21608/ebwhj.2020.21885.1070","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.21885.1070","url":null,"abstract":"Background: Outpatient hysteroscopy is a clinical procedure that is used for several diagnostic and therapeutic purposes. However, the most common adverse event and reason for procedure failure is pain. Several strategies were developed to manage pain during outpatient hysteroscopy.Aim: The aim of the present study is to compare the efficacy of intrauterine lidocaine instillation and rectal diclofenac in reducing pain associated with outpatient hysteroscopy.Materials and Methods: The present study was a randomized, comparative, trial that included. 200 female patients who underwent outpatient hysteroscopy at office hysteroscopy room at early cancer detection unit of Ain-Shams Maternity Hospital. The patients were randomly allocated to receive transcervical intrauterine instillation of 5 ml 2% lidocaine or 100 mg rectal diclofenac.Results: The most common cause for undergoing infertility, followed by menorrhagia and irregular uterine bleeding. In addition, the most common findings were submucous fibroid, endometrial polyp, and intrauterine adhesion. Regarding the primary outcome of the present study, it was found that the 100 mg rectal diclofenac was more effective than intrauterine instillation of 5 ml 2% lidocaine for pain relief during outpatient hysteroscopy. Both drugs were tolerable with no observed adverse events.Conclusion: Rectal diclofenac was more effective than local anesthetic in pain relief during outpatient hysteroscopy. This technique may be ideal for outpatient diagnostic hysteroscopy. However, further well-designed studies are still needed to confirm this finding.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129990125","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 : 2020-09-01DOI: 10.21608/ebwhj.2020.111350
M. Hammad, R. Elkabarity, M. Ammar, Milad Ragaie Zakry
Background: Post-laparoscopy analgesia is still a challenge. Many studies have been carried out to find the effect of different analgesic techniques in patients undergoing laparoscopic hysterectomy including ultrasonic guided TAP block and instillation of intraperitoneal local anesthetic.Aim: The aim of this study is to assess degree of pain control, duration of action, duration of postoperative analgesia, the effect on postoperative analgesic requirements in patients undergoing laparscopic hysterectomy and compare between Transversus abdominis plane block and intraperitoneal local anesthetics instillation.Materials and Methods: This study enrolled 50 cases for laparoscopic hysterectomy. They were divided randomly into two groups : TAP group (n=25) patients of this group received TAP block performed by ultrasound guidance and IPLA group (n=25) patients of this group received intraperitoneal local anesthetic (bupivacaine) instillation. After surgery, visual analogue score (VAS) was recorded at 1, 2,4,6,12,18 and 24 hours. Requirement of rescue analgesia when VAS score ≥ 4, total dose of morphine received in 24 h were noted in both groups postoperatively.Results: The overall VAS during the first postoperative 24 hours was significantly lower in TAP group (P = 0.048, 0.049, and 0.003 at 6, 12, 18 and 24 hours after surgery) and total analgesic consumption (morphine in mg) was lower (8.36 ± 1.98 mg) in TAP group (8.2 mg) compared to IPLA (12.24 ± 1.33 mg).Conclusion: TAP block provide better postoperative pain control and reduce postoperative opioid requirement in comparison with intraperitoneal local anesthetic instillation in patients undergoing laparscopic hysterectomy.
{"title":"Comparison between ultrasound guided Transversus abdominis plane block and local anesthetic instillation in patients undergoing laparoscopic hysterectomy","authors":"M. Hammad, R. Elkabarity, M. Ammar, Milad Ragaie Zakry","doi":"10.21608/ebwhj.2020.111350","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.111350","url":null,"abstract":"Background: Post-laparoscopy analgesia is still a challenge. Many studies have been carried out to find the effect of different analgesic techniques in patients undergoing laparoscopic hysterectomy including ultrasonic guided TAP block and instillation of intraperitoneal local anesthetic.Aim: The aim of this study is to assess degree of pain control, duration of action, duration of postoperative analgesia, the effect on postoperative analgesic requirements in patients undergoing laparscopic hysterectomy and compare between Transversus abdominis plane block and intraperitoneal local anesthetics instillation.Materials and Methods: This study enrolled 50 cases for laparoscopic hysterectomy. They were divided randomly into two groups : TAP group (n=25) patients of this group received TAP block performed by ultrasound guidance and IPLA group (n=25) patients of this group received intraperitoneal local anesthetic (bupivacaine) instillation. After surgery, visual analogue score (VAS) was recorded at 1, 2,4,6,12,18 and 24 hours. Requirement of rescue analgesia when VAS score ≥ 4, total dose of morphine received in 24 h were noted in both groups postoperatively.Results: The overall VAS during the first postoperative 24 hours was significantly lower in TAP group (P = 0.048, 0.049, and 0.003 at 6, 12, 18 and 24 hours after surgery) and total analgesic consumption (morphine in mg) was lower (8.36 ± 1.98 mg) in TAP group (8.2 mg) compared to IPLA (12.24 ± 1.33 mg).Conclusion: TAP block provide better postoperative pain control and reduce postoperative opioid requirement in comparison with intraperitoneal local anesthetic instillation in patients undergoing laparscopic hysterectomy.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122175243","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 : 2020-09-01DOI: 10.21608/ebwhj.2019.19209.1052
Hossam Kamel, A. Elboghdady, A. Youssef
Background: Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks gestation and can present as late as 4-6 weeks post-partum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema.Aim: The aim of the present study is to evaluate and assess the maternal and perinatal outcomes in preeclampsia (PE), according to serum albumin value.Materials and Methods: In this study, 50 preeclamptic patients were divided into two groups according to the serum albumin level. To date, there has been no widely accepted predictive test or therapeutic intervention to prevent or delay preeclampsia. Patients included in the study were divided into two groups : group A preeclampsia with an albumin value of > 25g/l (mild hypoproteinemia). Group b preeclampsia with an albumin value of < 25 g/l (severe hypoproteinemia). All the cases were subjected to full obstetric assessment and routine laboratory investigations including serum albumin value.Results: Severe hypoproteinemia has higher incidence of cesarean section delivery mode than mild hypoprteinemia. Severe hypopreteinemia has a higher percentage and risk of preterm labor than mild hypoprotenimia. Liver function and renal function tests are affected mainly with higher percentage in SHP than MHP. SHP is associated with more percentage of poor maternal and neonatal outcomes than MHP. Fetal growth restriction can be seen more often in SHP than mild hypoprotenimea.Conclusion: Pre-eclampsia is a disease of multisystemic affection, causing liver and renal injuries, hematological abnormalities and abnormal uteroplacental blood flow. Identification of women at high risk for PE could potentially improve pregnancy outcome because intensive maternal and fetal monitoring in such patients would lead to an earlier diagnosis of the clinical signs of the disease and the associated fetal growth restriction and avoid the development of serious complications through such interventions as the administration of antihypertensive medication and early delivery. Estimation of albumin levels in pregnancy is of value in the early prediction of pre-eclampsia. SHP PE is associated with a higher risk of adverse maternal and neonatal outcomes than MHP PE, deserving closer surveillance during pregnancy
{"title":"Association of Hypoproteinemia in Preeclampsia with Maternal and Perinatal Outcomes : A Prospective Analysis of High-Risk Women","authors":"Hossam Kamel, A. Elboghdady, A. Youssef","doi":"10.21608/ebwhj.2019.19209.1052","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.19209.1052","url":null,"abstract":"Background: Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks gestation and can present as late as 4-6 weeks post-partum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema.Aim: The aim of the present study is to evaluate and assess the maternal and perinatal outcomes in preeclampsia (PE), according to serum albumin value.Materials and Methods: In this study, 50 preeclamptic patients were divided into two groups according to the serum albumin level. To date, there has been no widely accepted predictive test or therapeutic intervention to prevent or delay preeclampsia. Patients included in the study were divided into two groups : group A preeclampsia with an albumin value of > 25g/l (mild hypoproteinemia). Group b preeclampsia with an albumin value of < 25 g/l (severe hypoproteinemia). All the cases were subjected to full obstetric assessment and routine laboratory investigations including serum albumin value.Results: Severe hypoproteinemia has higher incidence of cesarean section delivery mode than mild hypoprteinemia. Severe hypopreteinemia has a higher percentage and risk of preterm labor than mild hypoprotenimia. Liver function and renal function tests are affected mainly with higher percentage in SHP than MHP. SHP is associated with more percentage of poor maternal and neonatal outcomes than MHP. Fetal growth restriction can be seen more often in SHP than mild hypoprotenimea.Conclusion: Pre-eclampsia is a disease of multisystemic affection, causing liver and renal injuries, hematological abnormalities and abnormal uteroplacental blood flow. Identification of women at high risk for PE could potentially improve pregnancy outcome because intensive maternal and fetal monitoring in such patients would lead to an earlier diagnosis of the clinical signs of the disease and the associated fetal growth restriction and avoid the development of serious complications through such interventions as the administration of antihypertensive medication and early delivery. Estimation of albumin levels in pregnancy is of value in the early prediction of pre-eclampsia. SHP PE is associated with a higher risk of adverse maternal and neonatal outcomes than MHP PE, deserving closer surveillance during pregnancy","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129867121","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 : 2020-05-01DOI: 10.21608/ebwhj.2020.28672.1095
Mohamed S. Ali, Rehab F. Abdel Rahman, N. Wahba, M. Gaber
Background: Thyroid dysfunction and autoimmunity are relatively common clinical scenario in women within reproductive age group and have been correlated and linked to a spectrum of adverse pregnancy outcomes such as recurrent miscarriage. Aim: To investigate the correlation and linkage between anti-TPO antibody and recurrent miscarriage.Materials and Methods: This case control observational research study was conducted on 90 pregnant female out which 45 with history of recurrent miscarriage were cases and 45 without such history were controls.Results: The mean age of control group was 25.29 while it was 26.69 in cases group. The prevalence of anti-tpo antibody positivity in the study group was 18.8%.out of 90 pregnant female ;17 were positive for anti-tpo antibody. The prevalence of thyroid autoimmunity in pregnant women with recurrent abortion was (37.8%) while it was (0%) in the healthy group (P=0.0). Conclusion:There was significant relationship between anti thyroid antibody positivity and recurrent miscarriage. Thyroid autoimmunity can be considered as risk marker for recurrent miscarriage.
{"title":"Relation between anti-thyroid peroxidase antibody and recurrent pregnancy loss: A case control study","authors":"Mohamed S. Ali, Rehab F. Abdel Rahman, N. Wahba, M. Gaber","doi":"10.21608/ebwhj.2020.28672.1095","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.28672.1095","url":null,"abstract":"Background: Thyroid dysfunction and autoimmunity are relatively common clinical scenario in women within reproductive age group and have been correlated and linked to a spectrum of adverse pregnancy outcomes such as recurrent miscarriage. Aim: To investigate the correlation and linkage between anti-TPO antibody and recurrent miscarriage.Materials and Methods: This case control observational research study was conducted on 90 pregnant female out which 45 with history of recurrent miscarriage were cases and 45 without such history were controls.Results: The mean age of control group was 25.29 while it was 26.69 in cases group. The prevalence of anti-tpo antibody positivity in the study group was 18.8%.out of 90 pregnant female ;17 were positive for anti-tpo antibody. The prevalence of thyroid autoimmunity in pregnant women with recurrent abortion was (37.8%) while it was (0%) in the healthy group (P=0.0). Conclusion:There was significant relationship between anti thyroid antibody positivity and recurrent miscarriage. Thyroid autoimmunity can be considered as risk marker for recurrent miscarriage.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128327019","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 : 2020-05-01DOI: 10.21608/ebwhj.2020.22949.1074
A. Nassif, M. A. Elnory
Aim: The purpose of this study was to evaluate whether bilateral opportunistic salpingectomy (BOS) in premenopausal women has any detrimental effect on ovarian reserve (OR) and if this increases surgical consequences in women undergoing vaginal hysterectomy (VH)/Non-Descent vaginal hysterectomy (NDVH).Materials and Methods: This prospective, open-label, randomized, multisite, parallel group, concealed allocation, superiority trial was conducted at Benha University Hospital (BUH), and two private centers in El-Qalubia, Egypt, From September 2015 to September 2017. 110 women undergoing VH/NDVH were allocated to adding BOS (intervention group) or not (control group) at 1 : 1 ratio. The primary outcomes were differences in change of serum Anti-mullerian hormone (ΔAMH), serum follicular stimulating hormone (ΔFSH), antral follicular count (ΔAFC), flow index (ΔFI) vascularization index (Δ VI), vascularization flow index (Δ VFI) and calculated ovarian age with OvAge (Δ OvAge), measured preoperatively and at 6 to 8 months postoperatively. The secondary outcomes were surgical outcomes as well as the feasibility of performing BOS at VH/NDVH and hospital stay.Results: Baseline demographic, clinical, hormonal and three-dimensional ultrasound characteristics did not show significant differences between both groups according to both intention to treat (ITT) analysis as well as per protocol (PP) analysis. Also, the groups did not differ significantly regarding operative outcomes such as operative time, operative bleeding and hospital stay according to ITT and PP analyses. The BOS was surgically feasible in 95% (58/61) of tried cases. In both groups the postoperative AMH, AFC, VI, FI, VFI were decreased, while FSH, OvAge were increased. There were no statistically significant differences between intervention and control groups according to ITT as well as PP analyses regarding Δ AMH (P = 0.17), Δ FSH (P = 0.11), ΔAFC (P = 0.07), Δ VI (P = 0.82), Δ FI (P = 0.94),ΔVFI 9 (P = 0.96) and Δ OaAge (P = 0.78).Conclusion: Performing bilateral opportunistic salpingectomy at time of vaginal hysterectomy / Non-descent vaginal hysterectomy did not have a detrimental effect on ovarian reserve as well as surgical consequences when compared with a policy of performing hysterectomy alone. So adding BOS as ovarian cancer risk-reducing surgery appears to be a safe procedure in average OvCa risk premenopausal women undergoing VH/NDVH for benign gynecological indications.
{"title":"Impact of prophylactic bilateral salpingectomy on ovarian reserve in women undergoing vaginal hysterectomy: A randomized controlled trial","authors":"A. Nassif, M. A. Elnory","doi":"10.21608/ebwhj.2020.22949.1074","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.22949.1074","url":null,"abstract":"Aim: The purpose of this study was to evaluate whether bilateral opportunistic salpingectomy (BOS) in premenopausal women has any detrimental effect on ovarian reserve (OR) and if this increases surgical consequences in women undergoing vaginal hysterectomy (VH)/Non-Descent vaginal hysterectomy (NDVH).Materials and Methods: This prospective, open-label, randomized, multisite, parallel group, concealed allocation, superiority trial was conducted at Benha University Hospital (BUH), and two private centers in El-Qalubia, Egypt, From September 2015 to September 2017. 110 women undergoing VH/NDVH were allocated to adding BOS (intervention group) or not (control group) at 1 : 1 ratio. The primary outcomes were differences in change of serum Anti-mullerian hormone (ΔAMH), serum follicular stimulating hormone (ΔFSH), antral follicular count (ΔAFC), flow index (ΔFI) vascularization index (Δ VI), vascularization flow index (Δ VFI) and calculated ovarian age with OvAge (Δ OvAge), measured preoperatively and at 6 to 8 months postoperatively. The secondary outcomes were surgical outcomes as well as the feasibility of performing BOS at VH/NDVH and hospital stay.Results: Baseline demographic, clinical, hormonal and three-dimensional ultrasound characteristics did not show significant differences between both groups according to both intention to treat (ITT) analysis as well as per protocol (PP) analysis. Also, the groups did not differ significantly regarding operative outcomes such as operative time, operative bleeding and hospital stay according to ITT and PP analyses. The BOS was surgically feasible in 95% (58/61) of tried cases. In both groups the postoperative AMH, AFC, VI, FI, VFI were decreased, while FSH, OvAge were increased. There were no statistically significant differences between intervention and control groups according to ITT as well as PP analyses regarding Δ AMH (P = 0.17), Δ FSH (P = 0.11), ΔAFC (P = 0.07), Δ VI (P = 0.82), Δ FI (P = 0.94),ΔVFI 9 (P = 0.96) and Δ OaAge (P = 0.78).Conclusion: Performing bilateral opportunistic salpingectomy at time of vaginal hysterectomy / Non-descent vaginal hysterectomy did not have a detrimental effect on ovarian reserve as well as surgical consequences when compared with a policy of performing hysterectomy alone. So adding BOS as ovarian cancer risk-reducing surgery appears to be a safe procedure in average OvCa risk premenopausal women undergoing VH/NDVH for benign gynecological indications.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114250031","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 : 2020-05-01DOI: 10.21608/ebwhj.2020.22384.1072
S. Ibrahim
Aim of the work: Compare the effectiveness of L-carnitine versus Co-enzyme Q10 on improving pregnancy rates and decraese the rate of early pregnancy loss in patients with PCO resistant to clomiphene citrate.Setting and Design: A prospective randomized controlled study conducted in infertility clinic of a tertiary care center from June 2017 to June 2019.Patients and Methods: A total of 225 subjects presenting with infertility and diagnosed with PCOS (based on Rotterdam criteria 2003) and resistant to clomiphene citrate were enrolled in the study. Subjects were randomly allocated into three groups. Group A: received clomiphene citrate (CC) only, Group B: received clomiphene citrate plus L-carnitine (2gm). Group C: received clomiphene citrate plus co- enzyme Q10 (200 mg). Main outcome measures include the ovulation rate, cumulative clinical pregnancy rate (CPR) are the primary outcome measures.Results: The ovulation rate was significantly higher among the groups B,C compared to group A (62.5%, 66.6% vs 18.3% respectively). Total number of cases who get pregnant were higher in Group B 35(47.3%), Group C 33(44.6%) compared to Group A 6(8.1%). Cumulative Clinical pregnancy rate was 3%, 49.3%, and 47.8% for Group A, Group B, and Group C, respectively. The abortion rate was low in Group B 4 % and significantly lower in Group C 2.7% compared to Group A 6.7%. Conclusion: Adding either L-carnitine or Co-enzyme Q10 to clomiphene citrate in patients with clomiphene-resistant PCOS were beneficial in increasing the quality of ovulation, the clinical pregnancy rate ،also in decreasing the rate of early pregnancy loss.
{"title":"Comparative study between L-carnitine versus co-enzyme Q10 as an adjuvant therapy to clomiphene resistant pcos women on improving pregnancy rate and prevention of early pregnancy loss","authors":"S. Ibrahim","doi":"10.21608/ebwhj.2020.22384.1072","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.22384.1072","url":null,"abstract":"Aim of the work: Compare the effectiveness of L-carnitine versus Co-enzyme Q10 on improving pregnancy rates and decraese the rate of early pregnancy loss in patients with PCO resistant to clomiphene citrate.Setting and Design: A prospective randomized controlled study conducted in infertility clinic of a tertiary care center from June 2017 to June 2019.Patients and Methods: A total of 225 subjects presenting with infertility and diagnosed with PCOS (based on Rotterdam criteria 2003) and resistant to clomiphene citrate were enrolled in the study. Subjects were randomly allocated into three groups. Group A: received clomiphene citrate (CC) only, Group B: received clomiphene citrate plus L-carnitine (2gm). Group C: received clomiphene citrate plus co- enzyme Q10 (200 mg). Main outcome measures include the ovulation rate, cumulative clinical pregnancy rate (CPR) are the primary outcome measures.Results: The ovulation rate was significantly higher among the groups B,C compared to group A (62.5%, 66.6% vs 18.3% respectively). Total number of cases who get pregnant were higher in Group B 35(47.3%), Group C 33(44.6%) compared to Group A 6(8.1%). Cumulative Clinical pregnancy rate was 3%, 49.3%, and 47.8% for Group A, Group B, and Group C, respectively. The abortion rate was low in Group B 4 % and significantly lower in Group C 2.7% compared to Group A 6.7%. Conclusion: Adding either L-carnitine or Co-enzyme Q10 to clomiphene citrate in patients with clomiphene-resistant PCOS were beneficial in increasing the quality of ovulation, the clinical pregnancy rate ،also in decreasing the rate of early pregnancy loss.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122798649","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 : 2020-05-01DOI: 10.21608/ebwhj.2020.20643.1063
Mohamad A. Abdelhafeez, M. Salem, M. Eisa
Aim: The aim of this study was to detect the most common causative organism causing neonatal sepsis in women suffered preterm prelabour rupture of membranes and if it is different from that of the maternal genital swab.Materials and Methods: This study was carried out on 200 pregnant women with PPROM at gestational age between 23 weeks plus 6 days to 28 weeks. Genital swabs were taken for microbiological study and all women were managed conservatively. After delivery, buccal and nasal swab were taken from the neonates and the detected organism(s) were correlated with those detected from the mothers' swabs. Also, neonatal outcome was studied regarding incidence of neonatal sepsis, Neonatal Intensive Care Unit) admission and neonatal mortality.Results: From the 200 enrolled cases and their neonates, there were thirty-three neonates (16.5%) that were admitted to the NICU with twenty-one neonates (67.8%) of them suffering neonatal sepsis. Only thirteen neonates (61.9%) of those who had suffered sepsis shared the same organisms with their mothers. The other eight cases (38.1%) had different organisms. The most frequent organism regarding maternal vaginal swabs was Escherichia coli followed by Group B Streptococci sharing the same frequency with non-hemolytic Streptococci, Staphylococcus aureus and Group A streptococci sharing the same frequency with Klebsiella species.Conclusion: E-coli is the most common causative organism for neonatal sepsis in PPROM before 28 weeks of gestation.
{"title":"Assessment of Sexual Troubles in Egyptian Women with Female Genital Mutilation","authors":"Mohamad A. Abdelhafeez, M. Salem, M. Eisa","doi":"10.21608/ebwhj.2020.20643.1063","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.20643.1063","url":null,"abstract":"Aim: The aim of this study was to detect the most common causative organism causing neonatal sepsis in women suffered preterm prelabour rupture of membranes and if it is different from that of the maternal genital swab.Materials and Methods: This study was carried out on 200 pregnant women with PPROM at gestational age between 23 weeks plus 6 days to 28 weeks. Genital swabs were taken for microbiological study and all women were managed conservatively. After delivery, buccal and nasal swab were taken from the neonates and the detected organism(s) were correlated with those detected from the mothers' swabs. Also, neonatal outcome was studied regarding incidence of neonatal sepsis, Neonatal Intensive Care Unit) admission and neonatal mortality.Results: From the 200 enrolled cases and their neonates, there were thirty-three neonates (16.5%) that were admitted to the NICU with twenty-one neonates (67.8%) of them suffering neonatal sepsis. Only thirteen neonates (61.9%) of those who had suffered sepsis shared the same organisms with their mothers. The other eight cases (38.1%) had different organisms. The most frequent organism regarding maternal vaginal swabs was Escherichia coli followed by Group B Streptococci sharing the same frequency with non-hemolytic Streptococci, Staphylococcus aureus and Group A streptococci sharing the same frequency with Klebsiella species.Conclusion: E-coli is the most common causative organism for neonatal sepsis in PPROM before 28 weeks of gestation.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122476133","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 : 2020-02-01DOI: 10.21608/EBWHJ.2020.22320.1071
Iman B. Abd Rabou, Hanan Abd-Elmonem Mohammed, H. Mohamed
Background: Postdate pregnancy is a real problem in modern obstetrics. Its incidence has been reported to be between 4-14% with an average of 10.5%. Postdate pregnancy is associated with increased risk of perinatal morbidity and mortality. Assessment of fetal wellbeing is a corner stone in the management of prolonged pregnancy.Aim: To assess the usefulness of cerebroplacental ratio (CPR) compared with umbilical artery Doppler alone in prediction of the intrapartum fetal hypoxia and the adverse perinatal outcome in uncomplicated pregnancies (low risk pregnancy) beyond 40 weeks. Patients and Methods: This study was carried out on 60 pregnant women with uncomplicated postdate pregnancies beyond 40 weeks gestation attending the antenatal clinics of Al-Zahraa University Hospital for antepartum assessment of CPR. Results:CPR had a high predictive value in postdate pregnancy with sensitivity, specificity, PPV and NPV (85.7%, 73.9%, 50%, and 94.4%), respectively, in comparison to other parameters, with cut off value (0.94).Conclusion:CPR had the highest sensitivity and NPV in prediction of neonatal outcome. Cerebroplacental ratio less than 0.94 were the best predictor of adverse perinatal outcome and neonatal ICU admission.
{"title":"Correlation between Cerebroplacental ratio and umbilical artery Doppler with pregnancy outcome in postdates","authors":"Iman B. Abd Rabou, Hanan Abd-Elmonem Mohammed, H. Mohamed","doi":"10.21608/EBWHJ.2020.22320.1071","DOIUrl":"https://doi.org/10.21608/EBWHJ.2020.22320.1071","url":null,"abstract":"Background: Postdate pregnancy is a real problem in modern obstetrics. Its incidence has been reported to be between 4-14% with an average of 10.5%. Postdate pregnancy is associated with increased risk of perinatal morbidity and mortality. Assessment of fetal wellbeing is a corner stone in the management of prolonged pregnancy.Aim: To assess the usefulness of cerebroplacental ratio (CPR) compared with umbilical artery Doppler alone in prediction of the intrapartum fetal hypoxia and the adverse perinatal outcome in uncomplicated pregnancies (low risk pregnancy) beyond 40 weeks. Patients and Methods: This study was carried out on 60 pregnant women with uncomplicated postdate pregnancies beyond 40 weeks gestation attending the antenatal clinics of Al-Zahraa University Hospital for antepartum assessment of CPR. Results:CPR had a high predictive value in postdate pregnancy with sensitivity, specificity, PPV and NPV (85.7%, 73.9%, 50%, and 94.4%), respectively, in comparison to other parameters, with cut off value (0.94).Conclusion:CPR had the highest sensitivity and NPV in prediction of neonatal outcome. Cerebroplacental ratio less than 0.94 were the best predictor of adverse perinatal outcome and neonatal ICU admission.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130081567","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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