Pub Date : 2020-02-01DOI: 10.21608/ebwhj.2019.17886.1041
Shimaa M. Abd-el-fatah, M. Sharkawy, Nawara M. Hashish, Ahmed A Wali
Aim: To evaluate the accuracy of Pap smear and colposcopy as predictors of cervical histopathology in patients undergoing total hysterectomy for benign indications, and to determine the incidence of unexpected cervical pathology in these patients. Study Design: Prospective observational study Patients and Methods: One hundred women scheduled for total hysterectomy for benign indications were subjected to preoperative Pap smear and colposcopy, at Kasr Al-Ainy Hospital, Cairo University, Egypt, during the period from September 2017 to March 2018. Findings were compared with the histopathological results of the cervices of the hysterectomy specimens. Results: Out of 100 patients included in our study, 13 had an abnormal Pap smear and 44 had abnormal findings on colposcopy. Abnormal cervical pathology was found in 30 hysterectomy specimens. Pap smear had a sensitivity and specificity of 33.3% and 95.7%, respectively, while colposcopy had a sensitivity and specificity of 96.7% and 78.6%, respectively. The incidence of unexpected cervical pathology was 66.7% depending on the Pap alone, and 3.3% when depending on colposcopy.Conclusion: Pap smear has a good specificity, but a low sensitivity in predicting cervical histopathology. Meanwhile, colposcopy has a high sensitivity and a reasonable specificity in predicting the histopathology. Colposcopy has a higher sensitivity and specificity as a pathology predictor, when compared to Pap smear.
{"title":"Can Pap smear and colposcopy predict cervical pathology prior to hysterectomy?","authors":"Shimaa M. Abd-el-fatah, M. Sharkawy, Nawara M. Hashish, Ahmed A Wali","doi":"10.21608/ebwhj.2019.17886.1041","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17886.1041","url":null,"abstract":"Aim: To evaluate the accuracy of Pap smear and colposcopy as predictors of cervical histopathology in patients undergoing total hysterectomy for benign indications, and to determine the incidence of unexpected cervical pathology in these patients. Study Design: Prospective observational study Patients and Methods: One hundred women scheduled for total hysterectomy for benign indications were subjected to preoperative Pap smear and colposcopy, at Kasr Al-Ainy Hospital, Cairo University, Egypt, during the period from September 2017 to March 2018. Findings were compared with the histopathological results of the cervices of the hysterectomy specimens. Results: Out of 100 patients included in our study, 13 had an abnormal Pap smear and 44 had abnormal findings on colposcopy. Abnormal cervical pathology was found in 30 hysterectomy specimens. Pap smear had a sensitivity and specificity of 33.3% and 95.7%, respectively, while colposcopy had a sensitivity and specificity of 96.7% and 78.6%, respectively. The incidence of unexpected cervical pathology was 66.7% depending on the Pap alone, and 3.3% when depending on colposcopy.Conclusion: Pap smear has a good specificity, but a low sensitivity in predicting cervical histopathology. Meanwhile, colposcopy has a high sensitivity and a reasonable specificity in predicting the histopathology. Colposcopy has a higher sensitivity and specificity as a pathology predictor, when compared to Pap smear.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"63 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":"126506531","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.2019.17936.1039
Kamal Rageh, A. Barakat, K. Ahmed, Abdullah Mahmoud Mohamed Ahmed
Introduction: The endometrial function and endometrial receptivity have been accepted to be major limiting factors in the establishment of pregnancy. In spite of improved almost all aspects of IVF: ovarian stimulation, embryo culture and transfer, the pregnancy rates still not satisfactory. The bottleneck is the process of implantation. Recurrent implantation failure (RIF) is one of the nightmares in reproductive medicine and despite several strategies that have been described for management; there is no universal agreement yet. Recently, intrauterine infusion of platelet-rich plasma (PRP) is described to promote endometrial growth and receptivity, PRP has been investigated as a therapeutic approach for several medical disorders in dermatology and rheumatology, but its use in IVF is still limited.Aim: To evaluate the effectiveness of intrauterine perfusion of autologous platelet-rich plasma in improvement of pregnancy rate in RIF patients.Design: Prospective randomized controlled study.Patients and Methods: After ethical committee approval was obtained, 150 infertile women with history of RIF gave their consent to be included in this study, with age below 40 yrs, body mass index (BMI) below 30 kg/m2. They were divided into 2 comparable groups ; all participants underwent antagonist protocol. In the study group, intrauterine infusion of (PRP) was performed 48 hrs before blastocyst transfer, pregnancy tests were done 12 days after ET.Results: Out of 75 participants in each group, 32 got pregnant (43%) in the study group, compared to 11 pregnant participants (15%) in control group.Conclusion: According to our study, PRP significantly improved the pregnancy rate and may be a new hope in RIF patients.
{"title":"PRP in recurrent implantation failure, hope or hype? A Prospective randomized controlled study","authors":"Kamal Rageh, A. Barakat, K. Ahmed, Abdullah Mahmoud Mohamed Ahmed","doi":"10.21608/ebwhj.2019.17936.1039","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17936.1039","url":null,"abstract":"Introduction: The endometrial function and endometrial receptivity have been accepted to be major limiting factors in the establishment of pregnancy. In spite of improved almost all aspects of IVF: ovarian stimulation, embryo culture and transfer, the pregnancy rates still not satisfactory. The bottleneck is the process of implantation. Recurrent implantation failure (RIF) is one of the nightmares in reproductive medicine and despite several strategies that have been described for management; there is no universal agreement yet. Recently, intrauterine infusion of platelet-rich plasma (PRP) is described to promote endometrial growth and receptivity, PRP has been investigated as a therapeutic approach for several medical disorders in dermatology and rheumatology, but its use in IVF is still limited.Aim: To evaluate the effectiveness of intrauterine perfusion of autologous platelet-rich plasma in improvement of pregnancy rate in RIF patients.Design: Prospective randomized controlled study.Patients and Methods: After ethical committee approval was obtained, 150 infertile women with history of RIF gave their consent to be included in this study, with age below 40 yrs, body mass index (BMI) below 30 kg/m2. They were divided into 2 comparable groups ; all participants underwent antagonist protocol. In the study group, intrauterine infusion of (PRP) was performed 48 hrs before blastocyst transfer, pregnancy tests were done 12 days after ET.Results: Out of 75 participants in each group, 32 got pregnant (43%) in the study group, compared to 11 pregnant participants (15%) in control group.Conclusion: According to our study, PRP significantly improved the pregnancy rate and may be a new hope in RIF patients.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"74 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":"122818952","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.2019.17675.1035
M. El-Kady, Dina Ali, N. Boshnak, Salma K Ahmed
Aim:To investigate and evaluate serum levels of amyloid A in PET and healthy gestations, to help in detection of a correlation between PET and serum levels of amyloid A. Methodology: A randomized case control research study conducted at Ain-Shams University Maternity Hospital, Cairo, Egypt in a period of 6 months. There was 102 study subjects in the total cohort ; 51 cases diagnosed with preeclampsia and 51 study subjects with normal gestations as a control research group. Results: The median serum level of amyloid-A was statistically significantly higher in women of PE research group in comparison to women of the control research group (p value
{"title":"Amyloid A as a biomarker for preeclampsia","authors":"M. El-Kady, Dina Ali, N. Boshnak, Salma K Ahmed","doi":"10.21608/ebwhj.2019.17675.1035","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17675.1035","url":null,"abstract":"Aim:To investigate and evaluate serum levels of amyloid A in PET and healthy gestations, to help in detection of a correlation between PET and serum levels of amyloid A. Methodology: A randomized case control research study conducted at Ain-Shams University Maternity Hospital, Cairo, Egypt in a period of 6 months. There was 102 study subjects in the total cohort ; 51 cases diagnosed with preeclampsia and 51 study subjects with normal gestations as a control research group. Results: The median serum level of amyloid-A was statistically significantly higher in women of PE research group in comparison to women of the control research group (p value","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"216 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":"133154579","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.2019.18616.1045
A. Makled, Wessam Magdy Abuelghar, A. El-shahawy, Manar Elshazly
Background: Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. Suboptimal iron content in the average mother’s diet and the presence of insufficient iron stores during the reproductive years are causes for this predominance. In many developing countries, iron deficiency anemia (IDA) in pregnancy is more of a rule than an exception with a prevalence of 52%. In the Western societies, the frequency of IDA is approximately 25% in pregnant women not taking iron supplements and less than 5% in women taking iron supplements. Anemia has a significant impact on the health of the fetus and the mother. It can be associated with increased preterm labour, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths.Aim: To find out whether there is a difference between amino acid chelated iron and iron salts (ferrous fumarate) in effect, safety, adverse effects and outcomes in treatment of iron deficiency anemia during pregnancy.Patients and Methods: The study was conducted on pregnant women attending the antenatal care in the outpatient clinic at Ain-Shams University Maternity Hospital in the period from February 2019 to July 2019, with diagnosis of iron deficiency anemia between 14 -18 weeks with hemoglobin (HB) level 8–10.5g/dL, and serum ferritin <15μg/l. One hundred fifty pregnant women who met the criteria were randomized in to 2 groups (iron chelated amino acid “IAAC” group and ferrous fumarate “FF” group). Hemoglobin level, blood indices, serum iron and serum ferritin levels were measured in both groups at 4, 8, 12 weeks of treatment.Results: There was a significant hematological improvement (mean HB level, blood indices, serum iron and ferritin levels) in both groups which was significantly higher in IAAC group.Conclusion: Iron amino acid chelate achieves faster cure rate than ferrous fumarate in women with iron deficiency anemia in pregnancy as regards mean HB and serum ferritin level. Iron amino acid chelate is associated with fewer side effects than ferrous fumarate.
{"title":"Amino Acid Chelated Iron versus Ferrous Fumarate in the Treatment of Iron Deficiency Anemia with Pregnancy : Randomized Controlled Trial","authors":"A. Makled, Wessam Magdy Abuelghar, A. El-shahawy, Manar Elshazly","doi":"10.21608/ebwhj.2019.18616.1045","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.18616.1045","url":null,"abstract":"Background: Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. Suboptimal iron content in the average mother’s diet and the presence of insufficient iron stores during the reproductive years are causes for this predominance. In many developing countries, iron deficiency anemia (IDA) in pregnancy is more of a rule than an exception with a prevalence of 52%. In the Western societies, the frequency of IDA is approximately 25% in pregnant women not taking iron supplements and less than 5% in women taking iron supplements. Anemia has a significant impact on the health of the fetus and the mother. It can be associated with increased preterm labour, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths.Aim: To find out whether there is a difference between amino acid chelated iron and iron salts (ferrous fumarate) in effect, safety, adverse effects and outcomes in treatment of iron deficiency anemia during pregnancy.Patients and Methods: The study was conducted on pregnant women attending the antenatal care in the outpatient clinic at Ain-Shams University Maternity Hospital in the period from February 2019 to July 2019, with diagnosis of iron deficiency anemia between 14 -18 weeks with hemoglobin (HB) level 8–10.5g/dL, and serum ferritin <15μg/l. One hundred fifty pregnant women who met the criteria were randomized in to 2 groups (iron chelated amino acid “IAAC” group and ferrous fumarate “FF” group). Hemoglobin level, blood indices, serum iron and serum ferritin levels were measured in both groups at 4, 8, 12 weeks of treatment.Results: There was a significant hematological improvement (mean HB level, blood indices, serum iron and ferritin levels) in both groups which was significantly higher in IAAC group.Conclusion: Iron amino acid chelate achieves faster cure rate than ferrous fumarate in women with iron deficiency anemia in pregnancy as regards mean HB and serum ferritin level. Iron amino acid chelate is associated with fewer side effects than ferrous fumarate.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"51 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":"134345813","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.2019.17674.1034
G. El-Bishry, Abdel-Latif G. El Kholy, M. Sweed, Nada Hassan
Background: Induction of labor is defined as the process of artificially stimulating the uterus to start labor. It is usually performed by administering oxytocin or prostaglandins to the pregnant woman or by manually rupturing the amniotic membranes.Aim: The aim of the study is to assess the accuracy of fetal head to perineum distance and cervical length in predicting the outcomes of labor induction.Patients and Methods: This is a prospective, observational study aimed to assess the accuracy of fetal-head to perineum distance and cervical length measurement in predicting the outcomes of labor induction. The study was performed at Ain Shams University Maternity Hospital from December 2017 to July 2018, 112 pregnant women who met inclusion criteria and admitted for labor induction at term (between 37-41 weeks).Results: In predicting the outcomes of labor either vaginal delivery or CS, Bishop Score had low diagnostic performance while cervical length, FHPD and posterior cervical angle had moderate diagnostic performance. The mean for pain perception among women who had vaginal examination was 3.6±0.9 (range: 2.0-5.0) which is significantly higher than that among women who had perineal ultrasound 1.0±0.6 (range: 0.0-2.0).Conclusion: It can be concluded that, based on this study, the FHPD, CL and posterior cervical angle are useful in predicting the outcome of labor induction in comparison to Bishop Score. Ultrasound examination is better tolerated by women than pelvic examination.
{"title":"The Accuracy of Fetal Head to Perineum Distance and Cervical Length in Predicting the Outcomes of Labor Induction","authors":"G. El-Bishry, Abdel-Latif G. El Kholy, M. Sweed, Nada Hassan","doi":"10.21608/ebwhj.2019.17674.1034","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17674.1034","url":null,"abstract":"Background: Induction of labor is defined as the process of artificially stimulating the uterus to start labor. It is usually performed by administering oxytocin or prostaglandins to the pregnant woman or by manually rupturing the amniotic membranes.Aim: The aim of the study is to assess the accuracy of fetal head to perineum distance and cervical length in predicting the outcomes of labor induction.Patients and Methods: This is a prospective, observational study aimed to assess the accuracy of fetal-head to perineum distance and cervical length measurement in predicting the outcomes of labor induction. The study was performed at Ain Shams University Maternity Hospital from December 2017 to July 2018, 112 pregnant women who met inclusion criteria and admitted for labor induction at term (between 37-41 weeks).Results: In predicting the outcomes of labor either vaginal delivery or CS, Bishop Score had low diagnostic performance while cervical length, FHPD and posterior cervical angle had moderate diagnostic performance. The mean for pain perception among women who had vaginal examination was 3.6±0.9 (range: 2.0-5.0) which is significantly higher than that among women who had perineal ultrasound 1.0±0.6 (range: 0.0-2.0).Conclusion: It can be concluded that, based on this study, the FHPD, CL and posterior cervical angle are useful in predicting the outcome of labor induction in comparison to Bishop Score. Ultrasound examination is better tolerated by women than pelvic examination.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"14 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":"124501811","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.2019.18459.1043
Fatma M. El Sokkary, Aziza H. Nassef, Mai M. Zidan
Introduction: PPROM occurs in 3% of pregnancies and is responsible for about 30% of preterm births. So, the prediction of latency interval is helpful to the patient and obstetrician to allow possible interventions and proper management.Aim: This study aimed to assess the relation between the myometrial thickness, cervical length, amniotic fluid index and membrane thickness (measured by transabdominal ultrasound) and latency interval of labor in cases of preterm premature rupture of membranes (PPROM).Patients and Methods: This was a case control study that was conducted at Al-zahraa University Hospital and Shebin El-Kom Teaching Hospital. One hundred pregnant women (28-34 weeks gestation) were divided into two groups: The first group (fifty cases of PPROM) and the second group (control group = fifty cases with no PPROM), they were subjected to routine transabdominal ultrasound examination to assess fetal biometry, amniotic fluid index, thickness of fetal membranes, cervical length, and the myometrial thickness in 4 areas (the lower uterine segment, mid-anterior uterine wall, uterine fundus, and posterior uterine wall).Results: The myometrial thickness of the anterior wall and LUS was significantly thinner, cervical length showed significant shortening, AFI was significantly decreased and the membrane thickness was significantly thicker in PPROM cases than in controls. The latency interval showed a significant inverse correlation with gestational age and a significant direct correlation with myometrial thickness, cervical length and AFI.Conclusion: There was a significant thinning in the anterior and LUS myometrial thickness in addition to shortening of cervical length, decrease in amniotic fluid index and increase in membrane thickness. Also, the myometrial thickness, the cervical length and the AFI were directly correlated with latency interval.
{"title":"Prediction of latency interval of labour in preterm premature rupture of membranes by 2D ultrasound : Case control study","authors":"Fatma M. El Sokkary, Aziza H. Nassef, Mai M. Zidan","doi":"10.21608/ebwhj.2019.18459.1043","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.18459.1043","url":null,"abstract":"Introduction: PPROM occurs in 3% of pregnancies and is responsible for about 30% of preterm births. So, the prediction of latency interval is helpful to the patient and obstetrician to allow possible interventions and proper management.Aim: This study aimed to assess the relation between the myometrial thickness, cervical length, amniotic fluid index and membrane thickness (measured by transabdominal ultrasound) and latency interval of labor in cases of preterm premature rupture of membranes (PPROM).Patients and Methods: This was a case control study that was conducted at Al-zahraa University Hospital and Shebin El-Kom Teaching Hospital. One hundred pregnant women (28-34 weeks gestation) were divided into two groups: The first group (fifty cases of PPROM) and the second group (control group = fifty cases with no PPROM), they were subjected to routine transabdominal ultrasound examination to assess fetal biometry, amniotic fluid index, thickness of fetal membranes, cervical length, and the myometrial thickness in 4 areas (the lower uterine segment, mid-anterior uterine wall, uterine fundus, and posterior uterine wall).Results: The myometrial thickness of the anterior wall and LUS was significantly thinner, cervical length showed significant shortening, AFI was significantly decreased and the membrane thickness was significantly thicker in PPROM cases than in controls. The latency interval showed a significant inverse correlation with gestational age and a significant direct correlation with myometrial thickness, cervical length and AFI.Conclusion: There was a significant thinning in the anterior and LUS myometrial thickness in addition to shortening of cervical length, decrease in amniotic fluid index and increase in membrane thickness. Also, the myometrial thickness, the cervical length and the AFI were directly correlated with latency interval.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"49 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":"124794805","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.2019.17669.1033
H. Fathi, Haitham El Sabae, A. M. Elkotb, Yasmine Mohamed
Background: Myomectomies are more commonly performed than hysterectomies, mainly due to the fact that patients desire to retain their uterus for psychological, reproductive and cultural reasons even after completing their families. The average volume of blood loss during abdominal myomectomy is 200 to 800 mL. Surgical hemorrhage may result in anemia, hypovolemia, and coagulation abnormalities.Aim: To compare between bilateral uterine artery ligation and intermittent clamping of uterine and ovarian artery on amount of blood loss during abdominal myomectomy.Patients and Methods: This study was conducted at Ain-Shams University Maternity Hospital on 90 women with symptomatic myomas in the postmenstrual period presented by abnormal uterine bleeding, dull aching lower abdominal pain, dyspareunia, pressure symptoms, progressive abdominal enlargement or pelvic heaviness, diagnosed based on clinical examination and ultrasound scan with pre-operative hemoglobin level above 10gm/dl.Results: The preoperative Hb was 11.6 gm % and 11.8gm% for both clamping and ligation one respectively, and post-operative Hb for the groups was 9.4 gm% and 9.2 gm% for the 2 groups respectively. There was no significant difference between both groups regarding postoperative drop of hemoglobin which was 0.8 gm % in the clamping group and 1.1 gm% in the ligation group. Estimated inraoperative blood loss start was significantly fewer among clamping group than among ligation group. Hemoglobin reduction was significantly fewer among clamping group than among ligation group.Conclusion: Based on the results obtained by this study, intermittent clamping of uterine and ovarian artery is a preferred approach than bilateral uterine artery ligation on blood loss during abdominal myomectomy.
{"title":"The effect of bilateral uterine artery ligation versus intermittent clamping of uterine and ovarian artery on blood loss during abdominal myomectomy : A randomized controlled trial","authors":"H. Fathi, Haitham El Sabae, A. M. Elkotb, Yasmine Mohamed","doi":"10.21608/ebwhj.2019.17669.1033","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17669.1033","url":null,"abstract":"Background: Myomectomies are more commonly performed than hysterectomies, mainly due to the fact that patients desire to retain their uterus for psychological, reproductive and cultural reasons even after completing their families. The average volume of blood loss during abdominal myomectomy is 200 to 800 mL. Surgical hemorrhage may result in anemia, hypovolemia, and coagulation abnormalities.Aim: To compare between bilateral uterine artery ligation and intermittent clamping of uterine and ovarian artery on amount of blood loss during abdominal myomectomy.Patients and Methods: This study was conducted at Ain-Shams University Maternity Hospital on 90 women with symptomatic myomas in the postmenstrual period presented by abnormal uterine bleeding, dull aching lower abdominal pain, dyspareunia, pressure symptoms, progressive abdominal enlargement or pelvic heaviness, diagnosed based on clinical examination and ultrasound scan with pre-operative hemoglobin level above 10gm/dl.Results: The preoperative Hb was 11.6 gm % and 11.8gm% for both clamping and ligation one respectively, and post-operative Hb for the groups was 9.4 gm% and 9.2 gm% for the 2 groups respectively. There was no significant difference between both groups regarding postoperative drop of hemoglobin which was 0.8 gm % in the clamping group and 1.1 gm% in the ligation group. Estimated inraoperative blood loss start was significantly fewer among clamping group than among ligation group. Hemoglobin reduction was significantly fewer among clamping group than among ligation group.Conclusion: Based on the results obtained by this study, intermittent clamping of uterine and ovarian artery is a preferred approach than bilateral uterine artery ligation on blood loss during abdominal myomectomy.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"2 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":"128828140","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.2019.17527.1032
M. Kortam, R. Abdelrahman, H. Fateen
Aim: The aim of the study was to assess the efficacy of adding L-carnitine to clomiphene citrate for increasing the ovulation and the pregnancy rate in women with PCOS. The primary outcome was the ovulation rate and the secondary outcome was the pregnancy rate.Materials and Methods: This study was a randomized controlled clinical trial that was conducted on 94 women who attended at the Obstetrics and Gynecology Outpatient Infertility Clinic at Ain-Shams University Maternity Hospital, and they were diagnosed with PCOS according to the Rotterdam Criteria (11). The women were distributed randomly into two equal groups; Group L (n=47) received 100 mg of clomiphene citrate plus 3 gm of L-carnitine orally from day 3 to day 7 of the cycle with continuation of L-carnitine till the day of pregnancy test and Group C (n=47) received 100 mg of clomiphene citrate orally from day 3 to day 7 of the cycle.Results: There was a significant difference (P 0.05) between the two groups regarding the pregnancy rate (Group L: 8.5%; Group C: 6.4%). There was a highly significant difference (P 0.05) between the two groups regarding the level of progesterone after 8 days from the hCG injection.Conclusion: L-carnitine added to clomiphene citrate for induction of ovulation in PCOS women had a significant effect on the ovulation rate, but it didn’t have a significant effect on the pregnancy rate when compared to clomiphene citrate alone.
{"title":"L-Carnitine and Clomiphene Citrate for induction of ovulation in women with Polycystic Ovary Syndrome : Randomized controlled trial","authors":"M. Kortam, R. Abdelrahman, H. Fateen","doi":"10.21608/ebwhj.2019.17527.1032","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17527.1032","url":null,"abstract":"Aim: The aim of the study was to assess the efficacy of adding L-carnitine to clomiphene citrate for increasing the ovulation and the pregnancy rate in women with PCOS. The primary outcome was the ovulation rate and the secondary outcome was the pregnancy rate.Materials and Methods: This study was a randomized controlled clinical trial that was conducted on 94 women who attended at the Obstetrics and Gynecology Outpatient Infertility Clinic at Ain-Shams University Maternity Hospital, and they were diagnosed with PCOS according to the Rotterdam Criteria (11). The women were distributed randomly into two equal groups; Group L (n=47) received 100 mg of clomiphene citrate plus 3 gm of L-carnitine orally from day 3 to day 7 of the cycle with continuation of L-carnitine till the day of pregnancy test and Group C (n=47) received 100 mg of clomiphene citrate orally from day 3 to day 7 of the cycle.Results: There was a significant difference (P 0.05) between the two groups regarding the pregnancy rate (Group L: 8.5%; Group C: 6.4%). There was a highly significant difference (P 0.05) between the two groups regarding the level of progesterone after 8 days from the hCG injection.Conclusion: L-carnitine added to clomiphene citrate for induction of ovulation in PCOS women had a significant effect on the ovulation rate, but it didn’t have a significant effect on the pregnancy rate when compared to clomiphene citrate alone.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"33 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":"121935119","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.2019.17770.1037
Karam M. Bayoumy, A. Yehia, M. Salman, N. Alkady
Objective:To assess the value of pre-induction sonographic assessment of the posterior cervical angle (PCA) and cervical length in the prediction of successful induction of labor (IOL).Patients and Methods:The present prospective observational study included IOL candidates who had their PCA and cervical length assessed by transvaginal ultrasonography and the Bishop score at the Obstetrics and Gynecology Department, Ain-Shams Maternity Hospital, Cairo, Egypt, from 1st November 2018 to 31st May 2019. The accuracy of these tests in predicting successful IOL (defined as vaginal delivery) was compared.Results: The analysis included 41 women with successful IOL and 29 women with unsuccessful IOL. The suggested cutoffs for the prediction of successful IOL were a PCA of more than 100°, a cervical length of less than 31 mm, and a Bishop score of more than four. The areas under the receiver operating characteristics curves for these three measures were not significantly different. However, a PCA of more than 100° had the best sensitivity (87.80%), specificity (86.21), positive predictive value (90%), negative predictive value (83.3%) compared with the other two predictors.Conclusion: Posterior cervical angle had the best accuracy in predicting successful induction of labor compared with the cervical length and the Bishop score
目的:探讨引产前超声评估宫颈后角(PCA)和宫颈长度对人工智能(IOL)成功的预测价值。患者和方法:本前瞻性观察性研究包括2018年11月1日至2019年5月31日在埃及开罗Ain-Shams妇产医院妇产科接受经阴道超声检查和Bishop评分评估PCA和宫颈长度的IOL患者。比较了这些测试在预测成功人工晶状体(定义为阴道分娩)方面的准确性。结果:41例人工晶状体手术成功，29例人工晶状体手术失败。预测人工晶状体成功的临界值是PCA大于100°，宫颈长度小于31 mm, Bishop评分大于4分。三种测量方法的受试者工作特征曲线下面积无显著差异。然而，与其他两种预测因子相比，大于100°的PCA具有最佳的敏感性(87.80%)，特异性(86.21)，阳性预测值(90%)，阴性预测值(83.3%)。结论:与宫颈长度和Bishop评分相比，颈后角预测引产成功的准确性最高
{"title":"Posterior cervical angle and cervical length in predicting the successful induction of labour in nulliparous woman","authors":"Karam M. Bayoumy, A. Yehia, M. Salman, N. Alkady","doi":"10.21608/ebwhj.2019.17770.1037","DOIUrl":"https://doi.org/10.21608/ebwhj.2019.17770.1037","url":null,"abstract":"Objective:To assess the value of pre-induction sonographic assessment of the posterior cervical angle (PCA) and cervical length in the prediction of successful induction of labor (IOL).Patients and Methods:The present prospective observational study included IOL candidates who had their PCA and cervical length assessed by transvaginal ultrasonography and the Bishop score at the Obstetrics and Gynecology Department, Ain-Shams Maternity Hospital, Cairo, Egypt, from 1st November 2018 to 31st May 2019. The accuracy of these tests in predicting successful IOL (defined as vaginal delivery) was compared.Results: The analysis included 41 women with successful IOL and 29 women with unsuccessful IOL. The suggested cutoffs for the prediction of successful IOL were a PCA of more than 100°, a cervical length of less than 31 mm, and a Bishop score of more than four. The areas under the receiver operating characteristics curves for these three measures were not significantly different. However, a PCA of more than 100° had the best sensitivity (87.80%), specificity (86.21), positive predictive value (90%), negative predictive value (83.3%) compared with the other two predictors.Conclusion: Posterior cervical angle had the best accuracy in predicting successful induction of labor compared with the cervical length and the Bishop score","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"111 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":"122263714","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.2020.73814
M. Salih, M. Hussein, Azhar Tag Aldin, Mosab Nouraldein, BadrEldin Karam Alla Eljack, H. Mohammed, Rayan A. Ahmed
Aim: Randomized clinical trial aimed to know the possible correlation between laparoscopic ovarian autologous PRP injection and AMH level.Patients and Methods: Fifty-one Sudanese subfertile women attended to Banoon Fertility Center, Khartoum, Sudan, during the period from January 2018- June 2019 selected randomly and exposed to laparoscopic ovarian autologous PRP injection. AMH level of every participant measured before and after 3 months of administration of PRP to the ovaries.Results and Conclusion: We measured size of correlation between AMH level pre and post exposure of ovaries to PRP, AMH level increased in 33.3% (17) of the participants after PRP injection. Size of correlation = 0.64 which represent moderate positive correlation. The p-value was < .00001. The result is significant at p < .05. Further studies must be carried on with large sample size and involving different ethnic group. We are very grateful to all participated women whom voluntarily accept to engage in the study and to all cooperative staff at banoon fertility center.
{"title":"Correlation between antimullerian hormone level before and after laparoscopic ovarian autologous PRP injections","authors":"M. Salih, M. Hussein, Azhar Tag Aldin, Mosab Nouraldein, BadrEldin Karam Alla Eljack, H. Mohammed, Rayan A. Ahmed","doi":"10.21608/ebwhj.2020.73814","DOIUrl":"https://doi.org/10.21608/ebwhj.2020.73814","url":null,"abstract":"Aim: Randomized clinical trial aimed to know the possible correlation between laparoscopic ovarian autologous PRP injection and AMH level.Patients and Methods: Fifty-one Sudanese subfertile women attended to Banoon Fertility Center, Khartoum, Sudan, during the period from January 2018- June 2019 selected randomly and exposed to laparoscopic ovarian autologous PRP injection. AMH level of every participant measured before and after 3 months of administration of PRP to the ovaries.Results and Conclusion: We measured size of correlation between AMH level pre and post exposure of ovaries to PRP, AMH level increased in 33.3% (17) of the participants after PRP injection. Size of correlation = 0.64 which represent moderate positive correlation. The p-value was < .00001. The result is significant at p < .05. Further studies must be carried on with large sample size and involving different ethnic group. We are very grateful to all participated women whom voluntarily accept to engage in the study and to all cooperative staff at banoon fertility center.","PeriodicalId":224226,"journal":{"name":"Evidence Based Womenʼs Health Journal","volume":"29 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":"121100762","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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