Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Value of transvaginal ultrasonography versus Bishop Score in predicting successful induction of labor
125
130
EN
Marwa
Eid
Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University
Amal
Abdallah
Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-suef University, Egypt
amalkotb7295@yahoo.com
Ahmed
ElHalwagy
Department of Obstetrics and Gynaecology, Faculty of Medicine, Cairo University
10.21608/ebwhj.2017.5576
Background: Induction of labor is a widely used intervention in modern labor. Bishop score, the gold standard for assessing favourability for induction of labor is very subjective with a poor predictive value.<br />Objective: To compare the transvaginal ultrasonography and the score proposed by Kepansereel in prediction of success of labor induction.<br />Patients and Methods: A prospective study involved 50 women subjected to induction of labor. Preinduction assessment of Bishop score and ultrasound measurement of cervical length, posterior cervical angle and cervical funnelling was done.<br />Results: 35 and 15 cases had successful and unsuccessful induction .Cervical length was significantly longer and posterior cervical angle was significantly larger in cases of failed induction (p < 0.001 for both). The Bishop score and Keepanasseril core were significantly lower in association with induction failure (p < 0.001 for both).<br />Conclusion: Successful induction correlated significantly with the Bishop score and ultrasonographic cervical length and posterior cervical angle.
Bishop Score,Induction of Labour,new objective scoring system,ultras-sonographic evaluation of the cervix
https://ebwhj.journals.ekb.eg/article_5576.html
https://ebwhj.journals.ekb.eg/article_5576_c8785b36097d7b6969341a647bf74271.pdf
Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Predictive value of Lipocalin 2 and hyperuricemia on maternal and fetal outcome in pre-eclampsia
131
140
EN
Shahinaz
El-Shourbagy
Obstetrics and Gynecology, Faculty of Medicine; Tanta University
shahyshorbagy70@yahoo.com
Amira
Aloraby
Pathology Departments, Faculty of Medicine; Tanta University
Desouky
E.
Abo Amo
Clinical Pathology Departments, Faculty of Medicine; Tanta University
10.21608/ebwhj.2018.5579
Background: Pre-eclampsia is a complex hypertensive syndrome that originates in early pregnancy and leads to considerable maternal and fetal morbidity and mortality. Lipocalin 2 is low in healthy human tissue but increased in pathological conditions following endothelial cell injury. Women with pre-eclampsia showed elevated uric acid level in the maternal blood.<br />Objective: To assess the predictive value of Lipcalin 2 and hyperuricemia on the severity of pre-eclampsia and on maternal and fetal outcome.<br />Patients and Methods: Sixty women enrolled in the present study were forty affected by preeclampsia and 20 women with uncomplicated pregnancies formed the control group. All women included in the study were subjected to; complete history taking; clinical and blood pressure evaluation; measurements of biochemical parameters and evaluation of maternal and fetal well-being.<br />Results: Thirty-two of hypertensive women were mild pre-eclampsia having blood pressure ≥140/90mmHg but less than 160/110mmHg. Eight cases were severe pre-eclampsia with the presence of blood pressure ≥160/110 mmHg. All hypertensive women showed statistically significant increased biochemical parameters compared to control "p<0.001". Lipocalin 2 and serum uric acid levels in the studied group showed a positive correlation with various biochemical parameters and hyperuricaemia showed a good relation with the pathogenesis of the maternal and fetal manifestations.<br />Conclusion: Lipocalin 2 could be used as a sensitive indicator of severity of preeclampsia. On the other hand hyperuricaemia showed a good relationship with fetal outcome in hypertensive disorder of pregnancy, identifying those fetuses that are likely to have Intra Uterine Growth Retardation and high perinatal mortality.
biochemical parameters,hyperuricaemia,lipocalin 2,predicting,pre-eclampsia Received: 11
https://ebwhj.journals.ekb.eg/article_5579.html
https://ebwhj.journals.ekb.eg/article_5579_087225a0eb260a640142095dee3604df.pdf
Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Oral Versus Vaginal Progesterone In Preterm Labor
141
149
EN
Mustafa
H.
Abdelaziz
Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Egypt
drmustafa_ahmed@yahoo.com
10.21608/ebwhj.2018.5580
Background: Preterm labor (PTL) remains a distressing issue in modern obstetrics, and still associated with poor impact on the perinatal outcomes world-wide. Progesterone plays a vital role in preventing the PTL.<br />Objective: To compare different route of progesterone administration on the perinatal outcomes.<br />Patients and Methods: It was a prospective comparative clinical trial, conducted at Suez Canal University Hospitals, Ismailia from December 2015 to January 2017. One hundred and thirty eight pregnant patients were randomly selected at 20–24 weeks gestation´ at risk of PTL and were classified into: 72 women received oral dydrogesterone 10 mg twice a day [Duphastone®] (Oral group) and 66 women received vaginal progesterone 200 mg vaginally twice a day [Prontogest®] (vaginal group). The primary outcome measures were gestational age at delivery in weeks, birth weight in grams, Apgar score at 1 and 5 minutes, the need for neonatal intensive care unit admission and neonatal mortality.<br />Results: There was a significant difference between both group in favor to the vaginal group in all the studied outcome measures (p value < 0.05) with the exception of the Apgar score at 5 minutes post delivery (p value = 0.1). No cases of perinatal mortality in the vaginal group and only 3 cases in the oral group.<br />Conclusion: The vaginal route is of better and significant results.
Oral progesterone,preterm birth,preterm labor,Vaginal Progesterone
https://ebwhj.journals.ekb.eg/article_5580.html
https://ebwhj.journals.ekb.eg/article_5580_0663d9014f7c9495299bd1c1a737fc86.pdf
Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Predictive Value Of Glucose And β-Hcg Concentration In The Embryo Culture Medium Of Patients Undergoing Intracytoplasmic Sperm Injection
150
154
EN
Mohamed
Mourad
El Abd
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Alexandria, Egypt
Dalal
Nasr-El Din
El Kaffash
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Alexandria, Egypt
Mohamed
Abd-El Moety
El Samra
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Alexandria, Egypt
melsamra@yahoo.com
Nooman
Sallam
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Alexandria, Egypt
10.21608/ebwhj.2018.5582
Objective: The aim of this study was to evaluate 3 methods of embryo selection in predicting the embryos with the best method of achieving pregnancy in single embryo transfer cycles, namely embryo morphology, glucose concentration and β-HCG concentration in the embryo culture medium.<br />Patients and Methods: A total of 66 embryos in 66 ICSI cycles were studied: 33 pregnant and 33 non-pregnant cycles. Each embryo was scored using the Veeck's scoring method and the spent culture medium of each embryo was analyzed for its content of glucose and β-HCG using previously validated methods.<br />Results: The results showed that the Veeck's embryo score, the measurement of glucose levels and the measurement of β-HCG levels in the spent culture medium are all reliable and practical methods to be used for this purpose. The Veeck's embryo score had the best predictability followed by β-HCG levels, followed by glucose levels in the culture medium. Combining the 3 methods was superior to each methods studied alone as well as any combination of 2 methods.<br />Conclusion: The measurement of glucose and β-HCG in the spent culture medium of individual embryos is an effective and practical method for embryo selection in patients treated with ICSI. Combining both methods with the Veeck's embryo score gives the best predictability. However, these findings should be confirmed by a prospective randomized study, preferably in single embryo transfer cycles.
ICSI,Pregnancy,culture media,glucose,B-HCG
https://ebwhj.journals.ekb.eg/article_5582.html
https://ebwhj.journals.ekb.eg/article_5582_0c0ac53a5585029ff08ec8d4da4d0977.pdf
Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Role of Incisional infiltration with intraperitoneal instillation analgesia in non descent vaginal hysterectomy
155
162
EN
Tamer
Assar
Department of Obstetrics and Gynecologyو Faculty of Medicine, Banha University, Egypt
tamer.assar2000@gmail.com
Ashraf
Nassif
Elmentawy
Department of Obstetrics and Gynecology and, Faculty of Medicine, Banha University, Egypt
Ahmed
Ahmed
Mosaad
Department of Anesthesia, Faculty of Medicine, Banha University, Egypt
Elsayed
Mohamed
Abdelazim
Department of Anesthesia, Faculty of Medicine, Banha University, Egypt
10.21608/ebwhj.2018.5583
Design: A randomized, double blind, placebocontrolled study.<br />Setting: Benha University Hospital.<br />Objective: To evaluate the analgesic effect of post incisional infiltration and intraperitoneal instillation of long acting local anathetic on post-operative pain in non descent vaginal hysterectomy (NDVH).<br />Patients and Methods: Forty eight women undergoing NDVH received 50 ml ropivacine (0.50%) (n = 24) or 50 ml saline (n = 24) by post incisional infiltration (30 ml) and intraperitoneal instillation (20 ml). Main outcome measures: pain "using visual analogue scale (VAS) score", nausea, vomiting and analgesic requirements were recorded for 24 postoperatively as well as time spent in postanesthesia care unit and time to get out of bed.<br />Results: The mean pain VAS score after one, two, four, eight, twelve hours postoperatively were significantly lower in ropivacine group (P<0.0001, P≤ 0.0001 , P≤ 0.01, P≤ 0.01, P≤ 0.01). Pain with cough also, was significantly lower in ropivacine group at one, two, four, eight, twelve hours postoperatively (P ≤ 0.0001, P≤ 0.003, P≤ 0.001, P≤ 0.01, P≤0.03) and pain with movement at four, eight hours postoperatively were significantly reduced in ropivacine group (p ≤ 0.004, P≤ 0.008). Nausea, vomiting and time to first get out of bed were significantly lower in ropivacine group (P≤ 0.009, P≤ 0.01, P≤ 0.0001) respectively. Total narcotic dose at one, twenty four hours and total parentral NSAID dose were significantly lower in ropivacine group (P≤0.0003, P≤0.0001, P≤0.001) respectively.<br />Conclusion: Post incisional local infiltration and intraperitoneal instillation of ropivacine reduces postoperative pain in women undergoing NDVH and promotes early mobilization and enhance early recovery.
Now descent vaginal hysterectomy,visual analogue scale
https://ebwhj.journals.ekb.eg/article_5583.html
https://ebwhj.journals.ekb.eg/article_5583_07b570241321534895296ec3bd5a2168.pdf
Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Preoperative Tranexamic Acid in conjunction with Crystalloid Co-load improves the outcome of Elective Cesarean Section under spinal anesthesia
163
169
EN
Ibrahiem
Swedan
Department of Obstetrics & Gynecology,
Faculty of Medicine, Banha University, Egypt
Tamer
Mahmoud
Assar
Department of Obstetrics and Gynecologyو Faculty of Medicine, Banha University, Egypt
tamer.assar2000@gmail.com
Elsayed
Abdelazim
Department of Anesthesia, Faculty of Medicine, Banha University, Egypt
Mohamed
Fouad
Department of Anesthesia, Faculty of Medicine, Banha University, Egypt
10.21608/ebwhj.2018.5586
Objective: To evaluate therapeutic yield of tranexamic acid (TXA) injection and fluid co-load on the outcome of cesarean section (CS) conducted under spinal anesthesia<br />Study Design : Prospective randomized comparative study.<br />Patients and Methods: The current included 174 primipara scheduled for elective CS under spinal anesthesia. Intravenous (IV) fluid co-load (15 ml/kg warm lactated ringer solution) started as fast drip during and continued after spinal anesthesia. Patients were randomly allocated into two equal groups: Group TXA received a loading IV dose of 500 mg TXA 20 minutes before surgery followed by continuous TXA infusion at rate of 1 mg/kg/min till end of surgery. Group C did not receive prophylactic TXA, but both groups received a booster dose of 2 gm TXA if required. Patients were monitored for the frequency and severity of hypotension and dose of ephedrine used. Amount of bleeding since skin incision till 2-hours postpartum (PP), the frequency of patients had stopped PP bleeding till 2-hr PP and the total dose of oxytocin drugs and booster doses of TXA were recorded.<br />Results: Hypotension was recorded in 53 patients (30.5%); only 12 patients had blood pressure Conclusion: Preoperative administration of TXA significantly reduced perioperative bleeding with significant reduction of consumption of TXA booster doses and utrotonics without affecting safety. Fluid coloading allowed reduction of the frequency and extent of hypotension concomitant with spinal anesthesia
cesarean section,Fluid co-load,Tranexamic acid,Spinal anesthesia
https://ebwhj.journals.ekb.eg/article_5586.html
https://ebwhj.journals.ekb.eg/article_5586_5ec2aec9db75fc2e40cb64d97f33164b.pdf
Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Prophylactic Trans-vaginal Cervical Cerclage versus Conservative Management in Triplet Pregnancies
170
176
EN
Eissa
Mahmoud
Khalifa
Department of Obstetrics & Gynecology, Minia University, Egypt
eissa_mmk@yahoo.com
10.21608/ebwhj.2018.5584
Background: To compare the effect of prophylactic trans- vaginal cervical Cerclage versus the conservative treatment in management of triplet pregnancies and also the effect of parity on gestational age and birth weight in triplet pregnancies.<br />Patients and Methods: 40 women with triplet pregnancies were divided into 2 groups. Group 1 (20) received prophylactic cerclage. Group 2 (20) with no Cerclage [conservative management]. Each group subdivided into two half ; half of the women were primi-para and the other half were multi-para (including unipara &multi-para), women with possibility of cervical insufficiency were excluded and pregnancy was followed in all women until delivery.<br />Results: There was no significant difference between the both groups regarding the gestational age at time of delivery (31.45±4.68 in Cerclage group versus 32.65±4.01 in non Cerclage), the miscarriage rate (20% in Cerclage versus 15% in conservative management group) and time of delivery (35% delivered before 34 w, 35% between 34w and 36w, and 10% after 36w in cerclage group versus 35%, 40%, 10% in conservative management group respectively).<br />There was no significant difference between both groups regarding the neonatal birth weight (1390±467.24 in cerclage group versus 1405±475.7 in conservation group) & NICU admission (90% in both groups). parity has effect on gestational age of delivery (75% of prime para delivered before 34 wks. 20 % between 34-36 weeks and 5% after 36weeks while in multi para (35%,40%, and 10%) respectively.<br />Conclusion: Prophylactic trans- vaginal cervical cerclage in triplet pregnancies regarding pregnancy prolongation and neonatal outcomes is similar to conservation. Parity has effect on pregnancy prolongation & consequently the neo-natal outcomes.
Cervical Cerclage,preterm birth,triplets
https://ebwhj.journals.ekb.eg/article_5584.html
https://ebwhj.journals.ekb.eg/article_5584_71c30a87f3154cd17a615feb1795d1b0.pdf
Evidence Based Women’s Health Society
Evidence Based Women's Health Journal
2090-7265
2090-7257
7
4
2017
11
01
Cancer antigen 125 (CA-125) and serum progesterone as predictors of fate of threatened abortion: Case control study
177
183
EN
Marwa
Eid
Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University
Amal
Kotb
Abdallah
Department of Obstetrics and Gynecology, Faculty of Medicine, Beni-suef University, Egypt
amalkotb7295@yahoo.com
10.21608/ebwhj.2018.5585
Objective: To investigate the predictive value of serum progesterone and CA-125 regarding pregnancy continuation in women with threatened abortion.<br />Patients and Methods: A case control study was conducted on 200 women with intrauterine pregnancies between 6-12 weeks with demonstrable embryonic pulsation. They were classified into 2 groups: Group I included 100 women with the diagnosis of threatened abortion. Group II included 100 women with normal asymptomatic pregnancy.CA 125 and serum progesterone were measured in all women.<br />Results: Women with threatened abortion showed a significantly higher number of previous abortions and CA 125 levels (47.82±30.93 vs. 30.08±19.21, P =0.36) and lower rate of pregnancy continuation (76 vs. 90%, P = 0.044) when compared to controls. Women who continued their first trimester of pregnancy showed a significantly higher number of previous abortions and progesterone level (43.12±20.85 vs. 19.26±11.8, P = 0.01) and lower level of CA 125 (34.9±11.053 vs. 61.9±19.21, P = 0.022) when compared with those who aborted. The sensitivity, specificity, PPV and NPV of CA 125 and progesterone in predicting occuarance of abortion were (80.66, 100,100,95.4% and 78.88,97.05,93.7,01.3% respectively. Conclusion: CA125 and progesterone are good predictors for the outcome of 1st trimester of pregnancy in both normal women and those with threatened abortion. Both have excellent specificity and good sensitivity in prediction of the outcome.
CA 125,predictors of pregnancy outcome,serum progesterone,threatened abortion Received: 24
https://ebwhj.journals.ekb.eg/article_5585.html
https://ebwhj.journals.ekb.eg/article_5585_8e66786abf376ccf7ae7477d8f0a7fd7.pdf