2024-03-29T08:46:22Z
https://ebwhj.journals.ekb.eg/?_action=export&rf=summon&issue=17014
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Assessment of Thyroid Function in Pregnant Females Attending Suez Canal University Hospital
Ahmed
Abo El-Roose
N.
Al-Imam
A.
El-Deib
G.
Tawfik
contribute to these changes. These factors could contribute to thyroid dysfunction during pregnancy especially when adeficiency of iodine intake exists and when thyroid reserve is not sufficient.Aim: To study thyroid functions in pregnant women avoiding maternal and fetal complications associated with thyroiddysfunctions.Materials and Methods: A cross-sectional study was carried out on 100 pregnant women attending Obstetrics OutpatientClinic in Suez-Canal University Hospitals were invited to enroll in the study. At the end of study, the blood samples wereassessed for free T3, free T4 and TSH.Results: This study revealed that most of the pregnant women had normal thyroid functions (51%), while subclinicalhypothyroidism (39%) was the most prevalent disorder followed by clinical hypothyroidism (6%) and isolatedhypothyroxinemia (4%).Conclusion: The most prevalent pattern of thyroid dysfunction in pregnant women was subclinical hypothyroidism.
THYROID
TSH
T3
T4
Pregnancy
2020
09
01
181
187
https://ebwhj.journals.ekb.eg/article_111329_55f67b241b53d5cd3e24d4cda08a8663.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Ovarian and Uterine Blood Flow Indices in Patients with Unexplained Infertility Undergoing ICSI and their Relation to Clinical Pregnancy Rate
Ahmed
Ibrahim
Mohamed
El-Mandooh
Haitham
Mohammed Gad
Heba
Al Hariri
Background: Infertility is defined by the World Health Organisation (WHO) as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse and is estimated to affect as many as 48.5 million couples worldwide. Unexplained infertility (UI) constitutes an important portion of the infertility reasons (up to 30%) and is diagnosed when the causes of male or female infertility remains unknown.Aim: The aim of the study was to compare ovarian, uterine artery and subendometrial vessels resistance by measuring PI and RI of patients diagnosed as UI undergoing ICSI in the day of embryo transfer and control group diagnosed as fertile by having at least one livebirth in peri-implantation period from day 19 to day 21.Materials and Methods:The current study is a prospective case control study, which was conducted at the Assisted Reproduction Technology unit of Ain Shams University Maternity Hospital during the period from September 2017 to July 2019. The current study included two groups of patients one group is unexplained infertility attending the Assisted Reproduction Unit and the other is control fertile group each group consists of 51 women.Results: There was statistically significant difference between the unexplained infertility group and control fertile group as regard Uterine and subendometrial artery PI, RI and ovarian artery RI in which resistance indexes was significantly higher in the UI group than control group. The cut off values of PI, RI between unexplained infertility and fertile group are ≥1.88, ≥0.8 for Uterine artery, and ≥ 0.87, ≥0.53 for subendometrial arteries, and ≥ 0.59 for ovarian artery RI. Among the unexplained infertility undergoing ICSI patients the pregnancy rate is 23.5%. There was no statistically significant difference between the two groups (pregnant group and non-pregnant group) as regard the age, BMI, duration of infertility or the basal hormonal profile.Conclusion: Doppler parameters are useful tools to assess endometrial receptivity in unexplained infertility patients undergoing ICSI. This study found that Uterine, Ovarian, subendometrial arteries plasticity index (PI) and resistance index RI measured on the day of embryo transfer higher than fertile women and have value in judging endometrial receptivity and predict the final outcome of IVF/ ICSI- ET. Uterine, ovarian and subendometrial blood flow assessed by measuring PI, RI of these arteries was impaired in unexplained infertility patients compared to fertile women. Also, uterine arteries PI, ovarian and subendometrial arteries PI, RI differ in pregnancy outcome in unexplained infertility patients undergoing ICSI.
ICSI
Uterine blood flow indices
Unexplained infertility
2020
09
01
188
200
https://ebwhj.journals.ekb.eg/article_111332_34721c6f23077d1df36a44f64bb903c9.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Comparing Transcervical Intrauterine Lidocaine Instillation with Rectal Diclofenac for Pain Relief During Outpatient Hysteroscopy: A Randomized Controlled Trial
Amro
El-Houssieny
Haitham
Sabba
Heba
Allam
Mohamed
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.
Hysteroscopy
instillation
Lidocaine
Pain Relief
rectal diclofenac
transcervical intrauterine
2020
09
01
201
208
https://ebwhj.journals.ekb.eg/article_111333_ee694337d758a986f98b8e5c4f68960d.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Carbetocin versus Misoprostol in Reducing Blood Loss during Cesarean Section in low risk patients. A Randomized Controlled Trial
A.
Moustafa
S.
Abd Elhady
H.
Shalaby
waleed
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 < 0.02] and the need for blood transfusion [2 (1.2%) vs 10 (6.7%) 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.
carbetocin
cesarean section
oxytocin
Postpartum Hemorrhage
2020
09
01
209
215
https://ebwhj.journals.ekb.eg/article_111334_eec6655fda114d51f4d07f174a9ece37.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
COMPARATIVE STUDY BETWEEN VAGINAL NATURAL PROGESTERONE AND ORAL DYDROGESTERONE IN PREVENTION OF RED DEGENERATION OF UTERINE FIBROID IN PREGNANCY
Tarek
Karkour
Tamer
Abdeldaiem
Nirmeen
Hefila
Sarah
Elghareeb
Background: Uterine leiomyomas are highly prevalent benign monoclonal tumors, arising from the smooth muscle of the myometrium; they occur in up to 50-60% of reproductive age women, causing significant morbidity in up to 30% of women. The most serious complication of uterine fibroids; is red degeneration that causes severe pain, and may lead to preterm labour, miscarriage, fetal and maternal morbidity and mortality.Aim: This work was designed to compare between the effect of vaginal natural MP and oral dydrogesterone in prevention of red degeneration of uterine fibroid during pregnancy.Materials and Methods: Patients were recruited from El-Shatby Maternity University Hospital. They were 50 pregnant females, diagnosed having a uterine fibroid more than 3 cm in size then there were divided into two groups ; group A included twenty-five treated by vaginal natural progesterone, group B included twenty-five treated by oral dydrogesterone. All patients at 14-15 weeks of gestational age underwent complete history taking, clinical examination and ultrasound examination for mean gestational age and assessment of the type and uterine fibroid.Results: The results showed that there were no statistical significant differences as regards age, obstetric history (gravidity and parity), number, site, grade and size of the fibroid. There was a significant difference between the two studied groups regarding the acute abdominal pain, it occurred to only 3 cases (12%) in group A, versus 16 cases (64%) in group B. Regarding occurrence of red degeneration, it occurred only to 3 cases (12%) in group A, while in group B it occurred to 15 cases (60%).
Oral dydrogesterone
Pregnancy
red degeneration of uterine fibroid
vaginal natural progesterone
2020
09
01
216
222
https://ebwhj.journals.ekb.eg/article_111335_7d534475d4d32c0c37696708f03d8ef7.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Effect of Laparoscopic Adhesiolysis of Pelvic Adhesions in Management of Chronic Pelvic Pain on Quality of Life
Hossam
Abdou
Mohamed
Ismail
Haitham
Elboraie
Yasser
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.
Adhesions
adhesiolysis
Chronic pelvic pain
Laparoscopy
2020
09
01
223
229
https://ebwhj.journals.ekb.eg/article_111344_ad5d90f95e4b21022167d7cca1f063f4.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Comparison between ultrasound guided Transversus abdominis plane block and local anesthetic instillation in patients undergoing laparoscopic hysterectomy
mohamed
hammad
Reem
Elkabarity
Mona
Ammar
Milad
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.
Intraperitoneal analgesia
laparoscopic hysterectomy
pain after laparoscopy
TAP block
2020
09
01
230
238
https://ebwhj.journals.ekb.eg/article_111350_9d21580292a47d004066f5c747b2cc1c.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Complications Associated with First-trimester Surgical Abortion at Ain-Shams Maternity Hospital over the period from January 1, 2016 to December 31, 2017
Amr
Yasser
Yasser
Aboutalib
Rania
Ragab
maii
nawara
Background: First trimester surgical abortion is a common obstetric procedure with some known complications.Objective: The aim of this study was to examine the incidence of major complications of first trimester surgical abortion in Ain-Shams Maternity Hospital.Patients and Methods: Retrospective record-based case series in which records of patients who underwent first trimester surgical abortion in the period from January 1st, 2016 till December 31st, 2017 were examined.Results: A total of 1003 patients underwent first trimester surgical abortion. The overall major complication rate was 18.2%. There was a higher incidence of one or major complications in patients with previous abortions (P-value <0.002), valve replacement (P- value 0.001), missed and septic abortions, those requiring cervical dilatation, less hemoglobin, higher total leucocytic count, higher PTT.Conclusion: First trimester surgical abortion is a relatively safe procedure with hemorrhage being the most common complication.
First trimester abortion
surgical abortion
surgical evacuation
2020
09
01
239
245
https://ebwhj.journals.ekb.eg/article_111352_e1f81716866ccc482e4cbde4bbffe608.pdf
Evidence Based Women's Health Journal
2090-7265
2090-7265
2020
10
3
Association of Hypoproteinemia in Preeclampsia with Maternal and Perinatal Outcomes : A Prospective Analysis of High-Risk Women
Hossam El-Din
Kamel
Adel
Elboghdady
Abdelsalam
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
Hypoproteinemia
High risk women
preeclampsia
2020
09
01
246
253
https://ebwhj.journals.ekb.eg/article_111358_8954f2d0e9b7d72fce0163dcbfa34f51.pdf