ABSTRACT
Background: polycystic ovary syndrome [PCOS] is the most common endocrine disorder in women of reproductive age, with a prevalence of 610% in the general population. PCOS is characterized by the following: ovulatory dysfunction resulting in oligo-amenorrhea and/or anovulation, hyperandrogenism and/or hirsutism and the presence of polycystic ovarian morphology by ultrasound. Vitamin D also plays a physiologic role in reproduction including ovarian follicular development and luteinization via altering anti-Mullerian hormone [AMH], signaling, follicle-stimulating hormone sensitivity and progesterone production in human granulosa cells
Aim of the Work: this study aimed to compare levels of vitamin D in women with PCOS and healthy fertile women
Patient and Methods: this case control study was conducted in Ain Shams Maternity hospital in outpatient infertility clinics and family planning clinic during the period from March 2017 to October 2017. It was included 40 women diagnosed with PCOS based on Rotterdam criteria and 40 fertile women without PCOS who were recruited from family planning clinic
Results: 25[OH] vitamin-D level was significantly lower in PCOS group than in the control group
Conclusion: 25[OH] vitamin-D was significantly lower in PCOS group than in the control group, but not sufficient to be a diagnostic tool for PCOS
Recommendation: larger studies are still needed to clarify the rule of vitamin D in infertility
ABSTRACT
Background: The strength of the muscles of the pelvic floor and other supporting structures of the pelvic organs are affected by various events that occur during a woman's lifetime. Pregnancy and childbirth have a pronounced influence on maternal anatomy and physiology
Aim of the Work: The aim of the study was to investigate the impact of the mode of delivery on the sexual function [arousal-pleasure-orgasm-desire] -among a representative sample of Egyptian primiparae
Subjects and Methods: This cross-sectional observational comparative study was conducted at Ain Shams University Maternity Hospital during the period between November 2017and July 2018 on 260 women who had single uncomplicated delivery within a duration of not less than 6 months and not more than 2 years from recruitment of the study
Results: Pain was significantly positively correlated to the age [r=0.319, p=0.013] and social class [r=0.276, p=0.028]. Both satisfaction and the overall sexual function score was also significantly positively correlated to social class[r=0.275, p=0.032; r=0.237, p=0.048; respectively]. Pelvic floor muscle strength was poorly correlated to sexual function
Conclusions: The study revealed a significant difference in pelvic floor muscle strength between women who delivered vaginally and those who delivered by Cesarean section. However, there was no significant difference in sexual function between women who delivered vaginally and those who delivered by Cesarean section. Pelvic floor muscle strength was poorly correlated to sexual function. Recommendations: Cesarean section on demand should not be considered as prophylaxis against sexual dysfunction. A larger, nation-wide based study should be performed for assessment of sexual dysfunction among women of different age groups and parities
ABSTRACT
Background: Anemia is one of the most commonly encountered medical disorders during pregnancy. In developing countries it is a cause of serious concern as, besides many other adverse effects on the mother and the fetus it contributes significantly to high maternal mortality. According to United Nation declaration 1997, anemia is a major public health problem that needs total elimination. It is estimated that globally two billion people suffer from anemia or iron deficiency. Maternal anemia is frequently associated with premature delivery, reduced neonatal weight, infant iron deficiency, neonatal death, and low APGAR scores at 1 min. It is also suspected to reduce the oxygen supply to the growing fetus, leading to the redistribution of fetal blood flow
Objective: The aim of this study was to evaluate the effect of maternal anemia on fetal Doppler indices namely umbilical artery and middle cerebral artery in the last trimester of pregnancy
Patients and Methods: This study was designed as a prospective case control clinical trial carried out in Obstetric outpatient clinics and inpatient ward, Ain Shams University Maternity Hospital on 200 patients. The patients must follow these criteria, gestational age between 28-40 weeks of singleton pregnancy [calculated by their last menstrual period or by earlier ultrasound], fetus is alive and normal fetal ultrasound parameters
Results: The umbilical artery resistance index show a significant increase in moderate severe anemic patients more than control group, umbilical artery pulsatility index show a significant increase in severe anemic group more than the other 3 groups, umbilical artery systolic/diastolic ratio show a significant increase in severe anemic more than the other groups. Finally the umbilical artery cerebral/umbilical artery resistance ratio show a significant increase in severe anemic more than the other groups
Conclusion: GA at delivery in in different groups was matched. i.e. there was no statistical significant difference between different studied groups regarding GA at delivery [P > 0.05]. Neonatal ICU admission were 2[4%], 2[4%], 4[8%] and 9[18%] in different groups respectively. There was statistical significant difference between different studied groups regarding Neonatal ICU admission [P < 0.05]
ABSTRACT
Background: every year several million women have to undergo gynecological surgery. As a result of that they acquire an abdominal scar. Nowadays women of all ages place extreme importance on the appearance of the scar in addition to the symptoms of pain, tenderness and itching. An aesthetically poor scar can have a negative impact on the overall quality of life causing considerable distress, loss of self-esteem and unhappiness. The appearance of the scar is of significant importance and is often the only reminder of surgery
Aim of the Study: to compare between skin adhesive tape [steri-strips] and non-absorbable suture in closure of abdominal laparoscopic port sites
Patients and methods: the current prospective case control study was conducted at Ain Shams University maternity hospital .the participating women were randomly allocated into two arms .Arm [A]: women had laparoscopic port sites closed with skin adhesive tape. Arm [B]: women had laparoscopic port sites closed with non- absorbable sutures
Results: a total of 142 women were included. The overall incidence of pain was 0.1%and 0.2%, redness was 8.5% and 23.9%, hotness was 2.8% and 12.7%, discharge was 1.4% and 4.2%, impaired healing was 1.4% and 5.6% and satisfaction was 94.4%and 63.4% in arm A and B respectively
Conclusion: using skin adhesive tape [Steri Strep[registered sign]] in closure of abdominal laparoscopic port sites is associated with a decreased risk of wound complications and increased rate of patient satisfaction
ABSTRACT
Aim of the work: nerve block is a technique whereby local anesthetic solutions are infiltrated around a nerve [or perineurally] to provide anesthesia and analgesia. Nerve block for intraoperative and postoperative pain management is associated with improved analgesia, fewer opioid-related adverse events, earlier ambulation and shorter hospital stay when compared to intravenous opioid analgesia alone. This study aimed to assess the efficacy of adding dexamethasone to lidocaine for cervical block anesthesia for prolonging the duration and anesthetic effect in women with missed abortion undergoing vacuum evacuation
Patients and methods: this study is a randomized controlled trial and it was conducted in accordance with the ethical committee protocols and informed consent procedures of Ain Shams University Maternity Hospital during the period between Augusts to December 2016. Sample size was calculated using PASS® version 11 programs, setting the type-1 error [alpha] at 0.05 and the power [1-beta] at 0.8
Conclusion: para cervical block can be used as a safe and effective anesthetic technique in patients who need surgical uterine evacuation of missed abortion. Adding dexamethasone can increase effectiveness and duration of para cervical block. Intraoperative pain level was accepted in 80% of patients, these patients had no or mild to moderate accepted pain. We did not detect any postoperative complications in our patients including [excessive vaginal bleeding, hematoma or general manifestations of lidocaine toxicity] and It is recommended to apply PCB for cases of first trimester missed abortion who require uterine suction evacuation. Lidocaine is preferably mixed with dexamethasone to have better results as regards pain score. It is the anesthetic method of choice especially when general anesthesia is a high risk procedure
ABSTRACT
Background: infertility is customarily defined as the inability to conceive after 1 year of regular unprotected intercourse. The infertility evaluation is typically initiated after 1 year of trying to conceive, but in couples with advanced female age [> 35 years], most practitioners initiate diagnostic evaluation after an inability to conceive for 6 months
Aim of the Work: to assess endometrial receptivity in women with unexplained infertility using sub-endometrial vascular flow resistant index and endometrial leukemia inhibitory factor [LIF]
Patients and Methods: this clinical controlled trial was conducted at Ain Shams University Maternity Hospital during the period from August 2014 to September 2017 on 140 patients divided into two equal groups: Group I [study group]: women with unexplained infertility defined as inability to conceive inspite of regular marital life for at least 12 months. Group II [control group]: matched women with infertility due to tubal factor, recruited from outpatient gynecology or infertility clinic at Ain Shams University Maternity Hospital
Results: a cutoff value for LIF staining score of 0.71 for subendometrial blood flow RI predicted unexplained infertility with a sensitivity of 70.67% and specificity of 86.67%. A cutoff of
Conclusion: leukemia inhibitory factor may be a predictor for unreceptive endometrium in cases of unexplained infertility. Subendometrial blood flow RI and endometrial thickness may be used rather than LIF IHC [due to its invasive nature]for the prediction of endometrial factor status in cases of unexplained infertility because of the statistically significant negative correlation between the above parameters
Recommendations: further studies are needed to evaluate the predictive value of the multiple logistic model including [endometrial thickness, subendometrial blood flow color Doppler and LIF IHC score and even other proposed cytokines as VEGF, IL6 and integrins] in unexplained infertility