[Maternal health care indicators, causes of maternal mortality and quality of medical records; at Women's Health Hospital, Assiut University, 2012]

Introduction: Maternal mortality is a preventable tragedy; measuring maternal mortality and identifying its causes is essential, and should be calculated regularly for the purpose of planning, monitoring, and evaluation of provided maternal health care

Objectives: To calculate maternal morality ratio, identify causes of maternal mortality, quality of care indicators such as maternal mortality index, case fatality rate and direct obstetric case fatality rate and to identify the main its in medical records

Methodology: A descriptive study was done through reviewing the records maternal mortality cases in the hospital using validated specific criteria published in WHO bulletin [2000] and data of cases that were admitted to the hospital's intensive care unit was collected for one [2012], followed by performing dissemination meetings

Results: In year 2012, there were 479 vaginal deliveries and 9, 908 caesarean sections, and 20,887 live births. The Maternal morality ratio was [225/100,000]. The Leading causes of maternal death were obstetric hemorrhage [38.3%], complications after caesarean sections, [27.7%] and pre-eclampsia/ eclampsia [23.4%].The age of maternal mortality was 29.3 +/- 8.5. Nearly half [42%] of the deaths occurred during vacation days. Quality indicators revealed poor quality of health care. The main deficits in the medical records included no recording of time of informing staff members and start of management, observational chart and management plan

Conclusions and recommendations: Maternal mortality is alarmingly high. Obstetric hemorrhage and complications after caesarean section were the two main causes of death that require strict and quick management protocols

What are the most discriminating two-dimensional and doppler sonographic features in differentiation of benign and malignant adnexal masses?

To determine the two-dimensional and doppler sonographic features that best allow differentiation between malignant and benign adnexal masses, besides develop a new scoring system enable more accurate diagnosis with these features. A cross sectional prospective study was conducted on patients scheduled for surgery due to presence of adnexal masses at Women's Health Hospital, Assiut, Egypt between October 2012 and October 2013. All patients were evaluated by 2D ultrasound for morphological features of the masses aided by doppler examination of their vessels. The final diagnosis was based on histopathological reports used as gold standard. One hundred forty-six patients were recruited, 104 with benign masses, 42 with malignant masses. Features that allowed statistically significant discrimination of benignity from malignancy were; volume of mass, type of mass, presence and thickness of septae, presence and length of papillary projections, location of vessels at colour Doppler and colour score. A scoring formula was supposed combined those features together to develop a new scoring system; Assiut Scoring System [ASS]. The cut-off score with the highest accuracy in detection of malignancy had a sensitivity of 93.5% and specificity of '92.2%. Assiut Scoring System; a multiparameter scoring that use four 2D ultrasound and two doppler features, has a high sensitivity and specificity for prediction of malignancy in adnexal masses