Ultrasound diagnosis of intracranial lesions in the newborns presenting as breech at the time of delivery

This work was done upon 100 newborns in the Obstetrics and Gynaecology Department, Ain shams University. Fifty of them were with breech presentation and were delivered by caesarean section, and the other 50 were with breech presentation and were delivered vaginally. All the newborns were subjected to real time ultrasound within 6-48 hours after delivery. Ultrasound examination proved intracranial lesions in 2 newborns out of the 50 delivered vaginally while it did not demonstrate any lesion among those delivered by caesarean section, but the difference is not statistically significant [P < 0.05]. Proper conduct of vaginal delivery of breech is mandatory

Study of proteinuria and outcome of pregnancies complicated by hypertension

This study was conducted to determine the role of proteinuria on pregnancy outcome in hypertensive women with singleton pregnancies. It was conducted to compare and to evaluate pregnancy outcome in patients with nonproteinuric hypertension [gestational Gl, chronic G3] and in proteinuric hypertensive patients, [pre-eclampsia G2 and superimposed pre-eclampsia G4]. There was a statistical significant difference in the mean proteinuria between Gl and G2 and also between G3 and G4. As regards the incidence of caesarean section, the same difference was noted. There was a significant relation between G3 and G4 only as regards the mean birth weight. There was also a significant difference between the incidence of small for gestational age in G3 and G4. The same difference was found between depressed infants who were in need for neonatal intensive care unit between G1 and G2 and between G3 and G4

Pregnancy in women at and above forty

The changing life patterns for women in our current society have forced them to postpone childbearing. Furthermore, failure of proper contraceptive practice among elder women may result in an unplanned pregnancy at an older age. This study was carried out in Ain Shams Maternity Hospital on pregnant women aging 40 years or more. The incidence of maternal complications as hypertension, antepartum haemorrhage, malpresentation and abortion increases with aging. Caesarean section rate is increased to 18.6 percent. In our study, a high still birth rate [5.5 percent] is observed with increased incidence of premature delivery [11.2 percent]. There is also significant neonatal overweight

Role of fructosamine in management of gestational diabetes

Estimation of serum fructosamine can be used for screening and diagnosis of gestational diabetes and as an index of diabetic control. This measurement in late pregnancy is also of value in the detection of the foetal outcome. In this study, fructosamine estimation at 35-37 weeks gestation detected 83 percent of cases of gestational diabetes. There was a significant correlation between the diabetic group at 35-37 weeks gestation and also at the time of delivery. These results suggested that fructosamine estimation is an effective reflection of blood glucose control during the previous 1-3 weeks. There was also a significant correlation between maternal fructosamine level at 35-37 weeks gestation and at delivery time with foetal growth and birth weight

Evaluation of per-operative cholangiography

In 264 consecutive cases with cholelithiasis undergoing cholecystectomy, per-operative cholangiography [POC] was performed in 227[86%]. There were 204 [89.9%] true nagatives and the common bile duct [CBD] was not explored. False positives were seen in 2 [0.9%] cases. The CBD exploration was negative and subsequent T-tube cholangiograms were satisfactory. In one further patient [0.44%], there was a false negative finding and in another 19 [8.4%], true positive findings were confirmed by positive CBD exploration. In 11 [4.8%] of them, CBD stones were unsuspected pre-operatively. The whole procedure time was from 5 to 20 minutes [10 minutes]. There was one mortality [0.44%] and wound infection was the only complication occurring in 13[5.57%] patients. We therefore advocate the routine use of POC since it can detect unsuspected CBD stones, and it shows clearly the anatomy of the biliary tract. It appears that it neither causes unnecessary delay in the operation time nor any increase in the complications

Abdominal tuberculosis

This is a report of 19 patients with abdominal tuberculosis. Nine patients presented with intestinal obstruction due to ileocaecal involvement, 3 had widespread disease with ascites, 2 presented with features similar to appendicular mass, 2 had ileal and extensive colonic involvement with ascites, 2 had colonic stenosis after completely healed lesions, and one patient presented with generalised peritonitis as a result of perforation from an ileocaecal lesion. Seventeen patients had laparotomies [15 resections and 2 biopsies], and the condition in the other 2 cases was controlled medically. There were no deaths or complications and post-operative anti-tuberculous treatment continued for one year