Effect of placental insufficiency on the hematological profile of neonates

Placental insufficiency is the major cause of intrauterine growth retardation. Umbilical artery [UA] Doppler allows the non-invasive assessment of the severity of impaired placental vascular abnormality. UA end diastolic velocities are positive [PEDV] in mild placental insufficiency but are absent or reversed [AEDV] in 60-70% of the tertiary villous vessels are damaged. The degree of placental dysfunction determines the severity of fetal disease. In addition to disturbances in placental respiratory function, hematologic abnormalities during fetal life and at birth can occur. To evaluate the relationship between umbilical artery end diastolic velocity in growth restricted fetuses and hematologic parameters in the neonate. All cases of suspected placental insufficiency born over one years period at Al-Galaa Teaching Maternity Hospital were included in the study. They were distributed among three groups: Group [I]: 56 cases both term and preterm with mild placental insufficiency and PEDV and Group [II]: 44 cases both term and preterm with severe placental vascular compromise and absent [AEDV] or reversed [REDV] Group [III]: 50 cases both term and preterm acting as controls. Placental insufficiency and growth restricted fetuses were studied with ultrasound and Doppler evaluations of end-diastolic velocity. A complete blood count to assess the hematological parameters was collected from venous cord blood from all neonates born to compromised mothers at birth and a second sample of peripheral venous blood was collected at 48 hrs of life. A total of 103 cases met the inclusion criteria of the study. Our results showed significant anemia, leucopenia, thrombocytopenia, with marked increase in nRBCs in group [II] cases with severe placental insufficiency and absent or reversed end-diastolic volume compared to cases in Group [I] with mild placental insufficiency and positive end-diastolic volume. Again all hematological indices were significantly lower, with a marked increase in the nRBCs in Groups [I] and [II] compared to the control group [III]. The severity of hematological alternations at birth and during the first 48 hours of life growth restricted neonates was proportionate to and predicted by the antenatal umbilical artery end diastolic velocity Doppler status

Laparoscopic surgery versus laparotomy in common gynecological problems

Endoscopic surgery is rapidly advancing to be the surgery of the future. Laparoscopy is currently the most frequently performed gynecological procedure. Laparoscopic surgery is now firmly established as the operation of choice or "Gold standard" for treatment of most gynecological problems needing surgery. Laparoscopy is now fully accepted as the treatment of choice for conditions like ectopic pregnancies, pain due to adhesions, non-cancerous ovarian cysts, endometriosis, and infertility. Was to evaluate and compare the results of treating the adnexal pathology by using either operative laparoscopy or laparotomy. All studied patients were subjected to full routine clinical and gynecological examination including relevant investigations, and were allocated to two groups; Group [1] patients who had operative laparoscopy and Group [2] the laparotomy patients. In each group, 4 gynecological procedures were carried out: Ectopic Pregnancy, Ovarian cystectomy, Endometriosis with adhesiolysis, and Tubal sterilization. A total of 154 patients were included in the study. Comparing the operative laparoscopy group to the laparotomy group, there was a significant difference in all postoperative parameters including the operative time,% of Hb reduction, duration of hospital stay in days, operative cost, analgesia required in the 1[st] 24 hrs, and recovery after surgery. The patients treated with operative laparoscopy showed early resumption of oral intake [hrs], faster resumption of movement and domestic work [days], and earlier return to work [days]. Operative laparoscopy has become an effective and precise diagnostic and treatment procedure in gynecology