Sublingual versus intravenous nitroglycerin for management of retained placenta

This study was designed to investigate and compare the effect of sublingual versus intravenous nitroglycerin for management of retained placenta and to assess possible adverse effects of the treatment. Sixty patients in the third stage of delivery complicated by retained placenta were randomly divided into two groups: group [1] include 30 patients received 1 mg nitroglycerin sublingual, group [2] include 30 patients received 200 microgram intravenous nitroglycerin. Success rate for delivery of placenta, blood pressure, pulse rate and blood loss were examined and compared between two groups. All sixty women in both groups had successful delivery of placenta. There was no statistical significant difference regarding mean blood b among both groups. [P > 0.05]. No adverse effects of clinical importance were registered. Differences in haemodynamic parameters were significantly higher in group 2 compared to group 1 [P <0.001]. Sublingual or intravenous nitroglycerin seems to be effective for treatment of retained placenta without causing serious adverse effects

Prevalence of bacterial vaginosis among asymptomatic women attending the family planning and antenatal outpatient clinics of Benha University Hospital

Bacterial vaginosis is a polymicrobial condition. It is currently the most prevalent infectious cause of vaginitis. It has a strong correlation with many infective gynaecological and obstetrical complications. The aim of this work is to estimate the prevalence of Bacterial vaginosis in women attending Benha University Hospital, family planning and antenatal care clinics, and to assess the diagnostic value of different methods. This study was carried out on 500 asymptomatic women in their reproductive age, from September 2007 to September 2008. They were divided into two groups: [Group A] included 250 pregnant women coming for antenatal care. [Group B] included 250 non pregnant women seeking contraception. Bacterial vaginosis was reported in 40.4% of cases in group A [101 out 250 cases], and in 36% of cases in group B [90 out of 250 cases]. A vaginal PH > 4.5 was the most sensitive [100% in both groups], while presence of clue cells in gram stained smear was the most specific clinical criteria [100% in both groups]. Clinical observation of the vaginal disgorge was both the least sensitive and the least specific clinical criterion in group A [94.1% and 83.2% respectively], and in group B [88.8% and 87.5% respectively]. The most important organisms in B.V are gardnerella vaginosis and areaplasma urealyticum. It is concluded, that the amine and clue cells in wet mount are the most sensitive and specific criteria among 4 Amsel criteria. Also, the microscopic examination of Gramstained vaginal smears should be considered the gold standard for the diagnosis of bacterial vaginosis because the clinical signs are subjective and affected by many factors not related to infection. However, still the 4 clinical criteria are excellent tools for guiding the diagnosis of B.V

role of second trimester uterine artery doppler velocimetry assessment in early prediction of spontaneous preterm delivery

This study was designed to assess the association between uterine artery Doppler velocimetry abnormalities and idiopathic spontaneous preterm delivery, therefore value of uterine artery Doppler assessment for early prediction of preterm delivery. The study was carried out on 180 pregnant women [between 24 -28 weeks gestation] who had no maternal fetal complications and subsequently delivered vaginally the mean uterine systolic / diastolic ratio [S / D] of both uterine arteries was computed and the outcomes of pregnancies with spontaneous preterm and term deliveries were compared. Uterine artery [S / D] was significantly higher [P < 0.0001] in pretem than term deliveries [tenth percentile 1.80 versus 1.61, 90th percentile 2.80 versus 2.09]. The sensitivity, the specificity, the positive and negative predictive values of abnormal uterine S / D in predicting preterm labour were 58.9%, 88.9%, 27.8% and 95.9% respectively. The incidence of small for gestational age [SGA] newborn was significantly higher [P<0.0001] among preterm than term deliveries [33.3% versus 10.3%]. It could be concluded that abnormal uterine Doppler waveforms are predictive of preterm labour