ABSTRACT
There is need for simple, cheap and highly predctive test for spontaneous preterm labor (SPL). The "zone of endocervical crypts (ZEC)" is a well-defined sonographic landmark corresponding to enfolding of the endocervical mucosa. Early loss of ZEC might be considered as indicative of "premature effacement". We tested the efficacy of a "composite" parameter of cervical length plus ZEC loss for the prediction SPL.MATERIAL/METHODS The study included singleton pregnant women attending Asyout Clinic for Gynecology andObstetrics between 20 and <24 weeks' gestation. Transvaginal ultrasonography was used for:a) measuring the cervical length, and, b) detecting the existence/non-existance of ZEC.* Cervical lengthwas measured as the distance between the internal os of the cervix and theexternal os.* The Zone of Endocervical Crypts (ZEC) was defined as the heteroechoic area around thecervical canal (CC). Monoechoic appearance of the cervix was described as loss of the ZEC.The sensitivity, specificity, positive and negative predictive values (PPV,NPV) were calculated. RESULTS: Two thousand and one pregnancies were evaluated for the incidence and sonographic prediction of SPL (24 - <32 weeks, and 32-36 weeks).The overall SPL rate was 9%.Loss of ZEC, and, the combined ZEC loss with shortened cervix were found to have better specificity and better PPV than the cervical shortening alone. ZEC loss had better PPV for early rather than late PL."Funneling" had poor PPV, but, is still a good "negative". CONCLUSION: The composite parameter of the "lost ZEC" and short cervix is superior to the cervical length alone for the early prediction of SPL. Wider scale study is now being run for: a) ensuring the reproducibility of the parameter testing values, and b) to find any correlation between the ZEC loss and other clinical criteria
ABSTRACT
Background : Maternity resembled an important issue in ancient Egyptian life and medicine. Ancient Egyptian papyri contained different prescriptions for care of both pregnant women, birthing moms and their fetus/infant babies. The interventions included both: 1) remedies of different origins, and, 2) incantations. Material/Methods:Different Egyptian papyri and temple representation were studied for the variable remedies for specific cases of maternal/ perinatal problems in relation to pregnancy, birth, breast milk and babycare.Incantation approach was also analyzed. We tried to define the specific material used, and the possible "psychogenic influence of the incantation. Results 1. Some of the remedies could be identified and correlated to current time agents. Practical extrapolation of some of these agents proved of value in modern obstetric practice andtherapeutics. 2. Other remedies could not be characterized, and, up-till now, it was not possible to detect whether they could be corresponding to existing material, 3. The incantation approach could be, in some way, correlated to the "deep psychoanalysis" of modern psychiatry. 4. Many of the "non-medical" ancient Egyptian approaches for maternity/baby care are still resembled in some way of use by current time Egyptian women. Conclusion Ancient Egyptian maternal/infant care is a composite approach. Some of the recognized remedies used proved of value in modern clinical application Identification of further remedies seems to open further promise of extra-benefit. Modification of the of the "non-remedy" line might provide a form of "psychotherapy" better tailored for our societies' concepts