Ultrasonographic assessment predicts adverse perinatal outcomes

The aim of this work was to evaluate accuracy of the ultrasonographic assessment at the first or the second trimester of gestation as a predictor of adverse outcome in high risk pregnancies. A cross sectional study was conducted on 85 consecutive high risk pregnancies attending the Antenatal Clinic and Medical Genetics Center of Ain Shams University. Nuchal translucency thickness was obtained for all cases recruited during 1[st] trimester. Nuchal fold thickness was obtained for all cases recruited during 2[nd] trimester.We prospectively evaluated the outcome of each pregnancy. The mean age of participants, mean marriage duration, and gestational age were 32.5 +/- 6 years, 7.1 +/- 3.3 years and 14.5 +/- 2.1weeks respectively.Increased NT thickness and NF thickness were present in5%, and 8.89% respectively.Down syndrome was found in 1.2% of current pregnancy outcome, while, cystic hygroma was found in 1.2%, cystic hygroma with hydrops was found in 1.2%, skeletal dysplasia and renal agenesis was found in1.2% missed abortion was found in 3.53%.There is a highly significant difference between normal outcome pregnancy and abnormal outcome pregnancy regarding mean NF thickness while no significant differences regarding NT thickness. The findings of our prospective study demonstrate the feasibility of using NF thickness to screen for aneuploidies, adverse perinatal outcome in high risk pregnancies

Effect of Pain Management Post Cesarean Section on Mothers' Satisfaction

The aim of this study was to assess effect of pain management post cesarean section on mothers' satisfaction. The study design was an intervention study design. It was conducted on postnatal cesarean section room at Ain Shams Maternity University Hospitals. The study sample involved 150 mothers divided into 75 mothers as control group who received post cesarean section hospital routine analgesics for pain relief and their pain assessed at 6, 12 and 18 hours after the surgery and 75 mothers as intervention group who received foot and hand massage for 20 minutes and their pain assessed at 6, 12 and 18 hour after the surgery. Post cesarean section mothers were selected according to the following criteria: conscious mother, with intact hand and foot skin and free from arthritis, phlebitis, burn wound, injury, inflammation, eczema, cardiovascular and respiratory diseases. Four tools were used for data collection, a structured interviewing questionnaire sheet, a numerical rating scale, short form McGill pain questionnaire and likert scale. The results showed that, a significant improvement of pain level among intervention group compared to control group at different assessment time, [P =0.000] and these lead to a high satisfaction regarding pain management among mothers in intervention group than in control group. So, this study is highly recommended designing health educational training program for nurses about foot and hand massage as it is an inexpensive pain relief measure, with no harm to mothers. Also there is need for further study to investigate health team attitude regarding this method

Investigate the effect of trained companionship regarding supportive measures during laboron their knowledge and practice

The present study aimed to investigate the effect of trained companionship regarding supportive measures during labor on their knowledge and practice. An intervention study design was conducted at first in outpatoA. stimz, 4

Fetal chromosome abnormalities and congenital Malformations: an Egyptian study

Our objective were to determine and evaluate the role of genetic counseling and amniocentesis in early detection of chromosomal abnormalities or congenital malformations among women at risk. The study was performed on 784 pregnant women. The cause for seeking genetic counseling in 22.8% of the study cases was positive family history of CNS malformations, and in 17.9% was chromosomal abnormalities in previous child. Also, the results showed that the indications for amniocentesis in 60.8% were history of having previous child with Down syndrome, and in 15.3% were advanced maternal age. The results of chromosomal analysis of amniotic fluid samples; 21 cases [19.3%] had chromosomal abnormalities, where trisomy 21 [Down syndrome] were detected in 10 cases [9.2%], unbalanced translocation Down syndrome were detected in 9 cases [8.3%] and one had 46 XX, del [13-q], one had 45, XX, t[13;14] and 2.8% was 46, XX, +21, der[14;21][q10;q10]. The risk of complications of amniocentesis was associated with performing amniocentesis early in pregnancy, and with increased number of attempts. The results also showed that multiple cogenital anomalies [MCA] represented among 42.2%, congenital malformation of CNS represents 26.6%, congenital malformation of the skeletal system 20%, congenital polycystic kidney 8.8% andpyloric stenosis in 2.2%. Among the 21 women with abnormal karyotype of amniotic fluid, the decision to terminate the pregnancy was made in 3 [14.3%]. Among the 45 cases with abnormal findings suggesting fetal congenital malformation, 16 [35.6%] chose termination of their pregnancy. Public awareness of the risks and difficulties facing a child with chromosomal anomalies or congenital malformation and the effect on their future health and living is of great importance for acceptance of prenatal screening. Prenatal diagnosis may affect the reproductive descision after genetic counselling. It is essential that genetic counselling is noncoercive and nonjudjemental. The couple's decision [even if it is different from the counseller's views] should be respected

Epidemiological characteristics and the role of cytogenetic investigation in primary amenorrhea

Primary amenorrhea is a major problem in girls of adolescent age This descriptive study was conducted to describe the epidemiology and to identify the proportion of genetic causes and the different chromosomal pattern among patients representing with delayed puberty or primary amenorrhoea who attended the medical genetic center, Ain Shams University. A total of 102 patients were included in the study. All patients underwent complete full history taking, general physical examination, local examination of genital system, hormonal assay, pelvic ultrasound and Karyotyping analysis. Their mean age at diagnosis were [20.1 +/- 4.2.] Secondary sexual characters were not developed among most of the study group [74.5%] Normal phenotypic 46, XX were found among 67.6% of cases, while chromosome abnormalities were found in 32.4%. Among all patients with chromosomal aberrations, 48.5% of then1 had pure line 45, X [turner syndrome], and the remainder had mosaic with normal XX or other aberrations in X. Only one had 46XY, and another one had 47XXX. The frequencies of causes of primary amenorrhea were primary ovarian failure [gonadal dysgenesis] [49%] followed by constitutional delay of puberty [22.5%] then mullerian duct abnormalities [15.7 5%] The study recommended that all females with primary amenorrhea should be investigated cytogenetically and counseling should be directed to hormonal replacement of estrogen and growth hormone for development of secondary sexual characters and normal stature and prevention of osteoporosis