effect of hysterectomy on psychiatric morbidity [anxiety and depression]

To evaluate the psychiatric morbidity [anxiety and depression] in women underwent an abdominal and vaginal hysterectomy of a benign indication. This is a prospective observational study which was done in the Obstetric and Gynecology and Neuropsychiatry Departments, Sohag University Hospital. One hundred and two women were scheduled for undergoing hysterectomy after fulfilling the inclusion criteria. All women underwent a thorough history taking, clinical examination and complete psychiatric history. General health questionnaire [GHQ-28] was used to assess women with psychiatric co-morbidity before and after the operation. All women with psychiatric co-morbidity were re-evaluated by Beck depression inventory [BDI] and Hamilton anxiety scale [HAMA] before and after hysterectomy. On screening for psychiatric co-morbidity using the GHQ-28 for the 96 women who completed the follow up protocol of the study 35 [36.46%] scored >/= 4 [Group I] with psychiatric co-morbidity, and 61 [63.54%] scored <4 [Group II] without psychiatric co-morbidity. GHQ-28 was reapplied to all women in group II [post-operatively] where 48 [78.69%] scored >/= 4 [group IIa] and 13 [21.31%] scored <4 [group IIb. Severe anxiety and depressive symptomes were the most common presentation after the operation and represented 8 [40%] and 8 [53.3%], of patients of group I, respectively. In patient, of group II [without psychiatric morbidity] after hysterectomy, depressive and anxiety symptoms was the most common presentation in nulliparous women and was found in 7 [63.64%] and 3 [27.27%], respectively. However, the least depressive and anxiety symptoms was observed in women with parity >/= 5 and was found in 12 [38.7%] and 9 [29.03%], respectively. It is not worthy that the majority of women free from psychiatric co-morbidity was observed in women with parity >/= 5 and represented 10 [32.5%] of patients. It was clear that there was a definite significant relation between hysterectomized women and psychiatric morbidity of a depressive and anxiety nature. So we recommend that before hysterectomy in benign conditions, gynecologists should exhaust great effort of using the available recent less invasive modalities of treatment as first option

use of intracervical Foley catheter for preinduction cervical ripening

A randomized prospective study was conducted and included 100 primigravid and multigravid pregnant inpatients admitted for induction of labor with a modified bishop score of [0 <7] and fulfilling the inclusion. Sixty patients were randomized to receive intracervical Foley catheter and forty patients to receive prostin E2 vaginal tablets. Oxytocin drip was then given if necessary. The results showed that the two groups were comparable with respect to age, parity, gestational age, indications for induction and initial pelvic scoring. Both prostin E2 vaginal tablets and Foley catheter were found to be effective for inducing cervical ripening. However, prostin E2 vaginal tablets were found to be more efficient in inducing cervical ripening in multiparae and cases with low initial pelvic score. They were also found to be more efficient in establishing vaginal delivery within a short time, but were more liable to be associated with intrapartum complications

Epidemiological study of the infertility problem in Assiut rural area

Fifteen hundreds currently married couples in the childbearing period in one of Assiut rural areas were interviewed to reevaluate infertility problem, child loss and contraceptive practice. Infertility was found to represent more than 13.6% of women in the childbearing period. Out of them, 37.6% were primary infertile and 42.45 were secondary infertile. The percentage of child loss was 22.3% among the total number of live births. The percentage of contraceptive practice among women in rural areas was 10.0% of the total interviewed women. It was concluded that infertility is a major medical and social problem, child loss is still high and contraceptive practice is still low in this rural communities