Impact of body mass index on implantation rate in icsi cycles

Background: obesity and overweight are recognized as a growing global health problem Worldwide, prevalence of overweight or obesity, defined as an adult body mass index [BMI] of 25 kg m[2] or greater. Patterns of overweight and obesity differ between countries, regions and by country income, with overweight or obesity more prevalent among men in developed countries and among women in developing countries

Aim of the Work: this study aimed to evaluate the impact of female increased body mass index [BMI] on implantation rate and clinical pregnancy in women undergoing ICSI cycle

Patients and Methods: this is a retrospective study conducted on a total of 400 cycles of assisted reproduction treatment has been evaluated from Orabi IVF Centre and Mit_Ghamr IVF Centre. Data recruited from patient files from January 2016 to July 2018 who did ICSI trial during this period. Patients who included in our study were sub divided into 2 groups according to BMI: 1st group: normal weight with BMI between 18 and 24.9 kg/m2. [200 case], 2nd group: overweight and obese women >/= 25 kg/m2 [200 case]

Results: we showed that overweight and obese infertile women had a higher basal serum FSH, LH and estradiol levels than normal weight women. In our study group the duration of infertility was progressively higher as BMI increased. The two groups were comparable regarding female age were not statistically different in both groups. The duration of infertility showed no significant difference between the two groups. As in group [1] it range from 10-17 years with median duration of 6 years, while in group [2] it range from 0.5-23 with median duration of 5 years this result a significant difference with p value [0.057]

Conclusion: female overweight and obesity appeared to have deleterious effects on ovarian response to stimulation in women undergoing IVF and implantation rate. Moreover, female obesity compromised IVF outcome

Comparative study between hysterosalpingography, saline infusion transvaginal ultrasound and doppler studies in assessment of uterine factor of infertility

Background: One of the basic steps of an infertility workup is to evaluate the shape and regularity of the uterine cavity. Acquired uterine lesions, such as uterine fibroids, endometrial polyps, intrauterine adhesions, or all of these, may cause infertility by interfering with proper embryo implantation and growth

Aim of the Work: to compare the findings of hysterosalpingography, saline infusion transvaginal sonohysterography and Doppler studies in patients with suspected uterine causes of infertility

Patients and Methods: This is a comparative observational cross sectional study, which was conducted in the Obstetrics and Gynecology Department at Al Hussein and Sayed Galal University Hospitals, Al Azhar University in Cairo during the period from April 2017 to the end of September 2018. Sixty patients were included at the study who were recruited from the infertility outpatient clinics, with suspected uterine factors of infertility clinically, by hysterosalpingography [HSG] or by ultrasound

Results: HSG showed the highest sensitivity in the diagnosis of bicornuate uterus, septate uterus and intrauterine synechia [100%] followed by endometrial polyp [70%] then submucous myomas [62.5%]. High specificity [100%] was in the diagnosis of endometrial polyp and submucous myoma. Also it showed high false negative values as it missed the diagnosis of 7 cases

Conclusion: SIS is the gold standard of our study in assessment of uterine factor of infertility. Doppler studies showed high false negative results compared to HSG and saline infusion sonohysterography [SIS]. Some lesions were missed from HSG and diagnosed by SIS and these missed lesions may play a role in infertility, so SIS is very important modality in diagnosis and assessment of uterine factor of infertility

Prophylactic use of intraumbilical vein oxytocin in the management of third stage of labor

Background: the third stage of labor is defined as the period of time between delivery of the fetus and delivery of the placenta. The most common complication accompanying this stage is postpartum hemorrhage [PPH] and prolonged third stage of labor owing to placenta retention and uterine atony are among the underlying cause of most cases of PPH. The duration of the third stage of labor is 5-15 min

Aim: to assess the efficacy of intraumbilical vein oxytocin in reducing duration of third stage of labour and the amount of blood loss

Patients and Methods: this study included 150 women attending the delivery room of Department of Obstetrics and Gynecology which was divided according to the inclusion and exclusion criteria into two groups: Group A [study group]: include 75 cases which received 10 IU [1ml] of oxytocin in umbilical vein. Group B [control group]: include 75 cases which received 1ml of saline in umbilical vein

Results: the time of third stage took seconds in each group with no statistically significant difference detected [p>0.05]

Conclusion: intra-umbilical oxytocin is a useful alternative in patients where methylergometrine is contraindicated or in cases where intravenous fluids need to be restricted. For optimum effect, rapid injection immediately after clamping of the cord is essential

Prediction of preeclampsia by early pregnancy maternal homocysteine measurement

To study whether maternal early pregnancy homocysteine level can be used as a screening test for occurrence of subsequent preeclampsia. A prospective randomized study including 16 women [patients] and 22 pregnant women [controls]. Blood samples were taken to measure the plasma total homocysteine [tHcy] level at 8 and 32 weeks of gestation. Neonatal weight was also determined. Geometric means [ +/- standard error of the mean 'SEM'] of the tHcy concentrations at 8 w of gestation for the patients and controls groups are 7.73 +/- 0.03 and 5.72 +/- 0.01 micromol/L respectively. Geometric means +/- SEM of the tHcy concentrations at 32 w of gestation for the patients and controls groups are 5.48 +/- 0.11 and 5.21 +/- 0.17 micromol/L respectively. Geometric means +/- SEM of the newborn weight for the patients and controls groups are 2890 +/- 29.9 and 3342 +/- 25.8 gm respectively. When comparing tHcy concentrations of the patients group at 8 and 32 gestational weeks, there is a highly significant increase of the tHcy at 8 w [p< 0.0001] with 95% confidence interval [1.75- 2.93] with correlation coefficient [r] [0.16] and R squared 0.82. early maternal homocysteine measurement could be used as a predictor test for preeclampsia. Neonates of mothers with high early pregnancy [tHcy] have a significant loss of weight

Effect of rocuronium compared with succinylcholine on intraocular pressure and intubating conditions during rapid sequence induction of anesthesia

Rapid sequence intubation is developed to secure the airway rapidly and safely. Succinylcholine provides excellent intubating conditions and thus remains the muscle relaxant of choice in emergency situation. The aim of this study was to compare the effects of rocuronium and succuinylcholine on intraocular pressure [IOP] during rapid sequence induction of anesthesia using propofol and fintanyl. In addition assessment of intubating conditions after administration of both succinylcholine and rocuronium. In a randomized, double-blind study we studied 40 adult patients, randomly allocated to one of two groups. Anesthesia was induced with fentanyl 2 microg/kg and propofol 2 mg/kg. This was followed by succinylcholine 1.5 mg/kg [group S; n=20] or rocuronium 0.6 mg/kg [group R; n=20]. Laryngoscopy and tracheal intubation were performed 60 seconds later. IOP, mean arterial blood pressure [MAP] and heart rate [HR] were measured before induction, immediately before intubation and every minute after intubation for 5 minutes. Tonopen tonometer was used to measure IOP and the mean of three consequative readings obtained in the right eye at each measurement time was recorded. Simple scoring system was used to evaluate intubating conditions. In the succinylcholine group, IOP was significantly greater than that in rocuronium group mean 23.7 +/- [SEM 1.6] vs mean 14.2 +/- [SEM 0.9] mm Hg; p<0.001. Intubating conditions were similar in both groups. Rocuronium 0.6 mg/kg when used with propofol and fentanyl during rapid sequence induction of anesthesia does not cause a rise in IOP. Thus, it may be a suitable alternative to succinylcholine, especially in cases of penetrating eye injury