Transabdominal and transvaginal ultrsonographic evaluation of cases of perimenopausal bleeding

The present work tested the diagnostic accuracy of transabdominal ultrasound [TAS] and transvaginal ultrasound [TVS] in 100 cases with perimenopausal bleeding relative to the pathological diagnosis. 52 patients had proliferative endometrium, 34 had endometrial hyperplasia, 5 had secretory endometrium, 4 had endometrial carcinoma, 3 had retained products of conception, and 2 had atrophic endometria. TAS had 87.5%, while TVS had 90.8% overall diagnostic accuracy. When endometrial thickness was <10 mm [TAS] or <12 mm [TVS] endometrial carcinoma was not reported and hyperplasia was unlikely. When uterine length was <80 mm hyperplasia/carcinoma was rare and when the length was >120 mm the incidence was more than 35%. When myometrial invasion was not detected the possibility of malignancy was only 2%. Ultrasonography [USG] detected associated or causative lesions correctly in nearly 88% of such cases. It detected endometrial carcinoma missed by D and C biopsy in 2 occasions. USG seems to have an important complementary role in evaluating cases of perimenopausal bleeding. TVS had marginal advantage over TAS, though it is not free of limitations that may need further evaluation

Evaluation of knowledge and practice of tetanus toxoid vaccination among pregnant women in Assiut

The work showed that 42% of the neonatal deaths were due to tetanus neonatorum. A majority of them [86%] were from unimmunized mothers or those who received inadequate doses whose deliveries were attended by dayas in most of the time. The great majority of the sample were in mid-fertile age, illiterate housewives coming from rural areas. Most of them were grandmultipara with a large number of living and dead children. Most of the women heard about the vaccine, knew its value, and its right time and route of administration, but did not know its proper dose. Mass media was the main source of their knowledge. There was improvement in vaccination process during current pregnancies compared with previous ones regardless of residence. This improvement was attributed to the increasing effect of mass media and MCH centers and antenatal clinics, although lack of knowledge then unavailability still remain the main causes of missing the vaccine. Professional birth attendance and education and to less extent low parity have dramatic positive effect on vaccination process. It is concluded that tetanus neonatorum still represents a major cause contributing to the high incidence of neonatal mortality. Implementation of a proper TTV program will minimize this incidence. This goal can be achieved by educating women through mass media together with improving the performance of clinics dealing with maternity care. In addition, a special training program for dayas should not be ignored

Evaluation of daily fetal movement counting in some cases of high risk pregnancy

This study aimed at testing the value of daily fetal movement counting [DFMC] as a clinical method of antepartum fetal assessment in high risk pregnancy and its potential use as a screening test in low risk pregnancy. The study included comparison between DFMC and the more sophisticated methods as nonstress test [NST] and biophysical profile [BPP] regarding the perinatal outcome. A pilot phase including 100 normal pregnant women showed that time interval to perceive 10 fetal movements [FM] was 36 +/- 22 minutes [mean +/- SD]. A study phase including 40 high risk and 10 normal pregnant women showed that there was a significant association between decreased FM, nonreactive NST, poor BPP [<6/8] and poor perinatal outcome. Perinatal outcome was poor in as high as 50% of cases with decreased FM, while it was poor in only 2% of cases with normal FM. These results indicated that decreased FM places the fetus in a high risk category necessitating further evaluation of fetal condition. It is concluded that count-to- ten method of FMC is potentially useful in fetal assessment. Being reliable, simple, easy, inexpensive and noninvasive method, it can be used as a screening test on a wide scale. However, further larger study is recommended before extrapolation of the results

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

comparative study of the clinical performance of norplant-2 versus norplant subdermal contraceptive implants

Three hundred and seventy-five fertile healthy women were randomized in the ration of 2: 1 to the use of either norplant-2 covered rods or norplant six capsules, respectively. They were followed up for a period of one year. The one year continuation rate was 86.0 +/- 2.3/100 women in norplant-2 group and 87.2 +/- 3.0/100 women in norplant group. The commonest causes of discontinuation in both groups were menstrual bleeding problems. The use of both types of implants is commonly associated with menstrual disruption but women commonly bear them particularly if they were counseled as regards the possibility of their occurrence. On the whole, manifestation of reduced menstrual bleeding are commoner amongst NORPLANT-2 users than NORPLANT users during the first year of observation. The latter group showed higher incidence of manifestation of increased bleeding than the former group. No significant effect could be found on the body weight or hemoglobin concentration of the users of both implants at the end of the first year of use. NORPLANT-2 is well comparable to the original NORPLANT six capsules system as regards its efficacy, continuation rates and side effects. However, it is superior to NORPLANT in its easy and less expensive manufacture and easier insertion as well as removal procedures in addition to its effect in reducing menstrual blood loss