Endometrial Progesterone and Estrogen Receptors in Relation to Hormonal Levels in Women with Unexplained Recurrent Miscarriage.

Objective:  Recurrent miscarriage has been linked to hormonal disturbance due to dysregulation of its receptors rather than to the availability of the hormone. We aimed to investigate endometrial expression of progesterone and estrogen receptors in relation to serum and endometrial hormonal levels in unexplained recurrent miscarriage.

Methods:  The present case control study included 20 cases with unexplained recurrent miscarriage and 20 parous women as controls.

Diagnostic Accuracy of Placental Thickness in Lower Uterine Segment Measured by Ultrasound in Prediction of Placenta Accreta Spectrum in Patients with Placenta Previa. A Diagnostic Test Accuracy Study.

Objective: The aim of the study was to evaluate the association between placental thickness and placenta accreta spectrum (PAS) in patients with placenta previa.

Materials And Methods: In this prospective study, 40 patients diagnosed with placenta previa were included. The maximum placental thickness in the lower uterine segment was obtained using a transabdominal scan.

Conservative stepwise surgical approach for management of placenta previa accreta: A prospective case series study.

Objective: To describe a stepwise surgical approach for conservative management of placenta previa accreta to preserve the uterus and to evaluate the efficacy and safety of this approach in controlling postpartum hemorrhage including intrapartum hemorrhage.

Methods: A prospective case series study conducted on 62 pregnant women with one or more cesarean deliveries diagnosed with placenta previa accreta between January 2018 and June 2019 at Ain Shams University Maternity Hospital. All participants underwent a conservative stepwise surgical approach through Pfannenstiel skin incision with fetal delivery through a uterine incision just above the upper border of the placenta, followed by bilateral uterine artery ligation with myometrial excision of the remaining adherent placenta and cervico-isthmic sutures by MMG (the main surgeon) and MS.

First trimester placental volume and vascular indices in pregestational diabetic compared to nondiabetic pregnant women.

Aim: Comparing placental volume (PV) and vascular indices in pregestational diabetic and nondiabetic pregnant women at 11 and 13 weeks gestation.

Methods: A case-control study conducted at Ain Shams University Maternity Hospital in collaboration with Feto-maternal Unit for Ultrasound Assessment, Ain Shams University Maternity Hospital, Egypt. Ninety-two pregnant women divided into two groups: Group A included 46 women with pregestational diabetes mellitus and group B included 46 nondiabetic pregnant women as control.

How can methods of placental delivery in cesarean section affect perioperative blood loss? A randomized controlled trial of controlled cord traction versus manual removal of placenta.

Aim: Of the different described methods of placental delivery during cesarean section (CS), manual removal and cord traction are the most commonly used techniques. The ideal method of placental delivery during CS is still a conflicting issue as the data derived from the previous studies are widely heterogeneous and inconsistent. This study has investigated the effect of two different methods of placental delivery, controlled cord traction and manual removal, on perioperative blood loss.

Mechanical induction of labor and ecbolic-less vaginal birth after cesarean section: A cohort study.

Objective: During delivery counseling, some women with previous uncomplicated cesarean section (CS) wish mechanical induction of labor (IOL) but they are not accepting the added risk of using ecbolics to induce and/or augment labor. The objective of the study was to assess the safety and efficacy of the isolated use of transcervical Foley's catheter balloon as a mean of mechanical cervical ripening (CR)/IOL and successful ecbolic-less vaginal birth after cesarean section (VBAC).

Materials And Methods: A cohort study was conducted in two tertiary care maternity hospitals between October 2013 and July 2016 and recruited women with singleton pregnancy and cephalic presentation who had previous one uncomplicated CS and were scheduled for mechanical CR/IOL at term for routine obstetric indications.

Prediction of spontaneous preterm birth: salivary progesterone assay and transvaginal cervical length assessment after 24 weeks of gestation, another critical window of opportunity.

Measurement of salivary progesterone (SP4) levels and cervical length (CL) after 24 weeks to assess their potential predictive value among asymptomatic women at high risk of spontaneous preterm birth (PTB). This prospective observational (noninterventional) study consecutively recruited asymptomatic women at high risk of spontaneous PTB. SP4 and CL were measured at recruitment (24-28 weeks of gestation) then repeated after 3-4 weeks.

KLK10 exon 3 unmethylated PCR product concentration: a new potential early diagnostic marker in ovarian cancer? - A pilot study.

Background: KLK10 exon 3 hypermethylation correlated to tumor-specific lack of KLK10 expression in cancer cell lines and primary tumors. In the present study we investigate the possible role of KLK10 exon 3 methylation in ovarian tumor diagnosis and prognosis.

Results: Qualitative methylation-specific PCR (MSP) results did not show statistically significant differences in patient group samples (normal and tumor) where all samples were positive only for the unmethylated-specific PCR except for two malignant samples that were either doubly positive (serous carcinoma) or doubly negative (Sertoli-Leydig cell tumor) for the two MSP tests.

Assessment of hysteroscopic role in management of women with recurrent pregnancy loss.

Objectives: To assess the hysteroscopic value in the management of intrauterine lesion in women with recurrent pregnancy loss.

Methods: This study was done in Ain Shams Maternity Hospital after the approval of the research Ethics Committee, during the period between August 2014 and December 2015 where 200 nonpregnant women with a history of three or more consecutive unexplained first and second trimester miscarriages before 20 weeks were recruited from recurrent miscarriage clinic. A written informed consent was obtained from all women before participation.

Uterine salvage management for atonic postpartum hemorrhage using "modified lynch suture".

Background: To assess the effectiveness of the new modified technique in order to control bleeding in women presenting with atonic, flabby uterus compared to the most commonly described technique of classic B-Lynch suture.

Method: This study included 160 women of uncontrolled atonic postpartum hemorrhage delivered by cesarean section at Ain Shams University Maternity Hospital between January 2013 and October 2015. Participants were randomly assigned following simple randomization procedures (computerized random numbers) and divided into two groups.

Serum C3 and uterine artery Doppler indices at 14-20 weeks gestation for preeclampsia screening in low-risk primigravidas: A prospective observational study.

Problem: Preeclampsia affects 2-10% of human pregnancies with poor screening tests. In order to intervene preventively, high risk population should be identified before the 20th week of pregnancy and by a method not subjected to operator efficiency.

Methodology: Prospective observational study recruiting 825 low risk primigravidas.

Efficacy and safety of post-cesarean section incisional infiltration with lidocaine and epinephrine versus lidocaine alone in reducing postoperative pain: A randomized controlled double-blinded clinical trial.

Objective: Aim was to assess the efficacy and safety of incisional infiltration of lidocaine and epinephrine vs. lidocaine only to reduce postcesarean section (C/S) pain.

Material And Methods: It was a prospective, randomized, controlled, double-blinded clinical trial that was conducted in two tertiary hospitals in Egypt and included 153 women undergoing C/S under general anesthesia.

Serum tumor necrosis factor-α level and uterine artery Doppler indices at 11-13 weeks' gestation for preeclampsia screening in low-risk pregnancies: a prospective observational study.

Preeclampsia affects 1-2% of human pregnancies with no effective screening test. Studies have found some association between cytokines/other biomarkers and the later onset of preeclampsia. The challenge has been to find indicators with sufficient positive predictive value.

Value of three dimensional power Doppler ultrasound in prediction of endometrial carcinoma in patients with postmenopausal bleeding.

Objective: To determine whether endometrial volume or power Doppler indices measured by 3-dimensional (3D) ultrasound imaging can discriminate between benign and malignant endometrium in women with postmenopausal bleeding and endometrial thickness ≥5 mm.

Material And Methods: The current diagnostic accuracy study was conducted at Ain Shams University Maternity Hospital. Eighty-four patients with postmenopausal bleeding and endometrial thickness ≥5 mm underwent 3D power Doppler ultrasound examination of the corpus uteri.

Sacrospinous colpopexy using Masson luethy needle holder.

Objective: Sacrospinous colpopexy (SSC) is a well-known surgical technique to correct apical support defect, however its approach is still challenging. The current study describes an alternative and economic approach for suture placement in the sacrospinous ligament during SSC using Masson luethy needle holder.

Study Design: A prospective study was conducted in a tertiary care center.

Incidence of emergency peripartum hysterectomy in Ain-shams University Maternity Hospital, Egypt: a retrospective study.

Purpose: To estimate the incidence of emergency peripartum hysterectomy over 6 years in Ain-shams University Maternity Hospital.

Methods: Detailed chart review of all cases of emergency peripartum hysterectomy, 2003-2008, including previous obstetric history, details of the index pregnancy, indications for emergency peripartum hysterectomy, outcome of the hysterectomy and infant morbidity.

Results: The overall rate of emergency peripartum hysterectomy was 149 of 66,306 or 2.

Three-dimensional power Doppler and endometrial volume as predictors of malignancy in patients with postmenopausal bleeding.

Aim: The aim of this study was to evaluate the efficacy of 3D power Doppler angiography (3D-PDA) for distinguishing between benign endometrial lesions and endometrial carcinoma in patients with postmenopausal bleeding (PMB).

Material And Methods: One-hundred and fifty women with PMB and an endometrial thickness (ET) of ≥4 mm on 2D sonography were assessed by 3D-PDA before endometrial sampling to obtain definitive histological diagnosis of endometrial pathology. Endometrial volume (EV), vascularity index (VI), flow index (FI) and vascularity-flow index (VFI) were calculated by computer-aided analysis.

The role of magnetic resonance imaging in refining the diagnosis of suspected fetal renal anomalies.

Objective: This prospective study was designed to detect the role of magnetic resonance imaging (MRI) in refining the diagnosis of suspected fetal renal anomalies detected during screening sonography.

Material And Methods: 54 pregnant women, with suspected fetal renal anomalies detected during routine ultrasound screening, were rescanned by MRI to refine the diagnosis of the suspected renal anomalies. The pregnancy outcome was examined externally and by postnatal ultrasonography.

Pipelle endometrial sampling versus conventional dilatation & curettage in patients with abnormal uterine bleeding.

Objective: This study was designed to compare the diagnostic accuracy of Pipelle endometrial sampling with conventional dilatation & curettage in patients with abnormal uterine bleeding.

Material And Methods: One hundred and forty patients with abnormal uterine bleeding were included in this comparative study; where endometrial sampling was carried out before cervical dilatation by Pipelle device followed by conventional dilatation & curettage (D&C). The histopathology report of the Pipelle sample was compared with that of the dilatation & curettage sample and the dilatation & curettage reports were considered as the gold standard.

Risk of postpartum uterine synechiae following uterine compression suturing during postpartum haemorrhage.

Background: Uterine compression suturing is considered a successful, safe, inexpensive and simple ‎method for the conservative treatment of atonic postpartum haemorrhage (PPH). However, insufficient data are available about the potential risk of subsequent intrauterine ‎synechiae (IUS).

Aim: To determine the risk of postpartum uterine synechiae in women who received isolated uterine compression suturing for the management of major uncontrolled PPH.

Role of blunt suture needle in episiotomy repair at uncomplicated vaginal deliveries in reducing glove perforation rate: a randomized controlled trial.

Aim: The aim of this study was to evaluate the role of blunt suture needles for episiotomy repair at uncomplicated vaginal deliveries in reducing glove perforation rate.

Methods: This was a prospective randomized controlled trial wherein 300 nulliparous women with uncomplicated vaginal deliveries were randomized to episiotomy repair with either blunt or sharp suture needles. Patient demographics and clinical variables were collected.

Meperidine for uterine dystocia and its effect on duration of labor and neonatal acid-base status: a randomized clinical trial.

Aim: The aim of this study was to evaluate the effectiveness of meperidine, administered during the first stage of labor in patients with uterine dystocia, on the duration of labor and neonatal acid-base status at birth.

Material And Methods: We randomly assigned 240 nulliparous women with a singleton pregnancy at term who were diagnosed with uterine dystocia in labor at 4-6-cm cervical dilatation to receive either a single dose of 50 mg meperidine in 10 mL of saline (slow intravenous injection over 2 min) or 10 mL of isotonic saline (control group). The primary outcome measures were duration of labor (from the time of beginning of the intervention to the time of the expulsion of the fetal head) and umbilical cord arterial acid-base status.

Intraumbilical injection of three different uterotonics in the management of retained placenta.

Aim: The aim of this work was to compare the effect of intraumbilical injection of three different uterotonic solutions in the management of retained placenta.

Materials And Methods: This study was conducted in Ain-Shams University Maternity Hospital, Cairo, Egypt. A total of 78 women with retained placenta (>30 min after delivery of the fetus) were included in the study and subdivided into three groups.

Impact of seroconversion and antichlamydial treatment on the rate of pre-eclampsia among Egyptian primigravidae.

Objective: To evaluate the effect of antichlamydial treatment and Chlamydia pneumoniae seroconversion on the incidence of pre-eclampsia among Egyptian primigravidae.

Methods: The present prospective study included 600 healthy normotensive primigravidae who attended an outpatient clinic at 10-16weeks of pregnancy. A single venous blood sample was collected to test for C.