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Alanwar A, El Nour AA, El Mandooh M, Abdelazim IA, Abbas L, Abbas AM, Abdallah A, Nossair WS, Svetlana S. Prognostic accuracy of cerebroplacental ratio for adverse perinatal outcomes in pregnancies complicated with severe pre-eclampsia; a prospective cohort study. Pregnancy Hypertens 2018; 14:86-89. [PMID: 30527124 DOI: 10.1016/j.preghy.2018.08.446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/11/2018] [Accepted: 08/15/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The current study aims to assess the efficacy of fetal middle cerebral artery/umbilical artery pulsatility index ratio (cerebroplacental ratio CPR) in predicting the occurrence of adverse perinatal outcomes in pregnancies complicated with severe pre-eclampsia. MATERIALS AND METHODS This cohort study included 100 pregnant women between 34 and 40 weeks of gestation attended the labor ward and diagnosed with severe pre-eclampsia. Doppler evaluation was carried out to measure the CPR. Apgar score and fetal umbilical artery pH were assessed within 5 min of delivery. The rate of neonatal intensive care unit (NICU) admission was obtained. RESULTS Apgar score at 5 min >7 was in 82 cases (82%) and 12 cases (12%) scored < 7. Fetal blood PH was >7.2 in 67% of cases while 33% of cases had PH <7.2. As regard the NICU admission; 66% of neonates did not need admission while 34% of neonates were admitted to the NICU. There was a significant association between CPR and low Apgar score at 5 min (P < 0.001). The sensitivity of CPR in detection of Apgar score <7 was 50%, and specificity 88.1%. CPR had a poor predictive value of the low umbilical artery PH <7.2 (P = 0.318) with 43.75% sensitivity and 69.05% specificity. There was a significant association between CPR and NICU admission (P = 0.009). CONCLUSIONS Adding CPR ratio to routine antepartum fetal surveillance from 34 weeks gestation may help with patient counseling regarding adverse neonatal outcomes for women with severe pre-eclampsia as there is a strong correlation between it and adverse neonatal outcomes.
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Affiliation(s)
- Ahmed Alanwar
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Ayman Abou El Nour
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed El Mandooh
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ibrahim A Abdelazim
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Luma Abbas
- Department of Obstetrics and Gynecology, Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed M Abbas
- Department of Obstetrics and Gynecology, Woman's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ameer Abdallah
- Department of Obstetrics and Gynecology, Minia University, Minia, Egypt
| | - Wael S Nossair
- Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Shikanova Svetlana
- Department of Obstetrics and Gynecology, Marat Ospanov, West Kazakhstan State Medical University, Aktobe, Kazakhstan
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Elsokkary M, Elshourbagy M, Labib K, Mamdouh A, El-Shahawy Y, Nossair WS, Abd El Fattah O, Hemeda H, Sallam S, Khalaf WM, Ali M, Elsayed M, Kotb A, Abdelhadi R, Etman M, Abd El Aleem M, Samy M, Salama A, Abdelhaleem M, Abdelshafy A. Assessment of hysteroscopic role in management of women with recurrent pregnancy loss. J Matern Fetal Neonatal Med 2017; 31:1494-1504. [PMID: 28412850 DOI: 10.1080/14767058.2017.1319925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
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. RESULTS This current study was conducted in Ain Shams University Maternity Hospital during the period between August 2014 to May 2015 a total of 200 women with history of recurrent miscarriage were included in the study. Regarding the results of this study the mean age was 30.5(5.7), the mean number of previous abortion 3(3-5) the mean number of the first trimesteric abortion was 2 with range (2-2) the mean number of second trimesteric abortion was 2 with range (1-2). In this study, 88% of patients were nullipara. It was also found that hysteroscopic findings were found in 58.5%. Uterine anomalies was present in 21%, including septate uterus and intrauterine adhesion (IUAs) were present in 12.5%. Endometrial polyps were present in 8.5%, bicornute uterus in 4.5%, unicornuate uterus in 4.5% while submucous myomas were present in 7.5%. It was found that 48.5% need hysteroscopic intervention including 21% need septectomy 12.5% need adhesiolysis, 6.5% need myomectomy while 8.5% need polypectomy. The study found that no statistically significant difference between patients with normal hysteroscopic finding and patients with abnormal hysteroscopic finding as regard age, time of previous abortion and number of previous abortion. But there was statistically significant difference as regard number of previous delivery and abnormal HSG. CONCLUSIONS It appears that hysteroscopy is a useful tool in the diagnosis and treatment of the causes of recurrent miscarriage that can be performed safely without anesthesia in most cases. The prevalence of uterine anomalies in patients with recurrent miscarriages is 54.5%, septate uterus is the most common anomaly and for this reason uterine anomalies should be systematically assessed in patients with recurrent miscarriage.
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Affiliation(s)
- M Elsokkary
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - M Elshourbagy
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - K Labib
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - A Mamdouh
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - Y El-Shahawy
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - Wael S Nossair
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - O Abd El Fattah
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - H Hemeda
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - S Sallam
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - Waleed M Khalaf
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - M Ali
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - M Elsayed
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - A Kotb
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - R Abdelhadi
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - M Etman
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - M Abd El Aleem
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - M Samy
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - A Salama
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - M Abdelhaleem
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
| | - A Abdelshafy
- a Department of Obstetrics and Gynecology , Ain Shams University Maternity Hospital , Cairo , Egypt
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