ObjectivesTo compare the efficacy and safety of two uterine sparing techniques in conservative management of placenta accreta spectrum (PAS).MethodsThis multicenter randomized controlled study was conducted from January 1, 2017 to December 31, 2020 at two university hospitals. Patients were randomly allocated into two groups; Group 1 was managed by Assar's technique and Group 2 was managed by Shehata's technique. Operative time, blood loss, operative complications (organ or vessel injury), and postoperative complications (early and late) were reported. Success of the technique, units of blood transfusion, and intensive care unit admissions were recorded.ResultsDemographic data in both groups were not significantly different. The mean gestational age at the delivery time was 36 weeks in both groups. Operative time was 120 (100–140) minutes and 75 (60–100) minutes in Assar's and Shehata's techniques, respectively (P < 0.001). Blood loss was higher in Shehata's technique than in Assar's (P < 0.001). Intensive care unit admissions were minimal in both groups. Operative complications were comparable in both groups. The success of Assar's and Shehata's techniques in uterine preservation was 85% and 95%, respectively.ConclusionBoth techniques were safe and successful in uterine sparing. Therefore, we recommend these techniques for conservative management of PAS.Clinical trial registrationThe trial was registered on UMIN‐CTR and had the unique ID: UMIN000025315 on the following link: https://center6.umin.ac.jp/cgi‐open‐bin/ctr_e/ctr_view.cgi?recptno=R000029120.

Background: Long Acting Reversible Contraceptives (LARC) had a very high efficacy in lowering unintended pregnancies and their poor health sequalae. Although their reported efficacy, these methods are not widely used among patient’s due to non-awareness and faulty concepts linked to these methods.Methods: This cross-sectional study was conducted to determine the degree of awareness, attitude and preference of LARC by attendants of Tanta University contraceptive clinic in the period from January 1, 2016 to December 31, 2016. All patients were counseled with thorough discussion about LARC methods. The following issues were determined: age, parity, mode of previous delivery, residence, medical diseases, socioeconomic state of family, type of LARC method used, how she know about this method and why she preferred that type.Results: 391 women underwent this study with age range of 21-46 years, and BMI range of 20.46-31.87. LARC were preferred by 72.38% of patients and mainly IUDS (52.94%) while other LARC methods were of very low awareness. Most patients take their knowledge from paramedical staffs (49.87%). Occupation, education, residence and religion were not affecting patients' attitude and preference of one LARC over the other methods. Age was the most effective factor for determining whether to use LARC or not. Counseling revert a lot of faulty concepts and misbelieves about LARC.Conclusions: LARC were not widespread among Tanta University attendants for contraception except for IUDs. Young patients had no motivations towards LARC due to a lot of faulty concepts that need a lot of work to be eradicated.

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Objectives: To evaluate the efficacy, compliance, safety and economic cost for Fosfomycin trometamol and Nitofurantoin in uncomplicated lower urinary tract infections during pregnancy. Background: Nitofurantoin and Fosfomycin trometamol are recommended as the first-line agents for treatment of urinary tract infections (UTIs) in the latest guidelines endorsed by the Infectious Diseases Society of America (IDSA) and the European Society for Clinical Microbiology and Infectious Diseases (ESCMID). Fosfomycin is bactericidal and inhibits bacterial cell wall biogenesis and reduces bacterial adherence to uroepithelial cells. Fosfomycin has broad antibacterial activity against both Grampositive and Gram-negative pathogens, as Escherichia coli, Escherichia faecalis, and various Gram-negatives like Citrobacter and Proteus. Both Nitofurantoin and Fosfomycin are category B in pregnancy. Patients and Methods: This study was conducted at Tanta University Hospitals in the period from June, 1, 2015 to January, 1, 2017. Patients were recruited from outpatient clinics of Obstetrics and Gynecology and Urology Departments presenting with asymptomatic bacteruria or cystitis. Patients were allocated randomly into 2 groups: group I (n = 50 cases) received Fosfomycin therapy and group II (n = 50 cases) received Nitofurantoin therapy (n = 50 cases). After treatment, evaluation of patient symptoms, organism count, patient compliance and cost of treatment were done. Results: The enrolled patients were suffering from lower urinary tract infections; asymptomatic bacteruria (17 cases) or cystitis (83 cases). Ten patients were excluded. The demographic data of included patients were not significant for both groups. Complete relief (100%) of symptoms 5 days after start of treatment was noticed in Fosfomycin group while improvement of symptoms after 5 day-treatment was noticed in 86. 533difference in the reported side effects, (p-value = 0.003). Compliance was 38/38 (100%) in Fosfomycin group compared to 34/37 (91.89%) in Nitrofuantoin group (p-value = 0.001). Resistance was very minimal in Fosfomycin group where 1/38 case (2.63%) reported resistance for treatment compared to 8/37 cases (21.62%) in Nitofurantoin group (p-value = 0.001). Conclusion: Fosfomycin trometamine proved to be safe, effective, and has limited resistance. Moreover higher patient compliance and fewer side effects were recommending Fosfomycin to be a first choice drug for uncomplicated lower urinary tract infections during pregnancy at Tanta University.