No abstract

No abstract

Objective To compare the effectiveness and safety of repeat misoprostol versus expectant management in women with first‐trimester incomplete miscarriage who have been initially treated with misoprostol. Methods The study was an open‐labeled randomized controlled trial including women with an incomplete first‐trimester miscarriage after administration of misoprostol. The participants were randomly assigned to vaginal misoprostol or expectant management using a computer‐generated table of random numbers. The primary outcome was the number of women with a complete miscarriage at 1 week. Results Eighty‐eight women (44 women in each group) were analyzed. The rate of complete miscarriage at 1 week was significantly higher in the misoprostol group than the expectant management group—29 (69.0%) versus 7 (16.7%) (P < 0.001), respectively. Women in the misoprostol group were more satisfied (7.00 ± 0.77 vs 4.57 ± 1.61, P < 0.001) but reported more pain (7.95 ± 1.85 vs 5.26 ± 1.08, P < 0.001) than women in the expectant group. The misoprostol group reported more adverse effects than the expectant management group (P < 0.001). Conclusion In women with an incomplete first‐trimester miscarriage who were initially treated with misoprostol, repeat administration of misoprostol was more effective than expectant management for achieving complete miscarriage at 1 week. However, misoprostol was associated with more adverse effects. Registration site and number Clinicaltrials.gov: NCT03148561.

No abstract

Background: Prematurity and congenital abnormalities happened as a result of umbilical cord entanglement. It is possible to link cord-related problems, in which the foetal circulation is hampered by obstruction of the umbilical veins, to a major fraction of instances of intrauterine foetal death. Objectives: To evaluate how the results of the delivery are affected by nuchal umbilical cord (UC) loops during labour. Patients and Methods: A cross-sectional study included 470 women with singleton deliveries between 37-41 weeks of gestation from May 2019 till November 2020. Nuchal cord presence was categorized as either present or missing. The quantity of loops and the delivery results were noted, if applicable. After birth, the length of the umbilical cord was measured to see if nuchal cord loops were present. Results: The participants were classified into cases group (those with nuchal cord, n-220) and control group (without nuchal cord, n=250). The length of UC was significantly higher in the cases group (89.30 ± 14.44 vs. 73.57 ± 18.66 cm, P<0.0001) No significant differences between both groups regarding the rate of Apgar scores 7 (P-0.21), neonatal care unit admission (P-0.96) and perinatal mortality (P-0.26). Meanwhile, the length of UC was significantly higher in those with multiple nuchal loops (n=36) than single nuchal loop (n=184) (100.35 ± 1042 vs. 86,84 ± 14.07 cm. P<0.0001). The rate of Apgar scores 7, neonatal care unit admission and perinatal mortality was significantly higher in women with multiple nuchal loops than with single nuchal loop (P-0.007, 0.011, 0.043, respectively). Conclusions: Multiple nuchal cord loops increase the risk of prenatal morbidity and death in newborns. Nuchal cord loops are more frequent when the UC is long.