Background Secondhand smoke (SHS) exposure gained lesser interest than active smoking. There is evidence from previous studies that SHS exposure had negative effects on fetal growth. This study aimed to examine the effect of smoke exposure on pregnancy outcome and to evaluate the level of nicotine urinary end-product cotinine in pregnant women in the late trimester. We included 36 women with a history of SHS exposure and 48 women without a history of exposure; all were in last trimester of pregnancy. We measured cotinine level in urine and followed the two groups until delivery and recorded fetal outcomes. Fetal biophysical parameters and blood flow waveforms were measured using B-mode and Doppler ultrasonography, respectively. Results The total range of the urinary cotinine creatinine ratio (CCR) concentration in the SHS exposed pregnant women was 0.01–0.2, IQR = 0.18 ng/mg.cr, versus 0.01–0.1, and IQR = 0.03 ng/mg.cr in the non-exposed group. The mean value as well as the mean rank of CCR was significantly higher (0.1 ± 0.08 ng/mg.cr., 40.3 respectively) in the exposed pregnant women as compared to the non-exposed pregnant women ((0.04 ± 0.02), 29.3 respectively, p value < 0.05). Newborn of the exposed women had significantly low birth weight which negatively correlated with cotinine level and had a dose-response relationship. Conclusions SHS exposure had negative effects on fetal outcomes. Efforts should be utilized to increase awareness of the consequences of secondhand smoke on the fetus and strict follow-up of exposed women for early detection.

Introduction: PPROM occurs in 3% of pregnancies and is responsible for about 30% of preterm births. So, the prediction of latency interval is helpful to the patient and obstetrician to allow possible interventions and proper management. Aim: This study aimed to assess the relation between the myometrial thickness, cervical length, amniotic fluid index and membrane thickness (measured by transabdominal ultrasound) and latency interval of labor in cases of preterm premature rupture of membranes (PPROM). Patients and Methods:This was a case control study that was conducted at Al-zahraa University Hospital and Shebin El-Kom Teaching Hospital. One hundred pregnant women (28-34 weeks gestation) were divided into two groups: The first group (fifty cases of PPROM) and the second group (control group = fifty cases with no PPROM), they were subjected to routine transabdominal ultrasound examination to assess fetal biometry, amniotic fluid index, thickness of fetal membranes, cervical length, and the myometrial thickness in 4 areas (the lower uterine segment, mid-anterior uterine wall, uterine fundus, and posterior uterine wall). Results: The myometrial thickness of the anterior wall and LUS was significantly thinner, cervical length showed significant shortening, AFI was significantly decreased and the membrane thickness was significantly thicker in PPROM cases than in controls. The latency interval showed a significant inverse correlation with gestational age and a significant direct correlation with myometrial thickness, cervical length and AFI. Conclusion: There was a significant thinning in the anterior and LUS myometrial thickness in addition to shortening of cervical length, decrease in amniotic fluid index and increase in membrane thickness. Also, the myometrial thickness, the cervical length and the AFI were directly correlated with latency interval.

No abstract

Background Gestational diabetes mellitus (GDM) may cause fetomaternal complications. GDM can be diagnosed conventionally by an oral glucose tolerance test (OGTT). Glycated hemoglobin (HbA1c) is a marker for the blood glucose level in the previous 2–3 months. Objective The aim was to assess the role of using HbA1c as a predictor for developing gestational diabetes in the second trimester. Patients and methods Fifty pregnant women were investigated by ultrasound, and HbA1c and OGTT were performed for all cases at 18–22 weeks of gestation and repeated at 32–36 weeks of gestation. Results There were statistically significant differences between women with HbA1c value less than 5.7% and those with 5.7–6.4% according to BMI, parity, and maternal weight. A positive correlation was detected between HbA1c level and development of GDM according to OGTT, which was done in the third trimester, as women with HbA1c values less than 5.7% have decreased risks of developing GDM than women with higher levels of HbA1c. Follow-up of all cases detected significant relation between level of HbA1c and neonatal birth weight, neonatal ICU admission, and APGAR score, where the pregnant women whose HbA1c less than 5.7% got infant with less birth weight and better APGAR score and the incidence of neonatal ICU admission was less in their infants. Conclusion HbA1c can be used to predict the development of GDM in second trimester. Receiver operating characteristic curve identified that the best cutoff value of HbA1c was 5.2%, with sensitivity of 75%, specificity of 80%, positive predictive value of 71.4%, negative predictive value of 82.8%, with accuracy of 87.2% for diagnosing GDM.