Partogram (Partograph) is a graphical tool represents the events during labor, that helps the care provider to recognize slow progress of labor early, and to start appropriate interventions to prevent prolonged and obstructed labor. In this study, we compared between the percentage of birth trauma which occurred during labor for patients that crossing the alert line of partograph (Group I), and those who crossing the action line (Group II). This study showed that there is no difference statistically between Group I and Group II according to gravida and maternal age. while Group I is higher than Group II according to APGAR score >7 (P value =0.001). There is statistical differences between Group I & II , that Group I is lower than Group II according to perineal tear, fetal birth injuries and rate of C sections ( P value: 0.004 , 0.009 and 0.000). In conclusion: partograph may be a scientific evidence based to manage labour by early diagnosis, identifying and preventing problems during delivery.

Aim: Estimation of blood glycated hemoglobin A (HbA1c) level in newly pregnant women at time of pregnancy diagnosis (T0) and 3-monthly thereafter to detect any relation between these levels and the change in maternal blood glucose (BG) levels during pregnancy. Material and Methods: 304 newly pregnant women gave fasting blood samples for estimation of T0 HbA1c level and then underwent the 75-Oral glucose tolerance test (OGTT) and were asked to re-attend the clinic overnight fasting at the start of the 12 th and at the 24 th -28 th gestational week (GW) for estimation of HbA1c levels and to repeat the 75-OGTT. ΔHbA1c was calculated as the difference between HbA1c levels estimated at 12 th GW minus T0 levels. The results of the 75-OGTT were interpreted for diagnosis of gestational diabetes mellitus (GDM) and HbA1c at range of 4-6% indicates non-diabetic state. Study outcome is the ability of T0 levels of HbA1c to discriminate women vulnerable to develop GDM around the 24 th to the 28 th GW. Results: 38 women developed GDM, while 286 women completed their pregnancy free of GDM. GDM women had significantly higher T0 body mass index (BMI) and HbA1c levels than Non-GDM women. Moreover, the 12 th and 24 th GW HbA1c levels and ΔHbA1c were significantly higher in GDM women. The 24 th GW 2hr-postprandial BG (PPBG) levels showed significant positive correlation with T0 BMI, fasting BG and 2hr-PPBG and with T0 and 12th GW levels of HbA1c and ΔHbA1c. Regression analysis defined T0 level of HbA1c, ΔHbA1c, 12 th GW HbA1c level and T0 BMI as the significant positive predictor for the 24 th GW 2hr-PPBG level. ROC curve analysis defined T0 level of HbA1c and ΔHbA1c as the significant predictors for the 24 th GW 2hr-PPBG level which is diagnostic for GDM. Conclusion: Development and severity of GDM could be predicted at time of pregnancy diagnosis by high HbA1c level and assured by calculation of the extent of change in HbA1c level at the 12 th GW.

Aim: This is a pilot prospective self-controlled trial study. It aimed to explore the efficacy of intrauterine infusion of autologous platelet-rich plasma (PRP) in infertile ladies as an adjuvant to clomiphene citrate (CC) in ladies with previous CC failure attributed to a thin endometrium (≤ 7 mm). Materials and Methods: This study included thirty anovulatory PCOS women with CC failure for 3 cycles with a thin endometrium (7 mm). All patients underwent ovarian stimulations for 2 cycles; control cycle (30 women received CC alone and one got pregnant) and study cycle (29 women received CC plus an intrauterine infusion of PRP). Main endpoints included the comparison of the endometrial thickness (ET) and endometrial vascularity pattern by power Doppler on the day of hCG injection between both treatment cycles. Results: There was a statistically significant increase in the endometrial thickness on the day of hCG injection with CC plus PRP compared to CC alone (8.98 ±1.31 vs, 5.8 ±1.2; p < 0.0001). There was a significant improvement in the endometrial blood flow with the use of PRP (p= 0.00004). The pregnancy rate is significantly higher in the PRP cycles compared to control cycles (7 pregnancies (24.14%) vs. one pregnancy (3.3%) respectively; p = 0.0257). Conclusion: Intrauterine infusion PRP seems to be a promising adjuvant to increase endometrial thickness and endometrial blood flow with subsequent improvement in clinical pregnancy rate in ladies with CC failure due to thin endometrium.

No abstract