BackgroundPostpartum hemorrhage is the leading cause of maternal death, uterine atony accounts for 75-90% of primary postpartum hemorrhage. The efficacy of the Uterine compression suture in the treatment of atonic postpartum hemorrhage is time-tested and can be said to be almost established.The aim of this study was to assess the role of the Mansoura-VV uterine compression suture as an early intervention in the management of primary atonic postpartum hemorrhage.MethodsThis prospective observational study included 108 women with primary atonic PPH over a period of 44 months. Uterine atony was diagnosed when the uterus was soft and failed to respond to ordinary ecbolics. Early intervention by Mansoura-VV uterine compression sutures was carried out within 15 min of the second dose of ecobolics and before progressing to any further surgical procedure.ResultsFollowing the Mansoura-VV uterine compression sutures, uterine bleeding was controlled in all except one patient (107/108 cases; 99.07%) who required additional bilateral uterine vessels ligation. Another case (0.93%) was subjected to re-laparotomy due to intraperitoneal hemorrhage. Packed RBC transfusion was needed in 10 cases (9.25%). Admission to ICU was needed in 9 cases (8.33%) because of associated medical conditions. One week following the procedure, 1 case (0.93%) was diagnosed with haematometra.ConclusionEarly intervention in cases of primary atonic PPH using the Mansoura-VV uterine compression sutures is an easy, rapid and effective method in controlling PPH in low resource settings.Trial registrationThe study was registered at clinicaltrial.gov, Identifiers: NCT03117647 “retrospectively registererd” registered at April 7, 2017.

Background: Gestational trophoblastic tumors originate from trophoblastic tissues and secrete human chorionic gonadotrophin (hCG). Surgical treatment may be a line of treatment of chemoresistant cases. Objective: To evaluate the accuracy of hCG dipsticks in detection of hCG in tissues of trophoblastic tumors and healthy myometrium during surgery of trophoblastic tumors. Methods: We included 19 samples of tumor and apparently healthy myometrial tissues during surgical treatment of 5 cases of gestational trophoblastic tumors. The hCG dipstick was immersed in a solution containing 1x1 cm of tumor or myometrial tissues. The results of the tests were compared to the histopathological results. Results: The mean age of patients were 38.8 years, the mean parity was 3.4. The mean serum B-hCG level was 101,745.6 mu/ml. Except for one specimen in case 5, all results of the hCG dipsticks were concordant with final histopathologic analysis of the specimens. Sensitivity of hCG test was 100% and specificity was 90%. Conclusion: Intraoperative detection of hCG in different tissues and suspicious masses can be considered as simple, rapid, inexpensive, and reliable test. It can be used to detect the trophoblastic nature of tissues if frozen section is not available as some low resource setting countries. We recommend further larger prospective studies to compare the accuracy and reliability of this novel technique and frozen section analysis.

The objective of the study was to assess the safety and efficacy of conservative laparoscopic electrocoagulation adenomyolysis (CLEA) in the management of women with symptomatic adenomyosis. The study design is prospective observational study. The setting was Department of Obstetrics and Gynecology, Mansoura University Hospital. Thirty-nine premenopausal women, complaining of chronic pelvic pain and/or menorrhagia, were diagnosed to have adenomyosis by transvaginal ultrasonography (TVS) and/or magnetic resonance imaging (MRI), between June 2008 and June 2011. They were subjected to laparoscopic multiple uterine unipolar electrocoagulation diathermy punctures aiming at adenomyolysis. Women were evaluated before and at 3, 6, and 12 months after the procedure. Main outcome is the magnitude of pain by using the visual analog scale (VAS) and the overall patient self satisfaction as assessed by short form 36 (SF-36) questionnaires; secondary outcome is the uterine volume as measured by TVS. At 3-, 6-, and 12-month follow-up visits, there was a gradual, yet a significant, reduction in the median VAS scoring system of pain (p<0.01), a significant improvement in every scale of the SF-36 (p<0.01), and also a significant reduction (p<0.01) in the median uterine volume as assessed by TVS. Conservative laparoscopic electrocoagulation adenomyolysis may be an effective and safer minimal invasive procedure for the management of symptomatic adenomyosis in premenopausal women.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12884-017-1349-x.