Background: The two approaches for evaluating the female reproductive system are hysteroscopy and laparoscopy. Laparoscopy is becoming a standard component of infertility evaluation by virtue of its capability to visualize and manipulate the uterus, the ovaries and fallopian tubes. Hysteroscopy has become an important investigative tool for discovering possible causes of female infertility by examining the uterine cavity. The goal of this study was to examine the role of hystero-laparoscopy in diagnosis women with unexplained infertility.Methods: A total of 202 cases who were 20-35 years old women with 1ry or 2ry unexplained infertility were studied in this cross-sectional observational analytical study. All patients were subjected to: evaluation (physical, abdominal and bimanual), routine laboratory investigations, basic investigations (documentation of sound ovarian factor: hormonal assays and pelvic ultrasonography, normal hysterosalpingography, normal husband semen analysis) and hysterosalpingography (HSG) was reviewed or completed.Results: Abnormal laparoscopic was significantly higher in secondary cases compered to primary infertility (p=0.043). Abnormal combined hystero-laparoscopic was significantly higher in 2ry infertile cases compered to 1ry infertile cases (p=0.006). Pairwise comparison between 1ry and 2ry infertility was statistically significant difference (P=0.004).Conclusions: The percentage of abnormalities found during laparoscopy and hysteroscopy, are difficult to be visualized by the use of other noninvasive methods. While a thorough history, thorough examination, and early studies such as pelvic ultrasonography can all lead to the suspicion of numerous abnormalities, a considerable percentage of abnormalities may go undetected.
Objective: The aim of this work is to investigate the diagnostic value of platelet count (PC), mean platelet volume (MPV), the PC to MPV ratio and platelet distribution width (PDW) for prediction of pre-eclampsia (PE). Subjects and Methods: This prospective cohort study included 100 pregnant women, in the first trimester of pregnancy attending to University Hospital, Obstetric Outpatient Clinic, for routine obstetric care from January 2019 to December 2019. Routine obstetric follow-up consists of monthly visits until 32nd gestational week, bimonthly visits between 32nd and 36th gestational week, and weekly thereafter. Patients were classified into two groups: group I: 9 pre-eclamptic patients and group II: non pre-eclamptic 91 patients. CBC indices were measured at each planned visit Results: PC, PC/MPV were significantly decreased, MPV and PDW were significantly increased in group I than group II at the 2nd part of pregnancy. To predict pre-eclampsia, PC at cut-off ≤214, sensitivity was 77.78, specificity was 76.92. MPV at cut-off >9.7, sensitivity was 77.78, specificity was 100.00, PC-MPV at cut-off ≤26.89, sensitivity was 88.89, specificity was 78.02. PDW at cut-off >10.4, sensitivity was 88.89, specificity was 54.95. Conclusion: The increase in the MPV and PDW and the decrease in PC and PC/MPV were observed in preeclampsia. Thus, the platelet indices which are easily available, as well as economical, can also be used in the prediction and early diagnosis of preeclampsia.
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