Our data shows that repair with mesh is superior to anterior colporrhaphy with more satisfactory outcome to the patients. Due to the small size of our study and uncertainty of the long-term safety and resilience of the mesh, we recommend larger studies to confirm our preliminary results.
Objective:To evaluate the relation between uterine killer (uK) cells and unexplained repeated miscarriage (RM). Material and Methods: Eighty women with unexplained repeated miscarriage and missed miscarriage of current pregnancy were studied.Fetal viability and gestational age of the current pregnancy were confirmed by ultrasound, followed by suction evacuation to collect abortion specimens and uterine wall curettage to collect decidua specimens. Abortion specimens were collected for long-term monolayer cell culture and subsequent chromosome analysis using conventional G-banding. Decidua specimens were subjected to immunohistochemical staining using monoclonal antibodies specific to CD56+ and CD16+ expressed by uK cells.Results: CD56+ CD16+ uK cells were found in 85% [68/80] of the studied decidua specimens of women with unexplained repeated miscarriage; 88.5% [54/61] had normal abortion karyotyping and 73.7% [14/19] had abnormal abortion karyotyping. Moreover, 73.75% [59/80] of the studied women with a past history of early miscarriage had CD56+ CD16+ uK cells in their decidua specimens, and 66.25% [53/80] of studied women with a past history of late miscarriage had CD56+ CD16+ uK cells in their decidua specimens; the association between early and late miscarriage and CD56+ CD16+ uK cells in decidua specimens was significant. Conclusion:CD56+CD16+ uK cells were predominant in the decidua specimens of the studied women with repeated miscarriage. A significant association was found between the presence of CD56+ CD16+ uK cells in the studied decidua specimens and unexplained repeated miscarriage. (J Turk Ger Gynecol Assoc 2015; 16: 214-8) Keywords: Obstetrics, uterine killer cells, repeated miscarriage Received: 27 April, 2015 Accepted: 14 October, 2015 Relationship between uterine natural killer cells and unexplained repeated miscarriage Material and MethodsEighty women with unexplained repeated miscarriage and missed miscarriage of current pregnancy were included for evacuation and curettage because of a current missed miscarriage (>8 weeks, diagnosed by ultrasound). The women were studied after proper counseling, consent, and approval of the ethical committee. Unexplained repeated miscarriage was defined as ≥2 previous miscarriages after <20 weeks' gestation. A thorough history was obtained and a thorough examination was performed for all studied women, followed by trans-vaginal ultrasound to confirm fetal the viability and gestational age of the current pregnancy by a sonographer who was blinded to the patients' data. Peripheral venous samples were collected from the studied women for oral glucose tolerance tests; thyroid stimulating hormone assays; prolactin, serum anticardiolipin, and lupus anticoagulant assays; as well as activated protein C resistance tests, Leiden factor V and prothrombin gene mutations, and protein C, S, and anti-thrombin III deficiency tests. Women with septic miscarriage, documented endocrinopathies (diabetes, thyroid disorders, or hyperprolactinemia), uterine anomalies, p...
After 24 gestational weeks, SP4 assessment is a simple and reliable promising tool to predict spontaneous PTB among asymptomatic high-risk women, with a little superior performance than CL measurement.
Background: During labor, it is common for women to have no or little nutrient intake, inspite of the fact that the demand of energy increases as a result of skeletal and smooth muscle contraction. Aim of the Work: This study aims to evaluate the effect of intravenous dextrose-saline infusion compared with intravenous normal saline infusion in acceleration of active phase of labor in nulliparous women. Patients and Methods: This prospective randomized controlled trial was conducted on nulligravida patients recruited from those attending labor ward of Ain Shams University, Maternity hospital who are, singleton gestation, 36 weeks or more. Results: Total duration of first and second stages of labor was significantly shorter among Dextrose 5% group than among Normal saline group. Conclusion: Dextrose 5% solution administration is associated with shortened duration of labor because it provides the required energy for pregnant mothers during the labor procedure through the detraction of harmful metabolites produced together with ATP production and results in acceleration of the labor process. Recommendations: Dextrose 5% administration during labor is associated with shortened duration of labor. Further studies with larger sample sizes, more outcomes and different dextrose concentration is required to determine the exact effect of dextrose.
Background Preeclampsia is a common complication of pregnancy and remains a common cause of maternal and fetal mortality. The clinical symptoms of preeclampsia are caused by widespread endothelial dysfunction suggested to be a part of an exaggerated maternal inflammatory response to pregnancy. Since preeclampsia is associated with widespread endothelial dysfunction, proposed to be provoked by an increased maternal systemic inflammatory response, the maternal plasma level of SAA might be expected to be increased when compared to normal pregnancy levels. The maternal plasma level of SAA in normal pregnancy could differ from non-pregnant level due to increased hormone levels, increased adipose tissue and\or secondary to modifications of inflammatory response in normal pregnancy. Aims The aim of our study is to estimate the relation between serum amyloid A in pregnant women and preeclampsia. Methodology the study conducted this case control study in the emergency room of Ain Shams University Maternity Hospital starting from April 2018 on women with preeclampsia to estimate serum amyloid A in pregnant women with preeclampsia. Members of the control group are healthy, non-smoker pregnant women who had an uncomplicated antenatal course and all arterial blood pressure measurements were normal. Results The current study was conducted in Ain Shams University Maternity Hospital in the period between January 2017 and August 2018. A total of 75 women were included in the study. The process of recruitment and handling the study population during the course of the study is shown in the flow diagram (figure 1). In order to avoid any confounding effect for a possible subclinical ongoing pathophysiological process, four women with preeclampsia lacking severe features were excluded following the development of severe features shortly after measurement of serum amyloid A level. Conclusion Our data sustain the limited number of studies investigating the SAA levels in both preeclamptic and healthy pregnant women, in which it was hard to reach a consensus regarding the association between SAA levels and preeclampsia. Taken in consideration that an elevated plasma level of SAA in preeclamptic women should be considered pathologic, we believe that the response of relationship between the preeclampsia and SAA levels could be caused by an inflammatory condition associated with preeclampsia. Also, serum amyloid A can be used to discriminate between mild preeclampsia cases and controls and as discriminate between severe preeclampsia cases and controls. Recommendation We recommended further investigation on large sample size for the elucidation of the role of SAA in pre-eclampsia neonatal outcome and the possibility of these biochemical factors to be novel markers of such disorders in pregnant women.
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