Background A pregnancy loss (miscarriage) is defined as the spontaneous demise of a pregnancy before the fetus reaches viability. The term therefore includes all pregnancy losses (PLs) from the time of conception until 24 weeks of gestation. Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women in which levels of the sex hormones are disrupted. Hyperhomocysteinemia has been associated with clinical vascular thrombosis, and this could be the cause for early decidual and chorionic vessel damage that might result in disturbed implantation of the conceptus. Objective To determine the plasma homocysteine levels in patients with PCOS having recurrent pregnancy loss (RPL) compared with women with PCOS without RPL. Patients and methods This is a case–control study on 30 women with PCOS with RPL and 30 control women with PCOS without RPL. Plasma homocysteine levels were assessed from February 2019 to February 2020 at Al Zahraa University Hospital. Results There was a significant increase in the mean homocysteine level in the case group (20.14±3.21) compared with controls (9.01±2.24) (P=0.001), with odds ratio=2.193 (confidence interval 0.171–23.294) by homocysteine through cut-off more than 12 mmol/l. Conclusion Risk of RPL in patients with PCOS is increased with hyperhomocysteinemia (P<0.001).

Introduction Pain perception is a complex phenomenon that impacts the selection of analgesia. The majority of first-trimester surgical abortions in United States are performed with a paracervical block (PCB). Satisfactory pain control for women undergoing surgical abortion is important for patient comfort and satisfaction. Aim of the work The aim of this study was to estimate the pain related to first-trimester abortion under local or general anesthesia. Patients and methods A hundred female patients (American Society of Anesthesiologists)(ASA) I-II undergoing dilatation and curettage were randomly allocated into two equal groups. Group A (n=50): they received a PCB with 5 ml of 2% lidocaine injected into each side of cervix at the 3 and 9 o'clock positions. Group B (n=50): they received general anesthesia with intravenous bolus of 2.5 to 4 mg/kg propofol and 1 µg/kg fentanyl, and maintained anesthesia by 1 mac isoflorine in oxygen as inhalational anesthesia by face mask. Results The study showed that the most commonly prevalent type of pain by the visual analog scale is in group A during aspiration, curettage, and immediately postoperatively as 41; 27 and 48 patients felt mild pain, respectively; while during dilatation increase incidence of moderate pain as 26 (52%) patients felt moderate pain. Conclusion The PCB is more preferred than general anesthesia under condition that we wait a few minutes before beginning the procedure as it insures the satisfaction of the patient while avoiding the side effects of general anesthesia and is also not as expensive.

Background: Episiotomy is a surgical wound done with sterile scissors to widen the vaginal opening. There is little information on the prevalence of post-episiotomy infection worldwide. Contrary to WHO recommendations, prophylactic antibiotics are still prescribed in many hospitals including our hospital, to prevent the episiotomy site infection in all women after childbirth. Aim:To compare infectious morbidity rates between parturient women with uncomplicated vaginal birth who received either a prophylactic course of oral antibiotics post-episiotomy in addition to routine local care versus those who received routine local care only.