Background: Preeclampsia (PE) is one of the hypertension illnesses associated with pregnancy, affecting 3-5% of pregnant women, and is a significant cause of maternal morbidity and perinatal mortality. Detection of placenta changes in the first trimester by three-dimensional power-Doppler ultrasound can be used to detect preeclampsia early. Objective: The aim of the current work was to demonstrate if 3D-Indicators of placental volume and vascular flow in the first trimester might predict preeclampsia. Patients and methods: This prospective cohort study included 324 pregnant women with singleton pregnancies, attending at Prenatal Care Outpatient Clinic, Zagazig University Hospitals for regular antenatal care between weeks 11 + 0 and 13 + 6 of pregnancy. Transabdominal the 3D power Doppler ("placental biopsy") was used to assess placental vascularization. Making use of the Virtual Organ Computer-aided Analysis (VOCALTM) imaging tool, the obtained spherical volume was analyzed. three vascular indices, were calculated: Index of vascularization (VI), vascularization-flow index, as well as flow index (VFI). Results: A comparison of placental volume of healthy pregnancy group and preeclamptic pregnancies in the current study showed a statistically significant considerable distinction (P value 0.001). The mean volume in the two groups was 84.9±22.3 and 45.6±11.4 cm 3 , respectively. The volume of the placenta was higher in the healthy pregnancy group compared to preeclamptic pregnancy group. In addition, a comparison between normal pregnancy and pregnancies with PE, in terms of FI, VI, and VFI, indicated a difference that is statistically significant (P value 0.001). The averages of FI, VI, and VFI in the two groups were (95.4±9.1, 24.7±8.1, 13.1±3. 7) and (16.2±5.8, 54.6±10.9, 8.1±2.1) respectively. These findings clearly reveal that placentas from preeclampsia complicated pregnancies have lesser blood vessels (reduced VI) and lower blood flow (reduced FI). According to our findings, this ultrasonographic technology can forecast the development of PE. Conclusions: It could be concluded that the quantitative measurement of placental vasculature and volume using noninvasive 3D Power Doppler and the VOCAL™ technique during the first trimester may be utilized to predict preeclampsia. Patients who later develop preeclampsia tend to have decreased placental volume and poorer 3DPD indices in this critical area during the first trimester.

Background: Overactive bladder (OAB), a clinical condition with chronic, complex symptoms that negatively affect quality of life (QoL) and affects a large section of the population. Beta-3 adrenergic agonists that provides a different mode of action and are still in the early stages of development, are being used more frequently than antimuscarinics to treat OAB.Aim: To compare between antimuscarinics and a beta-adrenergic agonist (mirabegron) regarding efficacy and side effects in treatment of adult female with overactive bladder. Patients and methods: This prospective trial was carried out in the Obstetrics and Gynecology Department, Faculty of Medicine, Zagazig University on 82 female patients with OAB. Patient groups were divided into two groups (mirabegron 50 mg n = 41 and tolterodine 4 mg n = 41). Results: There was a significant difference between each group's baseline and final assessment in terms of post-void residual urine, number of micturitions, urgency episodes, incontinence episodes, and urgency incontinence episodes/24 h, volume voided/micturition, number of nocturia episodes, and number of incontinences. The only significant difference between the two groups was a lower number of nocturia episodes in mirabegron than tolterodine. Conclusion:In the Egyptian population, with a low incidence of side effects, mirabegron 50 mg and tolterodine 4 mg are efficient therapies for OAB symptoms.

Background: When used prior to a bowel injury, oral antibiotic bowel preparation (OABP) reduces intraluminal bacteria l load and, thus, the risk of surgical site infection (SSI). Objective: The aim of the current study was to investigate the role of preoperative oral antibiotic in gynecological oncology surgery in field visualization, reducing postoperative ileus and surgical site infection. Patients and methods: A cohort study was conducted on a total of 130 women who underwent tumor debulking surgery for gynecological cancer (ovarian, uterine, cervical or endometrial). On the day before surgery, patients received perioperative prophylactic oral antibiotics, and on the day of surgery, all patients were subjected to intravenous cephalosporin. Results: Preoperative oral antibiotic was associated with SSI incidence of 15.4%; 20 cases with surgical site infection (SSI) and 110 cases without SSI. Also favorable surgical field (reported as good or sufficient) was reported in 92.4% of cases. Return of intestinal function was early with mean duration of 19 hours. Conclusion: Preoperative oral antibiotic was associated with low incidence of SSI. Favorable operating field and early return of Bowel function.

Background: Preeclampsia is a major contributor of maternal and perinatal morbidity and mortality. The purpose of this study was to look at the predictive usefulness of placental growth factor (PLGF), maternal characteristics (MC), and uterine artery Doppler for preeclampsia in the first trimester. Patients and methods: A cross-sectional survey was conducted on 805 pregnant women between 11 + 0 and 13 + 6 weeks' gestation. A complete history and clinical examination were taken at the booking visit, a bilateral uterine artery Doppler study was estimated, and the mean pulse index (PI) was computed and recorded. A venous blood sample was drawn and centrifuged for 10 minutes at 3000 rpm to extract the serum, which was then frozen at 80 C for further examination for placental growth factor (PLGF). Results: PE developed in 54 (6.7%) cases; 11 (20.4%) early-onset and 43 (79.6%) late-onset. The following parameters were calculated: sensitivity, specificity, positive and negative value (PPV and NPV), and accuracy. The sensitivities for MC, PLGF and UADPI for prediction of early-onset preeclampsia were 27.3%, 54.5%, and 72.7%, respectively. The sensitivities for MC, PLGF and UADPI for prediction of late-onset preeclampsia were 14%, 55.8%, and 51.2%, respectively. The sensitivity for combination between the three factors used to predict PE were 85.7% for early-onset and 79.4% for late-onset preeclampsia, respectively. Conclusions: Effective screening for PE may be accomplished in the first trimester of pregnancy, at 11-14 weeks' gestation, by combining maternal features with the findings of uterine artery Doppler and placental growth factor to determine the risk of PE development.