Background: Preeclampsia [PE] is one of the commonest medical emergencies. It had high morbidity for the mother and her infant. Early diagnosis could reduce such morbidity. Aim of the work:To evaluate the role of maternal serum placental protein [PP13] levels and uterine artery Doppler in early prediction and prognosis of preeclampsia. Patients and Methods:The study included 60 pregnant women in their first and early second trimester with high risk for preeclampsia. Patients were divided into three groups: control, mild and sever preeclampsia. All were subjected to proper history taking, clinical and obstetrical examination, laboratory investigations and ultrasound examination. Results: Cesarean delivery was significantly increased in preeclampsia compared to controls [55% of mild and 20% of severe disease compared to 15% of controls]. Both uterine artery resistance index [RI] and pulsatility index [PI] were significantly increased in PE when compared to control and in severe when compared to mild PE groups. Finally, PP13 was significantly decreased in patients with severe PE [171.7±35.9] when compared to mild PE [213.1±41.8] or control group [254.8±51.1]. In addition, there was significant decrease in cases with mild PE when compared to control group. Finally, there was inverse [negative], moderate and statistically significant correlation between PP-13 from one side and each of systolic BP, diastolic BP, uterine artery RI and PI. In addition, both RI and PI were proportionally correlated with PI and RI. Conclusion:The present study showed that PP13 combined with PI or RI can predict PE with a good sensitivity and specificity.

Background: Recurrent pregnancy loss [RPL] is one of the most frustrating and difficult areas in reproductive medicine. Aim of the work: This prospective study aims to evaluate the roles of ultrasound and hysteroscopy in recurrent pregnancy loss. Patients and Methods: A total of 100 patients who had a history of two or more RPL had been included. All patients had been subjected to complete history taking, thorough clinical and gynecological examination, three-dimensional [3D] ultrasound and hysteroscopy. Results: The mean age was 27.43 years. In addition, 45% of the included females had two previous RPL while 55% of them had three or more RPL. Hysteroscopy revealed normal findings in 80 cases [80%], endometrial polyp in 7%, submucous myoma in 3%, uterine septum in 6%, and uterine synechiae in 4%. On the other side, three-dimensional ultrasound [3D US], normal findings had been detected in 83 cases [83%], endometrial polyp in 6%, submucous myoma in 3%, uterine septum in 5%, bicornuate uterus in 1%, and uterine synechiae in 2%. There was a statistically significant correlation between the two techniques in detection of the uterine findings in cases of RPL [p =0.001]. Conclusion: Three-dimensional ultrasonography is the best tool for diagnosis of different types of Mullerian duct anomalies whereas hysteroscopy is better in diagnosis of intracavitary lesions.

Background: Morbidity attached placenta [MAP] remain a major surgical problem for obstetricians due to severe hemorrhage and its incidence had been continually increased due to increased rate of cesarean deliveries. Aim of the work: To evaluate the safety and efficacy of a conservative intervention for management of placenta accreta. Patients and Methods: Forty-eight, pregnant females with a confirmed diagnosis of placenta previa accreta had been scheduled for elective cesarean delivery had been included. All females had been screened by full history taking, clinical examination, ultrasound and laboratory investigations. Blood loss, operative time, need for transfusion and need for other surgical interventions represented the main outcome and other complications were documented. Results: The blood loss [ml] ranged between 850 to 1300 ml; the mean values were 1082.29±105.89 ml. The operative time ranged between 60 to 130 minutes; the mean values were 87.92±19.35 minutes. There was significant decrease of post-partum hemoglobin when compared to corresponding pre-partum values [9.29±0.76 vs 10.71±0.54 mg/dl respectively]. Four patients [8.3%] need ICU admission, and nine patients [18.75%] need blood transfusion. However, no patients need further surgical intervention or developed DIC. In addition, no mortality had been reported in the current work. Conclusion: Combined uterine artery ligation, partial segmental myometrial resection and intrauterine balloon as a conservative treatment modality or placenta previa accreta is safe and effective.

Introduction and aim: Caesarean section (C-section) is one of the commonest surgeries accomplished all over the world, and it has several surgical methods. This work aimed to study the safety and efficacy of cutting diathermy for skin incision during C-section in comparison to surgical scalpel. Methodology: This was a prospective randomized comparative study that was performed in the Obstetrics and Gynecology department, Al-Azhar university hospitals (New Damietta) in the interval between September 2019 to October 2020. Results: The visual analogue scale (VAS) score in the diathermy-group was statistically significantly lower as in comparison to the scalpel-group at 2, 6, 12 and 24 h post-operative. Also, there was an increase in the VAS score in the two groups at 2, 6, and 12 hours’ post-operative as in comparison to the first hour post-operative. This difference didn’t achieve a statistically significant difference except at 12 hours (0.005 and 0.001) in the diathermy-group and scalpel-group respectively. Conclusion: The utilization of diathermy for skin incision in C-section in this work was accompanying with decreased incisional bleeding, incisional period, surgical period and post-operative pains. It had no impact on wound closures (epithelialization) and wasn’t accompanied with any postponement in wounds healing. It was pronounced safely in this work if performed in the suitable way and method with slight or no side-effects.