Background: Caesarean delivery (CD) rates in developing countries are rising beyond the recommended rates of World health organization. Objective of this study was to evaluate whether Dexamethasone injections reduce neonatal incubation admissions when given before scheduled caesarean delivery (CD) at term or not.Methods: A double blinded, two armed, randomized clinical trial was conducted at Tanta University hospitals in the period from October 2017 to March 2019. Four hundred pregnant women admitted for scheduled CD with gestational age ≥37 weeks were included. Patients were randomized into study group and control group. The study group was given 3 dexamethasone doses, 8 mg each while control group was given saline injections simultaneously as a placebo drug. The primary outcome was the neonatal incubatory admissions.Results: Demographic data in both groups were comparable. Transient tachypnea of newborn (TTN) was 15.47% in study group versus 20.33% in control group with p=0.227. The respiratory distress (RDS) in study group was 6.63% versus 9.89% in control group with p=0.260. The incubation admissions were nasal oxygen 12.71% versus 15.38%, continuous positive airway pressure ventilation (CPAP) 5.52% versus 8.24% and mechanical ventilation was 3.87% versus 6.59% in the study and control groups respectively.Conclusions: Although Dexamethasone administration before scheduled CD at term reduced both respiratory morbidity and incubation admissions, the differences between study and control groups were not significant.
ObjectiveThe current study aimed to evaluate the impact of mechanical cervical dilatation during elective cesarean section (CS) on postpartum scar integrity at 6 months post operation.MethodsA randomized double-blind clinical trial (UMIN000027946) was conducted at a tertiary university hospital in the period between July 1, 2017 and April 30, 2018. The study included pregnant women with a singleton fetus at term ≥37 weeks of gestation scheduled for elective CS. Eligible participants were allocated either to the study group (women with intraoperative cervical dilatation) or the control group (women with no intraoperative cervical dilatation). The patients were followed up at 6 months after CS by 3D ultrasonography to check for the scar integrity and quality. The primary outcome was the difference in sonographic parameters of the scar integrity between the two groups.ResultsFour hundred twenty two women were approached to participate in the study. There was no statistically significant difference regarding the baseline characteristics of both the groups. Scar width and depth were significantly higher in the cervical dilatation group (P=0.002 and 0.001, respectively). Fewer cases with scar defects (niche) were found in the cervical dilatation group than in the control group (5.03% vs 11.04%, respectively, P=0.048). There was no significant difference regarding the rate of wound infection or endometritis in both the groups (P=0.717 and 0.227, respectively). The incidence of febrile morbidity was higher in the no cervical dilatation group (10.5%) compared to (5.0%) the cervical dilatation group (P=0.045).ConclusionCervical dilatation during elective CS is associated with thick scars with low incidence of scar defects.
Aim: To evaluate the benefits and hazards of routine progesterone supplementation in threatened abortion and whether it is a sound practice or not. Materials and Methods: This study was conducted at Obstetrics and Gynecology Department, Tanta University in the period from January 2018 to December 2018. Eligible patients (n = 190) were randomly allocated into 2 groups: study group who will receive progesterone supplementation (prog. group) and control group who will receive no treatment (place. group). Results: No significant differences were found between both groups regarding all demographic data and pregnancy characteristics. Abortions were higher in place. group 17 (23.94%) than in prog. group 12 (16.44%) with no significant difference p value = 0.263. The incidence of preterm labour was also higher in the place. group 22 (30.99%) in comparison to the prog. group 17 (23.29%) with no significant difference p value = 0.300. Conclusion: Progesterone supplementation in threatened abortion was not beneficial although it reduced abortion and preterm labour rates.
Background: Uterine fibroids (UFs) are the most common benign tumors affecting women of reproductive age]. patients with uterine fibriod suffer from pelvic pain, menorrhagia, dysmenorrhea/dyspareunia, pressure-related symptoms, miscarriage, and subfertility. The aim of this study was to assess the relationship between occurrence, size, and clinical symptoms of uterine fibroid and the serum level of Vitamin D. Methods: The study was designed as an observational case control study. This study was conducted at Tanta University Maternity Hospital at the department of obstetric and Gynecology from March 2020 to September 2020.This study was conducted on 75 women in their reproductive age (20-45 yrs) recruited at Tanta obstetric and gynecology department (inpatient wards), they were subdivided into two groups:Group A: case group: 50 Women with uterine fibroid. Group B: control group: 25 Women with normal uterine examination and transvaginal ultrasound. Measuring the level of serum vitamin D3 in both control and women with uterine fibroid. Results: The age, in case group, ranged from 20-45 yrs with mean level 30.50± 4.56 yrs and in control group ranged from 20-45 with mean value 31.01+ 5.11 yrs. the diagnostic performance of vitamin D test in diagnosing uterine fibroid through illustrating sensitivity and specificity of vitamin D level to predict uterine fibroid. Area under the curve was 0.881with cut off value 14.3 ng/ml, the sensitivity of vitamin D to predict the fibroid was 79.3%, the specificity was 66.7 and test accuracy was 74.4%. Conclusions: The current study showed a significant association between vitamin D3 deficiency in reproductive age women and the occurrence of uterine fibroid, the mean vitamin D3 level in the case group was 13.8±7.93 ng/ml and in the control group was 20.79+8.95 ng/ml. There is correlation between vitamin D3 level and the size of uterine fibroid. Vitamin D3 deficiency is widely spread among the study population with 80 % prevalence while vitamin D3 insufficiency is prevalent in 14% among study participants
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