Background: Preterm labor (PTL) remains a major source of neonatal morbidity, and mortality. Currently the trans-vaginal cervical length (TVCL), and/or cervico-vaginal fetal fibronectin (fFN) are the common diagnostic tools used for prediction of PTL. Consequently, many women and their fetuses are exposed unnecessarily tocolysis and hospital admission. Objectives: This study was designed to compare the diagnostic accuracy of PremaQuick versus Actim Partus in prediction of PTL in symptomatic women within 14 days. Patients and Methods: Two-hundred and twenty women (220) were included in this comparative prospective study and classified into two groups: 110 women with threatened preterm labor (TPTL) in the study group, and 110 controls (no TPTL). Women included in the study were subjected to: through history, collection of the cervico-vaginal fluid (CVF) samples for assessment by PremaQuick and Actim Partus tests, followed by trans-vaginal cervical length (TVCL) assessment. Studied women managed according to the hospitals protocol, with follow-up weekly in the obstetrics outpatients' clinic after discharge from the hospital until delivery. The main outcome measures the diagnostic accuracy of PremaQuick versus Actim Partus in prediction of PTL in symptomatic women within 14 days of admission. Results: PremaQuick test was significantly more specific with higher positive predictive value (PPV) in prediction of PTL in symptomatic women within 14 days (95.5% and 89.6%; respectively) compared to CL < 25 mm (56.3% and 54.6%; 742 Open Journal of Obstetrics and Gynecology respectively), (P = 0.02 and 0.03; respectively). In addition, PremaQuick test was significantly more sensitive with higher positive predictive value (PPV) in prediction of PTL in symptomatic women within 14 days (39.8% and 89.6%; respectively) compared to Actim Partus (13.9% and 55.5%; respectively), (P = 0.001 and 0.01; respectively). The Odds ratio and the relative risk for prediction of PTL in symptomatic women within 14 days were significantly high for PremaQuick compared to the CL < 25 mm, and Actim Partus. Conclusion: PremaQuick test seems to be the best complementary test to the CL < 25 in prediction of PTL in symptomatic women within 14 days. PremaQuick test compensates the low specificity and low PPV of the CL < 25 mm in prediction of PTL.

Introduction: Evaluation of abnormal uterine bleeding (AUB) in women ≥ 40 years or menopausal women is of critical importance to confirm the benign nature of the problem, and to exclude endometrial carcinoma. This study was designed to evaluate the accuracy of saline infusion sonography (SIS) compared to hysteroscopy in diagnosing uterine cavity abnormalities in cases of AUB. Material and methods: One hundred and eighty-six women diagnosed with AUB were included in this comparative study, and agreed to have SIS, beside the hysteroscopic assessment of the uterine cavity. Results: In this study, hysteroscopy was more sensitive (98.7% vs. 97.4%), more specific (100% vs. 99.1%), and more accurate (99.5% vs. 98.4%) than SIS. In addition, hysteroscopy had higher predictive values, 100% positive predictive value, and 99.1% negative predictive value compared to 98.7% positive predictive value, and 98.2% negative predictive value for SIS in diagnosis of uterine cavity abnormalities. However, these differences were not statistically significant (p > 0.05). Conclusions: Saline infusion sonography is a simple, well-tolerated procedure that can be used in an outpatient setting to diagnose uterine cavity anomalies in cases of abnormal uterine bleeding when outpatient hysteroscopy is not available or as a complementary tool to confirm the diagnosis detected by hysteroscopy.

Introduction: Heavy menstrual bleeding (HMB) or menorrhagia is the most common form of dysfunctional uterine bleeding (DUB). In spite of medical treatment for DUB, many women will eventually require a hysterectomy, which is an invasive treatment option. NovaSure ablation offers a same-day non-invasive alternative to hysterectomy and hysteroscopic ablation. Case description: A 38-year-old woman presented with HMB in 2015. The attacks of HMB interrupted her lifestyle , and she refused to continue with medical treatment, which failed to resolve her symptoms. The patient was admitted to the hospital four times in 2015, due to anemia caused by the DUB. Medroxyprogesterone acetate and oral contraceptive pills failed to control the patient's bleeding episodes. Hysteroscopic examination of the uterine cavity showed a normal cavity, and the endometrial biopsy showed proliferative endometrium. She was counseled about NovaSure ablation as the last treatment option before hysterectomy. The NovaSure ablation procedure took 90 s, and the patient was discharged from the hospital 6 h after the procedure. At follow-up, the patient is completely amenorrheic, and she is satisfied with the NovaSure ablation results. Conclusions: This case report demonstrates that NovaSure endometrial ablation is a safe, effective, non-invasive alternative to hysteroscopic endometrial ablation for treatment of DUB.

The chances of pregnancy decrease with the natural aging process of the infertile couple. During treatment of an infertile couple, the clinicians are usually asked questions about the chance of conception. Ovarian reserve describes the reproductive ability of the woman. An ideal ovarian reserve test should be affordable, convenient and sensitive. Ovarian reserve tests help to predict a poor response or hyper-response to ovarian stimulation and help to formulate the treatment plan in an infertile couple. Decreased ovarian reserve refers to women whose ovarian response to exogenous gonadotropin stimulation is reduced compared to similar women of the same age.