Aim: Cesarean delivery is one of the most common surgical procedures in obstetric practice and its incidence is rising worldwide. In Egypt, the past decade has witnessed a sharp increase in the CS rate to reach about 52 %. Post cesarean section (CS) infectious morbidity is a major health problem, which can lead to maternal health morbidities in addition to economic burden. Endometritis, febrile morbidity and wound infection are considered of the most frequent complications of post cesarean infections. Endometritis is the commonest complication as it accounts up to 27%, followed by clinically significant fever, which was reported as 5-24%, while the incidence of wound infection is about 2-9%. This complication, up to 10 times more frequent after a cesarean delivery than after vaginal delivery. Materials and Methods: This study was conducted on 54 females undergoing elective cesarean section, admitted to El-Shatby Maternity University Hospital. Patients were divided into two groups, each group contained 27 cases. The first group received Preoperative vaginal cleaning with10% povidone iodine for 30 seconds. The second group did not receive preoperative vaginal cleaning. Results: The Comparison between the two studied groups regarding incidence of febrile morbidity, post-operative endometritis and wound infection were statistically significant; P = (0.009), (0.024) and (0.018) respectively. Appling povidone iodine reduced the rate from 37 % in the control group to 7.4 % in the treatment group, post-operative endometritis rate from 29.6 % in the control group to 3.7% in the treatment group and post-operative wound infection rate from 33.3 % in the control group to 7.4 % in the treatment group. Conclusion:This study has shown that vaginal cleaning with povidone iodine prior to cesarean section can prevent postoperative febrile morbidity.

Aim: To assess the risk of adverse birth outcomes in broad categories of maternal occupations including farming, office, non-manual and housewives. Methods: This Cross-sectional study was conducted in between January 2021 to December 2021 in Damanhur National Medical Institute (DNMI) El Behera Governorate, Egypt. Target women were Mothers admitted in DNMI, after giving birth to viable single neonates with or without adverse birth outcomes e.g.,) preterm birth, low birth weight, or congenital anomaly). Data on maternal occupation and occupational exposures included: duration of work and details on occupational exposure to stress factors, physical, chemical and/or biological hazards. Examination of newborn was done: weight (in grams), height (in cm), head circumference (in cm) and examination for any congenital anomalies. Results: Working mothers had 1.44 times more risk to experience adverse birth outcomes compared to non-working mothers (95% CI= 0.55-3.77). There was a significant association between exposure to chemical risk factors and having adverse birth outcomes (X 2 =6.11, P= P=0.03). There was an insignificant association between exposure to hard physical work and having adverse birth outcomes (X 2 =1.81, P=0.36) However, standing for long hours during work was significantly associated with adverse birth outcomes (X 2 =5.69, P=0.04) Mothers who reported exposure to biological hazards had 2.25 times more risk compared to mothers who were not exposed to biological hazards (95% CI= 0.31-16.41). Conclusions: Working mothers had more risk to experience adverse birth outcomes. Mothers who exposed to physical risk factors or biological hazards at work had more risk to have adverse birth outcomes. Furthermore, occupational exposure to chemical agents was significantly associated with adverse birth outcomes.

Background: Poor responders constitute a less fortunate group of patients attending any IVF/ICSI clinic. Identifying these patients helps in choosing the most appropriate stimulation protocol. Aim:This is a randomized controlled prospective study that aimed to study the effect of adding letrozole to GnRH antagonist protocol in poor responders undergoing ICSI. Materials and Methods: This study was carried out on a sample of 70 infertile couple, thirty five patients in each group, five cases were canceled in group I (letrozole/antagonist group), while six patients in group II (antagonist group) canceled the cycle. In group I, letrozole 5mg was given from day 2 cycle for 5 days. Initial dose of HMG 300 I.U from day three cycle, then the dose was modulated according to response in both groups and ICSI was done. The women were followed to detect the occurrence of pregnancy by measuring serum B-hCG 14 day after embryo transfer and clinical pregnancy was followed up at 6th week of gestation. Results: The dose of HMG was significantly lower in group I than in group II, while there were no significant statistical differences in the duration of stimulation, number of oocytes retrieved, fertilization rate, implantation rate, cycle cancelation rate, and clinical pregnancy rate with adding letrozole to GnRH antagonist cycles in women with POR. Conclusion:Letrozole is recommended to be added to ICSI stimulation protocols in poor responders. Although it didn't affect the pregnancy rate, letrozole decreases the dose and the cost of ICSI cycles.