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Background Placenta accreta spectrum is a serious obstetric disorder that is characterized by deeply penetrating villi which are abnormally attached to the myometrium of the uterus. This prevents its complete dissociation during the third stage of labor that may cause severe bleeding, with its marked risk on the mother life. All recent studies confirm that the occurrence of placenta accreta increased dramatically in the recent years with the increasing number of caesarean sections. The number of previous caesarean deliveries accompanied by placenta previa markedly increase the risk for placenta accreta. There is a continued need to study risk factors of abnormally adherent placenta to improve the antenatal diagnosis . Objective The current study aims to evaluate the effect of the short duration between the perior caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum. Patients and Methods a case control study which was performed in the Maternity Hospital of Ain Shams University. It compare the duration between the perior caesarean section and the current pregnancy in the placenta accreta cases and the matched controls to determine if it increases the occurrences of placenta accreta or not. It include all pregnant ladies with placenta accreta spectrum diagnosed radiologically or surgically in the period of the beginning of June 2019 to the beginning of December 2019 with in the inclusion criteria, also the matched controls. Results there was no difference with a statistical significance between control group and patients group regarding inter pregnancy interval. Conclusion this study reveals that there was no effect of the short duration between the previous caesarean delivery and the current pregnancy on the occurence of placenta accreta spectrum.

Background: Preterm prelabor rupture of membranes (PPROM) is a major cause of Pretem Birth (PTB), Pretem Birth (PTB) is the most significant cause of perinatal morbidity and mortality worldwide. Cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) have been postulated in several studies to have an important role in prediction of PTB. Up to our knowledge, this is the first study that combines the three cervical parameters in prediction of latency period in women with PPROM. Aim of the Work: To assess the accuracy of cervical length, posterior uterocervical angle and anterior uterocervical angle in prediction of latency period in women with Preterm prelabor rupture of membranes. Subjects and Methods: A Prospective cohort study on 205 women with PPROM was held at Ain Shams University Maternity Hospital, a transvaginal ultrasound was performed to measure cervical length, posterior uterocervical angle, anterior uterocervical angle. Results: A total of 205 pregnant women with PPROM were included in this study, the latency grade was within 2 days in 57 (27.8%) of cases while was after 2 days in 148 (72.2%) of cases. As regards cervical length cutoff value 25.0 mm, sensitivity was 78.9%, specificity was 65.5%, posterior uterocervical angle cutoff value 108.0˚, sensitivity was 93.0%, specificity was 60.1%, and anterior uterocervical angle cutoff value 106.0˚, sensitivity was 93.0%, specificity was 71.6%. Conclusion: The combination of cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) measurements greatly predicts the latency period in women with PPROM, and Anterior uterocervical angle (AUCA) ≥ 106.0˚ had the highest diagnostic value in predicting latency period within two days.

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Background Abortion is the termination of pregnancy by any means (surgical or medical) before the age of viability. The definition varies in duration of gestational age according to the countries and available facilities. Estrogen is important in the maintenance of pregnancy. Aromatase inhibitors such as letrozole, suppress the peripheral conversion of androgen to estrogen, the use of letrozole combined with vaginal misoprostol was more effective than misoprostol alone in termination of pregnancy. Objective Assessing the efficacy of addition of letrozole to Misoprostol in medically induced abortion in the second trimester of pregnancy in the Maternity hospital of Ain Shams University. Methods This clinical trial was conducted at Ain Shams University Maternity hospital in the period between December 2018 and May 2019. Patients that seem to be fulfilling the inclusion criteria were recruited, then informed written consent was taken from every patient before starting the examination That was followed by detailed history and examination of all patients to confirm fulfilling the inclusion and exclusion criteria. Results This study demonstrated that 10 mg letrozole for three days followed by 800 mcg of vaginal misoprostol is more effective than misoprostol alone for second trimester abortion. In the total of 72 women were recruited the complete abortion rate of the letrozole group was significantly higher than that of the control group (61,1% in the letrozole group compared with 33,3% in the control group). Conclusion s: The use of letrozole in addition to misoprostol was associated with a higher complete abortion rate, shorter induction to abortion interval and shorter curettage rates compared to a placebo followed by misoprostol in patients undergoing induction of abortion between 12 & 24 weeks gestation.