Missed abortion is a common obstetrical problem with a high incidence. Evidence supports a change in approach from the traditional dilatation and curettage to medical; however, few studies have investigated the prediction success of the medical approach. This study investigates whether first trimester missed abortion can be successfully terminated using Doppler indices, such as resistance index (RI) and pulsatility index (PI), as predictors. Material and Method: In this prospective study, the sample is made up of 78 patients, with a first trimester missed abortion range of 6-13 weeks of pregnancy who meets the maternal parameters as well as transvaginal Doppler indices, RI and PI. The participants were subdivided into 3 groups based on their response to sublingual misoprostol and weeks needed to terminate as Groups I (43/78), II (26/78), and III (9/78) aborted in the first, second, and third weeks, respectively. Results: Age, BMI, and gestational age of dead fetus were not significant for Groups I, II, and III with P = 0.13, P = 0.13, and P = 0.35, respectively. Parity and delivery mode showed significant di ferences (P < 0.0001) between group means of PI and RI. PI for Group I plus II and Group III are 1.53 (0.75-2.70) and 1.58 (1.10-2.10), respectively. RI for Group I plus II and Group III are 0.71 (0.50-1.00) and 0.80 (0.69-0.92), respectively. The coe ficient of correlation proves that RI is the primary predictor of successful termination of a first trimester missed abortion with a cut-o f value of 0.74 with associated sensitivity and specificity of 68.7% and 56.7%, respectively. Conclusions: Increased parity and a history of vaginal delivery, in addition to measured RI, were predictors of successful termination of a first trimester missed abortion. These results may be used in counseling patients to decide safest and most suitable option to terminate a first trimester missed abortion, depending on their demographic criteria and ultrasound scores.
Coronavirus Disease 2019 is a new and rapidly developing health crisis. Ongoing researches are looking at the prevalence and consequences of COVID-19 in the obstetric community and postnatal period. In COVID 19 era, pregnant mothers are prone to infection with the severe acute respiratory syndrome coronavirus 2, with a higher risk of poor pregnancy outcomes. Therefore, an accurate and early diagnosis is a necessity for this vulnerable group. Screening for asymptomatic carriers is a cornerstone to limit the COVID-19 pandemic. It is vital to evaluate patients’ clinical symptoms and epidemiological history carefully. Although the serological test; Polymerase chain reaction RT-PCR can confirm infection, it cannot determine the degree or severity of the illness. Moreover, it has false-negative results. Imaging tests allow exact diagnosis of lung damage, the severity of the disease, and the classification of patients. Comprehensive analyses of serological and imaging data will assist in the formation of an appropriate clinical diagnosis. This review will discuss the updates and critical points in establishing COVID-19 infection in pregnant women with their pros and cons.
Defining con-founders that affect the reliability of diagnostic tests for coronavirus disease 2019 is vital to breaking the chain of infection. The elderly population is a higher risk group for the emerging virus. However, gender seems to exert a critical role in modifying the infection risk among women owing to hormonal changes. The menopause transition is an exceptional period for older women where the protective and immunomodulatory effects of the estrogen hormone are lost. Accordingly, attention should be given to postmenopausal women since they will have an increased risk compared to their pre-menopausal peers.
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