Volume 4 Issue 1

Research Article: Cerebroplacental Ratio and Cerebrouterine Ratio in Predicting Neonatal Outcome in Preeclamptic Pregnant Women

Alaa ElDin El Guindy, Maii Nawara and Osama ElSanter*

Background: Doppler ultrasound velocimetry of uteroplacental umbilical and fetal vessels has become an established method of antenatal monitoring, Cerebroplacental and Cerebrouterine ratios have been studied to predict neonatal outcomes.
Aim of the Work: To assess if Cerebrouterine Ratio would be complementary to cerebroplacental Ratio in predicting adverse neonatal outcome in preeclamptic pregnant women.
Patients and Methods: The current study was carried out at Ain Shams University Maternity Hospital on (250) pregnant women with singleton pregnancies who were admitted to the Ain shams maternity Hospital presented with preeclampsia 34-37 weeks gestation, during a period from July 2017 to March 2018.
Results: The current study showed that among patients with abnormal CP ratio 35 case (47%) had fetal distress, 13 case (17.6%) were small for gestational age, 55 cases (47.3%) had APGAR 1 min < 7, 44 cases (59.5%) had APGAR 5 min < 7, 57 case (77%) admitted to NICU, and 9 cases (12.2%) suffered from Neonatal death, while among patient with abnormal CU ratio 49 case (45.8%) had fetal distress, 14 case (13.1%) were small for gestational age, 73 cases (68.2%) had APGAR 1 min < 7, 59 cases (55.1%) had APGAR 5min < 7, 79 case (73.8%) admitted to NICU, and 15 cases (14%) suffered from Neonatal death. In our study, Abnormal CP ratio and CU ratio are related to unfavorable pregnancy outcome. CU ratio had higher sensitivity and negative predictive value than CP ratio in prediction of APGAR 5 min, foetuses small for gestational age, foetal distress, NICU admission and neonatal death, while CP ratio had higher specificity and positive predictive value than CU ratio in prediction of APGAR 5 min, foetuses small for gestational age, foetal distress, NICU admission and neonatal death. Combining both ratios improved the specificity and prediction characteristics of neonatal outcomes compared to any of the ratios used alone.
Conclusion: Cerebrouterine ratio and cerebroplacental ratio were complementary to each other in predicting the adverse neonatal outcomes, than any of the ratios alone.
Recommendations: Cerebrouterine and cerebroplacental ratios should to be used complimentary to each other to predict neonatal outcome in cases of preeclampsia. The value of CP and CU ratios in smaller gestational ages should be investigated to predict neonatal outcome.
Keywords: Cerebroplacental ratio; Cerebrouterine ratio; Neonatal outcome; Preeclampsia

Cite this Article: El Guindy AE, Nawara M, ElSanter O. Cerebroplacental Ratio and Cerebrouterine Ratio in Predicting Neonatal Outcome in Preeclamptic Pregnant Women. Int J Reprod Med Gynecol. 2018;4(1): 022-027.

Published: 29 June 2018

Review Article: Pain Management for Office Hysteroscopy

Carugno Jose* and Andrade Fausto

Office hysteroscopy is an indispensable tool in modern gynecology. Diagnostic hysteroscopy is considered the gold standard for the study of intra-uterine pathologies [1].
Diagnostic hysteroscopy is commonly performed in an office setting by inserting the hysteroscope into the external cervical OS and advancing the scope under direct visualization until entering the uterine cavity distending the uterus with the selected distention media, commonly normal saline. Over the last few years, there have been great advancements in surgical instruments for use in gynecological procedures, the creation of smaller hysteroscopes, as well as improvements in operative techniques [2]. These advancements have facilitated the performance of hysteroscopy becoming a popular procedure. In an effort to decrease cost and facilitate patient access, hysteroscopic procedures are increasingly migrating from the operating room to the office [3-5]. One major obstacle to transitioning hysteroscopy to the outpatient settings is pain management as the procedure is largely viewed as painful. Pain along with inability to access the uterus are often cited as the main reasons for failed office hysteroscopy.

Cite this Article: Jose C, Fausto A. Pain Management for Office Hysteroscopy. Int J Reprod Med Gynecol. 2018;4(1): 017-021.

Published: 23 April 2018

Review Article: Klinefelter Syndrome: Review of the Literature Comparing TESE and mTESE, Sperm Retrieval and Pregnancy Rate

Vasilios Tanos1*, Adam Gajek2, M. Yousef Elsemary3, Karim Omar ElSaeed4, Kelsey Elizabeth Berry2 and Sayed ElAkhras5

Purpose: To review the Testicular Sperm Extraction (TESE) with and without microscopy on patients with Klinefelter Syndrome (KS).
Method: A literature search was conducted for studies comparing TESE and mTESE efficacy for men with KS. The efficacy was measured by using the SRR and PR following Intracytoplasmic Sperm Injection (ICSI). The studies used were divided into two groups: large studies with 40 or more patients, and small studies with fewer than 40 patients.
Results:Our review results demonstrate among 1,070 KS patients treated by ICSI the SRR was 46.3% and PR was 21% with mTESE and 45.6% SRR and 44.4% PR with TESE. The SRR was 9.5% higher in large studies but PR was higher for small studies by 7.8%. Higher pregnancy rates demonstrated by TESE although the sperm retrieval rate was similar in both techniques. Among 1070 patients with KS, treated by ICSI the SRR was 46.3% and PR was 21% with mTESE and 45.6% SRR and 44.4% PR with TESE.
Conclusions: mTESE seems to have no advantages in SRR and PR as compared to standard TESE. Our results and recent meta-regression analysis publication findings of similar SRR with TESE and mTESE and similar or even better PR by TESE merits further investigation by a prospective randomized study. Parameters predicting sperm retrieval in KS patients are missing. This review's findings of similar SRR with TESE and mTESE and similar or even better PR by TESE merits further investigation by a prospective randomized study.
Keywords: Klinefelter syndrome; Azoospermia; Male infertility; Testicular sperm extraction; TESE; Mtese

Cite this Article: Tanos V, Gajek A, Elsemary MY, ElSaeed KO, Berry KE, et al. Klinefelter Syndrome: Review of the Literature Comparing TESE and mTESE, Sperm Retrieval and Pregnancy Rate. Int J Reprod Med Gynecol. 2018;4(1): 012-016.

Published: 14 March 2018

Research Article: Effectiveness of Bovine Lactoferrin versus Ferrous Fumarate in the Management of Iron Deficiency Anemia in Pregnancy: Randomized Clinical Trial

Hossam M Hemeda, Ayman Abd El Kader Mohamed, Bassem Aly Islam, Amany Hasan A Eweis*

Objective: The aim of this research study is to compare ferrous fumarate and bovine lactoferrin as regard treatment of anemia in a pregnant patient with iron deficiency anemia.
Study design: A prospective open label randomized clinical trial which was conducted at Ain Shams University Maternity Hospital outpatient clinic in the period from 15 February 2016 to 15 August 2016. The study included 146 pregnant women suffering from iron deficiency anemia and divided in two groups.
Results: Comparison between research groups (ferrous fumarate vs lactoferrin) showed that both Hb after 1 month, Hb after 2 months, serum ferritin after 1month and serum ferritin after 2 months were statistically significantly higher among group B in comparison to group A (p < 0.05).
Conclusion: Both ferrous fumarate and bovine Lactoferrin are efficient in management of iron deficiency anemia in gestation. In comparison to ferrous fumarate, bovine Lactoferrin is more efficacious in management of iron deficiency anemia in gestation. Management of iron deficiency anemia in gestation with bovine Lactoferrin displayed an excellent safety profile and fair case compliance.

Cite this Article: Hemeda HM, El Kader Mohamed AA, Islam BA, A Eweis AH. Effectiveness of Bovine Lactoferrin versus Ferrous Fumarate in the Management of Iron Deficiency Anemia in Pregnancy: Randomized Clinical Trial. Int J Reprod Med Gynecol. 2018;4(1): 006-011.

Published: 13 February 2018

Research Article: Association between Unexplained Recurrent Miscarriage and Insulin Resistance

Tarek Tamara, Abdellatif Elkholy, Nashwa Elsaed, Mohamed Abdellatif*, Nermine Essam and Mohamed Selem

Methods: The current case-control study was conducted at Ain Shams University Maternity Hospital. The study included two groups of women: group A, including pregnant women with a history of unexplained recurrent miscarriage; and group B, including control pregnant women with no prior miscarriage. Women included in either group were at their first trimester of pregnancy (6-13 weeks of gestation). For all included women, 3-hour oral glucose test was performed. Serum insulin levels were measured at the same times. Markers of insulin resistance, including HOMA-IR, HOMA-B, AUCG and AUCI were calculated.
Results: There were no significant differences between women of both groups regarding HOMA-IR and HOMA-B. The mean values of AUCG and AUCI were, however, significantly higher in women of group A when compared to group B..

Cite this Article: Tamara T, Elkholy A, Elsaed N, Abdellatif M, Essam N, et al. Association between Unexplained Recurrent Miscarriage and Insulin Resistance. Int J Reprod Med Gynecol. 2018;4(1): 001-005.

Published: 02 January 2018

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