A triplet’s ectopic pregnancy in a non-communicating rudimentary horn and spontaneous rupture

Our aim is to feature the management of ectopic pregnancy in a non-communicating rudimentary horn. It has a remarkablelife-threatening potential, being rare and difficult to be considered during differential diagnosis of acute abdomenor sudden maternal collapse in early pregnancy. Therefore, this is a report of mid-trimester triplet’s ectopic pregnancywhich presented with sudden repeated syncopal attacks and hemodynamic instability that necessitated emergencylaparotomy to treat ruptured non-communicating rudimentary horn. The rarity of this clinical condition can lead tomultiple challenges. When a diagnosis is confirmed, the intervention plans should be independently tailored basedon the patient’s age, obstetric history, fertility wishes, as well as, surgeon’s experience. Moreover, most cases passedunnoticed till complications took place. Thus, early diagnosis of Mullerian anomalies preconceptionally or even duringthe initial antenatal visits is crucial step regarding the avoidance of such catastrophic maternal outcomes

The maternal and neonatal outcomes of teenage pregnancy in a tertiary university hospital in Egypt

Aim: To highlight the grave complications among teenage mothers in Assiut Woman\u27s Health Hospital compared with the adult mothers. Methods: This study was a prospective case control study, conducted at the Labor Ward of Assiut Woman\u27s Health Hospital from 1st of January 2016 to 30th of June 2016. We included teenage pregnant women (13-19 completed years at delivery) as case and adult mothers (20-29 years) formed the control group. The primary outcome of the study is the rate of pregnancy complications among teenage mothers. Results: Obstetric complications were higher among the teenage mothers (p=0.0001). The teenage mothers had a higher proportion of normal vaginal delivery (p=0.005). The adult mothers reported a higher rate of elective cesarean section (CS) and operative vaginal delivery (p=0.0001, p=0.002; respectively). The infants of teenage mothers tended to have a lower birth weight and Apgar score than the adult ones. Conclusion: This study clearly states that the teenage mothers and their infants were more liable to complications during pregnancy and labor compared to adult mothers

The maternal and neonatal outcomes of teenage pregnancy in a tertiary university hospital in Egypt

Aim: To highlight the grave complications among teenage mothers in Assiut Woman\u27s Health Hospital compared with the adult mothers. Methods: This study was a prospective case control study, conducted at the Labor Ward of Assiut Woman\u27s Health Hospital from 1st of January 2016 to 30th of June 2016. We included teenage pregnant women (13-19 completed years at delivery) as case and adult mothers (20-29 years) formed the control group. The primary outcome of the study is the rate of pregnancy complications among teenage mothers. Results: Obstetric complications were higher among the teenage mothers (p=0.0001). The teenage mothers had a higher proportion of normal vaginal delivery (p=0.005). The adult mothers reported a higher rate of elective cesarean section (CS) and operative vaginal delivery (p=0.0001, p=0.002; respectively). The infants of teenage mothers tended to have a lower birth weight and Apgar score than the adult ones. Conclusion: This study clearly states that the teenage mothers and their infants were more liable to complications during pregnancy and labor compared to adult mothers

Povidone-iodine versus normal saline solution in preoperative vaginal cleansing before office hysteroscopy: a randomized controlled trial

Background: Hysteroscopy is well-thought-out the gold standard for assessing the uterine cavity, and now can be done as an office process due to enhanced endoscopic advances with no need to in-patient admission. Objective of the present study was to compare the difference in the rate of postoperative vaginal irritation symptoms and postoperative infections after using povidone iodine (PI) and normal saline (NS) solution in vaginal cleaning before outpatient office hysteroscopy (OH).Methods: Women attended to the hospital for diagnostic OH were included for present study. Eligible women were randomly allocated in a 1:1 ratio to two groups. Group I "PI group" women exposed to PI for vaginal cleansing before hysteroscopy, and group II "NS group” women exposed to the NS solution for vaginal cleansing. The primary outcome of the study was to compare the difference in the rate of postoperative vaginal irritation symptoms and postoperative infections in both groups.Results: The mean age of the study participants was 34.26±4.14 years for NS group compared to 35.22±4.01 years for PI group (p=0.652). The PI group reported higher rate of vaginal irritation than NS group with no statistically significant difference between the two groups (p=0.179). Both groups were similar in postoperative fever, urinary tract infection and vaginitis (p>0.05).Conclusions: This study concluded that preoperative vaginal disinfection at the time of OH with a NS solution is less frequently causing postoperative vaginal irritation symptoms. Additionally, it is as effective as the usual agent (PI) in preventing postoperative infections

Three-dimensional power Doppler ultrasonography in evaluation of adnexal masses

The differential diagnosis of adnexal masses still represents a challenge in spite of the marvelous efforts that have been made to improve the sonographically based diagnosis. There were rapid technological advances in diagnostic ultrasonography in the last decade, with the recent development of three-dimensional power Doppler ultrasonography (3DPD). The introduction of 3DPD has opened the possibility to characterize microvasculature of the adnexal masses and objectively assess tumor vascularization. 3DPD allows also an objective measurement of vascularity of a given region of interest by estimating 3 vascular indices (vascularization index [VI], flow index [FI], and vascularization-flow index [VFI]) within such region. The aim of this review article is to evaluate the role of 3DPD in the assessment of adnexal masses vascularity, its ability to discriminate benign masses from malignant ones

Mechanical induction of labor and ecbolic-less vaginal birth after cesarean section: A cohort study

Objective: During delivery counseling, some women with previous uncomplicated cesarean section (CS) wish mechanical induction of labor (IOL) but they are not accepting the added risk of using ecbolics to induce and/or augment labor. The objective of the study was to assess the safety and efficacy of the isolated use of transcervical Foley's catheter balloon as a mean of mechanical cervical ripening (CR)/IOL and successful ecbolic-less vaginal birth after cesarean section (VBAC). Materials and methods: A cohort study was conducted in two tertiary care maternity hospitals between October 2013 and July 2016 and recruited women with singleton pregnancy and cephalic presentation who had previous one uncomplicated CS and were scheduled for mechanical CR/IOL at term for routine obstetric indications. No ecbolics were used for induction or augmentation of labor as per patients' request. The primary outcome variable was the rate of successful VBAC. Results: 108 Women had a completed trial of mechanical CR/IOL without ecbolics till delivery. Active labor started in 94 women (87%), however only 43 women (39.8%) had successful VBAC. No woman in the study cohort had uterine rupture, scar dehiscence, uterine tachysystole, postpartum hemorrhage and/or puerperal sepsis. No cases were admitted to intensive care units and there were no maternal mortalities. Prior successful VBAC and post-expulsion BS were the only independent predictors for successful VBAC and shorter duration of labor after balloon expulsion. Conclusion: Mechanical IOL with the mere use of transcervical Foley's catheter is a safe and effective method of VBAC in women refusing use of ecbolics