Effectiveness of tranexamic acid in preventing postpartum

Background: Caesarean section delivery is associated with severe maternal morbidity, including obstetric haemorrhage, hysterectomy, anaemia, blood transfusion, and infection. Among these operative morbidities associated with CS, obstetric haemorrhage is the leading cause of maternal mortality worldwide.Objective: The aim of this work was to achieve the minimal blood loss during elective cesarean section (CS) in order to decrease patients' morbidity by using tranexamic acid (TXA) injection before operation time.Patients and Methods: The current study was randomized-controlled clinical trial that was conducted at Department of Obstetrics and Gynecology, Zagazig University Hospitals through the period from April 2021 to September 2022.Results: The mean of blood loss during CS in tranexamic acid intervention group was 484.87 cc and mean of blood loss during CS in control group was 705 cc. The difference was highly statistically significant p=0.0001. Per cent of blood loss was 37% more among control group.Conclusions. Tranexamic acid is a good option to reduce the amount of blood loss during CS on high risk pregnancy

Correlation of polycystic ovary syndrome and recurrent miscarriage

Background: Numerous studies have investigated the association between polycystic ovary syndrome (PCOS) and recurrent miscarriage (RM). Increased rates of PCOS have been reported for women with RM. However, the actual prevalence is controversially discussed by the scientific community and remains unclear, since a wide range of rates from 8–82% can be found in the literature. Objective: To assess the relation between polycystic ovary syndrome and recurrent miscarriage and to evaluate the prevalence of polycystic ovarian syndrome within the recurrent miscarriage population. Patients and method: It is a cross sectional conducted at the infertility clinic in the outpatient department of University Hospital from March 2019 to March 2020. Patient sample was 47 participant. Hormonal profile FSH, LH, TSH, TSH, assessment of glycemic status and insulin resistance and ultrasonography for diagnosis of polycystic ovaries were done to every patients. Result: There was high statistically significant relation between the PCO and total number of follicles, number of follicles ≥ 18 mm and endometrial thickness. There was high statistically significant relation between the PCO and testosterone hormones and statistically significant relation between the PCO and FSH and LH. There was no statistically significant relation between the PCO and insulin resistance. Conclusion: In this study we concluded that the prevalence of PCOS seems slightly increased in women with recurrent miscarriage, PCOS on the other hand showed a rather high prevalence compared to the general population

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population