Introduction In low-resource settings (LRSs), pain relief during labor is often neglected. Women and health professionals (HPs) may lack awareness of analgesic options, may not accept these options, or may have concerns regarding their safety. Furthermore, even if women or HPs preferred labor analgesia, options may not be available at the hospital. This study was carried out to explore how HPs perceive and practice pain management during labor in Minia maternity units in Egypt. Methods A structured, self-administered questionnaire from 306 HPs in Minia maternity units from August 1, 2016, to August 30, 2017, after approval by the organizational Ethical Review Committee. Results The response rate was 76.5%. The majority, 78.2% of participants, believed in pain relief during labor. However, their practices are different. In the first stage of labor, almost 44.9% used nonpharmacological methods, whereas 36.8% used neither pharmacological nor nonpharmacological methods. Hospital-related factors were the major barriers against using pain-relief methods, as stated by HPs. Conclusion Although most HPs understand the role of analgesia in labor pain relief, there is a wide gap between the use of pain-relief methods and women's need in Minia, Egypt; HPs claim this is due to health care facilities. There is an urgent need to identify the barriers against and raise the awareness among the community and HPs of the need to use pain-relief methods as part of improving the quality of care during labor.
Long-term Statins' treatment was associated with clear improvement of all PCOS clinical and biochemical abnormalities, in addition to ovarian dysfunction as well.
Background: Placenta accreta spectrum (PAS) disorders are one of the most terrible conditions in obstetrics. The major complication associated with PAS disorders is massive hemorrhage, which ultimately may lead to maternal death. Objectives: This study aimed to detect the optimum time and mode of interventions to remove the morbidly adherent placenta after leaving it in situ for conservative management. Patients and Methods: This was a cohort study carried out at the Obstetrics and Gynecology Department, Minia Maternity and Children University Hospital through the period from March 2018 to December 2020. The total number of patients with a placenta that was left in place was 20 patients out of 29 patients who were eligible for the study. Results: This approach of leaving the placenta in place then interval placental delivery was successful in 16 cases (80%). Four cases needed hysterectomy. Placental removal was through spontaneous placental resorption in one case (5%), a spontaneous expulsion of the placenta in one case (5%), in addition to a successful interval placental delivery through D & C in 2 cases (10%) as well as removal by mini-laparotomy in 12 cases (60%). The mean time between the cesarean section and the 2 nd set of interventions to remove the placenta was 48.2 ± 6.7 days.
Conclusion:Conservative treatment by leaving the placenta in place followed by interval placental delivery seemed to be an appropriate management choice in selected patients desiring preservation of the uterus, but complications such as sepsis and secondary postpartum hemorrhage should be carefully diagnosed and appropriately managed.
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