Background: The objective of the present study was to find out the predictive values of an ultrasound-based scoring system in diagnosis of morbidly adherent placenta (MAP) for high risk group. Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt.Methods: 63 full term pregnant women (≥37 weeks of gestation) with high risk of morbidly adherent placenta underwent elective cesarean section. Placental assessment by 2 D ultrasound based on ultrasound scoring system in morbidly adherent placenta, these data were recorded for further comparison with intraoperative data for degree of placental adherence.Results: Incidence of MAP was 7.93% (4.76% had a focal form and 3.17% had a complete form of accreta). As regarding to scoring system, 82.5 of cases had a low risk (< 5), 9.5% had a moderate risk (6-7) and 7.93% had a high risk (8-12) of development of morbidly adherent placenta with p value <0.0001. The sensitivity, specificity, positive and negative predictive values of the US scoring system for morbidly adherent placenta were (92.3%, 94.1%, 87.453% and 98.2%) respectively.Conclusions: Ultrasound based scoring system had a high predictive value (sensitivity, specificity, positive and negative predictive values) in diagnosis of morbidly adherent placenta for pregnant women have any risk factors for developing MAP.
Polycystic ovary syndrome (PCOS) is considered as an endocrine disorder which affects about 5% to 10% of all females. All races and nationalities are affected and represent the commonest hormonal disorder in the women reproductive age and are considered the most common cause of female infertility [1]. For >30 years, gonadotropins have been used a crucial element in pharmacological ovarian stimulation drugs in assisted reproductive technology (ART) in the primary and secondary infertility and in the treatment of hypogonadotropic hypogonadism [2].Highly purified (HP) urinary FSH has been manufactured by the use of the monoclonal antibodies which is specific to FSH. Highly purified urinary FSH preparations contain < 0.1 IU LH and the FSH specific activity is 10,000 IU/mg protein, it contains less than 5% unidentified urinary proteins [3]. Lack of urinary proteins in HP-uFSH diminishes the adverse reactions like hypersensitivity or local Allergy [4,5], while LH absence has no negative impact in the ovarian stimulation in PCOS infertile women [6,7].
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