Patients included had ultrasound signs suggestive of placenta accreta, previous cesarean section with placenta implanted over the scar and suggestive ultrasonographic signs, and MRI signs of placenta accreta. Patients with average gestational age below 28 weeks were excluded. All cases were subjected to thorough
AbstractBackground: Placenta accreta occurs when the placental implantation is abnormal. The marked increase in incidence has been attributed to the increasing prevalence of cesarean delivery in recent years. The most common theory is that defective decidualization. The most important risk factor for placenta accreta is placenta previa after a prior cesarean delivery. The first clinical manifestation of placenta accreta is usually profuse, life-threatening hemorrhage. The recommended management of suspected placenta accreta is planned preterm cesarean hysterectomy with the placenta left in situ.
Patients and methods:It's a study of all cases of placenta accreta at El-Shatby Maternity University Hospital starting from 1/4/2016 till 1/10/2016. Selection of the cases will only be dependent upon their pregnancy gestational age above 28 weeks of gestation.
Results:The incidence of placenta accreta was 1/75 cesarean deliveries. The ultrasonography and doppler had a false negative rate of (54.6%) and a sensitivity of (45.2%) in diagnosis of placenta accreta. The rate of blood transfusion was (79.6%). Uterine preserving procedures performed in (66%). Cesarean hysterectomy performed in (34%). Intensive care unit admission occurred in (27.3%). The mean gestational age at delivery was 33.8 ± 4.6 weeks gestation. (31.8 %) admitted to the neonatal intensive care unit.
Conclusion:The incidence of placenta accreta increased due to the increasing rate of cesarean deliveries, prenatal diagnosis of placenta accreta is paramount, as most women are asymptomatic. Prenatal diagnosis allows time for a multidisciplinary team to make delivery plans, which will help decrease surgical complications.Citation: AbdElfatah EA, Awad EEM, MamdouhAbd-Eldaym T, Ali ZH (2017) Outcome of Patients with Placenta Accreta at El Shatby Maternity University Hospital. Obstet Gynecol Int J 8(2): 00281.
Background: Polycystic ovarian syndrome is associated with high LH related to infertility. Objectives: We aim at detecting the effect of day 1 LH on the outcome of controlled ovarian stimulationin slim PCOS cases to determine a cut-off value for LH. Study design: We retrospectively analysed the out-come of stimulated cycles in PCOS cases with a body mass index 18-29 kg/m2 visiting the reproductive medicine clinic in El Shatby university hospital ,Egypt. They were divided into two groups: Group A( LH less than or equal to 6IU/dl ) and Group B ( LH more than 6).Recombinent FEH was started day 2 and ovarian responce was monitored by folllicular scanning and serum estradiol (E2). HCG trigger was considered when the leading follicle is at least 18 mm , luteal phase was supported by vaginal micronised progesterone. Prenancy test in blood was done 16 days later. Results: significant difference was found in gonadotrophin dose and in pregnancy rate. Conclusion: Day 1 LH had a negative predictive value better than a positive predictive value for occurrence of pregnancy.
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