Background: Gestational diabetes is diabetes, or high blood sugar levels, that develops during pregnancy. It occurs in about 4% of all pregnancies. It is usually diagnosed in the later stages of pregnancy and often occurs in women who have no prior history of diabetes. Aim of the Work: To assess the predictive value of elevated glycosylated hemoglobin at 34 weeks' gestation with adverse fetal outcome as regard fetal macrosomia and neonatal hypoglycemia. Patients and Methods: This prospective longitudinal cohort study included 98 pregnant women who were recruited from the obstetric outpatient clinic and department at Al-Galaa Teaching Hospital. Results: HbA1c ≥7.9 has sensitivity of 88.1% and specificity of 66.1%, in prediction of macrosomia and a sensitivity of 91.9% and specificity of 63.9% in prediction of Hypoglycemia. Conclusion: HbA1c ≥7.9 has moderate diagnostic characteristics in prediction of macrosomia, and hypoglycemia, low diagnostic characteristics in prediction of RDS and NICU. Recommendations: Use of HbA1C is recommended for patients with GDM for screening, follow up and prediction of adverse neonatal outcomes.

Three-dimensional ultrasound is useful in prediction of dehiscent scars during pregnancy with perfect sensitivity. Machines with the availability of C dissection in the multiplanar view are more useful in this field.

No abstract

Background: neonatal respiratory morbidities are common neonatal outcome the worrisome the mothers the most when approaching labour. They vary in clinical presentations with various long term effects, the most importantly related to caesarean section are Transient Tachypnea of the Newborn (TTN), Respiratory Distress Syndrome (RDS), Persistent Pulmonary Hypertension (PPHN). Aim of the Work: the aim of this study is to assess the efficacy of Misoprostol or the Prostaglandin E1(PGE1) on the reduction of the neonatal respiratory morbidity in women scheduled for term caesarean section (38-38 +6 weeks Gestational Age (GA). Patients and Methods: this is a Randomized Controlled Trial (RCT) which was conducted over six months from November 2016, to April 2017 on 120 pregnant women who were approached before elective caesarean section (ECS), managed in Ain Shams University Maternity Hospital (ASUMH), and their neonates followed up in the Neonatal Intensive Care Unit (NICU) of Ain Shams University Maternity Hospital to assess the effect of Misoprostol when given for women one hour before their scheduled caesarean section upon reducing the neonatal respiratory morbidity. Results: the current study revealed a highly statistically significant difference between groups according to respiratory morbidity, and especially the TTN using Chi-square test, with p-value <0.001 Highly Significant. Conclusion: the study concluded that when a vaginal tab containing Misoprostol 200 microgram given to women one hour before term elective caesarean section between 38-38 +6 weeks compared to placebo, it simulates the normal labour to enable the neonate through catecholamines surge, and thus surfactant secretion for better adaptation to the extrauterine life. Recommendations: Misoprostol can be administered vaginally to candidate pregnant women with term pregnancies with certain inclusion criteria before an elective caesarean section (after exclusion of any contraindication and thorough good history taking and clinical examination) in order to reduce the neonatal respiratory morbidity and especially the transient tachypnea of newborn. Thus, decrease the duration of neonatal NICU admission and mortality.

Background: Accidental hemorrhage is defined as abnormal complete or partial separation of normally implanted placenta after 20 weeks of gestation and prior to birth. Risk factors which have been found associated with accidental hemorrhage include maternal age, parity, smoking, hypertension, past history of accidental hemorrhage, thrombophilic disorders, abdominal trauma and polyhydramnios. Aim of the Work: The aim of our study was to find if there is any role for decidual natural killer cells in cases with placental abruption. Patients and Methods: This is a case control study in which 60 pregnant women recruited from

Background Placenta accreta is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The incidence of placenta accreta has increased and seems to parallel the increasing cesarean delivery rate. Women at greatest risk of placenta accreta are those who have myometrial damage caused by a previous cesarean delivery with either an anterior or posterior placenta previa overlying the uterine scar. Diagnosis of placenta accreta before delivery allows multidisciplinary planning in an attempt to minimize potential maternal or neonatal morbidity and mortality. Aim of the Work To compare between alpha-fetoproteine as biological marker & ultrasound & Doppler findings for prenatal predication of morbid adherent placentation in anterior placenta on scar of previous cesarean section. Patients and Methods The current study is a prospective cohort study, conducted at a tertiary center: Ain Shams University Maternity Hospital during the period between February 2018 and April 2019,where 150 pregnant women having placenta previa covering scar of previous uterine surgery had been recruited from the outpatient obstetrics clinic or emergency room and admitted to antepartum inpatient high risk service, but 50 patients were dropped out due to loss in follow up because of emergency antepartum haemorrhage & C.S., others escaped follow up. Results The results of the current study showed a significant association between all criteria of the 3DPD with multislice view and presence of placental adherence, need for added surgical steps, CS hysterectomy and bladder injury with sensitivity 83% & specificity 57%, PPV 76%, NPV 66%. Conclusion The current study suggests that AFP assay, it isn't good test alone as regards its sensitivity &specificity &its level of accuracy 55% as compared to 2D &3D power doppler with multislice view, so it is unreliable test alone for antenatal diagnosis of morbidly adherent placenta.

Background: Accurate determination of gestational age has become impor-

Background: O3 therapy induces moderate oxidative stress when interacting with lipids. Aim: This work aimed to demonstrate the efficacy of the application of vaginal ozone insufflations in treatment of recurrent candidal vulvovaginitis compared to combined vaginal and systemic antifungal agents. Materials and Methods: This randomized controlled study was conducted on 50 women with recurrent vulvovaginitis recruited from the outpatient gynecology clinic of Ain-shams University Obstetrics and Gynecology Hospital who were attending for outpatient consultation. Subjects were assigned randomly into two groups; group A included 25 subjects who were treated with traditional, combined, topical and systemic antifungal therapy and group B included 25 subjects who were treated by vaginal ozone insufflations. Results: Twenty-two (88%) patients in the vaginal ozone group had clinical cure compared with only 14 (56%) patients in the traditional treatment group. This difference was statistically significant. Likewise, the microbiological cure rate was significantly higher in the vaginal ozone group compared with the traditional treatment group. Five out of 14 patients (35.7%) in the traditional treatment group suffered clinical recurrence compared with only 1 out of 22 patients (4.5%) in the vaginal ozone group. This difference was statistically significant. Likewise, the microbiological recurrence rate was significantly lower in the vaginal ozone group compared with the traditional treatment group. Conclusion:Ozone therapy has proven to be effective in treatment of the recurrent vulvovaginitis, where the persistence of clinical symptoms and positive culture exudates were measured.