Few potentially remediable risk factors are associated with the occurrence of preterm PROM.

Background: The primary aim of this study was to measure the prevalence of pregnant women who fast during Ramadan. The secondary outcome was their beliefs and motivations regarding fasting during Ramadan in addition to the consequences of fasting on maternal and neonatal outcome.Methods: A retrospective review of pregnant patients aged between 18-45 years who presented for antenatal care in the private clinic in Beirut, Lebanon during or after the month of Ramadan between 2010 and 2019 was performed.Results: A total of 502 pregnant patients were included in the study, of which 426 (84.9%) fasted during Ramadan and 76 (15.1%) did not fast at all. Of those who fasted, 148 (34.7%) fasted between 1 and 15 days while 278 (65.3%) fasted more than 15 days. Multiparous and non-Lebanese women had significantly higher rate of fasting compared to primiparous and Lebanese women. Adherence to fasting was associated with the spiritual environment that accompanies the month of Ramadan while non-adherence was mainly related to the fear from adverse effects on the mother and fetus. Fasting was not significantly associated with maternal complications or decreased neonatal birth weight.Conclusions: The present study showed that Ramadan fasting is important to pregnant Muslim women. This was manifested by the relatively high rate of fasting even in summer and spring seasons. Understanding the beliefs and motivations of pregnant women would provide valuable insight to physicians to appropriately advise these women without compromising the maternal or fetal well-being.

The intrauterine device (IUD) is a contraceptive method which are tiny, T-shaped plastic, that is placed within the uterus and left there, is used all throughout the world with more than 99% effectiveness rate. Pregnancy with a levonorgestrel-releasing intrauterine system (LNG-IUS) in situ is very rare. Intracavitary pregnancy with an IUD can lead to a higher risk of infection and preterm birth. We described a case of a live birth with an IUD inserted into the placenta. A 27-year-old Syrian woman in G4P3 with a history of healthy vaginal deliveries arrived in our delivery room at 39+3 weeks gestation complaining of labor pain A vaginal examination revealed bulging membranes and a fully dilated cervix. She delivered a live baby boy, weighing 3100 g and being sent to the nursery with an APGAR score of 9 to 10. When the placenta was examined, a white foreign object that was embedded there was discovered to be an intrauterine device. Although intrauterine pregnancy is a potential problem that must be taken into account, ectopic pregnancy is a reasonably common complication of intrauterine contraceptive devices. Although several studies have shown that term pregnancies with excellent prognoses can occur after the removal of intrauterine devices, close monitoring is necessary to detect misplaced copper-T and prevent undesired births.

Background: Central nervous system conditions may affect every aspect of female reproduction from fertility to lactation. The objective of this study was to examine the performance of computed tomography and magnetic resonance imaging in the diagnosis of maternal neurologic disorders and to examine the outcome of pregnancies complicated by abnormal neurologic imaging.Methods: Retrospective observational study of 20 parturients presenting with severe neurologic symptoms (January 2006 to January 2016).Results: Abnormal neuro-radiological findings were found. Only 10% of the computed tomography-scans were normal. Both magnetic resonance imaging and computed tomography that were performed in all cases showed cerebral edema (90%) with different degrees, thereby cerebral edema was the predominant lesion. Pertaining to its localization, 65% were localized in the parietal or occipital area, 10% in the paraventricular area, and 10% were diffused. Also, 35% showed intracerebral hemorrhage and 10% showed cerebellar hemorrhage. The incidence of neurological disorders in pregnancy and puerperium was high. Epilepsy and headache were the most common primary and secondary neurological disorders.Conclusions: The role of neuroimaging in diagnosing neurological disorders is crucial for prevention of severe complications.

Background: Ovarian cancer is often diagnosed in advanced stages due to the absence of specific symptoms. Yet, there are no reliable screening tests for ovarian malignancies. However, improvements in imaging techniques such as ultrasonography and color Doppler increased the probability of early detection. The purpose of this study was to compare between the ultrasonographic and color Doppler findings of ovarian masses with their histopathological diagnosis.Methods: A retrospective review was performed on patients between January 2017 and January 2020 diagnosed to have an ovarian mass. The eligible patients were subsequently divided into 2 groups: group A included patients who had abdominal and vaginal ultrasound in order to assess the morphology of the ovarian neoformation, and group B included patients whose ovarian masses were evaluated by color Doppler in addition to transabdominal ultrasound in order to identify their vascularization as well as their morphology.Results: A total of 74 patients were included in the study with 42 patients in group A and 32 patients in group B. Of the 42 adnexal masses studied in group A, 8 (19.0%) were malignant, 33 (78.6%) were benign and 1 (2.4%) was borderline. Ultrasound had a sensitivity of 89.0%, a specificity of 100.0%, a positive predictive value (PPV) of 100.0%, a negative predictive value (NPV) of 97.0% and accuracy of 97.0%.  On the other hand, of the 32 masses examined in Group B, 7 (21.9%) were malignant, 23 (71.9%) were benign and 2 (6.3%) were borderline. Color doppler had a sensitivity of 55.6%, a specificity of 95.5%, a PPV of 83.0%, a NPV of 84.0% and accuracy of 84.0%. When using color Doppler in addition to morphology score, the sensitivity was 100.0%, specificity 95.5%, PPV 90.0%, NPV 100.0% and accuracy 96.6%.Conclusions: Ultrasound combined to color Doppler improves the diagnosis of ovarian tumors with accurately detecting malignant from benign ones

Symbrachydactyly is a disruption of embryonic formation and differentiation that leads to a shorter and smaller upper limb with underdeveloped digits such as short or webbed digits, nubbins, or absence of digits. We report a case of a newborn who had symbrachydactyly of multiple digits in the right hand that was not diagnosed during the prenatal period.

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Background: The COVID-19 outbreak has affected pregnant women. The aim of this study was to examine the effect of COVID-19 outbreak and lockdown on maternal complications in pregnant women.Methods: A retrospective review of pregnant patients who presented for antenatal care to the private clinic in Beirut, Lebanon before or during the COVID-19 lockdown which started in March 2020. The first group consisted of women before the lockdown between September 1, 2019 and February 29, 2020. The second group included women during or after the lockdown between March 1, 2020 and August 31, 2020.Results: A total of 97 women were included, 48 in the before lockdown group and 49 during or after lockdown group. The percentage of epigastric pain was significantly lower in the first group (12.5% vs. 71.4% respectively, p-value<0.0001). Anemia was significantly lower in the before group (60.4% vs. 83.7%, respectively p-value=0.01). Vomiting and hypotension were significantly higher in the after group. Around 87% of women in the before group had flu-like symptoms such as muscle ache and dizziness compared to 44.9% and 46.9% in the after group (p-value<0.0001). None of the patients in the after group visited the emergency department or were hospitalized during pregnancy. Almost 43% of patients in the after group had severe anxiety compared to 14.6% in the before group (p-value=0.001).Conclusions: Lockdown influenced maternal complications during pregnancy and resulted in anxiety for many women. Management practices regarding pregnancy and childbirth after lockdown are necessary to minimize the associated negative consequences.