Our study suggests that first-trimester uterine artery impedance, as measured by Doppler ultrasound as well as low serum biomarkers (β-hCG and PAPP-A) can be used for prediction of preeclampsia and IUGR. The most sensitive is uterine artery PI. Adding β-hCG to PI improves specificity in prediction of both preeclampsia and IUGR. Uterine artery PI plus PAPP-A is the best combination for prediction of both preeclampsia and IUGR.
Background
Objective to assess the value of preoperative tranexamic acid (TXA) in reduction of intraoperative and postoperative blood loss in high-risk cesarean delivery (CD).
Methods
A double blind randomized controlled trial included 160 high risk women who underwent elective lower segment CD. They were equally randomized to receive either 1 g of TXA or placebo 15 min before surgery. The primary outcome was Intraoperative blood loss.
Results
The estimated blood loss was significantly higher in the placebo group when compared to TXA group (896.81 ± 519.6 vs. 583.23 ± 379.62 ml, P < 0.001).
Both postoperative hemoglobin and hematocrit were lower (9.2 ± 1.6 and 27.4 ± 4.1 vs. 10.1 ± 1.2 and 30.1 ± 3.4, P values < 0.001and 0.012 respectively) and their change percentages (15.41 vs. 7.11%, P < 0.001) were higher in the placebo group when compared to TXA one.
The need for further ecbolics was higher in placebo group when compared to TXA group (46.25 vs. 13.75%, P < 0.001).
Conclusion
Preoperative TXA is safe and effective in reducing blood loss during and after high-risk CD.
Trial registration
ClincalTrial.gov ID: NCT03820206.
BackgroundTo study the prevalence of Chlamydia infection in women with primary and secondary unexplained infertility using ELISA technique for antibody detection and real time, fully automated PCR for antigen detection and to explore its association with circulating antisperm antibodies (ASA).MethodsA total of 50 women with unexplained infertility enrolled in this case control study and a control group of 44 infertile women with a known cause of infertility. Endocervical specimens were collected for Chlamydia antigen detection using PCR and serum samples for antibodies detection. Circulating anti-sperm antibodies were detected using sperm antibody Latex Agglutination tests.ResultsThe overall prevalence of Chlamydial infection in unexplained infertility cases as detected by both ELISA and PCR was 40 % (20/50). The prevalence of current Chlamydial genital infection as detected by real-time PCR was only 6.0 % (3/50); two of which were also IgM positive. Prevalence of ASA was 6.0 % (3/50); all were sero-negative for anti-C.trachomatis IgM and were PCR negative.ConclusionThe incidence of Chlamydial infection in Egyptian patients with unexplained infertility is relatively high. In the setting of fertility investigations; screening for anti. C.trachomatis antibodies using ELISA, and treatment of positive cases should be considered. The presence of circulating ASA does not correlate with the presence of old or current Chlamydia infection in women with unexplained infertility.
Background
Abdominal binder is a non‐pharmacological method of relieving pain after surgical procedures.
Objectives
To evaluate the effectiveness of the abdominal binder in relieving pain and distress scores after cesarean delivery (CD).
Search strategy
The following terms were searched: cesarean section, cesarean, caesarean, abdominal deliveries, C‐section, abdominal delivery, abdominal binding, binder, and abdominal binder.
Selection criteria
Randomized controlled trials (RCTs) with patients undergoing CD receiving an abdominal binder compared with non‐users of the abdominal binder.
Data collection and analysis
Five electronic databases were searched until November 2019. Records were screened for eligibility. Data were extracted independently and analyzed. The main outcomes were pain and distress scores.
Results
The final analysis included six RCTs. Overall effect estimate favored the abdominal binder group over the control group in the following outcomes: VAS pain scores after 24 h (mean difference [MD] −1.76; 95% confidence interval [CI] −3.14 to −0.39; P = 0.01), VAS scores after 48 h (MD −1.21; 95% CI −1.51 to −0.90; P < 0.001), distress score after 24 h (MD −1.87; 95% CI −3.01 to −0.73; P = 0.001), and distress score after 48 h (MD −1.87; 95% CI −3.07 to −0.67; P = 0.002).
Conclusion
The abdominal binder could be an effective, simple, non‐pharmacological option of relieving pain and distress after CD.
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