Background: Various causes can be claimed for abdominal pain during pregnancy. Acute appendicitis is the most common cause of abdominal pain during pregnancy. Diagnosis of acute appendicitis during pregnancy is a quiet challenging due to anatomical and physiological changes that occur during pregnancy.Methods: On the period from January 2010 to January 2012we reviewed the number of pregnant patients presented to our facility by abdominal pain and diagnosed as acute appendicitis. Total number was 23 patients. 2 patients were excluded as their magnetic resonance imaging showed normal appendix and were discharged. 6 patients presented on the 1st trimester, 7 patients presented on the 2nd trimester and 8 patients on the 3rd trimester. Laparoscopic appendectomy performed in 9 patients while 12 patients had open appendectomy.Results: The operative time on the laparoscopic group ranged from 50-80 minutes while on the open appendectomy ranged from 40-60 minutes. The length of stay after laparoscopic procedure was 1.5-3 days in comparison to 3-5 days following open appendectomy. Postoperative wound infection detected in 2 patients after open appendectomy (16%) compared with 1 patient (11%) following laparoscopic appendectomy. The postoperative pathology was classified as normal appendix, suppurated appendix and complicated appendix. Table 2 showed the postoperative pathological examination. Preterm labor detected in one patient only had open appendectomy. Fetal outcome was evaluated by Apgar scoring together with fetal length and weight after delivery with no significant abnormality.Conclusions: Laparoscopic appendectomy is safe for both the mother and the fetus during pregnancy irrespective of gestational age, and the procedure is associated with a low risk of post-operative complications.
Background: A lot of studies conducted evaluating the effect of maternal weight on the In Vito Fertilization (IVF) cycles outcome, the results of these studies were conflicting. Methods: We conducted retrospective cohort study on young normal responding patients attending the clinic for fertility treatment. Patients divided in to three group according to their body mass index (BMI). All patients had intra cytoplasmic sperm injection cycle with antagonist protocol. The IVF laboratory outcome was calculated and compared between the three groups.Results: The intracytoplasmic sperm injection cycles laboratory outcome was evaluated in the three groups of patients. No significant difference was found between the laboratory out come in the three group.Conclusions: We concluded that in absence of sever major factor for infertility, maternal BMI has no effect on the laboratory outcome of intra cytoplasmic sperm injection cycles.
Patients with recurrent implantation failure had to be extensively studied to find way to achieve clinical pregnancy, it is well known that defects in the embryo or the endometrium or the alteration between both could be the reason. Exclusion of the possibilities of embryo abnormalities could help us to concentrate on the endometrial factors of failure. In this study we concentrated on endometrial receptivity displacement as a factor of implantation failure in patients with recurrent unexplained IVF failure. This is done through studying gene expression of endometrium in those cases to determine the receptivity timing and the window of implantation. Through retrospective study of 93 patients with recurrent implantation failure who underwent endometrial receptivity array testing, we found that the incidence of non-receptive endometrium in such cases was 45% 38 patients of 83 which is higher than other studies in the same field. Prevalence of pre receptive endometrium in those cases more than post receptive, Indicates the need to more exposure to Progesterone to achieve receptivity. Polycystic ovarian syndrome patients included in this study showed also high incidence of non-receptive endometrium10 out of 11patients (90.9%). In conclusion personalized embryo transfer according to ERA test could be useful to this category of patients. However larger studies are needed in the same group of patient
Background: Unexplained recurrent implantation failure is a devastating situation for both patients and the doctor treating them, with transfer of high grade euploid embryos this situation became more related to the endometrial receptivity and the interaction between the embryo and the endometrium. Till now the best way of detecting endometrial receptivity was through endometrial receptivity array of gene in endometrial tissue.Methods: A retrospective study was carried out in large IVF center in Abu Dhabi in period from 2017-2021. Patients included in the study were infertile patients with age limit of 43 years old with history of repeated IVF failure after multiple transfer trials of high grade embryos. All patients had ERA test then frozen embryo transfer of Euploid high grade embryos obtained through stimulated cycle of each patient according to Era test results.Results: 45 patients included in our study. Patients divided into 2 major groups according to Era test result. First group included patients with receptive endometrium. The second group was the patients with displaced window of implantation. Patients with receptive endometrium were 12 (26.7%) and the displaced window of implantation was found in 33 patients (73.3%). Higher pregnancy and cumulative pregnancy rate in the patients with displaced window of implantation more than the receptive group 19 (57.7%) versus 5 (41.6%) and 27 (81,8%) versus 6 (50%), but lower implantation rate in the displaced window of implantation group 6/12 (50%) versus 25/53 (47.2%) with higher miscarriage rate in the receptive group 2/6 (33.3%) versus 4/26 (14.8%), live birth and take home baby rate in the patients with displaced window of implantation 3 babies delivered to the receptive group 3/12 (25%), 24 babies to the group of displaced window of implantation 24/53 (45.3%).Conclusions: Patients with recurrent unexplained implantation failure may benefit from personalized embryo transfer after determining their window of implantations with endometrial receptivity array testing.
Background: The incidence of un explained infertility about 22-28% of all infertile couples. Several strategies have been implemented to improve the outcome of infertility treatment before shifting to ART. Management of unexplained infertility depends on patients age, ovarian reserve and period of infertility, management starts from simple to more complicated protocols to achieve pregnancy up to assisted reproduction techniques. Hysteroscopy provides diagnostic and therapeutic approach in such group of patients.Methods: Retrospective analysis of the reproductive outcome in young patients with unexplained infertility was conducted to evaluate such treatment protocol 163 patients included in the study.Results: Our results showed that around 29.4% of patients had intrauterine abnormalities which varies from endometrial polys to adhesions and one case found to have cervical stenosis, around 12.17% had endometritis. Patient were left for expectant management for 6 months, 22.7% pregnancy rate following hysteroscopy without any other intervention, patients who had polypectomy got 28% pregnancy rate while patients with apparent normal endometrial cavity got 23.76% pregnancy rate.Conclusions: Hysteroscopy could be an alternative treatment option in young patients with unexplained infertility because of its diagnostic and therapeutic effect.
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