Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) are important members of genital Mycoplasmas. They are implicated in urogenital infections and complicated pregnancy (chorioamnionitis, preterm delivery, abortion, and preterm birth) as well as bacterial vaginosis and cervicitis. The administration of antimicrobial agents to pregnant women with preterm rupture of the membranes (PROM) may extend the gestation period and decrease the risks of associated complications and neonatal infections. Despite empirical therapy is the rule in cases suspected to have genital infection in Egypt, the surveillance of the susceptibilities of used antibiotics is mandatory to ensure treatment efficacy and good prevention of any possible complications. This study aimed to assess the infection rate of genital Mycoplasmas (MH and UU) among pregnant females and their antimicrobial susceptibility pattern to provide a provisional idea about the effectiveness of antibiotics used empirically to treat cases of genital infections in pregnant women. High vaginal swabs of 50 pregnant females were examined using Mycoplasma IES kit, for identification of UU and MH. The kit also provides the antimicrobial susceptibility results for 12 antimicrobials of five different classes. UU and MH were detected in 26/50 (52%), and 7/50 (14%) of cases respectively, of which 5 cases showed mixed infection with both organisms. UU was most sensitive to quinolones (90-95%), followed by tetracyclines (80-85%). The least sensitivity was detected with chloramphenicol and clindamycin (40% and 30% respectively). The two MH isolates (100%) were sensitive to the three tested quinolones in addition to clindamycin and thiamphenicol. MH showed 100% sensitivity to clindamycin and 75% of UU isolates were sensitive to azithromycin. Further studies are needed to detect any future changes in the susceptibility pattern for these drugs or other antibiotics.

In view of these results, it might be concluded that umbilical cord tightness affecting fetal hemodynamics (expressed by changes in umbilical artery Doppler) might be a determinate factor affecting the intrapartum course.

Our results support previous studies which indicate the presence of meconium can be associated with chronic fetal hypoxia as demonstrated by elevated fetal NRBC levels.

Objectives: to determine the diagnostic accuracy of different endometrial sampling tests for detecting endometrial carcinoma. Design: a systematic review and meta-analysis of studies of diagnostic accuracy. Eligibility criteria: We included published cross-sectional studies of women, of all ages, who had an endometrial sampling for preoperatively detecting endometrial cancer with verification using histopathology of hysterectomy specimens as the reference standard. We excluded case control and case series studies. Information sources: We searched the Cochrane library, MEDLINE/PubMed, CINAHL, Web of Science, and Scopus from the date of inception of the databases to December 31, 2022. We did not apply any restrictions on language or date of publication. We searched the references of included studies and other systematic reviews. Risk of bias: We extracted study data and assessed study quality using the revised quality assessment tool for diagnostic accuracy studies (QUADAS-2). Synthesis of results: We used bivariate diagnostic random-effects meta-analysis and presented the results in a summary receiver operating characteristic curve. We assessed the certainty of evidence as recommended by the GRADE approach. Results: Ten included studies, published between 1986 and 2020, recruited 1390 participants. Seven studies were low risk of bias in all domains and all studies had low applicability concerns. The most commonly studies index tests were Pipelle and conventional dilation and curettage. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio (95% confidence intervals), for Pipelle were 0.774 (0.565, 0.900), 0.985 (0.927, 0.997), 97.000 (14.000, 349.000), and 0.241 (0.101, 0.442) and for conventional dilation and curettage were 0.880 (0.281, 0.993), 0.984 (0.956, 0.995), 59.300 (14.200, 153.000), and 0.194 (0.007, 0.732); respectively. Conclusion: High certainty evidence indicates that pre-operative endometrial sampling particularly using Pipelle or conventional curettage is accurate in diagnosing endometrial cancer. Studies assessing other endometrial sampling tests were sparse.

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The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

Background: The intrauterine contraceptive device (IUCD), which is a plastic T-shaped device with copper attached to it, is the most widely used type of reversible contraception in the world. It was developed more than 30 years ago and has since become the industry standard due to its long-term effectiveness, safety, and affordability. Objective: To compare the effectiveness of oral ibuprofen versus 10% lidocaine spray as pain killers during the installation of copper intrauterine devices. Patients and Methods: This prospective, randomized clinical study comprised 140 women who sought out the Family Planning Clinic at Ain Shams Maternity Hospital between December 2021 and June 2022 in order to have an IUCD inserted for the purposes of contraception. Two groups were created from the participants. Those in Group 1 were given four sprays (40 mg) of 10% lidocaine spray to be administered topically on the cervix uteri 3-5 minutes before to IUCD implantation, whereas those in Group 2 were given 400 mg of ibuprofen tablets orally to be taken at least 45 minutes before IUCD implantation. Results: Failure of insertion statistically was non-significantly different among lidocaine spray and ibuprofen tablet groups. Vasovagal reactions statistically were non-significantly less frequent among lidocaine spray. Patients' pain perception statistically was significantly lower among lidocaine spray group. Moderate pain statistically was significantly less frequent among lidocaine spray. Need to analgesics statistically was significantly less frequent among lidocaine spray. Conclusion: Pain from IUCD insertion may be effectively managed with 10% local lidocaine spray, which is more convenient than ibuprofen pills and takes action quickly. When deciding between ibuprofen pills and lidocaine spray for pain management following IUCD implantation, many women choose the latter.