Higher-degree perineal tears negatively affect FSF up to 1 year after delivery. Evaluation of FSF and appropriate counseling are necessary for women with perineal tears, especially the higher degree tears.

Objectives This study aimed to evaluate anxiety and depression in pregnant women during this global disease. Methods This was a cross-sectional study recruiting 120 pregnant women. The study was conducted at the outpatient clinic of a tertiary hospital. We recruited women attending for antenatal care. Anxiety was evaluated using an Arabic validated Kuwait University Anxiety Scale (KUAS). Depression was evaluated using a validated Arabic form of the Edinburgh Postnatal Depression Scale (EPDS). Results The study included 48 (40%) nulliparous and 72 (60%) multiparous women. The mean KUAS scores for nulliparous and multiparous women were 45.27±10.78 and 47.28±10.62. Both nulliparous and multiparous women had a fairly high possibility of depression. Fifty-three (44.2%) of them reported scores ≥ of 14. Ninety-three (77.5%) women thought that COVID-19 pandemic would affect their pregnancies. There was a significant association between the number of women reporting fear related to the COVID-19 pandemic and their KUAS and EPDS scores (p-value <0.001 each). Conclusions COVID-19 affected the mental health of pregnant women to a great extent. Care should be directed to measures that would decrease the impact of this pandemic on vulnerable populations.

Objective: To evaluate the predictive role of the uterocervical angle and the cervical length in preterm birth. Methods:This was cross-sectional analytical study, recruiting 167 women at high-risk for preterm birth (delivery before 37 weeks of pregnancy). They had transvaginal ultrasound for evaluation of the uterocervical angle and the cervical length between at 30 and 32, 32 +1 and 34, and 34 +1 and 36 +1 weeks of pregnancy. The primary outcome was to determine the predictive role of the uterocervical angle and the cervical length in preterm birth. Results:The mean uterocervical angle was significantly greater in those who delivered preterm (115.4° ± 9.1° versus 101.1° ± 8.3°, p < 0.001). The cervical length was insignificantly shorter in the same group (27.9 ± 4.0 and 29.1 ± 4.1 mm, respectively, p = 0.067). A uterocervical angle of 105° or more predicted preterm birth with sensitivity and specificity of 86.1% and 60.4%, respectively. A cervical length of 25 mm or less had sensitivity and specificity of 27.8% and 85.8%, respectively. Conclusion:A uterocervical angle greater than 105° poses a high risk for preterm deliveries. It provides a higher diagnostic performance in high-risk patients than cervical canal length measurement.

Background: Antenatal cervical length measurement has paramount importance in the prediction of labor. It was compared to the Bishop Score and incorporated in the modified Bishop score due to its relevance and convenience. It is a more accurate tool that imposes no harm or distress to the patients. The study aimed to evaluate the role of antenatal cervical length measurement in the prediction of a successful vaginal birth and its relation to the duration of labor. Methods: This was a prospective cohort study, conducted at the emergency ward of obstetrics and gynecology department. We recruited 162 women over 1 year from January 2018 to January 2019. Women eligible for the study had a transvaginal ultrasound for the examination of the cervical length before the onset of labor. The success of vaginal delivery was evaluated. Results: The mean cervical length (mm) was 43.3 ± 8.0. The majority of the patients labored spontaneously [102 (63.0%)] while the remaining ones required induction of labor due to different causes. One hundred and eight patients (66.7%) had a successful vaginal delivery. The cervical length was significantly shorter among patients who delivered vaginally than those delivered by CS (P-value < 0.001). Multiple factors had a significant role in the prediction of the mode of delivery (cervical length, BMI, the onset of labor, parity). Maternal body mass index and labor induction were associated with a prolonged duration of the active phase of labor. Conclusion: Antenatal cervical length measurement predicted the mode of delivery as well as the gestational age at which delivery ensued. It can be used in patients' counseling regarding the mode of delivery.

Background: Cesarean delivery is the one of the oldest procedures performed in the history of surgery. Nowadays closure of the uterine incision is a key step in CD, particularly given the increasing awareness of future scar dehiscence. Aim: to improve quality of cesarean delivery. Objective: to assess healing after single-and double-layer suturing of uterine scar. Patients and Method: Randomized clinical trial conducted at Obstetrics and Gynecology department, Suez Canal University Hospital. Eighty primigravida women with full term pregnancy undergoing first elective CS were equally randomized to either single-layer or double-layer unlocked suture. Six weeks after the operation, the integrity of the cesarean scar done by 2 operators was assessed by sonohysterography. The thickness of the residual myometrium covering the defect "RMT", width of the triangular hypoechoic niche "W", depth of the triangular hypoechoic niche "D" and healing ratio "D/RMT" were calculated as markers of uterine scar healing. Results: There were no significant differences between the groups in terms of estimated blood loss, operation time, or additional hemostatic suture. However, frequency of appearance of niche in single layer patients was 65% compared to 30% in the double layer patients. The mean thickness of the residual myometrium covering the defect was significantly higher 9 ± 1.1 mm after double-layer than 7.9 ± 0.92 mm after a single-layer closure (P = 0.002). The mean healing ratio in double-layer was 0.2948 ± 0.05 versus 0.2969 ± 0.04; P =0.922 in the single-layer closure. Conclusions: Double unlocked layer closure was associated with higher residual myometrial thickness than locked single layer and better uterine scar healing.

Background The current fact of increasing rates of cesarean deliveries is a catastrophe. Recurrent cesareans result in intraperitoneal adhesions that would lead to maternal morbidity during delivery. Great efforts are directed towards the prediction of intraperitoneal adhesions to provide the best care for laboring women. The aim of the current study was to evaluate the role of abdominal striae and cesarean scar characters in the prediction of intraperitoneal adhesions. Methods This was a case- control study conducted in the emergency ward of the obstetrics and gynecology department of a tertiary hospital from June to December 2019. The study was carried on patients admitted to the ward fulfilling particular inclusion and exclusion criteria. The study included two groups, group one was assessed for the presence of striae, and the degree of intraperitoneal adhesions was evaluated during the current cesarean section. Group two included patients without evidence of abdominal striae. They were evaluated for the severity of adhesions also after evaluation of the previous scar. Evaluation of the striae was done using Davey’s scoring system. The scar was assessed using the Vancouver Scar Scale. The modified Nair’s scoring system was used to evaluate intraperitoneal adhesions. Results The study group included 203 women, while the control group included 205 women. There were significant differences in the demographic characters of the recruited patients (p-value 0.001 for almost all variables). The mean Davey score in those with mild, moderate, and severe striae was 1.82 ± 0.39, 3.57 ± 0.5, and 6.73 ± 0.94, respectively (p-value < 0.001). Higher scores for the parameters of the Vancouver scale were present in patients with severe striae (1.69 ± 1.01, 1.73 ± 0.57, 2.67 ± 1.23, and 1.35 ± 1.06 for scar vascularity, pigmentation, pliability, and height respectively with a p-value of < 0.001 each). Thick intraperitoneal adhesions were noted significantly in women with severe striae [21 (43.75%), p-value < 0.001)]. The Davey’s and Vancouver scores showed highly significant predictive performance in the prediction of intraperitoneal adhesions (p-value < 0.001). Conclusion Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.

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Objective: To evaluate complete blood count (CBC) changes that suggest coronavirus disease-2019 (COVID-19) among asymptomatic pregnant women attending routine antenatal care Methods: A cross-sectional study included 187 healthy pregnant women who were attending the antenatal care clinic of a tertiary University hospital between March and June 2020. After a thorough history and examinations, a venous blood sample was taken from each participant for complete and differential blood counts. Those who showed CBC findings suggestive of COVID-19 were further scheduled for a nasopharyngeal swab for detection of SARS-CoV-2 specific antigens through polymerase chain reaction (PCR). Results: We found 5.3% (n=10) of the study population showed CBC changes that are suggestive of COVID-19. When they were scheduled for nasopharyngeal swab for a PCR confirmatory test, 30% (n=3) of them were PCR positive (which represented 1.6% of the entire study population). The most frequently encountered COVID-19-suggestive change in peripheral blood leukocyte differential counts was leucopenia (100%), followed by decreased eosinophil count (50%), then neutropenia and lymphocytopenia (30%). Conclusions: Certain differential leucocyte count changes (leucopenia, neutropenia, lymphocytopenia and decreased eosinophil count) among asymptomatic pregnant women might be related to COVID-19 infection and may indicate a need for further testing.