OBJECTIVEThe aim of this study was to estimate the accuracy of prenatal assessment of interventricular septum (IVS) thickness, right myocardial wall thickness (RMWT), and left myocardial wall thickness (LMWT) by two-dimensional (2D) ultrasound for the prediction of perinatal mortality and postnatal diagnosis of hypertrophic cardiomyopathy (HCM) among diabetic pregnant women.SUBJECTS AND METHODSA total of 120 diabetic pregnant women at 35 weeks or more were enrolled in this study from January 1, 2012, to June 30, 2014, at Ain Shams Maternity Hospital, Cairo, Egypt. The 2D ultrasound was done once for all the participants at the time of recruitment; IVS thickness, RMWT, and LMWT were measured. The glycosylated hemoglobin (HbA1c) levels of the participants were recorded. Neonatal assessment including postnatal echocardiography was done after 48 hours. Postnatal results were compared with the prenatal predictive results.RESULTSHigher thickness values for IVS, RMW, and LMW were obtained in the uncontrolled diabetic cases (HbA1c > 6.5%) than in the controlled diabetic cases (HbA1c < 6.5%; P < 0.01). Of the included 120 neonates, 10 (8.3%) were stillborn, 99 (82.5%) had a five-minute Apgar score ≥7, and 4 (3.3%) had a five-minute Apgar score ≤3. The four neonates with severe neonatal distress died after admission to neonatal intensive care unit within one week after delivery. Out of 110 live-born neonates, 4 (3.6%) neonates had a low ejection fraction (EF) (<50%) due to HCM; of them 2 (1.8%) died within one week after delivery, while 2 (1.8%) survived. Another two (1.8%) neonates died from severe respiratory distress syndrome. A cutoff value of ≥4.5 mm for prenatal IVS thickness was predictive of neonatal distress due to HCM with a sensitivity of 82%, specificity of 68%, and diagnostic accuracy of 72%. A cutoff value of <1.18 for the ratio of IVS thickness to LMWT had a sensitivity of 82%, specificity of 72%, and diagnostic accuracy of 74% for the prediction of neonatal distress due to HCM. In this study, 8 of the 10 fetuses with intrauterine demise and the 2 neonates who died within one week after delivery due to heart failure had a prenatal IVS thickness of ≥4.5 mm, while 7 of the 10 fetuses with intrauterine demise and the 2 neonates who died postnatal from heart failure had a prenatal IVS thickness to LMWT ratio of ≤1.18.CONCLUSIONA prenatal IVS thickness of ≥4.5 mm or an IVS/LMWT ratio of ≤1.18 seems to be predictive of HCM and is associated with almost twofold higher risk of intrauterine fetal death and almost threefold higher risk of possibly relevant perinatal mortality.

An endometrial volume of 1.35 mL or greater may predict malignancy in women with postmenopausal bleeding.

3D-PDA measurements may be useful for distinguishing between benign endometrial lesions and endometrial carcinoma in patients with postmenopausal bleeding.

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Introduction: Polycystic ovarian syndrome (PCOS) is the most prevalent worldwide female endocrine disorder, affecting nearly 5%-12% of reproductive-aged women. PCOS is the most common cause of anovulatory infertility and its foremost clinical symptoms include anovulation or oligo-ovulation, infertility, menstrual irregularity, polycystic ovaries and hyperandrogenism. PCOS is also common among infertile Arabian female population and it is associated with significant elevations in markers of metabolic syndrome, insulin resistance and cardiovascular risks. Unfortunately, PCOS is not a simple pathophysiologic process for which one treatment is sufficient to control all manifestations. Therefore, when choosing a treatment regimen, it should target specific manifestations and individualized patient goals. Aim of the Work: The aim of this study is to assess the safety and the efficacy of vitamin D supplementation therapy on ovulation and metabolic changes in women with PCOS. Study design: Prospective randomized controlled clinical trial. Patients and Methods: The current study was conducted in the infertility clinics of Ain Shams University Maternity Hospital in the period between May 2015 and May 2017. It included 300 women diagnosed with polycystic ovary syndrome attending the infertility clinics of Ain Shams University Maternity Hospital. Results: Being a classification criterion, 25OHD level was significantly lower in the vitamin D deficient subgroup compared to the normal vitamin D subgroup; whereas no significant differences were found between the vitamin D deficient group and the control group. In the same context, 25OHD level was statistically significantly lower in the control group compared to the normal vitamin D subgroup. Vitamin D deficient PCOS women tended to have higher degree of insulin resistance. Fasting glucose was statistically significantly higher in the vitamin D deficient subgroup compared to the normal vitamin D subgroup and the control group; and higher in the control group compared to the normal vitamin D subgroup. Fasting insulin level was statistically significantly higher in the vitamin D deficient subgroup and the control group compared to the normal vitamin D subgroup; whereas no statistically significant differences were found between the former two groups. HOMA2-IR was statistically significantly higher in the vitamin D deficient subgroup and the control group compared to the normal vitamin D subgroup; whereas no statistically significant differences were found between the vitamin D deficient subgroup and the control group. No statistically significant differences were found between the three groups in the various components of the lipid profile. Conclusion: Results of the thesis showed that cumulative ovulation rate was significantly higher in the vitamin D deficient subgroup following vitamin D supplementation compared to the normal vitamin D subgroup and the control group with a rate ratio of 1.27 and 1.22, respectively. Number needed to treat was calculated to be 5.34 and 6.38 compa...