Background: Placental thickness appears to be a promising parameter for estimation of gestational age of the fetus due to steady increase in placental thickness with gestational age. Aim of the work: To investigate the relationship between placental thickness and fetal outcome in patients with intrauterine growth restriction [IUGR]. Patients and Methods: This study included patients with fetuses diagnosed clinically and by ultrasound as IUGR [estimated fetal weight <10 th percentile for gestational age], singleton pregnancy, gestational age between 28-40 weeks of gestation, maternal age between 20-40 years old and body mass index between 18-30 kg/m 2. The placental thickness was measured at the second and third trimesters and correlated with the fetal outcome. Results: Results revealed that, estimated fetal weight significantly increased in normal placenta when compared to either thin or thick placentae. In addition, thin placentae had significantly low fetal birth weight [1936.4±409.2] when compared to thick placentae [2236.4±410.1] or normal placentae [2636.4±421.4]. Also, Apgar score was significantly higher and need for NICU admission were significantly lower with normal placentae. In addition, there is significant positive correlation between 3rd trimester placental thickness and fetal birth weight, placental weight and APGAR score. Conclusion: Placental thickness could predict deviations from norms of birth weight in late pregnancy. It seems to be promising for estimation of gestational age of the fetus and predicting fetal outcome.
Background: Unexplained infertility continues to be a health challenge irrespective of revolution in medical care. Endometriosis could be associated with infertility. However, its prevalence is underestimated, as it need laparoscopy for definite diagnosis. Aim of the work: To estimate the incidence of typical and atypical [subtle] pelvic endometriosis among women with unexplained infertility and chronic pelvic pain. Patients and Methods: A total of 100 patients with unexplained infertility [50 patients] and chronic pelvic pain [50 patients] who underwent diagnostic laparoscopy had been included in the current study. All were assessed clinically after full history taking and underwent ultrasound, then prepared for laparoscopy. The main outcome was laparoscopic and histopathologic diagnosis of pelvic endometriosis, and the association between endometriosis and different patient characteristics and other risk factors had been analyzed. Results: Endometriosis was diagnosed by laparoscopy in nearly 33 of patients included in this study of which 29 cases [12 with unexplained infertility and 17 with chronic pelvic pain] were confirmed by histopathologic examination. Thus, the final incidence of endometriosis was 29%. Development of endometriosis was significantly associated with positive family history, dysmenorrhea and higher CA125. Conclusion: Pelvic endometriosis is a frequent association with unexplained infertility and chronic pelvic pain. It should be considered in those women particularly when there was positive family history, dysmenorrhea or higher CA125.
Introduction and Aim: An accurate determination of gestational age (GA) is crucial to the management of all pregnancies, particularly high-risk pregnancies. This study aimed to comparing between the accuracy of ultrasonographic fetal kidney length and Transcerebellar diameter in GA determination in third trimester. Patients and methods: The study was a cross sectional one, carried out at the department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt. The study had been performed between January 2021 and January 2022. All were submitted to a detailed history, routine antenatal investigations, general and obstetrical examination. Then, measurements of all fetal biometric parameters were recorded using a real- time, grayscale, 3.5–5.0 MHz curvilinear array transducer. Results were compared to the gestational age determined by last menstrual period. Results: The patient age ranged between 18 and 37 years, their weight ranged between 55 and 109 kg, while gravidity ranged between 1 and 5 and parity ranged between 0 and 4. The GA as determined by last menstrual period (LMP) was ranged between 28 and 40 weeks. The calculated GA by different measurements were also included and they were around the same measurements as determined by LMP. This was confirmed by the absent statistically significant difference between GA by LMP and any of calculated gestational age by any method. The mean fetal kidney length is more accurate in determination of gestational age than transcerebellar diameter (96.3% vs 89.8%) and both were significantly correlated with other calculated gestational ages. Conclusion: The length of the fetal kidney length proportionately correlated with fetal gestation age with powerful correlation coefficient. Fetal kidney length is found to be more accurate in GA determination than transcerebellar diameter (TCD).
Background: Miscarriage is the most common adverse pregnancy outcome which has detrimental psychological consequences for the woman and her partner and delays successful childbearing. Normal embryonic heart rate is about [100-200] bpm at 5 weeks gestation then it increases progressively over the subsequent 2-3 weeks. Fetal demise often occurs within one week after the slow embryonic heart rate and always occurs by the end of the first trimester. Aim of the work: The aim of the present study was to investigate the relation between first trimester miscarriage and slow embryonic heart rate at sixth week of gestational age and other risk factors of miscarriage. Patients and methods: A prospective observational cohort study was conducted in the department of Obstetrics and Gynecology, Al-Azhar Faculty of medicine [Damietta] during the period from September 2017 to September 2018 on 90 pregnant women who had slow embryonic heart rate [80-100] bpm at sixth week of gestational age. All were submitted to full history taking, clinical and ultrasound examination and followed up till the end of their pregnancy and outcome was documented. Results: Percentage of aborted cases at the 8 th week of gestational age was [38.9%], while, [20%] at the 10 th week and [15.4 %] at 13 th week. Whom fetus had a heart rate less than 90 were at risk 23.8 times for experiencing abortions more than other females. Conclusion: Slow embryonic heart rate is one of the earliest predictors for the first trimester fetal demise and it is one of the newest studies.
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