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Objective: Preeclampsia accounts for 15% of maternal deaths and may cause fetal morbidity and mortality. The aim of this research was to evaluate the efficacy of maternal uterine artery Doppler versus serum beta-human chorionic gonadotropin (β-hCG), during the first trimester, in predicting preeclampsia and intrauterine growth restriction (IUGR). Materials and Methods: In a convenient sample of 388 pregnant women, uterine artery resistive index (RI) and pulsatility index (PI) were assessed, and serum β-hCG level was measured at 11 to 13 weeks of gestation. The patients' maternal blood pressure and fetal growth were monitored. Results: The patients with preeclampsia (n = 58) showed a significant uterine RI and PI increase with a significant β-hCG decrease compared with the normotensive patients (n = 330). The specificity of uterine PI and RI to predict preeclampsia and IUGR is higher than that of β-hCG. However, the sensitivity of combined diagnostic tools is higher than the singular use of these diagnostic tests. Conclusion: Uterine artery Doppler may be better than serum β-hCG in predicting preeclampsia and IUGR. However, combined diagnostic techniques may be better to screen at-risk patients. [ABSTRACT FROM AUTHOR]

Background: Women's pain satisfaction post-cesarean section remains a challenge. Accurate assessment of pain severity of post-cesarean section helps to choose the most appropriate anesthetic approach, drug, and dose, as well as improvement of treatment of postoperative pain. Our objective was to compare the efficacy of ultrasound-assisted transversus abdominis plane (TAP) block versus IV patient-controlled analgesia (PCA) in the first 24 h postoperative in women who underwent cesarean section. The primary outcome was postoperative pain at 2, 4, 6, 12, and 24 h. The secondary outcomes were intestinal mobility, early mobilization, nausea, vomiting, heart rate, and respiratory rate. Results: A cross-sectional study has been conducted on 70 women who are planned for elective cesarean section. They were divided into 2 groups; "group A" (n = 35), women who received TAP block, and "group B" (n = 35), those who received PCA. Pain score, heart rate, respiratory rate, intestinal motility, nausea, and vomiting have been assessed 2, 4, 6, 12, and 24 h postoperatively. The degree of pain was significantly lower in "group B" than in "group A" in all time intervals (p < 0.001). Heart rate was significantly higher in women in "group B" compared to those in "group A" only at 2 and 4 h postoperative (p < 0.001). Nausea and vomiting were also significantly higher in women in "group B" compared to those in "group A" (p value 0.03 and 0.04, respectively). Regarding intestinal motility, it was audible in "group A" earlier than in "group B." Conclusions: Both TAP block and PCA are effective in postoperative pain relief after cesarean section; however, PCA is more superior, especially for visceral pain. Nevertheless, TAP block has the privilege of avoiding systemic action of opioids used in PCA. PCA can easily be applied while TAP block needs more training and an intraoperative ultrasound machine. Complications and side effects of both were minimal when adjusting the doses. [ABSTRACT FROM AUTHOR]

Background: The benefit of hysteroscopy could extend beyond the treatment of intrauterine abnormalities. Irrigation of the cavity with saline may have a beneficial effect on implantation and pregnancy rates, since saline mechanically washes harmful anti-adhesive glycoprotein molecules on the endometrial surface involved in endometrial receptivity, i.e., cyclooxygenase-2 (COX-2), mucin-1 (MUC-1), and integrin. Objective: The aim of this study is to evaluate the role and benefit of routine hysteroscopy prior to ICSI in women with previous failed ICSI. Patients and methods: This prospective study has been carried out, at the outpatient clinic, on 100 women that have undergone hysteroscopy as a part of the infertility workup. Women were categorized into three groups according to the number of previous failed IVF/ICSI, once (n = 37), twice (n = 33), and thrice (n = 30). Results: After analyzing the data, we found that hysteroscopy was associated with 39% overall clinical pregnancy rate in women with previous/repeat IVF/ICSI failure. Treatment of polyp was associated with 58.3% clinical pregnancy rate (NNT = 1.71). Treatment of intrauterine adhesions was associated with 16.7% clinical pregnancy rate (NNT = 6). Treatment of submucous myoma and uterine septum showed a 75% and 50% clinical pregnancy rate, respectively. Conclusion: Hysteroscopic examination in women with previous failed ICSI may improve pregnancy rate even in the absence of uterine pathology. Consequently, hysteroscopy examination may be proposed as a routine step prior to ICSI in case of previous failure. [ABSTRACT FROM AUTHOR]