14 results on '"Abdellah MS"'
Search Results
2. Self-administrated vaginal 2% lidocaine in-situ gel for pain relief during copper intrauterine device insertion in women with previous caesarean delivery only: a randomised, double-blind placebo-controlled trial.
- Author
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Abbas AM, Abd Ellah NH, Hosny MA, Abdellah MS, and Ali MK
- Subjects
- Adult, Anesthetics, Local administration & dosage, Double-Blind Method, Female, Gels administration & dosage, Gels therapeutic use, Humans, Lidocaine administration & dosage, Pain etiology, Pain Management, Pregnancy, Treatment Outcome, Anesthetics, Local therapeutic use, Cesarean Section adverse effects, Intrauterine Devices, Copper adverse effects, Lidocaine therapeutic use, Pain drug therapy
- Abstract
Objective: To evaluate the analgesic effect of self-administered vaginal 2% lidocaine in-situ gel in pain relief during copper intrauterine device (IUD) insertion in women with previous caesarean delivery only., Methods: A Randomised, double-blind, placebo-controlled trial (Clinicaltrials.gov: NCT03166111) included reproductive-aged women who previously delivered only by caesarean section (CS) requesting Copper IUD insertion. Eligible women were recruited and randomised (1:1) to lidocaine in-situ gel vs. placebo. Each woman was supplied by a syringe filled with five ml lidocaine or placebo in-situ gel to be self-administered vaginally ten minutes before insertion. The primary outcome was the difference in pain scores during IUD placement using a 10-cm Visual Analogue Scale (VAS)., Results: The final analysis included 216 women ( n = 108 in each arm). Women in the Lidocaine in situ gel group were more likely to report statistically significant lower pain scores during vulsellum application, uterine sound placement, and during IUD placement [Mean difference (95%CI) = 2.04 (1.66-2.42), 2.62 (2.20-3.04), and 2.57 (2.12-3.01), respectively, p = 0.0001]. A significantly lower IUD insertion score indicating easier insertion was reported in the lidocaine group ( p = 0.004). Similarly, the duration of IUD insertion was significantly shorter in the lidocaine group ( p = 0.008). There was a higher level of satisfaction in the lidocaine group (5.92 vs. 3.34) in the placebo group ( p = 0.0001)., Conclusions: Self-administered vaginal lidocaine in-situ gel 10 min before copper IUD insertion is effective in pain reduction in women with previous caesarean delivery only. more...
- Published
- 2021
- Full Text
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Catalog
3. Uterine exteriorization versus intraperitoneal repair: effect on intraoperative nausea and vomiting during repeat cesarean delivery - A randomized clinical trial.
- Author
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Abdellah MS, Abbas AM, Ali MK, Mahmoud A, and Abdullah SA
- Abstract
Objective: The current study aims to compare the rate of intraoperative nausea and vomiting after repeat cesarean delivery (CD) under two different approaches: by intraperitoneal incision repair or by uterus exteriorization for incision reapair., Materials and Methods: We conducted a single-blinded randomized clinical trial (NCT03009994) at a tertiary University Hospital between the 1st of September 2016 and the 31st of December 2017. The study included pregnant women at term of gestation (>37 weeks) scheduled for repeat CD under spinal anesthesia. Women were assigned to either uterine exteriorization for incision repair (Group I) or intraperitoneal incision repair (Group II). The primary assessed was the rate of nausea and vomiting during CD., Results: The study included 1028 women in the final analysis. The rate of intraoperative nausea and vomiting was significantly lower in the intraperitoneal repair group compared to the exteriorization group (24% versus 38.7%, p= 0.001). Likewise, occurrence of uterine atony and the need for additional uterotonics were significantly lower in the intraperitoneal repair group (p= 0.001 and 0.02 respectively). Postoperatively, the rate of nausea and vomiting (12.6 % versus 21 %; P=0.001), and the time to the first recognized bowel movement (12.3 hours versus 14.1 hours; P=0.003) were significantly lower in the intraperitoneal repair group compared to the exteriorization group., Conclusions: Intraperitoneal repair of the uterine incision during repeat CD is beneficial compared to exteriorization. Improvements in the rate of intra- and postoperative nausea, vomiting, uterine atony and time to the first recognized bowel movement were observed in patients operated with this technique., Competing Interests: Conflict of interest:The authors declare that they have no conflict of interest. more...
- Published
- 2018
4. Vaginal misoprostol prior to intrauterine device insertion in women delivered only by elective cesarean section: a randomized double-blind clinical trial.
- Author
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Abdellah MS, Abbas AM, Hegazy AM, and El-Nashar IM
- Subjects
- Administration, Intravaginal, Adolescent, Adult, Contraception statistics & numerical data, Double-Blind Method, Egypt, Elective Surgical Procedures, Female, Humans, Intrauterine Devices, Copper, Middle Aged, Pain prevention & control, Patient Satisfaction, Placebos, Pregnancy, Cesarean Section, Contraception methods, Intrauterine Devices statistics & numerical data, Misoprostol administration & dosage, Pain Measurement
- Abstract
Objective: The current study aims to evaluate if vaginal misoprostol (400 mcg) administered prior to intrauterine device (IUD) insertion increases the ease and success of insertion among women who had delivered only by elective cesarean delivery (CD)., Study Design: The current study was a randomized, double-blind, placebo-controlled trial conducted in Assiut Women's Health Hospital, Egypt, between the 1st of April 2015 and the 31st of March 2016 and included women who delivered only by elective CD. One hundred forty women were randomized into two groups; misoprostol group received two misoprostol 400-mcg tablets vaginally, and placebo group received two placebo tablets 3 h before a copper T380A IUD insertion. The primary outcome measure was the difference in the ease of insertion score using a 10-cm visual analog scale between both groups with 0=very easy insertion, and 10=terribly difficult insertion., Results: The ease of insertion score was lower in the misoprostol group (2.2±0.5 vs. 4.2±0.5, p=.0001) with higher number of successful IUD insertions than the placebo group (69 [98.6%] vs. 61 [87.1%], p=.009). The mean pain score reported by the women was lower in misoprostol group (2.7±0.6 vs. 4.3±0.8) with higher level of satisfaction from the whole procedure (8.9±0.4 vs. 7.9±0.2) with p=.001 for both., Conclusions: Misoprostol 400 mcg vaginally prior to IUD insertion eases and increase the success of insertion with reduction of pain among women who had delivered only by elective CD., Implications: The use of vaginal misoprostol before IUD insertion in women who had never delivered vaginally before may increase the ease and success of insertion. Moreover, it may reduce the pain felt by women during the procedure., (Copyright © 2017 Elsevier Inc. All rights reserved.) more...
- Published
- 2017
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5. Vaginal misoprostol prior to intrauterine device insertion in women delivered only by elective cesarean section - reply to letter to the editor.
- Author
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Abbas AM and Abdellah MS
- Subjects
- Female, Humans, Intrauterine Devices, Pregnancy, Vagina, Cesarean Section, Misoprostol
- Published
- 2017
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6. Effect of cervical lidocaine-prilocaine cream on pain perception during copper T380A intrauterine device insertion among parous women: A randomized double-blind controlled trial.
- Author
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Abbas AM, Abdellah MS, Khalaf M, Bahloul M, Abdellah NH, Ali MK, and Abdelmagied AM
- Subjects
- Administration, Intravaginal, Adult, Double-Blind Method, Egypt, Female, Humans, Linear Models, Multivariate Analysis, Pain etiology, Pain Measurement, Pain Perception, Prospective Studies, Time Factors, Anesthetics, Combined administration & dosage, Anesthetics, Local administration & dosage, Intrauterine Devices, Copper adverse effects, Lidocaine administration & dosage, Pain drug therapy, Prilocaine administration & dosage
- Abstract
Objective: The objective was to investigate the analgesic effect of cervical lidocaine-prilocaine (LP) cream in alleviating pain during copper T380A intrauterine device (IUD) insertion among parous women., Study Design: We conducted a randomized, double-blind, placebo-controlled trial at Assiut Women's Health Hospital, Egypt, from October 2015 to April 2016 of parous women desiring copper IUD insertion. We randomized the subjects in a 1:1 ratio to LP cream or placebo. Seven minutes prior to IUD insertion, women received 2 ml of LP cream or placebo to the anterior cervical lip, followed by 2 ml placed in the cervical canal using a Q-tip applicator. The study end point was the subjects' self-reported pain using a 10-cm visual analog scale (VAS) during cervical tenaculum placement, sound insertion, IUD insertion and 5 min postprocedure. We considered a 2-cm difference in VAS scores between study groups as clinically significant. Also, the difference in the ease of insertion score using a 10-cm VAS with 0=very easy insertion and 10=terribly difficult insertion was assessed., Results: The study included 120 women (n=60 in each group). LP cream reduces the median VAS pain scores during tenaculum placement (2 vs. 4), sound insertion (3 vs. 6) and IUD insertion (3 vs. 6.5) with p=.0001 at all steps. A lower ease of insertion score was also determined among LP women (2.5±0.98 vs. 4.5±2.7, p=.001). Participants reported no side effects., Conclusions: Use of cervical LP cream prior to copper T380A IUD insertion may alleviate the IUD insertion pain among parous women., Implications: Cervical LP cream could be effective as an analgesic prior to copper T380A IUD insertion with no side effects. Further studies are needed to assess the women's satisfaction from lying with a speculum in place for 7 min while waiting for the cream to be effective., (Copyright © 2016 Elsevier Inc. All rights reserved.) more...
- Published
- 2017
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7. Multifactorial contributors to the severity of chronic pelvic pain in women.
- Author
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Yosef A, Allaire C, Williams C, Ahmed AG, Al-Hussaini T, Abdellah MS, Wong F, Lisonkova S, and Yong PJ
- Subjects
- Abdominal Wall, Adult, Body Mass Index, British Columbia epidemiology, Chronic Pain epidemiology, Cohort Studies, Constipation epidemiology, Constipation physiopathology, Cross-Sectional Studies, Dysmenorrhea epidemiology, Dysmenorrhea physiopathology, Dyspareunia epidemiology, Dyspareunia physiopathology, Female, Humans, Pain Measurement, Pelvic Floor, Pelvic Pain epidemiology, Prospective Studies, Severity of Illness Index, Surveys and Questionnaires, Abdominal Pain epidemiology, Catastrophization epidemiology, Chronic Pain physiopathology, Cystitis, Interstitial epidemiology, Endometriosis epidemiology, Pelvic Pain physiopathology, Sex Offenses statistics & numerical data, Smoking epidemiology
- Abstract
Background: Chronic pelvic pain affects ∼15% of women, and is associated with significant societal cost and impact on women's health. Identifying factors involved in chronic pelvic pain is challenging due to its multifactorial nature and confounding between potential factors. For example, while some women with endometriosis have chronic pelvic pain, there may be comorbid conditions that are implicated in the chronic pelvic pain rather than the endometriosis itself., Objective: We sought to explore multifactorial variables independently associated with the severity of chronic pelvic pain in women., Study Design: We used baseline cross-sectional data from an ongoing prospective cohort, collected from patient online questionnaires, physical examination, and physician review of medical records. Participants were recruited from a tertiary referral center for endometriosis and chronic pelvic pain in Vancouver, British Columbia, Canada, from December 2013 through April 2015. Exclusion criteria included menopausal status or age >50 years. Primary outcome was self-reported severity of chronic pelvic pain in the last 3 months (0-10 numeric rating scale). Potential associated factors ranged from known pain conditions assessed by standard diagnostic criteria, validated psychological questionnaires, musculoskeletal physical exam findings, as well as pain-related, reproductive, medical/surgical, familial, demographic, and behavioral characteristics. Mann-Whitney, Kruskal-Wallis, or Spearman test were used to identify variables with an association with the primary outcome (P < .05), followed by multivariable linear regression to control for confounding and to identify independent associations with the primary outcome (P < .05)., Results: Overall, 656 women were included (87% consent rate), of whom 55% were diagnosed with endometriosis. The following factors were independently associated with higher severity of chronic pelvic pain: abdominal wall pain (P = .005), pelvic floor tenderness (P = .004), painful bladder syndrome (P = .019), higher score on Pain Catastrophizing Scale (P < .001), adult sexual assault (P = .043), higher body mass index (P = .023), current smoking (P = .049), and family history of chronic pain (P = .038). Severity of chronic pelvic pain was similar between women with and without endometriosis., Conclusion: Multifactorial variables independently associated with severity of chronic pelvic pain were identified, ranging from myofascial/musculoskeletal, urological, family history, and psycho-social factors. Continued research is required to validate these factors and to determine whether any are potentially modifiable for the management of chronic pelvic pain., (Copyright © 2016 Elsevier Inc. All rights reserved.) more...
- Published
- 2016
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8. Intra uterine extra-amniotic versus vaginal misoprostol for termination of second trimester miscarriage: A randomized controlled trial.
- Author
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Abbas Mitwaly AB, Abbas AM, and Abdellah MS
- Abstract
Background: Termination of pregnancy in the second trimester using prostaglandins has been shown to be safe and effective. Misoprostol has multiple routes of administration; oral, vaginal, buccal, rectal and sublingual., Objective: The study aims to compare the efficacy and safety of intrauterine extra-amniotic and vaginal misoprostol in a dose of 200 microgram every 4 hours for the termination of pregnancy in cases of second trimester miscarriage., Materials and Methods: A prospective randomized open labeled clinical trial included 180 women with missed miscarriage in gestational age between 13 and 24 wks. Patients were randomized to receive subsequent doses of 200 µg misoprostol every 4 hrs either intra uterine extra-amniotic by Foley catheter or vaginally administered. Randomization was completed using a computer-generated random table. The primary outcome of this study was the mean duration from the initial misoprostol dose until complete fetal expulsion (induction-expulsion interval)., Results: The mean gestational age was 17.74 wks. The mean time to complete miscarriage in the intra uterine extra-amniotic group was 5.27 hrs, which was significantly lower than the vaginal group (9.92 hrs, p=0.001). Side effects were more common in vaginal group., Conclusion: Intra uterine extra-amniotic misoprostol with a dose of 200 µg every 4 hrs appears to be more effective and safer than vaginal misoprostol in induction of second trimester miscarriage. more...
- Published
- 2016
9. Safety and efficacy of postoperative continuous intra-peritoneal wash with lactated Ringer's for minimizing post-myomectomy pelvic adhesions: a pilot clinical trial.
- Author
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Abu-Elhasan AM, Abdellah MS, and Hamed HO
- Subjects
- Adult, Drainage methods, Female, Humans, Incidence, Infusions, Parenteral, Isotonic Solutions administration & dosage, Isotonic Solutions adverse effects, Length of Stay statistics & numerical data, Pilot Projects, Postoperative Care adverse effects, Prospective Studies, Ringer's Lactate, Severity of Illness Index, Tissue Adhesions epidemiology, Treatment Outcome, Isotonic Solutions therapeutic use, Leiomyoma surgery, Postoperative Care methods, Tissue Adhesions etiology, Tissue Adhesions prevention & control, Uterine Myomectomy adverse effects, Uterine Neoplasms surgery
- Abstract
Objectives: To assess efficacy and safety of post-operative intra-peritoneal wash with lactated Ringer's for 48h after myomectomy in reduction of adhesions compared to routine intra-operative irrigation. Study design A prospective, randomized trial that included 52 eligible participants who had undergone abdominal myomectomy. Participants were randomly allocated to a treatment group (n=26) which was subjected to continuous peritoneal wash for 48h via two intraperitoneal drains, and a control group (n=26). The incidence of de novo adhesions and their severity and extent were scored at a second-look laparoscopy 8-10 weeks postoperatively. Adhesions were graded using the local adhesion barrier scoring system score. Adverse effects were also assessed and reported., Results: There was no statistically significant difference in duration of hospital stay or in the incidence of adverse events. A significantly higher proportion of adhesion-free patients was found in the treatment group [11/23, 47.8%] compared to the control group [4/21, 19%] (P<0.01). The mean number of pelvic sites covered by adhesions was significantly lower in the treatment group than in the control group (2.2±0.3 versus 4.6±0.8, P<0.05). The total adhesion score was significantly lower in the treatment group than in the control group (2.1±0.5 versus 4.8±1.4, P<0.05) and the adhesion score was significantly lower at most of the individual anatomical sites., Conclusions: Application of postoperative intraperitoneal wash with lactated Ringer's solution for 48h may have reasonable safety and efficacy in minimizing postoperative pelvic de novo adhesions following abdominal myomectomy., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.) more...
- Published
- 2014
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10. Early amniotomy after vaginal misoprostol for induction of labor: a randomized clinical trial.
- Author
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Makarem MH, Zahran KM, Abdellah MS, and Karen MA
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- Adult, Apgar Score, Delivery, Obstetric, Female, Humans, Infant, Newborn, Intensive Care, Neonatal, Labor, Induced adverse effects, Pregnancy, Time Factors, Young Adult, Amnion surgery, Labor, Induced methods, Misoprostol administration & dosage, Oxytocics administration & dosage
- Abstract
Objectives: To test the effectiveness and safety of early amniotomy after vaginal misoprostol for the induction of labor., Study Design: A randomized clinical trial that included 320 women with medical or obstetric indication for labor induction. They were randomly assigned into two equal groups, amniotomy group and control group. Each participant received vaginal misoprostol 50 μg every 6 h for induction of labor. In amniotomy group, amniotomy was done in the early active phase of labor while in the control group, the membranes were left to rupture spontaneously or as judged by the senior resident in the duty., Results: More subjects in the amniotomy group achieved vaginal delivery within 24 h than in the control group [117 (73.13 %) vs. 105 (65.63 %)]. Subjects in the amniotomy group reported shorter induction to delivery interval (09.72 ± 4.61 h vs. 13.61 ± 5.61, P = .002), and better neonatal outcome compared to the control group. There were no statistically significant differences between both group with regard to number of doses of misoprostol, need for oxytocin, Cesarean Section indication and maternal side effects., Conclusion: Early amniotomy after vaginal misoprostol for labor induction is associated with higher successful vaginal delivery rate, shorter labor duration and better neonatal outcome. more...
- Published
- 2013
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11. Trichloroacetic acid for the treatment of dysfunctional uterine bleeding: a pilot prospective clinical trial.
- Author
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Abdellah MS and Elsaman AM
- Subjects
- Administration, Topical, Adult, Dilatation and Curettage, Endometrium drug effects, Female, Hemoglobins analysis, Humans, Metrorrhagia surgery, Pilot Projects, Treatment Outcome, Uterus, Metrorrhagia drug therapy, Trichloroacetic Acid administration & dosage
- Abstract
Objective: The aim of the trial was to assess the safety and efficacy of tricholoroacetic acid for the treatment of dysfunctional uterine bleeding using topical versus intrauterine instillation., Study Design: In a pilot prospective randomized clinical trial, seventy women were randomly allocated to one of two groups. In Group I, the patients were subjected to intrauterine instillation of 95% tricholoroacetic acid. Group II underwent dilatation and curettage before topical application of 95% tricholoroacetic acid., Results: The groups were similar regarding baseline clinical characteristics. There was a satisfactory clinical reduction of menstrual flow (amenorrhea, hypomenorrhea and eumenorrhea) at a rate of 97.1% (Group I) and 85.7% (Group II) at 6 months. A significant increase was observed in the mean haemoglobin value at 3 and 6 months in both treatment groups (P<0.05). Group I showed a significant increase in haemoglobin level compared to Group II (P<0.05) and a significant reduction of the endometrial thickness compared to Group II (2.21 ± 0.41 versus 3.03 ± 3.37)., Conclusion: Trichloroacetic acid use for treating dysfunctional uterine bleeding seems to be efficient and safe, especially in women who do not require conception. Trichloroacetic acid intrauterine instillation is associated with longer duration of reduced menstrual bleeding than topical application., (Copyright © 2012. Published by Elsevier Ireland Ltd.) more...
- Published
- 2012
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12. Intravaginal administration of isosorbide mononitrate and misoprostol for cervical ripening and induction of labour: a randomized controlled trial.
- Author
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Abdellah MS, Hussien M, and Aboalhassan A
- Subjects
- Administration, Intravaginal, Adult, Double-Blind Method, Drug Synergism, Female, Humans, Infant, Newborn, Isosorbide Dinitrate administration & dosage, Pregnancy, Prospective Studies, Young Adult, Cervical Ripening drug effects, Isosorbide Dinitrate analogs & derivatives, Labor, Induced methods, Misoprostol administration & dosage, Nitric Oxide Donors administration & dosage, Oxytocics
- Abstract
Background: Labor induction in the presence of unfavorable cervix is a common indication for the use of prostaglandins. However, in the last years, there has been a considerable interest in the use of nitrous oxide donors for cervical ripening and labor induction., Objective: To evaluate the efficacy and safety of intravaginal administration of NOD isosorbide mononitrate (IMN) plus misoprostol versus misoprostol alone for cervical ripening and induction of labor., Setting: Department of Obstetrics and Gynecology, Woman's Health Center, Assiut University., Methods: Two hundred and ninety women scheduled for labor induction were recruited and assigned randomly to IMN or placebo followed by misoprostol 50 μg. The efficacy of the medication was evaluated by predetermined outcome variables for cervical ripening and induction of labor and delivery., Results: The two groups were comparable with respect to age, parity, gestational age, indication for induction, and Bishop's score. Women receiving IMN plus misoprostol showed significant changes in the Bishop score 6 h after administration as compared to misoprostol plus placebo (8.57 ± 1.46 vs. 7.6 ± 1.39 h, P = 0.001), significantly shorter intervals from the beginning of the induction to the beginning of the active phase of labor (10.97 ± 2.87 vs. 13.91 ± 2.16 h, P = 0.0004) and from the beginning of induction to the time of delivery (19.56 ± 3.96 vs. 23 ± 2.62 P ≤ 0.001). No significant differences in the incidence of uterine hypersystole, tachysystole and hyperstimulation. Regarding headache, much more women suffer headache in the IMN group (51) with significant difference to placebo group (11)., Conclusions: Using a combination of IMN and misoprostol is more efficient than misoprostol alone in terms of fast cervical ripening and shortening of induction-labour interval. more...
- Published
- 2011
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13. Reproductive outcome after letrozole versus laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome.
- Author
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Abdellah MS
- Subjects
- Adult, Anovulation etiology, Clomiphene therapeutic use, Drug Administration Schedule, Drug Resistance, Female, Humans, Infertility, Female drug therapy, Infertility, Female etiology, Letrozole, Pregnancy, Reproduction, Treatment Outcome, Anovulation therapy, Aromatase Inhibitors therapeutic use, Fertility Agents, Female therapeutic use, Infertility, Female therapy, Laparoscopy methods, Nitriles therapeutic use, Polycystic Ovary Syndrome complications, Triazoles therapeutic use
- Abstract
Objective: To compare the clinical outcomes of letrozole and laparoscopic ovarian drilling (LOD) in patients with clomiphene-citrate-resistant polycystic ovary syndrome (PCOS)., Methods: In the present prospective randomized trial, 140 women with clomiphene-citrate-resistant PCOS were randomly allocated to receive 5mg letrozole from day 3 to day 7 of menses for 6 consecutive cycles, or to undergo LOD. When a leading follicle of at least 18 mm was present, ovulation was triggered with human chorionic gonadotropin (hCG). The 6-month rates of ovulation, pregnancy, abortion, and live births were evaluated., Results: The groups were similar with regard to baseline clinical characteristics and hormonal profiles. The ovulation rate was significantly higher in the letrozole group than in the LOD group (59.0% versus 47.5%). On the days of the hCG injection, women in the letrozole group had a significantly thicker endometrium than those in the LOD group (P<0.0001). Women receiving letrozole had a higher pregnancy rate (35.7% versus 28.6%) and a lower rate of spontaneous abortion (8.0% versus 20.0%, respectively), but these differences were not statistically significant., Conclusion: Letrozole seems to be a suitable second-line ovulation-inducing alternative to LOD in women with PCOS who do not conceive with clomiphene citrate., (Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.) more...
- Published
- 2011
- Full Text
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14. Sublingual versus vaginal misoprostol for induction of labor at term: a randomized prospective placebo-controlled study.
- Author
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Zahran KM, Shahin AY, Abdellah MS, and Elsayh KI
- Subjects
- Administration, Intravaginal, Administration, Sublingual, Adult, Chi-Square Distribution, Double-Blind Method, Female, Humans, Infant, Newborn, Patient Satisfaction, Pregnancy, Prospective Studies, Cervical Ripening drug effects, Labor, Induced methods, Misoprostol administration & dosage, Oxytocics administration & dosage
- Abstract
Aims: To assess the effectiveness and safety of sublingual misoprostol (50 microg), compared with the same dose administered vaginally every 6 h for cervical ripening and labor induction in women with a viable fetus in the third trimester of pregnancy., Methods: This double-blind randomized prospective placebo-controlled trial included 480 women with medical or obstetric indications for labor induction and undilated, uneffaced cervices. The patients were assigned randomly to receive 50 microg of sublingual or 50 microg of vaginal misoprostol every 6 h for 24 h. Maternal and neonatal outcome were analyzed., Results: A total of 169 (70.4%) patients delivered vaginally in the sublingual group compared to 160 (66.7%) in the vaginal group. The main indications for cesarean section in both groups were fetal distress (33/71 [46.4%] vs 38/80 [47.5%]), followed by failure of labor progress. Thirty three (13.8%) patients in the sublingual group had meconium staining of the amniotic fluid compared to 39 (16.3%) in the vaginal group. There was no difference between the groups regarding the induction-to-delivery interval, duration of labor, neonatal outcome or maternal side-effects., Conclusion: Sublingual misoprostol is as effective as vaginal misoprostol for induction of labor at term. Moreover, the sublingual route is associated with a significantly higher patient satisfaction rate than vaginal misoprostol. more...
- Published
- 2009
- Full Text
- View/download PDF
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