Impact of parity on early cesarean scar healing

Background: with increasing cesarean delivery rate the cesarean scar defects and related consequences should be evaluated

Aim of the work: this study aimed to assess impact of parity on cesarean scar wound healing

Methods: a prospective observational study was conducted on 51 females with singleton term pregnancy that underwent uncomplicated prelabor primary cesarean section. 6 weeks later they underwent saline hystrosalpingography. Females with medical diseases that can affect the healing process or received medications can affect wound healing as corticosteroids or anticoagulant were excluded. Women used intrauterine device as a contraceptive method inserted during CS, women with any structural uterine abnormality as cervical stenosis or fibroid uterus or with pelvic infection at the time of saline hystrosalpingography were excluded from this study

Results: 75% of the primiparous had CS niche, while, 82.9% of the multiparous group had CS defect [p=0.512]. The most prevalent shape of CS defect in the participants was the triangular shape [45.1%] followed by irregular defect [31.4%]. The anterior myometrial thickness and the residual myometrial thickness were significantly higher among primiparous women with negative correlation between parity, anterior and residual myometrial thickness [rho = - 0.917 and -0.753 respectively]

Conclusion: parity was associated with significant reduction of both the anterior and residual myometrial thickness

Effect of immediate versus early oral hydration on caesarean section postoperative outcomes: a randomized controlled trial

Background: Caesarean sections are increasing in number dramatically all over the world. So, it became very important to give more attention for their postoperative care. Objective: to evaluate the effect of immediate oral hydration initiated within 2 hours after uncomplicated Caesarean Section on the following post-operative outcomes: post-operative vomiting and abdominal distention, post-operative nausea and abdominal pain, the return of intestinal movements, duration of intravenous fluid administration, duration of hospital stay and participant satisfaction

Methods: this randomized controlled study was conducted at Ain Shams University Maternity Hospital. It was carried during the period from July 2016 to July 2017. 140 women, all of them underwent uncomplicated Cesarean Section under regional anesthesia were randomly assigned into two groups. In the immediate group: oral hydration was received in the first 2 hours postoperatively, and in the early group: oral hydration was received after 8 hours postoperatively

Results: all the results of the postoperative outcomes of both groups had non-significant differences except for the psychological satisfaction which was significantly higher in the immediate group with a [p<0.001]

Conclusion: immediate oral hydration group showed non-significant differences comparing with early oral hydration group regarding most of the postoperative outcomes, but the results were relatively better towards the immediate group. Also, immediate hydration is significantly better than early hydration regarding psychological satisfaction of women, allowing them to be more able to breastfeed their kids and to spend a less stressful time in the hospital

Effect of immediate versus early oral hydration on caesarean section postoperative outcomes: a randomized controlled trial

Background: caesarean sections performed every year are increasing in number dramatically all over the world. So, it became very important to give more attention for their postoperative care

Aim of the Work: to evaluate the effect of immediate oral hydration initiated within 2 hours after uncomplicated caesarean section on the following post-operative outcomes: post-operative vomiting and abdominal distention, post-operative nausea and abdominal pain, the return of intestinal movements, duration of intravenous fluid administration, duration of hospital stay and participant satisfaction

Patients and Methods: this randomized controlled study was conducted at Ain Shams University Maternity Hospital. It was carried during the period from July 2016 to July 2017. 140 women, all of them underwent uncomplicated cesarean section under regional anesthesia were randomly assigned into two groups. In the immediate group: oral hydration was received in the first 2 hours postoperatively, and in the early group: oral hydration was received after 8 hours postoperatively

Results: all the results of the postoperative outcomes of both groups had non-significant differences except for the psychological satisfaction which was significantly higher in the immediate group with a [p<0.001]

Conclusion: immediate oral hydration group showed non-significant differences comparing with early oral hydration group regarding most of the postoperative outcomes, but the results were relatively better towards the immediate group. Also, immediate hydration is significantly better than early hydration regarding psychological satisfaction of women, allowing them to be more able to breastfeed their kids and to spend a less stressful time in the hospital

TSH and AMH in infertile women

Introduction: Infertility is defined as the inability of a couple to achieve pregnancy over an average period of one year [in women under 35 years of age] or 6 months [in women above 35 years of age] of unprotected sexual intercourse. Infertility can be due to female, male reasons or both. It can be either primary or secondary

Aim of the work: The aim of this study is to evaluate the association between thyroid function and serum AMH levels

Methodology: Type of the study: this study was conducted a case control study. Study site: This study was carried out at Ain-Shams maternity hospital [outpatient infertility clinic]. Duration of study: In the period between December 2015 and December 2016. Patients and study design: According to the sample size calculation by using the IBM Sample Power Software [IBM Corp., Armonk, NY, USA], the study performed on 128 women divided into 2 equal groups as follows: Group "1" [study group]: 64 infertile women at reproductive age [20-35] years. Group "2" [Control group]: 64 normal fertile women aged [20- 35] years

Result: TSH and patient age that were strongly correlated with AMH levels in 26 post-matched infertile patients using multivariate logistic regression. Both TSH levels and patient age significantly impacted AMH levels in infertile patients

Conclusion: AMH levels were inversely correlated with TSH levels in infertile women of reproductive age

Recommendations: The study should be done using larger sample sizes in a multicenter trial including both urban and rural areas to validate results. Autoimmune thyroid antibodies [thyroglobulin antibody and thyroid peroxidase antibody] could be assessed with TSH, FT4, FT3 and AMH as there is a strong association between infertility and autoimmune thyroid antibodies