Ultrasonographic wall thickness measurement of the upper and lower uterine segments in the prediction of the progress of preterm labour.

OBJECTIVE: To assess the role of ultrasonographic measurement of the upper and lower uterine segments wall thickness in predicting the progress of preterm labour in patients presenting with preterm labour pains. STUDY DESIGN: Fifty pregnant women presenting at Obstetrics Department - Suez Canal University, Egypt with regular lower abdominal pains and diagnosed as having preterm labour were enrolled in the study. MATERIALS AND METHODS: Measurements of the upper and lower uterine segments wall thickness by transabdominal ultrasonography in-between contractions and with full bladder were taken. The upper/lower uterine wall thickness ratio was calculated and correlated to the progress of the preterm labour and to the response to tocolytics. RESULTS: The ultrasonographic upper/lower uterine wall thickness ratio was directly related to the progress of preterm delivery (PTD). The change in this ratio is correlated inversely with the response to tocolysis. Using the ROC curve, when the upper/lower uterine wall thickness ratio was ≤ 1.26 the sensitivity was 94.74 and the specificity was 100.00, and when the ratio was ≤ 1.52 the sensitivity was 100.00 and the specificity was 83.33. CONCLUSIONS: These data may serve as a baseline ultrasonographic reference values for further studies in prediction the progress of preterm labour in patients presenting with preterm labour pains.

Prevalence of menopausal related symptoms and their impact on quality of life among Egyptian women.

OBJECTIVE: To assess the prevalence of menopausal-related symptoms and to evaluate their impact on quality of life (QoL) among a sample of menopausal women from Egypt. MATERIALS AND METHODS: A cross-sectional hospital-based study conducted at the Gynecology department, Suez Canal University, Ismailia - Egypt. A total 1,214 women aged 40 - 70 years were recruited and studied using an interview questionnaire. The questionnaire contains four main items: socio-demographic data, menstruation status assessment, modified Menopausal Rating Scale (MRS), and World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. RESULTS: Mean age was 48.1 ± 10.3 years, with 26.6% of the studied participants were illiterates. According to menstruation status, 40.9% of the studied women were postmenopausal, 41.4% were premenopausal, while 17.7% were perimenopausal. Most of the studied participants have mild/moderate somatic symptoms. Mild/moderate depressive mode, irritability, and anxiety have been reported in 63%, 58.4%, and 58.2% of women, respectively. Postmenopausal women have significantly higher scores on MRS except for urogenital score that was higher in perimenopausal women. They also had significantly lower QoL score in all subscales of WHOQOL-BREF except for psychological domain that was lowest among perimenopausal women. MRS total score has significant negative correlation to all domains of WHOQOL questionnaire. CONCLUSION: Postmenopausal women have higher prevalence of menopausal symptoms that significantly affect their quality of life more than pre- and perimenopausal women. Those in the transition period (perimenopausal) have higher prevalence of psychological symptoms with higher impact on their psychological welfare.

Intimate partner violence among Egyptian pregnant women: incidence, risk factors, and adverse maternal and fetal outcomes.

AIMS: To assess incidence and risk factors of intimate partner violence (IPV) during pregnancy among a sample of women from Egypt and to evaluate its impact on maternal and fetal adverse health outcomes. MATERIALS AND METHODS: After obtaining ethical approval, a total of 1,857 women aged 18 - 43 years completed the study and were investigated using an interview questionnaire. The questionnaire contains five main items: demographic characteristics of women, intimate partner characteristics, assessment of IPV during current pregnancy, and assessment of maternal as well as fetal/neonatal adverse outcomes. Women were also examined to detect signs of violence and identify injuries. RESULTS: Exposure to IPV during pregnancy was reported among 44.1% of the studied women. Emotional violence was the most common form. Women exposed to violence were of younger age, higher parity, and lower educational level. Their partners were older, less educated, and more likely to be addicted to drugs and alcohol. Women were also found to have significantly higher incidence of adverse pregnancy outcomes (miscarriage, preterm labor, and premature rupture of membrane), and fetal/neonatal adverse outcomes (fetal distress, fetal death, and low birth weight). A total of 297 cases had been exposed to physical violence (15.9%) vs 32.6% and 10% exposed to emotional and sexual violence, respectively. The most common form of physical violence was kicking. CONCLUSION: Violence during pregnancy is prevalent among Egyptian women. Exposure to violence was a significant risk factor for multiple adverse maternal and fetal health outcomes.

Rising cesarean section rates, a patient's perspective: experience from a high birth rate country.

PURPOSE OF INVESTIGATION: To investigate the effect of social class, education and antenatal care on cesarian section (CS) rate and women's preference for CS. MATERIALS AND METHODS: This is a descriptive study performed on 509 women attending postnatal clinics in three primary care units in Ismailia governorate, Egypt. The study performed via a structured questionnaire including questions related to background socio-demographic data, questions related to obstetrical history for the last pregnancy and delivery, and questions related to economic standards. RESULTS: The study included 266 participants (52.3%) that delivered by CS in their last delivery. CS rate was significantly higher in highly educated women and high economic standard. Only 29 (7.7%) reported that they had preferred CS as a method of delivery. Educational level and economic standards significantly affected the proportion of women preferring CS as a method of delivery (p = 0.02 and p = 0.01, respectively). In a stepwise logistic regression model, significant factors affecting CS rate were: the method of delivery preferred (p < 0.005) and educational level (p < 0.05). CONCLUSION: Educational level and economic standards significantly affected women's preference towards CS and CS rate.

Primary cytomegalovirus infection in pregnant Egyptian women confirmed by cytomegalovirus IgG avidity testing.

OBJECTIVE: To determine the frequency of primary cytomegalovirus (CMV) infection in pregnant Egyptian women using CMV IgG avidity testing. SUBJECTS AND METHODS: A cross-sectional study was conducted at Suez Canal University Hospital, Ismailia, Egypt. A total of 546 pregnant women, presenting for routine antenatal screening, were tested for CMV IgG and IgM using a commercially available enzyme-linked immunosorbent assay (ELISA). Sera from CMV IgM-positive women were tested by CMV IgG avidity assay. RESULTS: All the 546 pregnant women were seropositive for anti-CMV IgG. Of the 546 women, 40 (7.3%) were positive or equivocal for IgM antibodies. All sera from the 40 women (IgG+/IgM+) showed a high or intermediate CMV IgG avidity index. Of the 40 women, 23 (57.5%) were in the second or third trimesters of pregnancy and had their first-trimester blood retrieved, and the tested CMV IgG avidity assay showed a high avidity index. CONCLUSION: Women who were IgM positive had no primary CMV infection in the index pregnancy as evidenced by the high CMV IgG avidity testing.