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The Prognostic Value of BMI, Serum Glucose, Endometrial Echo Pattern and Uterine Artery Doppler Velocimetry as a Predictor for Endometrial Pathology in Women with Postmenopausal Bleeding (Prospective Observational Study)

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Open Journal of Obstetrics and Gynecology 2020年第1期10卷 13-24页

作者： yehia.a.wafa Ahmed T.Abd Alfattah Mohammed Sayed Korany Department of Obstetrics and Gynecology Faculty of MedicineAl Azhar UniversityCairoEgypt

Background: Post-menopausal bleeding is a warning sign that accounts for about 5% of all outpatient gynaecologic visits and is a common indication for referral to rapid access clinics because of the fear of underlying malignancy. Endometrial malignancies differ from other malignancies in that early symptomization is common, allowing early cure. Patients and Methods: During the study period, 100 women with post-menopausal bleeding having inclusion criteria were evaluated in Al Hussein University Hospital. For each patient full history, general, abdominal and pelvic examination was performed. Routine pre-operative investigations were done. Patients were divided into four groups: Group 1 included 29 patients with endometrial polyp. Group 2 included 34 patients with endometrial hyperplasia. Group 3 included 21 patients with atrophic endometrium. Group 4 included 16 patients with endometrial carcinoma. Results: As regards the predictive value of BMI, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. When discussing the predictive value of blood glucose level, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. It is worth to mention that the predictive value of endometrial thickness, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups providing the highest specificity and sensitivity. At the last the predictive value of uterine artery velocimetry, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. Conclusion: BMI, blood glucose level, endometrial thickness and uterine artery velocimetry indices, improve the prediction of endometrial carcinoma in women with post-menopausal bleeding.

关键词： BMI Serum Glucose Endometrial Echo Pattern Uterine Artery Doppler Velocimetry Endometrial Pathology Postmenopausal Bleeding

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Fetoscopy Role in Fetal Surgery and Fetal Medicine

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Open Journal of Obstetrics and Gynecology 2019年第11期9卷 1477-1485页

作者： Wael S. S. Elbanna Ibrahim A. Oun Emad M. Abd Ellatif Wael R. Hablas Walid I. El Shaikh yehia A. wafa Department of Obstetrics & Gynecology Al-Azhar University Cairo Egypt Department of Clinical Pathology Al-Azhar University Cairo Egypt

Aim: We attempted to illustrate our experience of fetoscopic therapy in a tertial institute, whereby to highlight the present Egyptian situation regarding this issue. We described fetoscopic therapy undergone at Al-Hussein Hospital, Al-Azhar University, Cairo, Egypt, from Dec-2012 to Sep-2019. Presentation of cases: Sixteen women with 17 fetuses were included in the analysis of this study with a mean age of 25.31 ± 6.15 years;four with positive marriage to a near relevant, and eight were primigravida. The fetus of twelve women had lower urinary tract obstruction (LUTO), two fetal anemia, one hydrothorax, and one twin-to-twin transfusion syndrome (TTTS). The mean time for fetoscopy was gestational week 24.13 ± 3.77. We did therapeutic drainage to amniotic fluid in hydrothorax and LUTO, therapeutic septostomy to the TTTS case, and blood transfusion in cases of fetal anemia. During the operation, the procedure succeeded in 14 out of 16 women. Overall, nine of the 16 women experienced some complications;five with rupture of membranes, four with preterm labor, and three with intrauterine fetal death (IUFD). Conclusion: Fetoscopy can manage LUTO and well-selected cases of TTTS, hydrothorax, and fetal anemia. The procedure is promising. Fetoscopic therapy has just begun in Egypt, and this report may contribute to the future advance of fetoscopic therapy in Egypt.

关键词： Fetoscopy Lower Urinary Tract Obstruction LUTO Twin-to-Twin Transfusion Syndrome Fetal Anemia Complications Rate

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Evaluation of Fetoscopy Role in Fetal Surgery and Fetal Medicine

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Open Journal of Obstetrics and Gynecology 2018年第11期8卷 946-957页

作者： Wael S. S. Elbanna Ibrahim A. Oun Emad M. Abd Ellatif Wael R. Hablas Walid I. El Shaikh yehia A. wafa Department of Obstetrics & Gynecology Azhar University Cairo Egypt Department of Clinical Pathology Azhar University Cairo Egypt

Introduction: This study aimed to evaluate, discuss and illustrate the role of fetoscopy diagnostically and therapeutically. Material and Methods: This study was conducted in private center in under the supervision of the professors of Azhar University, Egypt from Dec-2012 to Mar-2017. Women with confirmed fetal congenital malformations, and willing to do fetoscopy were recruited. Fetoscopy was attempted in all cases to treat the underlying fetal conditions. Follow up was made until delivery. Results: Twenty patients with 22 fetuses were included in this study with different congenital anomalies. Therapeutic drainage or coagulation was made in all cases. In cases of lower urinary tract obstruction, fetoscopy confirmed pre-suspected urethral atresia and changed the diagnosis from complete PUV to urethral atresia in some cases. The procedure succeeded in all cases. However, the on-going success rate was 17 (77.3%) of fetuses. The overall number of live birth was 11 fetuses (50%). Overall, 15 (75%) of the 20 patients experienced some complication withpreterm labor the most prevalent 15 (75%). Conclusion: Fetoscopy can diagnose and differentiate between posterior urethral valve (PUV) and atresia, and manage well-selected cases of twin to twin transfusion syndrome (TTTS), and have a reasonable survival rate in lower urinary tract obstruction (LUTO).

关键词： Fetoscopy Lower Urinary Tract Obstruction LUTO Twin-to-Twin Transfusion Syndrome Hydrocephalus Hydrothorax Sacrococcygeal Teratoma Complications Rate

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