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This was a cross sectional study surveying a total of 451 physicians. A questionnaire was constructed and distributed electronically to the participants. The main outcome measure was evaluation of physicians' knowledge, attitude, and practice towards VBAC in Egypt. Although 76.3% of the physicians agreed to present VBAC as an option, 38.1% disagreed with encouraging it. Also, a large proportion of them advised against the induction of labour and refused it if post-term (69.4% and 76.1%, respectively). The physicians' attitude towards VBAC was to allow vaginal birth if the patient went into spontaneous labour (72.3%) and perform repeat CS if not in labour (86.7%). Fear of complications (78.71%) was the most common cause of not conducting VBAC. The consensus of practice was to present VBAC as an option for women with a single Caesarean scar; however, one-third of them did not encourage VBAC. They strongly refused the induction of labour. Impact Statement

Objective To evaluate domestic violence and sexual dysfunction in infertile women. Materials and methods We recruited women complaining of infertility (primary or secondary infertility). A control group of fertile women attending the outpatient clinic for any concern was recruited. Domestic violence was evaluated using the Arabic validated NorVold Domestic Abuse Questionnaire (NORAQ). Female sexual function was evaluated using the Arabic validated female sexual function index. Results There was no significant difference between both groups in rates of exposure to violence (p-value 0.830). Primary infertility was a significant contributing factor in infertile women's exposure to violence (p-value 0.001). All the studied population had female sexual dysfunction, with more dysfunction was reported by the infertile women (total score 18.87 ± 5.92, 19.51 ± 5.42, p-value 0.072). They differed significantly in arousal (2.83 ± 1.33, 3.13 ± 1.29, p-value 0.001) and satisfaction (3.98 ± 1.27, 4.28 ± 1.28, p-value 0.003) which were impaired in infertile women. Conclusions The recruited infertile women were exposed to violence. Emotional abuse was the most common reported type of violence. Sexual dysfunction was reported in the entire studied population with no significant difference relating to fertility.

Objective: Intracorporeal suturing is an effective hemostatic technique after laparoscopic ovarian cystectomy, but evidence of suturing superiority over electrocoagulation is lacking. This study co...

Introduction: Polycystic ovary syndrome is widely prevalent among adolescents and early diagnosis is crucial. While accurate diagnosis is not straightforward, anti-Mullerian hormone was found to be a reliable marker among young patients with polycystic ovary syndrome. However, its serum level was found to be affected by many other variables. This study assessed the relation between serum levels of anti-Mullerian hormone and body mass index in adolescents with polycystic ovary syndrome. Methods: This was a cross sectional analytical study, conducted at the Gynecology and Obstetrics outpatient clinics at Suez Canal University hospitals in Ismailia. It included 100 adolescents with PCOS who fulfilled the revised Rotterdam diagnostic criteria for PCOS, attending secondary stage or higher levels of education in Ismailia, Egypt. The recruited patients were divided into two groups. Group one reported to have BMI ≥ 30 and group two included those who have BMI < 30. Complete history taking, clinical examination (BMI) and biochemical markers including assessment of serum LH and AMH level, and ultrasound assessment to detect ovarian volume, antral follicular count, and presence of ovarian cysts. Results: AMH levels were not affected by BMI in adolescent patients with PCOS (r 0.19, p value 0.185). There were significant correlations between serum AMH and LH level, & between AMH and ovarian morphology among the studied population. The AMH was higher among those with menstrual irregularity and those with hyper-androginism. Accordingly, AMH level is not affected by patients' weight. Conclusion: The AMH was correlated to clinical and biochemical findings of PCOS.

Objective: To assess whether sildenafil citrate improves blood flow in fetal um- bilical arteries and middle cerebral arteries in pregnancies at high risk for fetal growth restriction. Methods: A quasi-experimental study was carried out at the Department of Ob- stetrics and Gynecology, Suez Canal University Hospital in Ismail- ia over the period from June 2017 to April 2018. Trans-abdominal obstetric ultrasonography (U/S) was done for 30 pregnant women aged24 to 35 years, gestational age ranged between 33- 36 weeks, at high risk for fetal growth restriction (mild pre-eclampsia, diabetes mellitus, history of previous pregnancy with a small for gestational age, stillbirth, severe pre-eclampsia or pregnancies with abnormal umbilical artery indices-above 90th centile). Fetal umbilical and middle cerebral artery blood flow Doppler indices were determined before and 2 and 6 hours after ingestion of sildenafil citrate 20 mg tablet. Results: There was a statistically significant decrease in umbilical artery Dop- pler indices before, two hours and six hours following sildenafil ci- trate therapy in the studied patients (P

Background Depression is a serious mental health disorder that might affect women in the childbearing period. Incidences increase during pregnancy as well as after delivery. Its association with intimate partner violence (defined as physical, sexual, or psychological harm by a current or former partner) has been reported in many countries. Data about this sensitive issue are lacking in Egypt. The aim of the study was to determine the relation between intimate partner violence and depression during pregnancy. Methods This was a case control study conducted at the outpatient clinics in Suez Canal University hospital, from January 2019 to March 2020. The study included two groups, the study group included women exposed to violence during the current pregnancy and a control one included women with no history of violence. Both groups were recruited according to the predetermined inclusion criteria (women aged 18-45 years, continuous marital relationship, no history of depression in current or previous pregnancies, and singleton pregnancy). Women were asked to complete the Arabic validated NorVold Domestic Abuse Questionnaire (measuring four types of abuse: emotional, physical, sexual, and violence in the health care system, the last one being excluded). Depression was evaluated using the Arabic validated form of the Edinburgh Postnatal Depression Scale (comprises 10 questions that represent patients’ feelings in the last 7 days). The main outcome measure was to assess the association between intimate partner violence and depression. Results We recruited 158 women in each group. Both groups were matched in their demographic characters. Although emotional violence was reported prominently among women exposed to IPV 87.9% (139/158), it was not significantly reported in depressed women (P value 0.084). Physical and sexual violence were significantly reported among depressed women (P value 0.022 and 0.001, respectively). There was a significant difference between women exposed to violence and those who were not exposed to violence in the total depression scores (13.63 ± 5.47 and 10.65 ± 5.44, respectively with a p value p value Conclusion There was a strong association between intimate partner violence and depression during pregnancy.

INTRODUCTION The levonorgestrel intrauterine system (LNG-IUS) is a long-acting hormone-releasing uterine device that has many non-contraceptive benefits. The study aims to assess the safety and efficacy of LNG-IUS in the management of adenomyosis. MATERIAL AND METHODS We searched the following bibliographic databases: MEDLINE via PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Google Scholar for the relevant studies which used LNG-IUS in management of patients with clinically or ultrasonographic diagnosed adenomyosis.The main outcome measures are pain score at the end of follow-up, bleeding, symptomatic relief, uterine volume (mL), endometrial thickness (mm) and/or hemoglobin level. RESULTS Ten prospective studies (patients n = 551) were included. The overall effect estimates showed that the LNG-IUS led to significant reductions in pain score after 12 months (standardized mean difference [SMD[ -3.87, 95% confidence interval [CI] -5.51 to -2.23, P

To evaluate the efficacy and safety of the Triple-P procedure as a conservative method in women with morbidly adherent placenta (MAP).A prospective trial conducted on 20 women performing elective cesarean sections (CS) at 37 weeks for anterior placenta previa accreta or increta. All women were young aged with low parity and previous CS deliveries. Triple-P procedure involved delivery of the fetus through a uterine incision placed above the upper border of the placenta, bilateral uterine arteries ligation immediately after delivery of the fetus followed by placental nonseparation and myometrial excision with reconstruction of the uterine wall in a T-shaped manner. The study outcome measures included duration of surgery, amount of intra and postoperative blood loss, Percentage of hemoglobin (Hb %) reduction, the need to perform hysterectomy and postoperative complications.Mean duration of surgery was 58 ± 1.8 min, mean intraoperative blood loss was 1.3 ± 0.3 l, mean postoperative blood loss was 180 ± 94 ml and mean Hb % reduction was 1.5 ± 0.1 g/dl. Only one case necessitated hysterectomy for severe bleeding.Triple-P procedure is a novel effective weapon that can replace hysterectomy in suitable women with MAP, especially in young patients with low parity.

Objective: To evaluate tender points number, pressure pain threshold and incidence of fibromyalgia in women with dyspareuniaPatients and Methods: Married women dyspareunia were compared to 35 healthy controls. Females were asked if they encountered sexual intercourse throughout the preceding month and dyspareunia was rated from zero to 3 by usingMarinoff Dyspareunia Scale (MDS). Dolorimeter (pressure algometer) was employed to assess pressure pain threshold. Diagnosis of Fibromyalgia was based on the 1990 American College of Rheumatology (ACR) criteria. Depression status of was assessed using the Beck Depression Inventory (BDI).Results: No significant statistical difference was found among both patients and control groups in relation to age, body mass index (BMI). Myalgic score and total tender point score was significantly lower in the dyspareunia group. Tender points score among dyspareunia patients was significantly higher. Themean score of Beck Depression Inventory (BDI) was 18.1±6.7 among dyspareunia group diagnosed with fibromyalgia compared to 11.3±4.1 in the dyspareunia group without fibromyalgiaConclusion: fibromyalgia is a contributing factor to dyspareunia

Objective: Domestic violence (DV) is an important social and public health problem affecting women globally. This study aims to assess the prevalence and risk factors of DV among infertile Egyptian...

Background The current fact of increasing rates of cesarean deliveries is a catastrophe. Recurrent cesareans result in intraperitoneal adhesions that would lead to maternal morbidity during delivery. Great efforts are directed towards the prediction of intraperitoneal adhesions to provide the best care for laboring women. The aim of the current study was to evaluate the role of abdominal striae and cesarean scar characters in the prediction of intraperitoneal adhesions. Methods This was a case- control study conducted in the emergency ward of the obstetrics and gynecology department of a tertiary hospital from June to December 2019. The study was carried on patients admitted to the ward fulfilling particular inclusion and exclusion criteria. The study included two groups, group one was assessed for the presence of striae, and the degree of intraperitoneal adhesions was evaluated during the current cesarean section. Group two included patients without evidence of abdominal striae. They were evaluated for the severity of adhesions also after evaluation of the previous scar. Evaluation of the striae was done using Davey’s scoring system. The scar was assessed using the Vancouver Scar Scale. The modified Nair’s scoring system was used to evaluate intraperitoneal adhesions. Results The study group included 203 women, while the control group included 205 women. There were significant differences in the demographic characters of the recruited patients (p-value 0.001 for almost all variables). The mean Davey score in those with mild, moderate, and severe striae was 1.82 ± 0.39, 3.57 ± 0.5, and 6.73 ± 0.94, respectively (p-value p-value p-value Conclusion Abdominal striae and cesarean scar were significant predictors for intraperitoneal adhesions.

To assess the knowledge, attitude, and practice of private obstetricians and gynaecologists towards abortion, post-abortion care, and post-abortion family planning.A cross-sectional study, from June 2017 to May 2018, using a self-administered questionnaire of 150 obstetricians/gynaecologists at private clinics, centres, hospitals in Ismailia, Egypt. The questionnaire was composed of four broad sections: section one was about the socio-demographic characteristics of the participants; section two was about physicians' knowledge, attitude and practices regarding abortion; section three was about their attitudes and practices regarding post-abortion family planning and screening for sexually transmitted diseases (STDs) in patients presenting for induced abortion; and section four was about the socio-demographic characteristics of women seeking induced abortion taken from the physicians' views.Only 15.2% of participants had performed an abortion for unwanted pregnancies at ≤12 weeks vs. 3.8% for unwanted pregnancies12 weeks' gestation. The most common reason for not performing an abortion was religious prohibition (80.35% vs. 86.6% for unwanted pregnancy ≤12 and12 weeks, respectively). Social causes were the most common reason for seeking an induced abortion. None of the physicians used manual vacuum aspiration (MVA) for abortion or had received training in MVA. Post-abortion family planning counselling was offered by 20.5% of physicians, while 13.6% screened for STDs.The majority of private obstetricians/gynaecologists in Ismailia, Egypt, do not perform abortions for unwanted pregnancies because of their religious beliefs. Post-abortion screening for STDs and family planning services are not sufficiently integrated into post-abortion care.

Objective: The current study aims to assess the prevalence of menopausal symptoms among postmenopausal Egyptian women and their effect on the quality of these women's lives.Study design: A ...

INTRODUCTION The levonorgestrel intrauterine system (LNG-IUS) is a long-acting hormone-releasing uterine device that has many non-contraceptive benefits. The study aims to assess the safety and efficacy of LNG-IUS in the management of adenomyosis. MATERIAL AND METHODS We searched the following bibliographic databases: MEDLINE via PubMed, SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Google Scholar for the relevant studies which used LNG-IUS in management of patients with clinically or ultrasonographic diagnosed adenomyosis.The main outcome measures are pain score at the end of follow-up, bleeding, symptomatic relief, uterine volume (mL), endometrial thickness (mm) and/or hemoglobin level. RESULTS Ten prospective studies (patients n = 551) were included. The overall effect estimates showed that the LNG-IUS led to significant reductions in pain score after 12 months (standardized mean difference [SMD[ -3.87, 95% confidence interval [CI] -5.51 to -2.23, P

To examine the incidence, causative factors, maternal and foetal outcomes and subsequent fertility in cases of uterine rupture in scarred and unscarred uteri.A 20 years' retrospective review was carried out where relevant data were collected from the medical records. Outcome measures included labour characteristics, operative procedures, maternal and perinatal outcome in addition to subsequent fertility.Forty-nine cases of complete uterine rupture were identified. Women in the unscarred group were older, had higher parity and heavier babies (p values0.05). Alternatively, the scarred group cases were associated with more silent rupture discovered at time of surgery, recession of the presenting part and more visceral involvement in particularly the urinary bladder. Admission to NICU and birth asphyxia were more frequent in the scarred group while stillbirth and early neonatal death were more common in the unscarred one. Twenty-four out of 49 cases had repair with no bilateral tubal ligation and out of these, 13 patients subsequently conceived and had 22 babies.Physicians should be vigilant to the risk factors and clinical presentations of uterine rupture during pregnancy. Cautious attempts to repair the ruptured uterus should be tried for patients' wellbeing and to help maintain fertility.