Badraoui Mh

Laparoscopic adhesiolysis for infertile patients with pelvic adhesive disease

Thirty patients with secondary infertility were subjected to laparoscopic adhesiolysis during the period January 1986 to February 1987 at Al‐Azhar Endoscopy and Microsurgery Unit. Second look laparoscopy (SLL) was performed after a period of 9–12 months. At laparoscopy, pelvic adhesive disease was staged according to the severity of the disease and compared with the finding at SLL. Five patients defaulted, three patients (12%) became pregnant and 22 patients underwent SLL. Ten patients (45.5%) showed no recurrence of adhesions. This study suggests that laparoscopy has a role in adhesiolysis of mild and moderate adhesions and SLL provides further opportunity to relyse reformed adhesions in some cases.

Effect of some progestational steroids on lactation in Egyptian women I. Milk yield during the first year of lactation

The effect of monthly injectios of 300 mg Depo-Provera or 150 mg Deladroxone, and of daily oral administration of .5 mg chlormadinone acetate or .3 mg quingestanol acetate on lactation was studied in Egyptian women during the 1st year of lactation. Women receiving Depo-Provera had the highest milk yield, followed by those taking Deladroxone and quingestanol acetate. The milk yields while taking these hormonal preparations were higher than in untreated controls. However, those women taking chlormadinone acetate had lower milk yields than untreated controls. The increased milk yield is probably due to the progestagenic activity, and minimal estrogenicity, of these drugs.

Effects of some progestational steroids on lactation

4 progestational contraceptive formulations were tested for their effects and effectiveness as contraceptives during postpartum lactation. 100 women were enrolled in the study and were divided into 4 groups: Group 1 monthly injections of 300 mg of Depo-Provera intramuscularly; Group 2 monthly intramuscular injections of 150 mg of Deladroxone (dihydroxyprogesterone acetophenide); Group 3 daily per oral administration of .5 mg of chlormadinone acetate; and Group 4 daily per oral administration of quingestanol acetate. Milk samples were collected on the 3rd 5th and 7th days and then monthly until the end of the 12th month for biochemical assays. Initiation of lactation was not affected by using any of the 4 progestogens. Milk yield was lowest in Group 3 but was basically comparable in all groups. Lipid content of milk showed no significant difference among groups receiving medication and between medicated groups and controls during the 1st month. Later drops were demonstrated. Lactose content showed a rise during the 3rd and 5th days postpartum in all groups as compared to controls and later it dropped. Body weights of infants in medicated groups and controls fell within established percentiles; however male and female infants of Groups 1 and 3 showed the greatest increment increase. No pregnancies occurred. Menstrual patterns are shown figuratively. Menstrual disturbances were however the main complaint and side effect of this postpartum contraception. Abdominal distension occurred in 12% of the Depo-Provera users and in 4% of the chlormadinone acetate group. 2% of Deladroxone users reported loss of hair. Depo-Provera showed the best results followed by Deladroxone quingestanol acetate and chlormadinone acetate.

Lactation patterns in Egyptian women II. Chemical composition of milk during the first year of lactation

In Part 1 of this study the amount of milk produced by lactating women were found to vary from one month to another and to be affected by maternal age parity and length of interval between deliveries. Part 2 of this study analyzes the milk samples of these 238 women for their total protein lipid and lactose content. Proteins were measured using the microkjeldahl method followed by direct nesslerization (mcMeekin 1924). Gerbers tube method was used to measure lipids while the modified Folin method was used to determine lactose content. The results show that protein content decreased gradually from the 2nd month of lactation and remained nearly constant during the last 5 months. Maternal age parity and length of inter-delivery intervals correlated with amount of protein produced. There was a strong correlation between inter-delivery intervals and protein content. The highest amount of lactose was produced during the 4th to 7th month of lactation decreasing gradually during the following months. The longer the inter-delivery intervals the higher the lactose content of the milk. Lipid content gradually increased during the course of the year and more so in the last 3 months. (Summary ARA)

Effect of some progestational steroids on lactation in egyptian women II. Chemical composition of milk during the first year of lactation

The effects of progestational steroids on the chemical composition of milk during the 1st year of lactation are described. The milk samples were analyzed for total protein lipid and lactose content. When compared with a group of nonmedicated women chlormadinone acetate Depo-Provera and Deladroxone all caused a marked increase in protein co ntent in the early stages of lactation while quingestanol acetate had little overall effect. The average protein content in gm% over the period was as follows: chlormadinone acetate 1.07 Depo-Provera 1.04 Deladroxone .96 quingestanol acetate .86 and controls .83. Lipid and lactose content showed irregular changes in the medicated groups as compared with the controls. The general trend towards an increase in milk protein with all 4 progestagens may be explained by the direct stimulating effect of their estrogenic metabolites on mammary tissue.

Lactation patterns in Egyptian women I. Milk yield during the first year of lactation

The milk yield in a group of 238 women who delivered normally at the Maternity Section of Al Azhar University Hospital in Cairo Egypt was estimated during the first 12 postpartum months in an effort to obtain a base line of information regarding variations in the quantity and chemical composition of milk during the 1st year of lactation. Overall the milk yield increased significantly from the 2nd month onwards. The increase continued at a slow pace and reached its maximum at the 7th month followed by a gradual decrease up to the 12th month of lactation. The mothers aged 21-30 years produced a better yield than mothers in the 18-20 or the 30 and older age group. The best yield was given by women with a parity of 2-4 and the longest of the inter-delivery intervals was also associated with a better yield.

The benefit of lactation amenorrhea as a contraceptive.

A group of 148 lactating women who delivered normally at El‐Galaa Hospital, Cairo, were followed up monthly for 1 year to study the pattern of lactation amenorrhea, the return of menstruation and ovulation, and the incidence of pregnancy. By the end of the sixth week postpartum, only 1.3% of the women had begun menstruating; the percentage gradually increased to 60.2% by the end of the first year. The amount of blood loss and the duration of menstruation increased gradually until the fourth postpartum menstrual period. Ovulation had occurred in 58.1% and pregnancy in 26.1% of all cases at the end of the 12th postpartum month. Among menstruating, lactating mothers, ovulation occurred in 86.5% and pregnancy in 32.6%, while in amenorrheic, lactating mothers only 6.1% had become pregnant at 1 year postpartum.

Minilaparotomy for Female Sterilization: A Feasibility Study of a New Technique

Hefnawi, F., Badraoui, M. H. H. and Serour, G. I. (Dept. of Obstetrics and Gynaecology, Al‐Azhar University Teaching Hospital, Cairo, Egypt). Minilaparotomy for female sterilization: A feasibility study of a new technique.

First trimester idiopathic recurrent miscarriage, protocol for management

complications of pregnancy were found: threatened abortion in 23 patients, spontaneous abortion in 2 women, late toxemia of pregnancy in 10 and immature delivery in 4 women, insufficiency of placenta of various stage in 12 patients, chronic fetal asphyxia in 10. Basically insufficiency of placenta was found in women with late toxemia of pregnancy. Cesarean section was performed in 15 women. Labor activity anomalies took place in 12 patients. All newborn were born alive, there were no perinatal losses. Despite of lactation was not suppressed, there was no signs of microadenoma progression in puerperium. The conclusion: the pregnancy in woman with hyperprolactinemia and infertility up to pregnancy is at high risk of obstetric and neonatal pathology.