Hassan S. Kamel

Comparison of transvaginal ultrasonography and vaginal sonohysterography in the detection of endometrial polyps

Background. The diagnostic accuracy of transvaginal ultrasonography and vaginal sonohysterography in detecting endometrial polyps in women suffering abnormal uterine bleeding are compared.

Psychological and obstetrical responses of mothers following antenatal fetal sex identification.

This work was designed to study the impact of prenatal knowledge of fetal sex both on the psychological and obstetrical aspects of the expectant mothers during pregnancy and labour. One hundred pregnant women attending the outpatient antenatal clinic of Assiut University Hospital were recruited. All were in the third trimester, parous, with normal pregnancy and having no past or present psychiatric disorders. The desired sex of the expected child was registered. Symptom checklist 90 (SCL‐90) was applied before, and 2 weeks after sonographic fetal sex determination. Women who desired male sex scored significantly higher depressive symptoms than those who desired female sex. Women who were proven sonographically to have the undesired fetal sex showed significantly higher scores of depression, somatization, anxiety, hostility and phobia scales of SCL‐90 than women whose desired fetal sex was confirmed. The second part of the study to evaluate the effect of knowing the fetal sex on the progress of labour was designed as a case control study including 57 women previously informed about their fetal sex and 40 women ignorant of their fetal sex as controls. Women delivering a baby with undesired sex showed more obstetric difficulties. In the first stage of labour, they had significant reduction in frequency of uterine contractions and rate of cervical dilatation. They also needed much more sedation, analgesia and oxytocin augmentation.

Role of ultrasonography in managing IUD-related complaints

The study included 211 women using Cu-T 380A, of whom 155 presented with complaints related to IUD use. All women were examined by real-time ultrasound using abdominal sector and/or vaginal scanners. The parameters that were studied included the top-fundal distance (distance between the device top and the highest point in the uterine cavity), the intercornual and the fundus-isthmus diameters (of the uterine cavity). Any abnormal finding was also recorded. About 50% of complainers had top-fundal distance more than 4 mm, compared to 28% of non-complainers. An intercornual diameter, too small (less than 30 mm) or too wide (greater than or equal to 38 mm), was significantly more frequent in women complaining of bleeding and pain. Other abnormal findings were diagnosed in 25% of complainers compared to 7% in those without complaint. These findings included partial expulsion, appearance suggestive of pelvic inflammatory disease, ovarian swellings, embedding and fibroid uterus. Ultrasonography can give useful insights in managing IUD-related complaints in selected cases.

Simplified Biophysical Profile: An Antepartum Fetal Screening Test

A total of 330 high-risk pregnant women with gestational ages of 32–42 weeks were followed until delivery using the biophysical profile (BPP) and a screening test consisting of the amniotic fluid index together with fetal acoustic stimulation under ultrasound M-mode scanning. The test was compared with the BPP and nonstress test (NST) for predicting abnormal outcome. The sensitivities of the BPP, NST and the proposed test were 100, 98.4 and 100%, respectively, the negative predictive values were 100, 99.4 and 100%, while the false-positive rates were 21.3, 39.3 and 67%. Our simplified biophysical testing method is suggested to be a good negative preliminary screening test, while positive results require further fetal testing methods. This test reduced the need for BPP in many high-risk patients and had the advantages of simplicity, low cost and less time consumption.