Publications by authors named "Ahmed S S A Rashwan"

3 Publications

  • Page 1 of 1

Comparative study regarding effect of pH on Misoprostol in induction of labor in full term primigravida pregnant women, a double blind randomized controlled trial.

J Perinat Med 2020 Aug 18;49(1):43-49. Epub 2020 Aug 18.

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Objectives: To evaluate the effect of altering vaginal pH on induction of labor in full-term pregnancies using Misoprostol.

Methods: This randomized controlled trial was conducted at Kasralainy Hospital, Cairo University, Egypt and Algezeera Hospital, Egypt. A total of 218 healthy term primigravida pregnant women who were scheduled for pregnancy termination were recruited in the study. The included patients were divided into three groups; Group A: Those who received normal saline vaginal wash (0.9% NaCl), Group B: those who received alkaline vaginal wash (5% sodium bicarbonate) and Group C: those who received acidic vaginal wash (5% acetic acid). Patients received 25 μg of Misoprostol E1 (Vagiprost® Adwia Pharmaceuticals, Egypt) every 6 h for a maximum of 24 h (total of four potential doses).

Results: The 'acid' group participants took a mean time of 20.46 h to reach active stage of labor, followed by the 'normal saline' group with 21.45 h and the 'alkaline' group with 22.59 h. The difference between the groups was statistically significant, with a p-value of 0.013.

Conclusions: Douching the vagina with acidic solution seems to supplement the effect of Misoprostol on inducing labor in full-term pregnancies, as evidenced by having the shortest mean time needed to reach active stage of labor.
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http://dx.doi.org/10.1515/jpm-2020-0212DOI Listing
August 2020

Vaginal Dinoprostone in Reducing Pain Perception During Diagnostic Office Hysteroscopy in Postmenopausal Women: A Randomized, Double-Blind, Placebo-Controlled Trial.

J Minim Invasive Gynecol 2020 May - Jun;27(4):847-853. Epub 2019 Aug 1.

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt (Drs. Samy, Rashwan, Metwally, Hammad, Ibrahim, Elzahaby, Zaki, and Sharkawy).

Study Objective: To evaluate the efficacy of vaginal dinoprostone in reducing pain perception during diagnostic office hysteroscopy (OH) in postmenopausal women.

Design: Randomized, double-blind controlled trial.

Setting: Tertiary university hospital.

Participants: Postmenopausal patients scheduled for OH.

Interventions: Eligible participants were randomized in a 1:1 ratio to the dinoprostone and placebo groups. The severity of pain was assessed with a visual analog scale (VAS) ranging from 0, no pain to 10, worst pain during OH and 30 minutes after OH.

Measurements And Main Results: The difference in the intensity of pain using the VAS score during the procedure. One hundred women (50 in each arm) were included in the study. The mean VAS score during OH was significantly lower in the dinoprostone group compared with the placebo group (3.9 ± 0.8 vs 5.6 ± 0.7; p <.001). The passage of the hysteroscope through the cervical canal was easier in the dinoprostone group (62.4 ± 9.5 vs 42.8 ± 10.8; p <.001). The 2 groups were comparable in terms of the duration of the procedure (p = .91) and the rate of adverse effects.

Conclusion: Vaginal dinoprostone is effective in relieving pain during diagnostic OH in postmenopausal women with few adverse effects.
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http://dx.doi.org/10.1016/j.jmig.2019.07.026DOI Listing
August 2019

The efficacy of intrauterine misoprostol during cesarean section in prevention of primary PPH, a randomized controlled trial.

J Matern Fetal Neonatal Med 2020 May 26;33(9):1459-1465. Epub 2018 Sep 26.

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Postpartum hemorrhage is the leading cause of maternal mortality worldwide. To compare the incidence of postpartum hemorrhage in women eligible for elective cesarean section (CS) delivery when using intrauterine misoprostol added to oxytocin versus oxytocin alone. This parallel randomized controlled trial study was conducted in two institutions in Egypt (Kasralainy and Aljazeerah hospital) 0.300 women eligible for elective CS delivery were enrolled in the study. Before randomization, all women received the same preparations. After randomization; in the study group ( = 150), intrauterine misoprostol was used after placental delivery. In the control group ( = 150), the routine oxytocin alone was used. Both groups were comparable (-value >.05) with regard to the age, BMI, and gestational age as well as hemoglobin and hematocrit levels. The incidence of postpartum hemorrhage was significantly lower ( = .018) in the study group (1.33%) than the control group (6.67%). The absolute risk reduction was 5.3% (CI 95%: 0.8-10.6%) with a relative risk of 0.20 (CI 95%: 0.05-0.90) and number needed to treat (NNT) 19 (CI 95%: 125-9). Moreover, the needs for a blood transfusion, extra uterotonics or additional interventions were significantly lower in the study group than in the control group ( < .05). All the three parameters of blood loss ie the mean blood loss, and the mean reductions of hemoglobin and hematocrit levels were significantly (value <.05) lower in the study group (mean and SD) (442.59 and 151.33 mL,0.46 and 0.3 g/dL, and 0.84 and 0.56%), respectively than in the control group (591.01 and 287.97 mL,1.2 and 1.39 g/dL, and 3.47 and 3.52%), respectively. Adverse events were comparable between groups; these were fever, nausea, and vomiting and shivering. Intrauterine misoprostol (400 mg) when added to oxytocin is safe and effective in decreasing the incidence of postpartum hemorrhage (PPH) and reducing the amount of postpartum blood loss in case of elective CS delivery.
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http://dx.doi.org/10.1080/14767058.2018.1519796DOI Listing
May 2020