Publications by authors named "Dina Mohamed Refaat Dakhly"

3 Publications

  • Page 1 of 1

The role of prophylactic internal iliac artery ligation in abnormally invasive placenta undergoing caesarean hysterectomy: a randomized control trial.

J Matern Fetal Neonatal Med 2019 Oct 25;32(20):3386-3392. Epub 2018 Apr 25.

a Department of Obstetrics and Gynaecology , Cairo University , Cairo , Egypt.

To identify the role of bilateral internal iliac artery (IIA) ligation on reducing blood loss in abnormally invasive placenta (AIP) undergoing caesarean hysterectomy. In this parallel-randomized control trial, 57 pregnant females with ultrasound features suggestive of AIP were enrolled. They were randomized into two groups; IIA group ( = 29 cases) performed bilateral IIA ligation followed by caesarean hysterectomies, while Control group ( = 28 cases) underwent caesarean hysterectomy only. The main outcome was the difference in the estimated intraoperative blood loss between the two groups. There was no significant difference between the two groups regarding the intraoperative estimated blood loss (1632 ± 804 versus 1698 ± 1251, value .83). The operative procedure duration (minutes) (223 ± 66 versus 171 ± 41.4, value .001) varied significantly between the two groups. Bilateral internal iliac artery ligation, in cases of AIP undergoing caesarean hysterectomy, is not recommended for routine practice to minimize blood loss intraoperatively.
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October 2019

Ultrasound-guided intrauterine device insertion: a step closer to painless insertion: a randomized control trial.

Eur J Contracept Reprod Health Care 2017 Oct 5;22(5):349-353. Epub 2017 Oct 5.

a Department of Obstetrics and Gynecology , Cairo University , Cairo , Egypt.

Aim Of Study: To reduce the pain and duration of the intrauterine device (IUD) insertion procedure through minimizing instrumentation and using trans-abdominal sonography (TAS).

Methods: This randomized control trial was conducted in a university hospital and included 102 eligible females, fulfilling the inclusion criteria. They were randomly assigned into two groups via 1:1 computer-based randomization program; the trans-abdominal guided IUD insertion group (n = 51), and the traditional IUD insertion group (n = 51). The main outcomes were the pain experienced during the procedure as scored by the visual analogue score and the duration of the procedure.

Results: The trans-abdominal guided IUD insertion was found to be statistically superior to the traditional technique for IUD insertion regarding the pain scores (according to the Visual Analogue Scale, from 0 to 10) recorded by the candidates (2.4 ± 2.1 vs. 5.0 ± 1.7, p < .001) as well as the time (in seconds) taken for IUD insertion procedure (32.2 ± 14.8 vs. 77.7 ± 30.6, p < .001).

Conclusions: Due to the decrease in pain and time taken for IUD insertion, the trans-abdominal guided technique can be used as a modified technique for IUD insertion. Identifier: NCT02582268.
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October 2017

Does the addition of growth hormone to the in vitro fertilization/intracytoplasmic sperm injection antagonist protocol improve outcomes in poor responders? A randomized, controlled trial.

Fertil Steril 2016 Mar 13;105(3):697-702. Epub 2015 Dec 13.

Department of Obstetrics and Gynaecology, Cairo University, Cairo, Egypt.

Objective: To evaluate the effectiveness of the addition of growth hormone (GH) to the antagonist protocol in IVF/intracytoplasmic sperm injection cycles in poor responders.

Design: Parallel randomized, controlled, open-label trial.

Setting: University hospital.

Patient(s): A total of 141 patients (GH, n = 68; gonadotropins only, n = 73) were enrolled. Twenty-five patients had their cycles cancelled. Analysis was performed per cycle start as well as per ET.

Intervention(s): Patients received the antagonist protocol with or without GH supplementation.

Main Outcome Measure(s): Mean number of cumulus complexes, metaphase II oocytes retrieved and fertilized, chemical and clinical pregnancy rates, early miscarriage rate, ongoing pregnancy and live birth rates.

Result(s): The addition of GH significantly lowered duration of hMG treatment, duration of GnRH antagonist treatment, and dose of gonadotropin. It significantly increased mean E2 levels on the day of hCG administration, number of collected oocytes (7.58 ± 1.40 vs. 4.90 ± 1.78 [mean ± SD]), number of metaphase II oocytes (4.53 ± 1.29 vs. 2.53 ± 1.18), number of fertilized oocytes (4.04 ± 0.96 vs. 2.42 ± 1.03), and number of transferred embryos (2.89 ± 0.45 vs. 2.03 ± 0.81). There was no significant difference in the clinical pregnancy rate per cycle (22.1% vs. 15.1%) or live birth rate per cycle (14.7% vs. 10.9%).

Conclusion(s): Growth hormone as an adjuvant treatment in IVF/intracytoplasmic sperm injection cycles for poor responders should be cautiously used with the antagonist protocol, because there is still no identified impact on pregnancy outcomes. However, evaluation of the clinical pregnancy and live birth rates in our data was limited by low statistical power.

Clinical Trial Registration Number: Identifier: NCT02195947.
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March 2016