Papers by Mohamed Fathalla
<p>* Both the provider and patient have given informed consent, as outlined in the PLOS con... more <p>* Both the provider and patient have given informed consent, as outlined in the PLOS consent form, to publication of their photograph.</p
![Research paper thumbnail of Treatments and outcomes for standardized cohorts of 1,000 women with shock from maternal hemorrhage, by NASG intervention scenario[1], [2]](https://a.academia-assets.com/images/blank-paper.jpg)
<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062282#po... more <p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062282#pone.0062282-Hogan1" target="_blank">[1]</a>. Proportion of cohort with severe shock (MAP<60) is 18% for Egypt and 72% for Nigeria. This is derived from clinical trial data<sup>15,16</sup>, combining pre and post trial periods.</p><p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0062282#pone.0062282-United1" target="_blank">[2]</a>. Top 3 definitive diagnoses by country and study phase: Egypt: [Pre (N = 432): Uterine atony (34%), Ectopic pregnancy (19%), Placental abruption (14%)] [Post (N = 558): Uterine atony (44%), Abortion complications (14%), Ectopic pregnancy (13%)] Nigeria [Pre (N = 175): Retained placenta (30%), Uterine atony (25%), Placental abruption (11%)] [Post (N = 277): (Uterine atony (26%), Retained placenta (23%), Placental abruption (17%)].</p
Journal of Obstetrics and Gynaecology, 2011
The current study aims to evaluate the incidence, maternaland perinatal outcomes in cases present... more The current study aims to evaluate the incidence, maternaland perinatal outcomes in cases presented with uterine rupture (UR) and to explore the differences in presentaon, management and outcome of UR in paents with scarred versus unscarred uterus. Materials and methods: A cross-seconal study conducted in a terary care hospital over a period of two years. The study included all women diagnosed with UR and admied to the emergency unit between January 2016 and December 2017. A structured quesonnaire was used to collect the preoperave demographic and clinical data. An observaon checklist was used for intraoperave findings and management. Postoperave data were collected about maternal and fetal outcomes. Data were analyzed using SPSS soware. Qualitave variables were compared between groups using Chi-square testwhile quantave variables were compared using Mann-Whitney test. Results: Sixty two women were diagnosed with Uterine Rupture (0.32% of all deliveries). The mean age of the included paents was 29.6 ± 5.6 years while the mean parity was 3.0 ± 1.8. Uterine repair was successful in 52 cases (83.9%).There were four (6.5%) maternal deaths and 42 (67.8%) perinatal deaths. Ten paents (16.1%) were transferred to the postoperave ICU. Re-exploraon was carried out in 3 cases. The most common complicaon of UR was DIC occurred in 8 women (12.9%). Maternal and perinatal mortality were significantly higher in paents with unscarred uterus (p=.0001 and .026 respecvely). Conclusions: The incidence of UR is 32/10,000 deliveries in our terary hospital. Rupture of unscarred uterus is associated with more maternal and fetal mortality. However, rupture of scarred uterus was more common due to the rising rate of cesarean secons.
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium... more Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The study aims to determine if the nonpneumatic antishock garment (NASG), a first aid compression device, decreases severe adverse outcomes from nonatonic obstetric haemorrhage. Women with nonatonic aetiologies (434), blood loss> 1000 mL, and signs of shock were eligible. Women received standard care during the preintervention phase (226) and standard care plus application of the garment in the NASG phase (208). Blood loss and extreme adverse outcomes (EAO-mortality and severe morbidity) were measured. Women who used the NASG had more estimated blood loss on admission. Mean measured blood loss was 370 mL in the preintervention phase and 258 mL in the NASG phase (P <0.0001). EAO decreased with use of the garment (2.9 % versus 4.4%, (OR 0.65, 95 % CI 0.24–1.76)). In conclusion, using the NASG improved maternal outcomes despite the worse...
The study aims to determine if the nonpneumatic antishock garment (NASG), a first aid compression... more The study aims to determine if the nonpneumatic antishock garment (NASG), a first aid compression device, decreases severe adverse outcomes from nonatonic obstetric haemorrhage. Women with nonatonic aetiologies (434), blood loss > 1000 mL, and signs of shock were eligible. Women received standard care during the preintervention phase (226) and standard care plus application of the garment in the NASG phase (208). Blood loss and extreme adverse outcomes (EAO-mortality and severe morbidity) were measured. Women who used the NASG had more estimated blood loss on admission. Mean measured blood loss was 370 mL in the preintervention phase and 258 mL in the NASG phase (P < 0.0001). EAO decreased with use of the garment (2.9% versus 4.4%, (OR 0.65,). In conclusion, using the NASG improved maternal outcomes despite the worse condition on study entry. These findings should be tested in larger studies.
American Journal of Obstetrics and Gynecology, 2019
2017). The UW severe UNC, nulliparous term singleton vertex (NTSV) and primary TSV CD rates befor... more 2017). The UW severe UNC, nulliparous term singleton vertex (NTSV) and primary TSV CD rates before and during CofS promotion were compared using chi-square or 2-tailed Fisher's exact test. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS: 89 (1.33%) of 6649 term infants had confirmed severe UNC, including neurologic(n¼32), respiratory(n¼25) and infectious morbidities(n¼12), shock(n¼10), transfer(n¼9) and neonatal demise(n¼1). The severe UNC rate was 0.88% during CofS promotion compared to 1.61% prior (OR 0.55, 95%CI 0.34-0.88; P¼0.014; Figure 1). The primary TSV CD rate increased during CofS (P¼.004) while the NTSV CD rates did not differ significantly (Table 1). CONCLUSION: CofS was associated with a 45% reduction in severe UNC and a 19% increase in primary TSV CD. CofS may be a useful addition to the labor management toolkit when seeking the ideal balance between maternal and infant outcomes.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Termination of pregnancy in second trimester is one of the greatest challenges in mod... more Background: Termination of pregnancy in second trimester is one of the greatest challenges in modern obstetrics practice and is more risky than during first trimester. Now the main concern of the obstetrician is to provide the most effective, safest, and cost-effective regimen with least or no complications. Describe the different indications, technique and complications of different methods of TOP used at Women’s Health Hospital, Assiut University. Identify gap between current practice and guidelines and setting recommendations for filling gap to improve outcomeMethods: Studying the different methods used for all cases with gestational age 13-24 weeks attending at Women′s Health Hospital, Assiut University from the 1st July 2015 to the 1st June 2016, for second trimester termination of pregnancy who are eligible for termination of pregnancy, with exclusion criteria including any case with scared uterus, multiple pregnancy and rupture of membranes.Results: Of the 146 patients, 55 p...
Reference Module in Biomedical Sciences, 2017
ABSTRACT A global overview of sexual and reproductive health provides reasons for public health, ... more ABSTRACT A global overview of sexual and reproductive health provides reasons for public health, development, and human rights concern. Improving the situation, alleviating the burden, and addressing the glaring inequity have been on the international and national agendas for many years now. Although progress has been made, it has been uneven, and major parts of the world still fall short of desired goals.The know-how is available. Cost-effective interventions are affordable. A sustained collaborative effort supported by political commitment, together with mobilization and rational allocation of resources, can bring about a brighter future for sexual and reproductive health.
To assess the prevalence and correlates of gynecologic and related morbidity in Omani women, a na... more To assess the prevalence and correlates of gynecologic and related morbidity in Omani women, a nationally representative sample of Omani women selected by a multi-stage, stratified probability sampling procedure was selected (total = 364). Questionnaire interview, physical and gynecological examination, and laboratory investigations were used to elicit information. The prevalence of lower reproductive tract infections was 22.4%, upper reproductive tract infections 2.7%, and cervical dysplasia was very rare. Genital prolapse was present in 10%, 11% had a urinary infection, 27% were anaemic, 23% were hypertensive, and 54% were either overweight or obese. The predictors of common morbidities were assessed using regression analysis according to a pre-specified conceptual model. ( 2004; 8[3]:188-197) Afin d'évaluer la prévalence et les corrélats de la morbidité associée et gynécologiques chez les femmes omanaises, un échantillon nationalement représentative des femmes omanaises qui été selectionné à travers un processus d'échantillonage de probabilité stratifiée à stades multiples a été selectionné (364 au total). Pour obtenir des renseignements, on s'est servi des interviews à questionnaire, des examens physiques et gynécologiques ainsi que des investigations de laboratoire. La prévalence des infections de la voie de reproduction inférieure était de 24%, des infections de la voie de reproduction supérieure était de 2,7% alors que la dysplasie cervicale était rare. 10% des femmes ont présenté le prolapsus génital, 11% avaient de l'infection urinaire, 27% ont été anémique, 23% ont été hypertendues et 54% avaient une surcharge pondérale ou étaient obèses. Les indices des morbidités ordinaires ont été évalués à l'aide de l'analyse de la regression d'après un modèle conceptuel pré-dénommé.
Clinical and Applied Thrombosis/Hemostasis, 2016
Background: Recurrent miscarriage (RM) is one of the most common clinical problems in reproductio... more Background: Recurrent miscarriage (RM) is one of the most common clinical problems in reproduction with no definite cause in about 50% of the cases. The study aims to evaluate the effect of low-molecular-weight heparin (LMWH) in the treatment of women with RM negatively tested for antiphospholipid antibodies (APAs). Methods: An open-labeled registered randomized controlled study (NCT 01608347) included women who attended the outpatient clinic in Assiut Women Health Hospital and Nag-Hamady Central Hospital, Egypt, with 3 or more unexplained RM. Eligible participants were randomly assigned into 2 groups. The study group included 150 patients receiving LMWH (Tinzaparin sodium 4500 IU) subcutaneous daily injection with 500 µg folic acid once daily orally started once positive pregnancy test till the 20th week of gestation. The control group included 150 patients receiving the same dose of folic acid alone. The primary outcome of the study was the rate of continuation of a viable pregnan...
Page 1. WHO Regional Publications Eastern Mediterranean Series 30 A Practical Guide for Health Re... more Page 1. WHO Regional Publications Eastern Mediterranean Series 30 A Practical Guide for Health Researchers Mahmoud F. Fathalla Professor of Obstetrics and Gynaecology Assiut University, Egypt Chairman, WHO Global ...
European Journal of Obstetrics and Gynecology and Reproductive Biology, Jan 9, 2008
The objective of this study was to compare reproductive function after two neurosurgical procedur... more The objective of this study was to compare reproductive function after two neurosurgical procedures for treating non-neoplastic hydrocephalus; endoscopic third ventriculostomy (ETV) and ventriculo-peritoneal shunt (VP). A cohort of 96 women who underwent neurosurgical procedures to treat non-neoplastic hydrocephalus at the Cleveland Clinic between January 1995 and January 2004 was identified. A follow up mailed survey was sent to all identified women between 15 and 45 years of age. In addition, phone interviews were performed to complete the required data. Clinical, laboratory and operative details were collected from 69 participants. There was a two-fold significant increase in the menstrual irregularities after the procedure in the ETV group [5/52(10%)-10/52(19%), P=0.03] while those treated with VP shunt maintained the same menstrual pattern postoperatively. The rate of pregnancy was higher in the VP group compared to the ETV group, but did not reach statistical significance [8/17(47%) vs. 17/52(33%), P=0.462]. Similarly, the rate of term pregnancies was higher in the VP group compared to ETV group [8/8(100%) vs. 13/17(76%), P=0.269], which reflected a higher spontaneous miscarriage rate in ETV compared to VP group [4/17(33%) vs. 0/8(0%), P=0.269]. ETV appears to alter reproductive function postoperatively. In patients who establish a pregnancy, abortion rates seem to be higher in the ETV group; however, a prospective study will be required to validate these observations.
Int J Gynecol Obstet, 2000
American journal of obstetrics and gynecology, Aug 5, 2016
Benign non-endometriotic ovarian cysts are very common and often require surgical excision. Howev... more Benign non-endometriotic ovarian cysts are very common and often require surgical excision. However, there has been a growing concern over the possible damaging effect of this surgery on ovarian reserve. The aim of this meta-analysis was to investigate the impact of excision of benign non-endometriotic ovarian cysts on ovarian reserve as determined by serum anti-Müllerian hormone (AMH) level. MEDLINE, Scopus, ScienceDirect and Embase were searched electronically. All prospective and retrospective cohort studies as well as randomised trials that analyzed changes of serum AMH concentrations after excision of benign non-endometriotic cysts were eligible. Twenty-five studies were identified, of which ten were included in this analysis. Two reviewers performed the data extraction independently. Pooled analysis of 367 patients showed a statistically significant decline in serum AMH concentration after ovarian cystectomy (weighted mean difference (WMD) -1.14 ng/ml; 95% confidence interval ...
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Papers by Mohamed Fathalla