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Badawy, A. N., M. S. El-Basiouny, M. Bibars, S. Salama, M. Maged, amr mostafa, G. Elshorbagy, D. Saeed, E. M. H. Ebrashy, and A. H. Elnoury, "Effect of vaginal CO2 laser therapy in mixed urinary incontinence.", Fizjoterapia Polska , vol. 23, issue (5); , pp. 191-196, 2023.
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Khalil, K., M. Cherine, A. Elnoury, H. Sholkamy, M. Breebaart, and N. Hassanein, "Labor augmentation in an Egyptian teaching hospital.", International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, vol. 85, issue 1, pp. 74-80, 2004. Abstract

OBJECTIVES: The study documented facility-based obstetric practices for normal labor in Egypt for the first time, to determine their relationship to evidence-based medicine. This paper describes the labor augmentation pattern observed.

METHODS: 176 cases of normal labor were observed by medically-trained observers using a checklist. Ward activities were also documented. Observed women were interviewed postpartum and all findings were shared with the providers for their feedback.

RESULTS: Labor was augmented in 91% (165) of the labors observed; this was inappropriate for 93% or 154 women. Reasons for inappropriateness were: oxytocin ordered at the first vaginal exam (41%); in spite of intact membranes (36%), at the time of membrane rupture (42%), in spite of good progress (24%), or a combination of these. The monitoring of oxytocin-receiving women and their babies was inadequate.

CONCLUSIONS: Labor augmentation and monitoring deviated from evidence-based guidelines. Obstacles to implementing protocols need to be explored.

Cherine, M., K. Khalil, N. Hassanein, H. Sholkamy, M. Breebaart, and A. Elnoury, "Management of the third stage of labor in an Egyptian teaching hospital.", International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, vol. 87, issue 1, pp. 54-8, 2004. Abstract

OBJECTIVES: The study describes normal labor practices in an Egyptian teaching hospital for the first time, where postpartum hemorrhage is the leading cause of maternal mortality. Third-stage management patterns are described and compared to evidence-based medicine. Reasons for third-stage practices observed are explored.

STUDY DESIGN: 176 normal births were directly observed. Women were interviewed postpartum and study findings were shared with providers.

RESULTS: Third-stage active management was correctly done for 15% of women observed. Most common deviations for the remaining 85% were: giving uterotonic drugs after placental delivery (65%) and without cord traction (49%). Passive management was not done for any observed delivery.

CONCLUSIONS: The preventive role actively managing the third stage can provide against postpartum hemorrhage was lost to the majority of the deliveries observed. Obstacles to adopting protocols shown to reduce hemorrhage should be explored, given the contribution of postpartum hemorrhage to maternal deaths in Egypt.

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