Cesarean Scar Defect has been linked to Obstetric and Gynecological pathology, with the high number of patients undergoing C-section end the frequency with which it is expected to have symptomatology, this prospective study try to find the frequency of Isthmocele, its symptomatology and with analysis of the literature propose factors to decide the best treatment. We confirmed the frequent of his presence, found that his symptomatology is based in spotting, dysmenorrhea and polymenorrhagia and found that the more symptomatic (RELEVANT) cases had cesarean scar defects bleeding producers and that the rest of symptomatic cases have cesarean scar defects bleeding collectors that often those not affect the daily life of the patient and don’t require treatment. Finely we propose bases to take in count to decide treatment.

The aim of this work is evaluation of different management options for patients with morbidly adherent placenta and its effect on pregnancy outcomes to find the best method of management to decrease morbidity and mortality. In this prospective study, there were 42 patients diagnosed as having morbidly adherent placenta previa and hospitalized between January 2019 to February 2020. Different management options performed to patients with morbidly adherent placenta previa were recorded, blood loss was estimated for each patient, operative procedures, maternal and fetal outcome was recorded. The results showed the following: Different methods were tried to preserve the uterus including bilateral uterine artery ligation in 13 (59%) cases, bilateral ovarian artery ligation in 3 (13.6%) cases, bilateral internal iliac artery ligation in 3 (13.6%) cases, intrauterine tamponade in 4 (18.1%) cases and hemostatic sutures in placental bed in 11(50%) cases, while B-lynch suture was not done, while procedures which were performed to control pelvic hemorrhage after hysterectomy included internal iliac artery ligation in 8 (27.5%) cases, pelvic packing in 5 (17.2%) cases and internal iliac balloon inflation to control hemorrhage in 1 (3.4%) case. The postoperative complications were DIC occurred in 2 patients (4.8%), ICU admission occurred in 5 cases (11.9%), two cases required reoperations, one patient (2.4%) had wound infection, Postpartum collapse occurred in 2 case (4.8%). Pulmonary embolism occurred in 1 case (2.4%), Median duration of hospital stay was 4 days (range: 2-25).

Accurate calculation of fetal weight relies on two equally important factors: the use of a formula with strong intrinsic properties, and the use of sonographic biometric parameters that are not susceptible to errors in measurement. From a statistical perspective, the inclusion of multiple variables in a model improves multicollinearity chances and decreases each measurements internal error. Precisely predicting estimated fetal weight during childbirth may have a significant impact on successful obstetric management, especially in the case of suspected macrosomia or low birth weight. Macrosomic fetuses can cause maternal and neonatal complications during childbirth, and low-born fetuses are at increased risk for perinatal morbidity and mortality. The main aim of the study was to assess the accuracy of measurement of mid-thigh soft tissue thickness and femur length, in estimation of expected fetal birth weight The study was conducted during the period January 2017 to August 2019, at Tanta University hospitals, Obstetrics & Gynecology department. 65 pregnant ladies at term (between 37-40weeks) were included in the study. Results: Mean difference between fetal weight by Hadlock formulae and actual fetal weight is -10.88g; percent difference is (0.32%). The difference statistically insignificant p>0.05. Mean difference between fetal weight by Scioscias formulae and Actual fetal weight is 2.83; the percent difference is (0.08%). The difference statistically insignificant p>0.05. Good agreement between Hadlock formulae and Actual Fetal Weight Kappa value (0.73).Also shows moderate agreement between Scioscias formulae and Actual Fetal Weight Kappa value (0.52). area under curve Hadlock formulae (0.79), Scioscias formulae (0.78) for detecting fetal weight =3500gm among pregnant women at 39-40 weeks of gestation. Conclusion: The mid-thigh soft tissue thickness and femur length can be used in estimation of expected fetal birth weight like as other sonographic parameters. The validity of Scioscias formulae is not better than Hadlock formulae in detection of fetal weight less than 3500 gm. The validity of both formulae Scioscias and Hadlock in detection of fetal weight more than 3500 gm. Reduced and cannot be dependable in extremes of weight.

Postmenopausal vaginal bleeding is a sign that should not be Ultrasound imaging has become an effective diagnostic tool of gynecological practice throughout the years. Endometrial diagnosis typically involves invasive investigational approaches. Today, however, with the advent of high-resolution transvaginal ultrasound and Doppler ultrasonography (non-invasive diagnostic tool), is an alternative candidate to replace invasive approaches. The aim of this study is to evaluate the contribution of the terms and definitions described by the IETA group when designing a malignancy model for better diagnosis of malignancy in cases with postmenopausal uterine bleeding. In the present study 120 patients with postmenopausal bleeding were included in the study. The study was conducted from April 2017 to April 2019 at Tanta University hospitals, Obstetrics & Gynecology and Diagnostic Radiology departments. Both patients were subjected to the following: full history taking, general examination, local examination, 2D transvaginal ultrasonography, Doppler study, hysteroscopy examination, endometrial biopsy. Symptomatic postmenopausal women with endometrial thickness > 5 mm have been chosen because women with a lower endometrial thickness have a very low incidence of cancer and a prospective evaluation. In this study: The best cut off value for endometrial thickness in predicting malignancy was =12mm. Doppler color content score > 2 showed differentiation between benign and malignant cases. IETA Doppler vascular pattern showed multiple vessel pattern was found in 70% in cases of endometrial cancers. An endometrial malignancy model was designed including the five significant variables with accuracy about 95% and AUC 0.9 consisted of Endo. thick. =12mm, heterogenous endometrium, irreg. endo. midline, ll defined endo. myo. interface, Doppler Score >2. The best cut off score that have the highest positive predictive value, highest +v likelihood ratio and the largest area under receiver operator curve was =10. Conclusion: We may conclude that: applying a malignant model for postmenopausal bleeding cases allows for easy classification of cases into low and high risk, with the ability to restrict the invasive procedure on dangerous cases only for better diagnosis of endometrial cancer.