where the enrolled patients will have the IUD applied in the middle of the uterine cavity and then attached to the fundus of the uterus by an absorbable suture "Hang up technique"

will include patients where IUD will be inserted after 6 weeks post-partum.

will serve as our control group where the enrolled patients will have the IUD just applied into the middle of the uterine cavity at the level of the fundus without attachment

IUD Insertion Complication

IUD; Complications, Infection or Inflammation

obstetrics and gynecology department, Kasr Alainy hospital

Comparing Expulsion Rates for Different Intrauterine Device Insertion Techniques

Comparing Expulsion Rates When Using "Hang Up" Intrauterine Device Insertion Technique to Postplacental and Postpartum Insertion

IUD expulsion among the 3 groups at different intervals 24hours, 6 weeks, 3 and 6months postpartum

postpartum fever (38 degrees celsius or above)

defined as irregular bleeding and menorrhagia discovered at 6 weeks, 3 and 6months postpartum

Defined as smelly odor, discharge diagnosed at 6 weeks, 3 and 6months postpartum

Defined as heavy bleeding after delivery diagnosed in the first 24 hours after labor

Ahmed M.Kamel

Asst. Professor of obstetrics and gynecology

Kasr El Aini Hospital

randomised computer generated table and closed envelope system

participants receive a single dose of 400mcg vaginal misoprostol preoperatively (60minutes before) during open myomectomy

Uterine Fibroid

insertion of a preoperative single dose 400 micrograms of Misoprostol Pfizer Brand placed vaginally

Misoprostol Pfizer Brand

participants in this arm will receive the standard of care which in our setting involves the use of either a tourniquet to control intraoperative blood loss especially if the fibroids are large or rarely, other interventions like oxytocin, tranexamic acid, vasopressin and occasionally not using either of the interventions.

Non-insertion of Misoprostol Pfizer Brand

Makerere University

The Efficacy and Safety of Preoperative Misoprostol in Blood-loss Reduction During Myomectomy.

Efficacy and Safety of Pre-operative Vaginal Misoprostol in Reduction of Intraoperative Blood Loss During Myomectomy. Amulticentre Single Blind Randomized Trial.

Soaked mops will be weighed and blood loss estimated by subtracting the soaked weight from the dry weight and by multiplying this by 1.060 (average density of human blood is 1.06g/ml); a volume in ml would be acquired. Only mops are intended to be routinely used during the operation for cleaning and clearing the operation field although measurement of blood collected in the suction cylinder in milliliters if used will also be added. Adequate mops will be provided to avoid any spillage onto the operating table polythene sheet. A standardized digital weighing scale will be availed in each operating room. Any spillage onto the bed, however, will be collected in a polythene sheet and poured into a measuring cylinder for quantification.

from incision time to time for insertion of last stitch

number of days spent within the hospital post-operatively

hemodynamic instability during and after open myomectomy following profuse hemorrhage as assessed by the clinicians.

death, massive transfusion >5 units of blood, development of deep venous thrombosis pulmonary edema and pulmonary embolism

Hemoglobin estimation done both pre- and post-operatively; difference between the two values to be a measure of amount of blood lost. patients that receive blood transfusion to be excluded.

College of Health Sciences

Principal Investigator

multicenter-randomized single blind controlled trial with a (1:1) allocation ratio.

Dengue Fever

Clinical Research Centre, Hospital Kuala Lumpur

The Clinical Epidemiology of Hospitalized Dengue Cases in Malaysia

Dr. Woon Yuan Liang

Doctor

Clinical Research Centre, Malaysia

25 micrograms/kg by subcutaneous injection once daily for four days, then once daily on day 1-7 during each of six consecutive menstrual cycles

Neumega (Oprelvekin, Interleukin 11, IL-11): 25 micrograms/kg by subcutaneous injection once daily for four days, then once daily on day 1-7 during each of six consecutive menstrual cycles

IL-11

Sex: Female, Male

Region of Enrollment

Subjective estimate of blood loss was measured by using a Pictorial blood assessment chart (PBAC) . The PBAC measures scores on a scale where 0 to 100 is normal and greater than 100-200 are abnormal.

>50% Reduction in PBAC (Pictorial Blood Assessment Chart) at 6 Months

No. of subjects with detectable VWFmRNA, a measure of IL-11 (interleukin-11) function, specifically increasing VWF synthesis.

No. of Subjects With Detectable VWF mRNA (Von Willebrand Factor Messenger RNA).

The number of subjects with IL-11 associated adverse events.

No. of Subjects With IL-11 Associated Adverse Events.

Overall Study

Dr. Margaret Ragni

Von Willebrand Disease

Oprelvekin, Interleukin 11, IL-11

Hemophilia Center of Western PA

IL-11 in Women With Von Willebrand Disease and Refractory Menorrhagia

Phase II Clinical Efficacy Trial of Recombinant Interleukin-11 (rhIL-11, Neumega) in Women With Type 1 Von Willebrand Disease and Refractory Menorrhagia

menorrhagia/feber

Comparing Expulsion Rates for Different Intrauterine Device Insertion Techniques

The Efficacy and Safety of Preoperative Misoprostol in Blood-loss Reduction During Myomectomy.

The Clinical Epidemiology of Hospitalized Dengue Cases in Malaysia

IL-11 in Women With Von Willebrand Disease and Refractory Menorrhagia

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