Aim of the study: To evaluate the value of uterine artery Doppler indices and waveformpattern in predicting fetuses at risk for intrauterine growth restriction in hypertensive
disorders of pregnancy. Materials and methods: This was a prospective cross-sectional
study including 80 pregnant subjects with hypertensive disorders of pregnancy and two
control groups. Uterine artery Doppler sonography was performed in all study participants.
Uterine artery Doppler indices across the groups were compared using the analysis
of variance (ANOVA) while the presence of prediastolic notch was analyzed with the Chi
Square test. Results: For the hypertensive disorders of pregnancy group, resistivity index
> 0.66 had a sensitivity of 50.0%, specificity of 69.1% and a positive predictive value of
22.2% for predicting intrauterine growth restriction. The odds ratio was 2.2 with a 95%
confidence interval of 0.6–7.8. The presence of prediastolic notching had a sensitivity of
100.0%, specificity of 96.0% and a positive predictive value of 80.0% for predicting intrauterine
growth restriction. The odds ratio was 22.7 with a 95% confidence interval of
7.5–68.5. Conclusion: Uterine artery Doppler sonography is useful for predicting fetuses
at risk for intrauterine growth restriction in hypertensive disorder of pregnancy. Prediastolic
notching is more sensitive and more specific than uterine artery resistivity index in
predicting fetuses at risk of intrauterine growth restriction in established hypertensive
disorder of pregnancy.

Background: Adequate post-operative pain control is essential for smooth recovery after surgery. This study assessed the opioid-sparing effect of immediate post-induction intramuscular midazolam in patients who underwent myomectomy under general anesthesia.Methods: This is a randomized double-blinded controlled study of sixty ASA I and II female patients allocated into three groups. Group A received intramuscular midazolam 0.1mg/kg, group B received intramuscular diclofenac 75mg while group C had a placebo following induction of anesthesia. All patients had morphine 0.1mg/kg for intraoperative analgesia before skin incision. Pain scores were compared at recovery, then at 1st, 2nd, 4th and 8th post-operative hours. In addition, the total opioid consumption over the first 24 hours postoperatively was compared between the three groups.
Results: The pain scores at the end of surgery, 1st and 2nd hours were comparable in the 3 groups; however there was statistically significant difference at the 4th hour postoperatively (p = 0.0001), with lowest pain scores in the midazolam and diclofenac groups (3.70 ± 0.66 and 3.80 ± 1.01 respectively) compared to the placebo group (4.75 ± 0.79). The total additional opioid (pentazocine) consumption in first 24 hour after surgery was significantly reduced in the midazolam group (105.00 ± 15.39 mg) compared to diclofenac and placebo groups (112.50 ± 13.33 mg, and 121.50 ± 18.14 mg respectively, p = 0.007).
Conclusion: Post induction intramuscular Midazolam at 0.1mg/kg appears to have a better opioid sparing effect compared to intramuscular diclofenac 75mg in the early postoperative period
following myomectomy done under general anesthesia.