RESUMEN
BACKGROUND: The relationship between periodontal disease (PD) and adverse pregnancy outcomes remain unclear. The authors' objective was to assess the risk of adverse pregnancy outcomes in Jordanian women with periodontal disease compared to those without. MATERIALS AND METHODS: Between April 2009 and June 2010, 277 pregnant women with no systemic diseases at gestational age < 20 weeks were enrolled in the study. Dental and oral health examination was performed at enrollment after demographic, medical, and obstetrical information were recorded. Pregnancy outcomes were obtained by phone contact and review of medical records. RESULTS: The incidence of periodontal disease in the pregnant women enrolled was 31%. Women with PD were at higher risk for developing preeclampsia (PE), preterm birth (PB), and low birth weight (LBW). The rate of PE in women with PD was 18.6% compared to 7.3% in the control group (p = 0.005) (OR = 2.7, 95% CI: 1.2, 6.0). The OR for PB was (4.4, 95% CI: 1.7, 11.7) and for LBW was (3.5, 95% CI: 1.6, 7.5). CONCLUSIONS: PD is associated with increased risk of PE, PB, and LBW in healthy Jordanian women.
Asunto(s)
Enfermedades Periodontales/epidemiología , Resultado del Embarazo , Adolescente , Adulto , Estudios de Cohortes , Femenino , Humanos , Jordania/epidemiología , Persona de Mediana Edad , Salud Bucal , Periodontitis/epidemiología , Preeclampsia/epidemiología , Embarazo , Nacimiento Prematuro/epidemiología , Adulto JovenRESUMEN
We evaluated the predictors of VBAC success in Jordanian women with a single previous low transverse caesarean section of a gestational age of at least 28 weeks, followed by a trial of spontaneous labour at two tertiary hospitals between January 2008 and February 2010. Among 207 women, 117 (57%) women achieved a successful VBAC. Multivariate analysis showed that a cervical dilatation of ≥ 7 cm at the time of previous caesarean section was an independent predictor of successful VBAC (with a success rate of 80%). Parity of ≥ 2 was significantly associated with increased odds of success (OR = 2.7, 95% CI: 1.2, 6.2). Compared with women who had no previous VBAC, those with previous VBAC had higher odds of success (OR = 3.8 (95% CI: 1.5, 9.5). We concluded that women with a previous caesarean section who achieved a cervical dilatation of ≥ 7 cm before caesarean, had a previous history of successful VBAC and had parity of ≥ 2, have the greatest likelihood of successful VBAC.
Asunto(s)
Primer Periodo del Trabajo de Parto , Parto Vaginal Después de Cesárea/estadística & datos numéricos , Adulto , Femenino , Humanos , Recién Nacido , Jordania , Embarazo , Estudios Retrospectivos , Adulto JovenRESUMEN
The objective of this retrospective study was to investigate the indications, interventions and clinical outcome of pregnant and newly delivered women admitted to the multidisciplinary intensive care unit at the King Abdullah University Hospital in Jordan over a 7-year period from January 2002 to December 2008. The collected data included demographic characteristics of the patients, mode of delivery, pre-existing medical conditions, reason for admission, specific intervention, length of stay and maternal outcome. A total of 43 women required admission to the intensive care unit (ICU), which represented 0.37% of all deliveries. The majority (95.3%) of patients were admitted to the ICU postpartum. The most common reasons for admissions were (pre)eclampsia (48.8%) and obstetric haemorrhage (37.2). The remainder included adult respiratory distress syndrome (6.9%), pulmonary embolism (2.3%) and neurological disorders (4.6%). Mechanical ventilation was required to support 18.6% of patients and transfusion of red blood cells was needed for 48.8% of patients. There were three maternal deaths (6.9%). A multidisciplinary team approach is essential to improve the management of hypertensive disorders and postpartum haemorrhage to achieve significant improvements in maternal outcome. A large, prospective study to know which women are at high risk of admission to the intensive care units and to prevent serious maternal morbidity and mortality is warranted.
Asunto(s)
Unidades de Cuidados Intensivos/estadística & datos numéricos , Complicaciones del Trabajo de Parto/mortalidad , Adulto , Femenino , Humanos , Jordania/epidemiología , Persona de Mediana Edad , Complicaciones del Trabajo de Parto/terapia , Admisión del Paciente , Embarazo , Estudios Retrospectivos , Adulto JovenRESUMEN
Umbilical cord prolapse (UCP) is an obstetric emergency. The objective of our study was to determine the frequency of cord prolapse, its aetiological factors and to evaluate fetal prognosis. This was a retrospective review of cord prolapse deliveries in the main two civil hospitals in North Jordan between 1995 and 2005, at Princess Badeea Hospital and at King Abdullah University Hospital (KAUH) in Irbid, North Jordan. There were 146 patients identified with UCP among a total of 64,192 consecutive births. The incidence of cord prolapse was one in 440 cases (146/64,192). It occurred mostly in women over 25 years, and significantly more in pre-term births, low birth weight babies, multigravida, and only a few were associated with induced cases. It was not associated with higher rates of perinatal mortality and this supports the benefit of clinical management of UCP by emergency (crash) delivery.
Asunto(s)
Enfermedades Fetales/epidemiología , Cordón Umbilical , Adulto , Estudios de Casos y Controles , Femenino , Hospitales de Enseñanza , Humanos , Jordania/epidemiología , Embarazo , Prolapso , Estudios Retrospectivos , Factores de RiesgoRESUMEN
BACKGROUND: Malpresentation is a deviation from the normal presentation, which occurs in approximately 5% of labours (Seeds and Cefalo in Clin Obstet Gynaecol 25:145-156, 1982). The commonest form of malpresentation at delivery is breech presentation followed by face and brow presentation. OBJECTIVES: To review the incidence and management of face and brow presentation in north of Jordan. MATERIALS AND METHODS: This was a retrospective review of the experience of face and brow presentation deliveries in the two main civil hospitals in north of Jordan between 1995 and 2005. RESULTS: The incidence of face and brow presentation was 1 in 813 and 1 in 1,689 deliveries, respectively. There was no significant increase in the incidence of prematurity nor very low birth weight and no higher incidence of postmaturity among those delivered by face or brow in the same period. All the foetuses presenting by the brow and by face (mentoposterior) and only 16.7 % of foetuses presenting by face (mentoanterior) were delivered by caesarian section. CONCLUSION: The incidence of face and brow presentation was 1 in 813 and 1 in 1,689 deliveries, respectively. All the babies presenting by brow presentation did undergo caesarean section. The management of face and brow presentation is heading towards a safe delivery and not merely to accomplish vaginal delivery.
Asunto(s)
Presentación en Trabajo de Parto , Complicaciones del Trabajo de Parto/epidemiología , Complicaciones del Trabajo de Parto/terapia , Adulto , Cesárea/estadística & datos numéricos , Estudios de Cohortes , Cara , Femenino , Humanos , Incidencia , Jordania/epidemiología , Complicaciones del Trabajo de Parto/diagnóstico , Embarazo , Estudios Retrospectivos , Factores de Riesgo , Resultado del TratamientoRESUMEN
We evaluated maternal complications in relation to number of previous caesarean sections in Princess Badea Teaching Hospital, Irbid, Jordan. Analysis of the medical records of 1739 patients delivered by caesarean section was conducted. It revealed a 14-fold increase in the risk of caesarean hysterectomy in patients with placenta praevia and previous caesarean section compared to patients with placenta praevia and no previous caesarean section. The risk of caesarean hysterectomy increased with increasing number of previous caesarean sections. Those with 3 or more previous caesarean sections were at significantly higher risk of blood transfusion. Post-operative pyrexia was commoner in women with 3 or more previous caesarean sections compared to those undergoing their first one.
Asunto(s)
Cesárea/efectos adversos , Resultado del Embarazo/epidemiología , Trastornos Puerperales , Transfusión Sanguínea/estadística & datos numéricos , Cesárea Repetida/efectos adversos , Femenino , Fiebre/epidemiología , Fiebre/etiología , Edad Gestacional , Hospitales de Enseñanza , Humanos , Histerectomía/estadística & datos numéricos , Jordania/epidemiología , Edad Materna , Mortalidad Materna , Paridad , Placenta Previa/epidemiología , Placenta Previa/etiología , Embarazo , Embarazo de Alto Riesgo , Trastornos Puerperales/epidemiología , Trastornos Puerperales/etiología , Estudios Retrospectivos , Factores de Riesgo , Esterilización Tubaria/estadística & datos numéricos , Dehiscencia de la Herida Operatoria/epidemiología , Dehiscencia de la Herida Operatoria/etiología , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/etiología , Rotura Uterina/epidemiología , Rotura Uterina/etiologíaRESUMEN
We investigated the complication rates of repeat caesarean deliveries in 3 hospitals (national health, military, university) in Irbid by examining the obstetric records of 989 women from 1 December 1999 to 30 March 2004. There was a statistically significant difference between the number of previous caesarean sections and hospital. In total, 579 (58.5%) patients underwent elective caesarean section. There were statistically significant differences between hospitals for "failure to progress in labour" and "other" indications for caesarean section. After adjusting for the number of caesarean sections, regression analysis revealed that women from the military and university hospitals were more likely to have placenta praevia. There were no statistically significant differences between hospitals as regards post-operative complications.
Asunto(s)
Cesárea Repetida/efectos adversos , Complicaciones Intraoperatorias/etiología , Complicaciones del Trabajo de Parto/etiología , Complicaciones Posoperatorias/etiología , Trastornos Puerperales/etiología , Adulto , Análisis de Varianza , Cesárea Repetida/estadística & datos numéricos , Procedimientos Quirúrgicos Electivos , Femenino , Hospitales Militares , Hospitales Públicos , Hospitales Universitarios , Humanos , Histerectomía/estadística & datos numéricos , Complicaciones Intraoperatorias/epidemiología , Jordania/epidemiología , Modelos Logísticos , Complicaciones del Trabajo de Parto/epidemiología , Selección de Paciente , Placenta Previa/etiología , Complicaciones Posoperatorias/epidemiología , Hemorragia Posparto/etiología , Embarazo , Trastornos Puerperales/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Infección de la Herida Quirúrgica/etiología , Rotura Uterina/etiologíaRESUMEN
OBJECTIVE: This study was designed to evaluate the predictive value of beta-hCG levels in predicting the pregnancy outcome. METHODS: A retrospective analysis was done on 423 pregnant patients following assisted conception (stimulated in vitro fertilization [SIVF] and stimulated intra uterine insemination [SIUI]). These were monitored with plasma beta-hCG on day +18 post hCG injection. Ongoing pregnancy was defined as greater than 20 weeks. RESULTS: Four hundred twenty three patients had a positive serum quantitative beta-hCG level 18 days post hCG injection. Of these 321 (75.9%) were ongoing pregnancies. The spontaneous miscarriages were 98 (23.2%), and four ectopic pregnancies were recorded. Of the successful pregnancies, 279 were single births, and 42 were multiple births (15.1%), that is either twins (31) or triplets (11). Tables were calculated to help predicting the pregnancy outcome. CONCLUSIONS: It can be shown that +18 levels of beta-hCG in cases of assisted conception are useful and provide predictive information concerning pregnancy outcome which should be helpful for the staff and the infertility patients.
Asunto(s)
Gonadotropina Coriónica Humana de Subunidad beta/sangre , Edad Gestacional , Técnicas Reproductivas , Aborto Espontáneo/sangre , Femenino , Fertilización In Vitro , Humanos , Inseminación Artificial , Embarazo , Resultado del Embarazo , Embarazo Ectópico/sangre , Embarazo Múltiple , Valores de Referencia , Trillizos , GemelosRESUMEN
In this study we tested the hypothesis of an association between consanguinity and pre-eclampsia/eclampsia. This is a case-control study conducted at Princess Badea Teaching Hospital, Irbid-Jordan during the period May 1997-April 1998. The study population were Jordanian women delivered at Princess Badea Teaching Hospital with or without hypertensive disorders of pregnancy. The total number was 208 pre-eclamptic/eclamptic women (76 primiparous and 132 multiparous) and 618 randomly selected non-hypertensive women. In primiparous as well as multiparous women, it was evident that neither consanguinity nor the degree of the relationship to the husband in consanguineous marriages had an impact on the incidence of preeclampsia/eclampsia. However, comparing the incidence of consanguinity between pre-eclamptic/eclamptic and non-hypertensive, multiparous women married to a relative other than first cousin, the P value was 0.0248, which we explained as chance incidence. When we compared the incidence of consanguineous marriages as a whole between pre-eclamptic/eclamptic and non-hypertensive, multiparous women, there was no evidence of any impact of consanguinity on the incidence of pre-eclampsia/eclampsia.
RESUMEN
The objective of this study was to explore details of the clinical relationship between meconium-stained amniotic fluid (MSAF) in labour, abnormal fetal heart pattern and meconium aspiration (MA). This was a prospective study carried out in Princess Badeea Teaching hospital during a 6-month period from March to September 1997. During the study period 344 (8.5%) of the deliveries had MSAF (344 women). Continuous fetal heart monitoring was routinely used and 36 women with MSAF (10.5%) needed to be delivered by caesarean section because of fetal distress (diagnosed by abnormal fetal heart pattern) in early labour, compared with 0.95% in those with clear amniotic fluid (CAF), (P <0.00001). Many infants in the MSAF group had a low Apgar score and required ventilation at birth. Nineteen infants (5.5%) developed MA, three of whom (15.8%) died. We conclude that there is an association between MSAF, abnormal fetal heart pattern in labour and a low Apgar score and that it should be considered a high risk situation. MA a problem that occurs with particulate meconium was significantly related to abnormal fetal heart pattern and longer length of labour.