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Sickle cell disease (SCD) is a chronic genetic hematological disorder with multiorgan involvement and is associated with complications during the pregnancy. This is a well-known disorder in Saudi Arabia, but no study has reported its outcomes in pregnant Saudi females of the Eastern region. This study was carried out to compare the fetomaternal outcome in patients with SCD with those without SCD. This was a retrospective cohort study done in the Eastern Province of Saudi Arabia in a tertiary care, teaching hospital, by retrieving the data through the code ICD-9 for SCD, the control group was also selected with comparable characteristics. A total of 302 SCD pregnant patients were included for comparison with 600 pregnant women without SCD as control, during the period of Jan 1, 2008 to December 31, 2018. After the data retrieval, percentages of complications were calculated between the study and control groups. Fischer's exact test and t-test were used for statistical analysis by using SPSS version 22. The results showed higher complication rates in pregnancies of patients with SCD. Hypertensive disorders (13.3%), abruptio placenta (1.6%), intrauterine growth restriction (19.2%), thromboembolism (6.6%) and stroke (2.6%) were all higher in SCD as compared to the control group .The complications of SCD itself including anemia (89.4%), acute chest syndrome (13.2%) and sickle cell crisis (39.2%) were also increased during the pregnancy. Both still birth (3.3%) and neonatal intensive care unit admission (1.6%) were also higher in SCD. SCD during the pregnancy is a high-risk situation and can lead to many fetomaternal complications; however, preconceptional counselling, early booking, a careful monitoring during pregnancy and multidisciplinary management approach can prevent potential adverse outcome in this regard.

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Endometriosis is defined as the presence of endometrial tissue at the sites other than the uterine lining and responds to the cyclical ovarian hormonal activity. It is a multidimensional and a complex disease which has an impact on physical, mental, sexual, and social aspects of the life of a woman. Here is a case report of a patient, presented to the department with pain and swelling in her left side of the previous cesarean scar. It was surgically removed and was diagnosed to be an endometrioma of rectus sheath and rectus abdominis muscle on histopathology.

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Bariatric surgery (BS) is a novel treatment for weight reduction with longer lasting health benefits. This review aimed to summarise the available evidence regarding the fetomaternal outcomes and the most common challenges and complications in pregnancies following BS. Google Scholar (Google LLC, Mountain View, California, USA) and PubMed® (National Library of Medicine, Bethesda, Maryland, USA) databases were searched for articles published until December 2018. A total of 64 articles were included in this review and results showed that BS mitigates the risk of gestational diabetes mellitus, hypertensive disorders in pregnancy and fetal macrosomia. However, it can also have detrimental effects on fetomaternal health. There is paucity of data regarding small for gestational age intrauterine growth restriction, premature rupture of membranes and long-term effects on the children born to women who underwent BS.

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OBJECTIVE: This study sought to evaluate the safety of induction of labour with prostaglandin E2 (PGE2) gel in grand multiparous (GMP) women and to compare the labour outcome of GMP women who have undergone one previous Caesarean section (CS) with that of GMP women who never had a previous CS. METHODS: This prospective cohort study (Canadian Task Force Classification II-2) evaluated induction of labour with 1 mg of PGE2 gel in 96 GMP women with one previous CS (study group) and in 104 GMP women without previous CS (control group). RESULTS: One uterine rupture occurred in the study group (1%), and another occurred in the control group (0.9%). Additional oxytocin was used in seven patients (7.3%) in the study group and in 28 others (26.9%) in the control group (P = 0.002). Both uterine ruptures occurred with oxytocin augmentation. One case of uterine scar dehiscence was found in the study group. There was no significant difference between the study group and the control group regarding the rate of vaginal delivery (74 [77.1%] vs. 78 [75%]) or the rate of CS (21 [21.9%] vs. 24 [23.1%]), respectively. There was no significant difference between the groups in 5-minute Apgar scores ≤7. There was no neonatal death in either group. CONCLUSION: A low dose (1.0 mg) of PGE2 gel for induction of labour in GMP women with one previous CS is appropriate and appears to be safe for both mother and baby. Augmentation by oxytocin should be used judiciously.

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OBJECTIVE: The objective of this study was to compare obstetrical outcome in obese women with a body mass index (BMI) ≥29.9 kg/m2 and women with a normal BMI of 20-24.9 kg/m2. METHODS: This is a prospective cohort study of 300 Saudi females aged between 20 and 35 years in their first trimester of pregnancy and 300 nonobese pregnant controls attending the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. Patients with a preexisting disease were excluded from the study. RESULTS: A significantly higher proportion of obstetrical complications were seen among women with higher BMI compared with those with a normal BMI. The specific complications seen in obese women were gestational hypertension/preeclampsia, antepartum hemorrhage, gestational diabetes, postpartum hemorrhage, cesarean delivery, macrosomia, shoulder dystocia, birth asphyxia, neonatal intensive care admission, premature birth, wound complications and thromboembolism. CONCLUSION: Obesity in pregnancy is associated with higher fetomaternal morbidities and a comprehensive plan should be implemented to provide a better outcome for both women and their infants.

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OBJECTIVE: Preterm birth (PTB) increases the risk of adverse outcomes for new born infants. Subgingival bacteria are implicated in causing PTB. The aim of the present study was to assess the accuracy of some subgingival gram positive and gram negative bacteria detected by routine lab procedures in predicting PTB. METHODOLOGY: Pregnant Saudi women (n= 170) visiting King Fahad hospital, Dammam, Saudi Arabia, were included in a pilot cohort study. Plaque was collected in the 2nd trimester and screened for subgingival anaerobes using Vitek2. Pregnancy outcome (preterm/full term birth) was assessed at delivery. Sensitivity, specificity and positive and negative likelihood ratios were calculated for the identified bacteria to predict PTB. RESULTS: Data about time of delivery was available for 94 subjects and 22 (23.4%) had PTB. Three gram negative and 4 gram positive subgingival bacteria had sensitivity ≥ 95% with two of each having negative likelihood ratios ≤0.10. Three gram positive bacteria had specificity > 95% with only one having positive likelihood ratio >2. CONCLUSION: Subgingival bacteria identified using readily available lab techniques in the plaque of pregnant Saudi women in their 2nd trimester have useful potential to rule out PTB.