Neonatal hyperbilirubinemia following the use of oxytocin in labour

90 full term pregnant mothers aged 18-35 years with non-complicated normal pregnancy, they were divided into 3 groups: - 30 patients were given syntocinon drip for induction of labour. - 30 patients were given syntocinon for acceleration of labour. - 30 patients had spontaneous labour and not given syntocinon and considered as control group. Mothers with possible maternofetal blood group iso immunisation were excluded. The babies were healthy full term with gestational age of 38-41 weeks, birth weight of 2.8-3.8 Kg, and with Apgar score of 7 or more at one minute. Blood sample was taken from the newborn at birth and after 72 hours for total bilirubin level. It was found that all cases of the first group showed highly significant results when compared to the control group. In the second group the results are not highly significant when compared to the control group. Oxytocin may induce neonatal hyperbilirubinemia in cases of induced labour of normal pregnant women. It is advisable to avoid unnecessary use of oxytocin in labour unless it is really indicated and to keep its total dose to a minimum and to limit the volume of the infusion to be as small as possible to avoid the risk of water intoxication

Correlation of ultrasound findings and endometrial histopathology in women with abnormal uterine bleeding

30 patients with abnormal uterine bleeding were chosen from the gynecology clinic for the study. Their age ranged from 26-60 years [10 in the childbearing period and 20 in the postmenopausal period], they were investigated with ultrasound to the pelvic organs especially the thickness of the uterine mucosa, and an endometrial biopsy was taken under general anaesthesia for histological examination. The sonographic data and histopathological results were correlated with each other and were statistically analysed. Ultrasonography is a good method for diagnosing any gynecological pathology as a cause for the abnormal uterine bleeding also it is a good method for screening of uterine neoplasm in presymptomatic postmenopausal women. An endometrial thickness of 5mm is an appropriate cut off level for conservative management of patients with post menopausal bleeding not receiving hormonal treatment, also in screening for endometrial carcinoma. An endometrial thickness of 10mm. or more in the childbearing period as measured by ultrasonography must be considered for further histopathological examination

Colposcopy of the postmenopausal cervix

With modern life about one third of human females live in the post menopausal period and spend about one third of their life in it. The colposcope is a low power binocular microscope which allows the cervix to be viewed stereoscopically at magnifications of x6 to x40, aiming at detection of the changes in the epithelium, subepithelium and vascular pattern. It is an easy, practical, inexpensive, accurate and with no morbidity. The cervix in the postmenopause shows some changes which makes colposcopy difficult, the cervix decreases in size and elasticity with narrowing of the cervical canal and external os. The region of the external os is pushed up into the cervical canal. In the postmenopause the squamous epithelium is atrophic, pale red in colour. Colposcopy is used to evaluate the cervix in cases of abnormal cytology. 48 postmenopausal women were selected for the study. the changes that occur in the cervix were studied cytologically by papanicolaou smear and colposcopically by the colposcope and the results were correlated. The cytology was abnormal in 42 patients, chronic cervicitis was a common finding in cervical smears. The colposcopy was unsatisfactory in 21 patients, [43.75% of the cases studied] atrophic epithelium was common in this group. 2 cases of squamous cell carcinoma were picked up in this study. Cytology and colposcopy are complimentary to each other, the accuracy of diagnosis increases by the combination of both and this can give an accuracy of up to 95%

Obstetric behavior of grandmultipara- A retrospective study

This retrospective study included 1298 grandmultipara who had delivered 5 or more viable babies out of 9443 total deliveries in the year 1984 at Madina Maternity Hospital, Saudi Arabia. The incidence was 13.75%. The mean age was 35 +/- 5.2 years. 21.3% of them were para 6 and 7.1% were para 10 more. This group was compared with mothers Para 0 to 4 who had delivered in the same hospital, in the same year [8145 deliveries]. All the data were collected from the files of all patients and comparison between the two groups was carried out. It was found that the incidence of obstetrical and medical complications of pregnancy, and that of labour was increased in the grandmultipara group than in the Para 0-4 group, there was an increase in the maternal and perinatal mortality among the grandmultipara group. As all the complications of pregnancy and labour are much frequent among grandmultipara and the risk increases with parity, these women must be considered as high risk patients. They must be booked at a consultant unit, have a good sympathetic care, and have a hospital delivery. Good councelling about family planning should start during the antenatal period. The use of oxytocin is dangerous in the grandmultipara, even with the closest supervision as it may not be able to prevent sudden and catastrophic uterine rupture, the frequent occurence of malpresentations adds to this risk