Premature and early menopause: risk factors is Jordanian women

To identify risk factors associated with the onset of premature [<40 years] and early [40-45 years] menopause in a sample of Jordanian women. This prospective study was undertaken at Princess Aisha Medical Complex, Amman between August 2007 and February 2008. A total of 1,000 postmenopausal women were included. Factors taken into consideration were age at menarche, age at first delivery, parity, number of miscarriages, history of gynaecological or obstetric surgeries [ovarian, tubal and /or uterine], smoking status and history of premature menopause in first-degree relatives. Out of the 1,000 women, 129 [12.9%] had had menopause before the age of 46 years: 27 [2.7%] before the age of 40 and 102 [10.2%] before the age of 46 years. In these groups, the only statistically significant factor was history of premature menopause in fist-degree relatives. Interestingly, in women who had had menopause after the age of >/= 46 years, the rate of hysterectomies was statistically higher. Early and premature menopause is strongly associated with history of premature menopause first-degree relatives. No other factors studied proved to have any statistical significance

Misoprostol for termination of second trimester pregnancy in a scarred uterus

To investigate whether Misoprostol for mid-trimester pregnancy interruption in women with a scarred uterus has any adverse effects compared with those without a scar. During 5-year period from 2000-2004 at Queen Alia Military Hospital, Royal Medical Services, Amman, Jordan, a consecutive series of 520 women of 15-28 weeks of gestation who underwent termination of pregnancy were studied. Sixty-three patients had undergone at least previous one cesarean section and 457 served as control. Termination was undertaken using Misoprostol 400 ug vaginally as a starting dose followed by 200 ug vaginally every 6 hours, complications for each group were recorded. The induction to abortion time was not significantly different in both groups [p=0.16]; the median dosage was almost the same [p=0.31]. The rate of incomplete abortion was significantly higher in the study group than control 82% versus 60% and 11.5% versus 6.1% for bleeding of more than 500 cc, while the rate of other complications was almost the same. In the second trimester termination of pregnancy, the use of Misoprostol in women with previous single or multiple cesarean sections was not associated with excess complications

Brachial plexus injury in vaginal delivery

To study the incidence and persistence of brachial plexus injury [BPI] and the ability to predict its occurrence pre-natally depending on patients' criteria and antepartum-partum course. During a 3-year period from June 2001-June 2004 at Queen Alia Military Hospital, Royal Medical Services, Amman, Jordan, all newborns with BPI were identified [patients group] and followed-up for a one-year period. Obstetric details were compared with a control group who were delivered during the same period. Obstetrical neonatal features of both groups were compared. Over the mentioned period, 30 cases of BPI were identified from a total 11560 deliveries [0.25%]. Persistency for more than one year was present in 5 cases [17%]. Both groups were compared regarding certain known maternal and intra-partum risk factors. Significant risk was history of having shoulder dystocia in previous and current pregnancy [p<0.05] and duration of labor [p<0.05]. Brachial plexus impairment was encountered in the presence of normal course of labor and delivery. No predictable risk factors were found that could be avoided antenatally to prevent BPI