Prospective study of delivery after previous one caesarean section at king Hussein medical center

To evaluate the mode of delivery and safety of vaginal delivery in women with previous caesarean section at King Hussein Medical Centre. Three hundred thirty women with previous caesarean sections were enrolled into the study. Age, parity and indication for the previous caesarean sections were recorded. All events of labour were also recorded [mode of delivery, apgar scores, birth weight, and duration of oxytocin and prostaglandin use]. Intrapartum and postpartum complications were recorded Analysis of the rate of vaginal delivery was made in relation to parity and the indication for the previous caesarean section. The mean age of women was 29.2 years [19-45]. One hundred and twenty six [38%] were Para 1. Overall, the vaginal delivery rate was 71% Among women who had one previous caesarean section 62% achieved vaginal delivery. Overall 11.8% of women had an elective caesarean section. The highest vaginal delivery rate was in patients who had caesarean section for breech presentation [74%], followed by fetal distress [68%]. Even in women, where the previous caesarean section was due to failed progress, 55% achieved vaginal delivery. There was one case of ruptured uterus in the vaginal delivery group, which resulted in a perinatal mortality. The mean birth weight was 3.168 for the vaginal delivery group and 3.4 kg for the caesarean section group. Trial of labour alter previous caesarean section can be very successful with vaginal delivery rate reaching 62%. Even when the previous caesarean section was due to failed progress, vaginal delivery was achieved in 55% of cases. Although the risks of vaginal delivery were small in our series, these should not be overlooked when making decisions regarding mode of delivery after previous caesarean section

significance of bacteriuria and previous history in prediction of urinary tract infection in pregnancy

To study the value of a history of previous urinary tract infection, and presena of asymptomatic bacteriuria in antenatal prediction of urinary tract infection in pregnancy. A total number of 1420 pregnant women were included in our study, at King Hussein Medical Centre Between 1997-2000. The records of all patients were reviewed, and results for significant bacteriuria were noted together with any previous history of urinary tract infection. The prevalence of urinary tract infection was detected clinically and bacteriologically according to the presence or absence of asymptomatic bacteriuria and previous history of urinary tract infection. A total number of 1420 pregnant woman were involved in this study; All were screened for the presence of bacteriuria and a previous urinary tract infection. About 9% had significant bacteriuria, and 17% had a previous history of urinary tract infection. Around 22.5% of bacteriuric-positive women had a previous history, compared to about 16% of a bacteriuric-negative group. Twelve present of the women with a previous history of urinary tract infection had asymptomatic bacteriuria, compared with 8.5% in those without a prviouse history. The overall incidence of urinary tract infection in pregnancy was about 3%. Urinary tract infection occurred in 12.4% of bacteriuric-positive women, compared with about 2% in bacteriuric-negative group. A bout 63% of women with urinary tract infection were not predicted by the bacteriuric screening. Urinary tract infection in pregnancy developed in about 8% of women with a previous history, compared with about 2% in those without a previous history. Fifty seven percent of women with urinary tract infection were not predicted by a previous history screening method. The use of both screening methods would predict only 7 of the 44 [15.9%] women with urinary tract infection. Prediction of urinary tract infection by bacteriuria testing is unsatisfactory. A combination of both asymptomatic bacteruria and a previous history of urinary tract infection signify a considerable risk

Oxytocin and syntometrine in prevention of postpartum hemorrhage

To compare the effect and side-effects of intramuscular syntometrine and syntocinon in the management of the third stage of labor. Five hundred eighty-three women with a singleton pregnancy and normal vaginal delivery were randomly allocated to receive syntometrine [n=293] or oxytocin [n=290] at Queen Alia Military Hospital between 1° February 30th April 1997. The rate of postpartum hemorrhage and side effects of syntometrine and oxytocin in the two groups were statistically compared using chi-square test. No statistical significant difference was found between both groups, for postpartum hemorrhage at the end of 2nd and 3rd stage of labour. However, there were significant statistical differences in the incidence of side effects [Nausea, vomiting, hypertension] at the end of 2nd and 3rd stage of labor between both groups. Intramuscular Oxytocin is equally effective to intramuscular syntometrine in prevention of post-partum hemorrhage, but carried less side effects and complication in comparison to intramuscular syntometrine

Molar pregnancy in A 53-year-old patient

We report a case of hydatidiform mole in a 53-years-old patient referred to Gynecology and Obstetric Department at King Hussein Medical Center with irregular vaginal bleeding; she was found to have a mole and underwent total abdominal hysterectomy and bilateral salpingoophorectomy