ABSTRACT
To evaluate the prevalence, indications, and factors associated with successful induction of labor [IOL], and maternal and neonatal outcomes. All women booked for IOL at King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia from April 2010 to March 2011 were included. The characteristics of women who had successful IOL were compared to those who delivered by cesarean section [CS]. A multivariable logistic regression analysis was performed to evaluate the factors associated with successful IOL. During the study period, 564 women had IOL. The prevalence rate of IOL was 16%. Vaginal delivery was achieved in 472 [84%] women. The most common indications for IOL were post-term pregnancy in 174 [31%], and diabetes mellitus in 131 [23.2%] of the participants. Maternal characteristics associated with risk of CS were nulliparity [odds ratio: 1.58; 95% confidence interval: 1.09-2.320; p=0.01], and high maternal body mass index [p=0.01]. Neonates of women with successful IOL had significantly higher APGAR scores [p=0.04], and more frequent pH ?7.1 at delivery [p=0.02]. There was no difference in the rate of post-partum hemorrhage, CS, or ruptured uterus between the women who had IOL, and those who went into spontaneous labor. Nulliparity and maternal weight are the main determinants of the outcome of IOL. Case selection for IOL is vital for achieving outcomes similar to spontaneous labor
ABSTRACT
Saudi Arabia has no precise data on causes of death. We sought to ascertain the commonest causes of death as stated in death certificates of adults and evaluate the completeness of death certificates at a teaching hospital in Riyadh. A cross-sectional study carried out at King Khalid University Hospital in Riyadh, Saudi Arabia, during the year 2008. All death certificates that were issued in 2008 were reviewed and data were checked by two reviewers. Causes of death were coded according to specially-designed codes. The mean [SD] age of death was 63.9 [20.7] years. More than 80% arrived alive at the hospital. Among the 410 certificates, 62.2% had the first reported cause of death being classified as "inappropriate" and this tended to be slightly, but significantly more frequent among women. The first most common appropriately reported cause of death was malignancy of any type [7.3%] followed by ischemic heart diseases [4.9%]. Accidents and fractures were more common in the younger age groups and among men. This is the first study that documents the possible gaps among healthcare professionals in Saudi Arabia in their understanding of death and its certification based on the clinical assessment of the deceased. The findings needs to be validated by similar studies from other health care sectors. It is clear, however, that proven educational, system-related and legal interventions to improve the accuracy of death certification are strongly needed if the health care priorities are to be properly identified.