Effectiveness of prophylactic cervical cerclage in prolonging higher-order multiple pregnancies

Objectives: This study aimed to assess the value of prophylactic cervical cerclage in prolonging higherorder multiple pregnancies

Methods: This retrospective study included all women with higher-order multiple pregnancies beyond 24 gestational weeks treated at the King Abdullah University Hospital in Irbid, Jordan, and King Fahad Medical City in Riyadh, Saudi Arabia, between February 2014 and January 2015. Selected maternal characteristics and obstetric outcomes were compared between women who received prophylactic cervical cerclage and those who did not

Results: A total of 146 women with higher-order multiple pregnancies were included in the study; of these, 94 [64.4%] underwent a prophylactic cervical cerclage insertion procedure and 52 [35.6%] women did not. No significant difference was found between the two groups with regards to maternal age, parity or number of fetuses. However, the mean gestational age at delivery was significantly higher for women without compared to those with prophylactic cervical cerclage [32.9 weeks versus 31.7 weeks] according to both univariate and multivariate analyses [P = 0.013 and 0.046, respectively]. Additionally, 40.4% of women without and 14.9% of women with prophylactic cervical cerclage gave birth after 34 gestational weeks [P = 0.003]

Conclusion: Overall, prophylactic cervical cerclage was not associated with prolongation of the pregnancy among women with higherorder multiple pregnancies in the current study

The use of human mature cystic ovarian teratoma as a model to study the development of human lymphatics / 대한해부학회지

The angiogenic theory to the development of human lymphatics is not clear. The objective of this study was to investigate the development of human lymphatics. Semi-thin and thin paraffin sections from human mature cystic ovarian teratoma tissues were studied using light and electron microscopy. Lymphatics were formed by the differentiation of mesenchymal cells that gradually acquired morphological features of endothelial cells. It is suggested that in human mature cystic ovarian teratoma the lymphatic endothelium develops from mesenchymal cells, and not from cells derived from mature endothelium of a preexisting vein or lymphatic.

Acute transient puerperal psychosis: a case report

Postpartum psychosis occurs in 1 to 2 cases per 1000 post-partum women. This includes psychotic and bipolar disease. The impact of puerperal psychosis on the relationship between mother and infant could have long-termadverse effects on both mother and child. Former mental illness is a major risk factor for puerperal psychosis, but the effect of other independent factors, such as birth complications and side effects of drugs and their interactions, it is not clear. Some independent risks can be elucidated as causative factors of puerperal psychosis through the study of mothers that are affected by it, for the first time, in the puerperium. Few reports have addressed this problem. We report, for the first time, a case of acute transient puerperal psychosis.

Traditional practices for newborns care: the north of Jordan perspective

Jordan has witnessed a noticeable increase in women education and employment. A descriptive study of the traditional care practices of mothers for their newborn babies is exhibited here. Household Cross- sectional population survey in the north of Jordan was conducted over a 4-week period in July, 2004. Mothers of children less than five years of age at time of questionnaire were selected using systematic random sampling technique till the required sample of mothers was completed. Four common issues were studied including; circumcision, umbilical cord care, swaddling the baby in relation to Developmental Dislocation of the Hip [DDH] and care of a newborn baby with jaundice. These four issues were studied in relation to level of education and socio-economic status. Around 90% were circumcised by the age of one year. Circumcision was mainly performed by ritual circumcisers and mainly for religious reasons. For umbilical care, 40% used sulfa powder, 13% used alcohol swabs and 25% used traditional methods such as salty water, cigarette ash and coins. There was no statistical difference in the rate of developmental dislocation of the hip between swaddled and non-swaddled babies. Mothers used home light [37%], sugared water [18%], garlic necklaces [15%] and sun exposure [21%]. Only 50% of the mothers realized that jaundice may have future disability effect on babies. Traditional ways are still common in Jordan. Medical consequences of these practices are not clear and need further studies

Repeat intracytoplasmic sperm injection. clinical Perspective

To report the results of repeat intracytoplasmic sperm injection [ICSI] after complete failure of fertilization with initial ICSI. The medical records of the couples undergoing repeat ICSI at the Human Reproductive Biology Unit, Soliman Fakeeh Hospital, Jeddah, Kingdom of Saudi Arabia, after complete failure of fertilization by initial ICSI between December 1994 and December 2000 were retrospectively examined. Seven hundred and eighty two oocytes from 146 women failed to fertilize by initial ICSI. The main indications for the procedure were severe oligoasthenoteratozoospermia or azoospermia. Fresh sperms were used in 136 cases, of which 98 [72%] were ejaculated, 33 [24.3%] were obtained by testicular sperm extraction, and 5 [3.7%] by testicular sperm aspiration. Of the remaining 10: 3 were from cryopreserved semen samples and 7 were from cryopreserved testicular biopsies. The age of the women [mean +/- standard deviation] was 31 +/- 16.2 years. The duration of infertility was 10.5 +/- 9.4 years. A total of 151 [19.3%] oocytes were fertilized after repeat ICSI. The number of cleaved embryos was 125 [15.9%]; of which 2 [1.6%] were grade 5, 47 [37.6%] were grade 4, 65 [52%] were grade 3, and 11 [8.8%] were grade 2. A total of 122 embryos were transferred to 71 women. This resulted in one pregnancy and the birth of a healthy full term baby. In cases of complete failure of fertilization with initial ICSI, fertilization and pregnancy can follow repeat ICSI. Further clinical and cytogenetic studies in this area are necessary