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

Ultrasonography of the uterus after normal vaginal delivery.

To define the appearance of the uterus and the uterine cavity, as revealed by ultrasound in normal women following a vaginal delivery. This prospective, longitudinal study took place at the Prince Hashem and Prince Ali Military Hospitals, Amman, Jordan from December 2002 to March 2003. Fifty-four women were scanned on postpartum days 1, 7, 14, 28, and 56. Ultrasound examination was performed transabdominally for all women. The involution process of the uterus was assessed by measuring the anteroposterior diameter and uterine cavity. The appearance of the uterine cavity contents was documented. Factors related to the involution process: parity, breast-feeding, smoking and infant's birth weight were also evaluated. The maximum anteroposterior diameter of the uterus diminished substantially and progressively from 93 mm on day one postpartum to 38.5 mm on day 56. The maximum anteroposterior diameter of the uterine cavity diminished from 15.2 mm on day one to 4.0 mm on day 56. The position of the uterus, its shape and the appearance of its cavity during the normal puerperium were observed. The uterus was most often retroverted and empty in the early puerperium. Fluid and debris in the whole cavity were seen in mid puerperium. In late puerperium, the cavity was empty and appeared as a thin white line. No correlation was found between the involution of the uterus and parity, breast-feeding and the infant's birth weight. Transabdominal sonography is suitable for examination of the uterus during the early puerperium period. The uterine body and position, as well as the cavity, are easy to examine by ultrasound. Accumulation of fluid and debris in the uterine cavity is a common and insignificant finding of the involuting uterus

Ectopic pregnancy: Its incidence, diagnosis and management at tertiary hospital in Jordan

The aim of this work was to review the incidence, diagnosis and management of ectopic pregnancy for a period of five years at a tertiary hospital. The medical records of all patients with a diagnosis of ectopic pregnancy from August 1 1997 until July 31 2002 were reviewed. The total number of deliveries and abortions during the same period was also determined. Diagnosis and management modalities of ectopic pregnancy were analyzed and compared with international figures. The study concluded that the incidence of ectopic pregnancy is lower than that in the developed countries. Laparoscopy is a valid approach to the diagnosis and management and has the advantage of shorter hospital stay and less morbidity