Pattern of acute poisoning in Al-Qassim region: a surveillance report from Saudi Arabia, 1999-2003

We reviewed all registered cases of acute chemical poisoning reporting to the preventive medicine department in the Qassim Region of Saudi Arabia from 1999 to 2003. The number of cases increased from 66 to 114 during the study period. Mean age of patients was 17.7 years, and over 39% were children aged

Trial of labour following cesarean section

To evaluate the safety and fetomaternal outcome in cases undergoing a 'trial of labour' after previous caesarean section under existing hospital conditions. Design: Prospective 2 years study on all cases with previous caesarean section delivered vaginally or by caesarean section in current confinement. Setting: Lady Willingdon Hospital: A teaching institution affiliated to King Edward Medical College, Lahore. Subjects: Three hundred eighty cases with previous caesarean scar admitted from January 1, 1 991 through December 31, 1992. Mom outcome measures: Comparison of maternal and perinatal outcome of cases undergoing trial of labour versus those delivered by elective caesarean section. Perinatal mortality and morbidity was evaluated by perinatal death rate, Apgar score, meconium aspiration, respiratory distress syndrome and birth trauma. Maternal morbidity was determined by scar rupture, genito-urinary infections, wound infections, need for transfusion and hospital stay. Elective caesarean section was performed in 202 [53.16%] cases. Out of 178 [46.84%] cases undergoing trial of labour, 127 [71.35%] were delivered vaginally, while in 5 1 [28.65%] cases labour was terminated by an emergency caesarean section. Patients who went into spontaneous labour had a significantly better chance of vaginal delivery than those who were induced. The incidence of scar rupture was similar in various study subgroups. Successful trial of labour [TOL] was associated with significantly fewer postpartum complications and shorter hospital stay. The incidence of febrile morbidity and wound infection was significantly increased in cases of failed trial of labour. No maternal death was recorded in this study. The overall perinatal mortality rate was 44.7/ 1000 births. The corrected perinatal mortality rates was 5.6/1 000 for trial of labour compared to none in elective caesarean section group. Conclusions: Vaginal delivery in properly selected cases with previous caesarean scar is safe and without increased risk to the mother or fetus