Antenatal diagnosis, prevalence and outcome of congenital anomalies of the kidney and urinary tract in Saudi Arabia

To study the prevalence, pattern of distribution, and the outcome of different types of kidney and urinary tract anomalies [CAKUT] diagnosed during the antenatal period. The second objective is to test the accuracy of antenatal diagnosis of CAKUT. In a cross-sectional hospital-based study, all cases diagnosed antenatally with urinary tract anomalies at King Abdulaziz University Hospital [KAUH], Jeddah, Kingdom of Saudi Arabia, were studied. The prevalence, pattern of distribution, and immediate postnatal outcomes, in addition to the accuracy of antenatal diagnosis, of those cases are reported. One hundred and forty-one cases of urinary tract anomalies were antenatally diagnosed; postnatal diagnosis was confirmed in 128 cases [90.1%]. The prevalence of CAKUT in our population is 3.26 per 1000 births. The most common abnormalities detected were hydronephrosis, polycystic kidney disease, multicystic dysplastic kidney, and renal agenesis, in descending order of frequency. The perinatal mortality rate among fetuses with CAKUT is 310 per 1000, the majority of these cases [90%] occurred in cases with renal parenchyma involvement. The prevalence of different types of CAKUT is higher than that reported in developed countries. Urinary tract anomalies can be accurately diagnosed and classified in the antenatal period using ultrasonography imaging. Antenatal diagnosis is a helpful tool in planning immediate postnatal care and deciding the place for delivery. This might prevent or slow renal function deterioration and help in early identification of patients who need early surgical intervention

Congenital heart defects in Down syndrome patients from western Saudi Arabia

To characterize congenital heart defects in individuals with Down syndrome [DS] in the Western Region of Saudi Arabia, and compare with studies from other regions of Saudi Arabia and with international figures. We conducted a prospective study including all patients attending the DS clinic at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia between October 2007 and October 2011. All patients underwent full history and physical evaluations, dysmorphologic assessment, chromosomal studies, and echocardiography. A total of 130 individuals [59% males and 41% females] with ages ranging between 0-33 years [mean=5 +/- 4.9] were included. Most individuals [90.9%] had trisomy 21 due to non-disjunction, 5.05% due to Robertsonian translocation, and 4% had mosaicism. Congenital heart defects were found in 86.8% of patients. The majority 71/92 [77%] showed combined cardiac defects, while 21/92 [23%] of DS patients had isolated congenital heart defects [CHD]. The most frequent CHDs detected in this study were: patent ductus arteriosis in 44/92 [47.8%], atrial septal defect in 38/92 [41.3%], trivial tricuspid regurge in 31/92 [33.7%], ventricular septal defect in 27/92 [29.3%], and patent foramen oval in 26/92 [28.3%]. We found a higher incidence of CHDs among DS individuals from the Western Region, compared to national and international figures. We detected more combined CHD and a different pattern of distribution

corrected perinatal mortality rate a hospital-based study in Saudi Arabia

To determine the corrected perinatal mortality rate [PMR] in a single tertiary care center, and to test the effect of unbooked pregnancies on the PMR, and amalgamate the 2 to develop a new terminology known as the extended corrected PMR. We conducted a retrospective cohort study of all women who delivered at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia between January 2000 and December 2010. We recorded all cases of perinatal death and calculated the PMR per annum. The PMR was corrected for extreme prematurity and congenital anomalies. The unbooked cases were reported, and the PMR was further corrected for booking status. For statistical analyses, the Statistical Package for Social Sciences was used for descriptive analysis and tests of significance. The total number of births was 46,677. Seven hundred and seventy-one perinatal deaths were reported, giving a PMR of 16.5 per 1000 per year. The corrected perinatal mortality was 11.0 per 1000. The PMR decreased significantly to 6.4 per 1000 [odds ratio 2.6, 95% confidence interval 1.2-2.4, p=0.001] after correction for booking status. The PMR in our study population is higher than those in developed countries, and when corrected for congenital anomalies and extreme prematurity, it is marginally higher. It was then considerably reduced after correction for booking status.

Histopathological pattern of ovarian neoplasms and their age distribution in the western region of Saudi Arabia

To identify the different histopathological types of ovarian neoplasms and their age distribution. This is a retrospective study were ovarian neoplasms received by the Pathology Department of King Abdulaziz University, Jeddah, Saudi Arabia between January 1995 and December 2010 were reviewed and their frequencies in different age groups were calculated. Out of 618 ovarian specimens studied, 382 [61.8%] were ovarian neoplasms while 38.2% were non-neoplastic functional cysts. Benign neoplasms [n=278; 72.8%] were more common than borderline [n=20; 5.2%] and malignant ones [n=84; 22%] in all age groups. Surface epithelial neoplasms were the most common [61%] followed by germ cell [28%], gender cord stromal [7.6%] and metastatic tumors [3.4%]. The most common benign neoplasm was serous cystadenoma [44.6%] and the most common malignant was serous cystadenocarcinoma [33.3%]. The most common ovarian neoplasm below the age of 20 years was surface epithelial tumors [n=24] followed by germ cell tumor [16 cases]. Benign neoplasms [n=213] were more common than malignant ones [n=42] in the age group from 20-51 years. Malignant ovarian neoplasms [35 out of the 71] were more common than benign [34 cases] in the age above 52. Benign ovarian neoplasms are more common than malignant ones. The most common benign ovarian neoplasm is serous cystadenoma and the commonest malignant neoplasm is serous cystadenocarcinoma. The prevalence of malignant ovarian neoplasms increases with increasing age

Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding

Abnormal uterine bleeding is a challenging gynecological problem caused by various endometrial pathologies. The present study aims to identify the pattern of histopathological diagnoses encountered in women of various age groups presenting with abnormal uterine bleeding. A retrospective age specific comparative analysis. Department of Pathology. Two thousand two hundred ninety-five endometrial samples from women presenting with abnormal uterine bleeding from January 1995 to June 2008 were retrieved and analyzed. The commonest histopathological diagnosis was secretory endometrium 571 [24.9%], followed by proliferative endometrium 498 [21.7%], endometrial polyp 227 [9.9%], disordered proliferative endometrium 200 [8.7%], simple cystic hyperplasia 160 [7%], chronic endometritis 134 [5.8%], inactive endometrium 126 [5.5%], atrophic endometrium 70 [3.1%], uterine malignancies 41 [1.8%], complex hyperplasia without atypia 33 [1.4%] and finally complex hyperplasia with atypia 15 [0.7%]. Two hundred twenty [9.6%] revealed no endometrial tissue and were considered insufficient for diagnosis. Uterine malignancies and complex hyperplasia with atypia were more common in the age group of 52 years and older, 3.3% and 1.2% respectively. The present study revealed that secretory and proliferative endometrium are the most common endometrial histopathological patterns identified in endometrial samples obtained for abnormal uterine bleeding in our region

Rhesus alloimmunization in pregnancy. A tertiary care center experience in the Western region of Saudi Arabia

To determine the distribution of ABO blood group and rhesus [RH] factor among pregnant women, to estimate the prevalence of Rh alloimmunization, and report the perinatal outcome of all cases of Rh alloimmunization at King Abdul-Aziz University Hospital [KAUH]. This is a retrospective study of pregnant women attending the antenatal clinics in KAUH, Jeddah, Saudi Arabia between January 2004 and December 2009. Records of patient diagnosed as Rh negative blood group were reviewed for the presence of antibodies, antibodies titer, and progress in the level of antibodies. Maternal and neonatal outcomes were reported. Twenty-four thousand and five pregnant women were included in this study. The most common blood group was O followed by A, B and AB positive. Rhesus negativity blood group was reported in 7.5%. Four hundred and twenty-four cases were reported as Rh antibody positive with a prevalence of alloimmunization of 1.8% in the studied population, and 23.6% among Rh negative women. The perinatal mortality rate was 250 per 1000 in alloimmunized women compared to 17 per 1000 in the study population. Blood group O positive is the most prevalent blood group among pregnant women attending our antenatal clinics and the prevalence of Rh negativity was 7.5%. The prevalence of Rh alloimmunization in the present study was 10-folds higher than that reported in the developed countries. Rhesus alloimmunization represent an avoidable direct cause for perinatal morbidity and mortality in our population