Effects of perinatal risk factors on common neonatal respiratory morbidities beyond 36 weeks of gestation

To assess the incidence of respiratory morbidity [RM] in all single live neonates born >36 weeks of gestation, and the effects of perinatal characteristics on these morbidities. This is a prospective hospital based study covering a 12-month period. The study took place at the Department of Pediatrics, Jordan University Hospital, Amman, Jordan, between January and December 2009. The effects of different perinatal characteristics on RM including transient tachypnea of the newborn [TTN] and respiratory distress syndrome [RDS] were analyzed. A total of 2282 newborns were included. One thousand two hundred and seventy-six [55.9%] of the newborns were delivered by vaginal delivery and 1,006 [44%] by cesarean section [CS] [24.5% by emergency CS and 19.5% by elective CS]. Respiratory morbidity was reported in 3.7%. The incidence of TTN was 2.9% and RDS was 0.7%. Elective CS was found to be a risk factor for RM development when the gestational age was <39 weeks. Maternal hypertension and diabetes mellitus, and the absence of labor were independent risk factors for RM. The emergency CS and large for gestational age babies were risk factors for TTN, while male gender and GA <37[o+6] weeks were risk factor for RDS. The collaborative obstetric and neonatology responsibility helps to identify the risk factors for adverse respiratory outcome when considering the time and mode of delivery. The pregnant mother should be informed regarding this possibility if delivery by elective CS is performed before the 39[o+6] weeks of gestation

Accuracy of sonographic fetal weight estimation within 14 days of delivery in a Jordanian population using hadlock formula 1

To assess the accuracy of sonographic fetal weight estimation within 14 days of delivery in a Jordanian population using Hadlock formula 1 in the third trimester. Estimated fetal weights and actual fetal weights data were collected from the medical records of pregnant women who had undergone sonographic fetal weight estimation within 14 days of delivery over the period of March 2008 to June 2010. The analysis included 409 Jordanian women; 6 of them had twins, so the study involved estimation of 415 fetal weights, and these were compared to the actual recorded neonatal weights. Using Hadlock formula 1, we compared the estimations with the infants' actual birth weights. The data were analyzed in 2 groups: within 7 days and 8-14 days. The mean estimated fetal weight was 3,133 +/- 475 g [range 1,343-4,420 g]. The mean actual birth weight was 3,179 +/- 450 g [range 1,300-4,450 g]. The mean absolute percentage of error of ultrasound fetal weight estimation for all infants was 6.5%; however, it was 6.1 and 8.2% if the fetus was delivered within 7 days or 8-14 days of sonography, respectively. Overall, 78.8% of fetal weight estimations were within 10% of actual birth weight; however it was 81.3 and 69.9% if the fetus was delivered within 7 days or from 8-14 days of sonography, respectively. The use of Hadlock formula 1 for sonographic fetal weight estimations in Jordanian women showed acceptable results relative to the actual neonatal weight at birth. However, fetal weight estimation was more reliable when performed within 7 days of delivery

balanced anesthesia with dexmedetomidine decreases postoperative nausea and vomiting after laparoscopic surgery

To evaluate the effect of adding dexmedetomidine to a balanced anesthetic technique on postoperative nausea and vomiting after laparoscopic gynecological surgeries. A prospective double-blind randomized study was designed at Jordan University Hospital, Amman, Jordan between December 2008 and February 2009. Eighty-one female patients in their child-bearing age [17-48 years]; American Society of Anesthesiologists [ASA] clinical status I, who were scheduled for elective diagnostic laparoscopic surgeries under general anesthesia were divided into 2 groups. Group D [n=42] received dexmedetomidine infusion, while group P [n=39] received 0.9% sodium chloride infusion along with the balanced anesthesia. The incidence of early [up to 24 hours] postoperative nausea, vomiting, nausea and vomiting, and the need for postoperative rescue anti-emetic medications were recorded. The total incidence of postoperative nausea and vomiting decreased significantly in group D; 13 out of 42 patients [31%], compared to group P; 23 out of 39 patients [59%], vomiting alone did not significantly change, the incidence of postoperative nausea, and the use of rescue anti-emetic medications were significantly different. A significant drop in overall consumption of fentanyl and sevoflurane was also noted in group D. Combining dexmedetomidine to other anesthetic agents, results in more balanced anesthesia and a significant drop in the incidence of postoperative nausea and vomiting after laparoscopic gynecological surgeries