RESUMO
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
RESUMO
To estimate the stillbirth and hospital early neonatal death rates at the main referral hospital in the north of Jordan [King Abdullah University Hospital]. All infants born at the King Abdullah University Hospital [KAUH] over a 5-year period from January 1. 2005 to December 31, 2009 were identified retrospectively. Medical records of the patient who were considered stillbirth or died in the first week of life were reviewed. The following data: age. gestational age, birth weight, maternal medical and obstetric history, duration of stay and cause of death were collected and analyzed .The main cause of death was taken from death certificates. A total of 10,030 newborns were included in this study. There were 89 stillbirths and 102 early neonatal deaths. Stillbirth rate was 9.0 per 1000 births and early neonatal mortality rate was 10.3 per 1000 live births. Of the early neonatal deaths, 79.4% were born premature, 77.5% were born with low birth weight, 28.4% of them were born of mothers with hypertensive disorders and 17.6% were born of mothers with diabetes. Almost half of deaths [52.9%] occurred in the first day of life and 20.6% of deaths occurred in the second day of life. The most common cause of early neonatal death was respiratory distress syndrome [50.0%] followed by multiple congenital anomalies [19.6%] and sepsis [12.7%]. The three causes together contributed to 82.3% of deaths. In a referral tertiary center in the north of Jordan, stillbirth rate was 9.0 per 1000 births and early neonatal mortality rate was 10.3 per 1000 births. About half of early neonatal deaths occur in the first day of life. Prevention and treatment of prematurity, prevention of sepsis and better understanding of congenital anomalies may help to decrease early neonatal death. Attention to prevention and treatment of respiratory distress syndrome is warranted