ABSTRACT
BACKGROUND: The purpose of the study was to evaluate the role of ultrasound (US) and magnetic resonance imaging (MRI) in the diagnostics and management of abnormal placentation in women with placenta previa and to compare the morbidity associated with that to placenta previa alone. MATERIAL/METHODS: The study includes 100 pregnant women with placenta previa with and without abnormal placentation. The results of MRI and US in abnormal placentation were compared with post-operative data. The patients' files were reviewed for assessment of operative and post-operative morbidity. The results of our statistical analysis were compared with data from the literature. RESULTS: US and MRI showed no significant difference in sensitivity and specificity in diagnosing abnormal placentation (97-100% and 94-100%, respectively). MRI was more sensitive than US for the detection of myometrial invasion and the type of abnormal placentation (73.5% and 47%, respectively). The difference between pre- and post-operative hemoglobin values and estimated blood loss were the most significant risk factors for abnormal placentation, added to risk factors known for placenta previa. Post-partum surgical complications and prolonged hospital stay were more common in the cases of placenta previa with abnormal placentation, however statistically insignificant. CONCLUSIONS: US and MRI are accurate imaging modalities for diagnosing abnormal placentation. MRI was more sensitive for the detection of the degree of placental invasion. The patient's morbidity increased in cases with abnormal placentation. There was no significant difference in post operative-complications and hospitalization time due to pre-operative planning when the diagnosis was established with US and MRI.
ABSTRACT
OBJECTIVE: To assess maternal and fetal outcomes, in epileptic and non-epileptic pregnant women. METHODS: A retrospective case-control study was conducted from January 2005 - December 2006 at Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia. A total of 16508 live birth charts were reviewed. Maternal, obstetrical, and fetal outcomes were compared between women with epilepsy Group 1 (n = 53) and women who did not have epilepsy (controls) Group 2 (n = 60). RESULTS: There were no significant differences between either group in total length of labor, labor induction and oxytocin augmentation, need for labor analgesia, total blood loss and the need for blood transfusion, mode of delivery, and the length of hospital stay. There were no significant differences in all maternal complications between either group (p=0.8, 95% CI: 0.3-2.1). There was an increase in the mean dose of the antiepileptic medications needed during pregnancy. However, 4 women (7.5%) in the epileptic group had major seizures during pregnancy. All of these women needed addition of a second antiepileptic medication. Major congenital malformations occurred in 2 newborns (3.8%) of epileptic women, and none occurred in the control group. Both newborns were from women who received polytherapy. CONCLUSION: Women with epilepsy are not at increased risk for obstetric and neonatal complications, provided there is a combined team management approach by a neurologist and an obstetrician.
