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1.
J Obstet Gynaecol ; 32(4): 379-82, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22519486

RESUMO

The objective of this study is to examine the effect of repeated transvaginal ascitic fluid aspiration on the reproductive outcome in patients undergoing in vitro fertilisation treatment complicated with severe ovarian hyperstimulation syndrome. A total of 65 women with severe early OHSS were hospitalised and managed with transvaginal ascitic fluid aspiration either in < 3 occasions (control group; n = 29) or ≥ 3 occasions (multiple aspirations) (study group; n = 36). All patients in both groups received intravenous fluid, human albumin and thromboprophylaxis. Patients in the study group received significantly lower amounts of parenteral fluid (p < 0.05), human albumin (p < 0.01), and LMWH (p < 0.001). In addition, they had significantly lower days of hospitalisation (p < 0.01) as compared with the control group. There was no significant difference in the cancellation rate between the two groups, but patients who underwent multiple aspiration had a significantly higher pregnancy rate (82.8% vs 41.7%, p < 001) and significantly lower abortion rate (10.3% vs 40%, p < 0.05) compared with the control group. Repeated transvaginal asitic fluid aspiration even with large amounts is safe and effective in the treatment of symptomatic patients with severe OHSS. The pregnancy rate increased significantly along with a significant decrease in the abortion rate was observed after multiple aspirations compared with < 3 aspirations.


Assuntos
Fertilização in vitro , Síndrome de Hiperestimulação Ovariana/terapia , Indução da Ovulação/efeitos adversos , Aborto Espontâneo/epidemiologia , Adulto , Líquido Ascítico , Aspirações Psicológicas , Feminino , Humanos , Síndrome de Hiperestimulação Ovariana/complicações , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Vagina , Adulto Jovem
2.
East Mediterr Health J ; 13(4): 855-61, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17955768

RESUMO

A prospective study examined the safety, efficacy and labour outcome in 436 women undergoing labour induction using intravaginal prostaglandin E2. Women with singleton pregnancies (235 nulliparas and 201 multiparas) were recruited if they had a clinically unfavourable cervix, and indications for induction. The mean (standard deviation) interval from initiation to delivery was statistically significantly shorter in multiparas than nulliparas: 13.5 hours (SD 1.8) versus 15.5 hours (SD 2.4). No more than 2 x 3 mg tablets were needed to achieve a clinically feasible cervix for amniotomy. The overall need for oxytocin augmentation of labour was 42%, significantly higher in nulliparas (47%) than multiparas (35%). Intrapartum complications, caesarean section and perinatal deaths showed no statistically significant differences between the groups.


Assuntos
Maturidade Cervical/efeitos dos fármacos , Dinoprostona , Trabalho de Parto Induzido/métodos , Ocitócicos , Administração Intravaginal , Adolescente , Adulto , Âmnio/cirurgia , Índice de Apgar , Distribuição de Qui-Quadrado , Esquema de Medicação , Feminino , Idade Gestacional , Humanos , Jordânia/epidemiologia , Trabalho de Parto Induzido/efeitos adversos , Trabalho de Parto Induzido/estatística & dados numéricos , Idade Materna , Pessoa de Meia-Idade , Complicações do Trabalho de Parto/epidemiologia , Complicações do Trabalho de Parto/etiologia , Paridade , Seleção de Pacientes , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Prospectivos , Segurança , Fatores de Tempo
5.
(East. Mediterr. health j).
em Inglês | WHO IRIS | ID: who-117322

RESUMO

A prospective study examined the safety, efficacy and labour outcome in 436 women undergoing labour induction using intravaginal prostaglandin E2. Women with singleton pregnancies [235 nulliparas and 201 multiparas] were recruited if they had a clinically unfavourable cervix, and indications for induction. The mean [standard deviation] interval from initiation to delivery was statistically significantly shorter in multiparas than nulliparas: 13.5 hours [SD 1.8] versus 15.5 hours [SD 2.4]. No more than 2 x 3 mg tablets were needed to achieve a clinically feasible cervix for amniotomy. The overall need for oxytocin augmentation of labour was 42%, significantly higher in nulliparas [47%] than multiparas [35%]. Intrapartum complications, caesarean section and perinatal deaths showed no statistically significant differences between the groups


Assuntos
Prostaglandinas E , Estudos Prospectivos , Administração Intravaginal , Ocitocina , Trabalho de Parto Induzido
6.
East Mediterr Health J ; 11(4): 657-62, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16700381

RESUMO

To assess the effectiveness of intravaginal misoprostol for second trimester uterine evacuation, we studied 70 women with singleton pregnancies complicated by fetal malformation or dead fetuses. Participants received 200 microg misoprostol administered at 4-hour intervals. Gestations with dead fetuses had a shorter induction-abortion interval [14.2 hours, standard deviation (SD) 4.3] than those with live, malformed fetuses (20.2 hours, SD 7.3) (P< 0.001). The abortion rate was significantly higher for gestations with dead fetuses (92.1%) than those with live, malformed fetuses (68.8%) (P< 0.05). There were no major complications and no significant difference in the incidence of side-effects. All women aborted within 38 hours. Administration of misoprostol is an effective clinical method to terminate second trimester, complicated pregnancy.


Assuntos
Abortivos não Esteroides , Aborto Induzido/métodos , Anormalidades Congênitas/terapia , Morte Fetal/terapia , Misoprostol , Dor Abdominal/induzido quimicamente , Abortivos não Esteroides/efeitos adversos , Aborto Induzido/efeitos adversos , Administração Intravaginal , Anormalidades Congênitas/diagnóstico por imagem , Diarreia/induzido quimicamente , Esquema de Medicação , Feminino , Morte Fetal/diagnóstico por imagem , Febre/induzido quimicamente , Idade Gestacional , Hospitais Militares , Humanos , Jordânia , Misoprostol/efeitos adversos , Náusea/induzido quimicamente , Paridade , Hemorragia Pós-Parto/induzido quimicamente , Gravidez , Segundo Trimestre da Gravidez , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Pré-Natal , Vômito/induzido quimicamente
7.
(East. Mediterr. health j).
em Inglês | WHO IRIS | ID: who-116991

RESUMO

To assess the effectiveness of intravaginal misoprostol for second trimester uterine evacuation, we studied 70 women with singleton pregnancies complicated by fetal malformation or dead fetuses. Participants received 200 microgram misoprostol administered at 4-hour intervals. Gestations with dead fetuses had a shorter induction-abortion interval [14.2 hours, st and ard deviation [SD] 4.3] than those with live, malformed fetuses [20.2 hours, SD 7.3] [P< 0.001]. The abortion rate was significantly higher for gestations with dead fetuses [92.1%] than those with live, malformed fetuses [68.8%] [P< 0.05]. There were no major complications and no significant difference in the incidence of side-effects. All women aborted within 38 hours. Administration of misoprostol is an effective clinical method to terminate second trimester, complicated pregnancy


Assuntos
Abortivos , Administração Intravaginal , Morte Fetal , Misoprostol , Gravidez , Segundo Trimestre da Gravidez
8.
East Mediterr Health J ; 10(4-5): 547-53, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-16335645

RESUMO

The efficacy, safety and outcome of prostaglandin (PG)E2 was compared with Foley catheter for labour induction in grand multiparous women. At a hospital in Jordan, 147 women with Bishop score < or = 5 were randomized to receive 3 mg PGE2 vaginal tablets (n = 75) or 50 mL intracervical Foley catheter (n = 72). The change in Bishop score was significantly higher in the PGE2 group than the catheter group, and time from induction to delivery was significantly shorter in the PGE2 group. Significantly more women needed oxytocin for labour augmentation in the catheter than the PGE2 group and fetal distress was significantly more frequent. For grand multiparas, PGE2 vaginal tablets may be preferable for ripening the cervix as well as for labour induction.


Assuntos
Cateterismo/métodos , Maturidade Cervical , Dinoprostona/uso terapêutico , Trabalho de Parto Induzido/métodos , Ocitócicos/uso terapêutico , Paridade , Administração Intravaginal , Adulto , Maturidade Cervical/efeitos dos fármacos , Parto Obstétrico/métodos , Dinoprostona/farmacologia , Feminino , Sofrimento Fetal/etiologia , Idade Gestacional , Hospitais Militares , Humanos , Jordânia , Idade Materna , Ocitócicos/farmacologia , Seleção de Pacientes , Pré-Eclâmpsia/terapia , Gravidez , Resultado da Gravidez , Gravidez Prolongada/terapia , Estudos Prospectivos , Segurança , Comprimidos , Fatores de Tempo
9.
(East. Mediterr. health j).
em Inglês | WHO IRIS | ID: who-119447

RESUMO

The efficacy, safety and outcome of prostagl and in [PG]E2 was compared with Foley catheter for labour induction in gr and multiparous women. At a hospital in Jordan, 147 women with Bishop score </= 5 were r and omized to receive 3 mg PGE2 vaginal tablets [n = 75] or 50 mL intracervical Foley catheter [n = 72]. The change in Bishop score was significantly higher in the PGE2 group than the catheter group, and time from induction to delivery was significantly shorter in the PGE2 group. Significantly more women needed oxytocin for labour augmentation in the catheter than the PGE2 group and fetal distress was significantly more frequent. For gr and multiparas, PGE2 vaginal tablets may be preferable for ripening the cervix as well as for labour induction


Assuntos
Administração Intravaginal , Parto Obstétrico , Sofrimento Fetal , Idade Gestacional , Hospitais Militares , Trabalho de Parto Induzido , Idade Materna , Paridade , Maturidade Cervical
10.
East Mediterr Health J ; 9(5-6): 1068-74, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-16450539

RESUMO

To determine the microbiology of wound infection following caesarean section and to evaluate the use of Gram stain for the predicton of subsequent microbiological culture results, 1319 surgical wounds were followed up. We did Gram stains and cultures on exudates from open wounds and on aspirates if the wounds had demonstrable fluid collection. Incidence of post-caesarean wound infection was 8.1%. Ninety-three (86.9%) of 107 infected wounds were culture positive, with Staphylococcus aureus the most frequently found organism (42%). Organisms seen by Gram stain yielded a sensitivity of 96.6%, specificity of 88.9%, positive predictive value of 97.7% and negative predictive value of 84.2% when used to predict positive culture results for bacterial wound infection.


Assuntos
Cesárea/efeitos adversos , Infecção da Ferida Cirúrgica/microbiologia , Antibioticoprofilaxia/métodos , Causalidade , Infecções por Escherichia coli/microbiologia , Exsudatos e Transudatos/microbiologia , Feminino , Violeta Genciana , Hospitais Militares , Humanos , Incidência , Controle de Infecções , Jordânia/epidemiologia , Infecções por Klebsiella/microbiologia , Testes de Sensibilidade Microbiana , Fenazinas , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Sensibilidade e Especificidade , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus , Supuração/microbiologia , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle
11.
(East. Mediterr. health j).
em Inglês | WHO IRIS | ID: who-119365

RESUMO

To determine the microbiology of wound infection following caesarean section and to evaluate the use of Gram stain for the predicton of subsequent microbiological culture results, 1319 surgical wounds were followed up. We did Gram stains and cultures on exudates from open wounds and on aspirates if the wounds had demonstrable fluid collection. Incidence of post-caesarean wound infection was 8.1%. Ninety-three [86.9%] of 107 infected wounds were culture positive, with Staphylococcus aureus the most frequently found organism [42%]. Organisms seen by Gram stain yielded a sensitivity of 96.6%, specificity of 88.9%, positive predictive value of 97.7% and negative predictive value of 84.2% when used to predict positive culture results for bacterial wound infection


Assuntos
Antibioticoprofilaxia , Causalidade , Infecções por Escherichia coli , Exsudatos e Transudatos , Violeta Genciana , Hospitais Militares , Incidência , Controle de Infecções , Infecções por Klebsiella , Testes de Sensibilidade Microbiana , Fenazinas , Infecções Estafilocócicas , Staphylococcus aureus , Infecção da Ferida Cirúrgica , Cesárea
12.
Clin Exp Obstet Gynecol ; 28(3): 183-6, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11530870

RESUMO

UNLABELLED: This study was carried out to examine the effect of antenatal corticosteroid therapy on pregnancies complicated by premature rupture of membranes (PROMs). For this purpose, 139 patients with a singleton pregnancy (27-34 weeks of gestation) complicated by PROMs were evaluated prospectively during the period January 1997 to February 1999 at two Jordanian military hospitals (Prince Rhashed and Prince Zaid). Patients were allocated into two groups; Group 1 included 72 patients treated with dexamethsone (24 mg divided into 4 doses 12 hours apart), and Group 2 which included 67 patients whoreceived no treatment (control group). All women were examined clinically and the diagnosis of PROMs was demonstrated using vaginal speculum, nitrazine paper examination and ultrasonography. All neonates were evaluated clinically, radiologically, and by laboratory investigations. Pearson's Chi-square and Fisher's exact tests were used to assess the significance of differences between the two study groups. Respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), intraventricular haemorrhage (IVH), and days of hospital stay were significantly reduced in premature infants of the corticosteroid treated women compared with the controls (p<0.04, p<0.04, p<0.04, and p<0.05, respectively). The perinatal mortality was significantly decreased among the corticosteroid treated group in the gestational subgroups 31-32 and 33-34 weeks (p<0.04), and in all birth weight subgroups (p<0.03). RDS was statistically a significant factor which resulted in increased perinatal mortality in the control group (p=0.02). Regarding the occurrence of postpartum endometritis there was a statistically significant increase among the corticosteroid treated group compared with the controls (p<0.04). CONCLUSION: Antenatal corticosteroid therapy in pregnancies complicated by PROMs has a positive influencing effect on premature infants between 31 and 34 weeks of gestation, decreasing significantly the perinatal morbidity and mortality. It should be used with particular relevance to the developing world where surfactant is not available or where neonatal intensive care units are lacking.


Assuntos
Hemorragia Cerebral/prevenção & controle , Dexametasona/uso terapêutico , Enterocolite Necrosante/prevenção & controle , Ruptura Prematura de Membranas Fetais/complicações , Glucocorticoides/uso terapêutico , Síndrome do Desconforto Respiratório do Recém-Nascido/prevenção & controle , Adulto , Índice de Apgar , Feminino , Humanos , Recém-Nascido , Tempo de Internação , Gravidez
13.
Saudi Med J ; 20(11): 841-4, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27645005

RESUMO

Full text is available as a scanned copy of the original print version.

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