Does the number of previous caesarean deliveries affect maternal outcome and complication rates?

We evaluated maternal complications in relation to number of previous caesarean sections in Princess Badea Teaching Hospital, Irbid, Jordan. Analysis of the medical records of 1739 patients delivered by caesarean section was conducted. It revealed a 14-fold increase in the risk of caesarean hysterectomy in patients with placenta praevia and previous caesarean section compared to patients with placenta praevia and no previous caesarean section. The risk of caesarean hysterectomy increased with increasing number of previous caesarean sections. Those with 3 or more previous caesarean sections were at significantly higher risk of blood transfusion. Post-operative pyrexia was commoner in women with 3 or more previous caesarean sections compared to those undergoing their first one

Variation in repeat caesarean section complication rates among 3 hospitals in northern Jordan

We investigated the complication rates of repeat caesarean deliveries in 3 hospitals [national health, military, university] in Irbid by examining the obstetric records of 989 women from 1 December 1999 to 30 March 2004. There was a statistically significant difference between the number of previous caesarean sections and hospital. In total, 579 [58.5%] patients underwent elective caesarean section. There were statistically significant differences between hospitals for "failure to progress in labour" and "other" indications for caesarean section. After adjusting for the number of caesarean sections, regression analysis revealed that women from the military and university hospitals were more likely to have placenta praevia. There were no statistically significant differences between hospitals as regards post- operative complications

Value of a single intraperitoneal dose of heparin in prevention of adhesion formation: an experimental evaluation in rats.

The effect of a single dose of intraperitoneal heparin on postoperative adhesion formation was examined in the rat. Seventy-two rats were divided into two groups. Trauma was produced with a brush in one group, and by transection of one uterine horn followed by microsurgical reanastomosis in the second group. Single doses of intraperitoneal and subcutaneous heparin were compared, with respect to adhesion formation, with a similarly administered dose of normal saline. A beneficial effect in reducing adhesion formation was demonstrated with intraperitoneal heparin. The effect was more pronounced after microsurgical anastomosis. No harmful effect on haemostasis or wound healing was observed. In view of the adverse effect of postoperative adhesions on the result of infertility surgery, we suggest that the use of intraperitoneal heparin in the human should receive serious consideration.

Effect of cyclosporin A on the morphology and function of the ovary and fertility in the rabbit.

The effect of Cyclosporin A (CyA) on the ovary was studied in the rabbit using immunotherapeutic doses of 15 mg/kg body weight/day I.M. for 14 days. Dysfunction and structural injury were demonstrated in the ovaries of all the animals that received the drug. The similarity of the lesions to those described in the ovaries of patients who received cytotoxic drugs raises the possibility of gonadotoxic effect of CyA in the human. This study was prompted by the observation of certain peculiarities of the rejection of CyA immunosuppressed ovarian allografts in the rabbit; this will be the subject of a forthcoming communication.