Evaluation of antiepileptic drugs in pregnancy in a Jordanian army hospital.

We aimed to determine a treatment protocol for pregnant women with epilepsy. We selected 50 pregnant women from the antenatal clinic, King Hussein Medical Centre, who had been treated for epilepsy prior to pregnancy. They were divided into 3 groups. Group A (n = 16) received monotherapy with carbamazepine, group B (n = 16) received combined therapy with carbamazepine and phenytoin, and group C (n = 18) received no drugs because they refused treatment for fear of harming the fetus. Only 1 woman on monotherapy had seizures. In group B, no one had seizures, but 2 pregnancies were terminated because of neural tube defects. In group C, 5 patients had 1-2 seizures. No babies delivered to women in group C had congenital anomalies but 25% of babies born to mothers in groups A and B had minor congenital anomalies, a statistically significant difference.

Evaluation of antiepileptic drugs in pregnancy in a Jordanian army hospital

We aimed to determine a treatment protocol for pregnant women with epilepsy. We selected 50 pregnant women from the antenatal clinic, King Hussein Medical Centre, who had been treated for epilepsy prior to pregnancy. They were divided into 3 groups. Group A [n = 16] received monotherapy with carbamazepine, group B [n = 16] received combined therapy with carbamazepine and phenytoin, and group C [n = 18] received no drugs because they refused treatment for fear of harming the fetus. Only 1 woman on monotherapy had seizures. In group B, no one had seizures, but 2 pregnancies were terminated because of neural tube defects. In group C, 5 patients had 1-2 seizures. No babies delivered to women in group C had congenital anomalies but 25% of babies born to mothers in groups A and B had minor congenital anomalies, a statistically significant difference

An appraisal of computed tomography pelvimetry in patients with previous caesarean section.

This study was conducted to determine the value of computed tomography (CT) pelvimetry in patients with previous caesarean section. Of 219 pregnant women with one previous caesarean section, 100 had antenatal CT pelvimetry and a control group of 119 women had no CT pelvimetry. In the CT pelvimetry group, 51.0% delivered by caesarean section, 28.0% underwent elective caesarean section for contracted pelvis based on the findings of CT pelvimetry and 23% underwent emergency caesarean section after a trial labour. In the control group, 21.8% underwent emergency caesarean section. The differences in birth weight and Apgar scores between the groups were not statistically significant. CT pelvimetry increased the rate of caesarean delivery, suggesting that CT pelvimetry before a vaginal birth after a previous caesarean delivery is of limited value.

An appraisal of computed tomography pelvimetry in patients with previous caesarean section

This study was conducted to determine the value of computed tomography [CT] pelvimetry in patients with previous caesarean section. Of 219 pregnant women with one previous caesarean section, 100 had antenatal CT pelvimetry and a control group of 119 women had no CT pelvimetry. In the CT pelvimetry group, 51.0% delivered by caesarean section, 28.0% underwent elective caesarean section for contracted pelvis based on the findings of CT pelvimetry and 23% underwent emergency caesarean section after a trial labour. In the control group, 21.8% underwent emergency caesarean section. The differences in birth weight and Apgar scores between the groups were not statistically significant. CT pelvimetry increased the rate of caesarean delivery, suggesting that CT pelvimetry before a vaginal birth after a previous caesarean delivery is of limited value

Comparative study of transvaginal hysterosonography and biopsy for the evaluation of post-menopausal bleeding.

BACKGROUND: The aim of this prospective study was to evaluate transvaginal hysterosonography (TVHS) in post-menopausal bleeding (PMB) as an alternative to endometrial biopsy. The study was conducted at the Zarka Military Hospital, Amman, Jordan, over a one-year period from 1996 to 1997. PATIENTS AND METHODS: The study comprised 98 women presenting with post-menopausal bleeding who had been listed for diagnostic dilatation and curettage. Transvaginal sonography (TVS) and transvaginal hysterosonography were performed one week before operation. The mean age of the women was 57 years, and all of them had had their menopause for at least six months. RESULTS: Sixty-one women (62%) demonstrated endometrial thickness of more than 5 mm by transvaginal sonography. All the women had transvaginal hysterosonography, except seven on whom hysterosonography could not be performed for technical reasons and who had to be excluded from the study, leaving a total of 54 women. TVS confirmed the presence of endoluminal mass in 30 of 54 women (60%). Twenty-two of the 30 endoluminal mass cases were pedunculated while eight were sessile. Sixteen of the pedunculated cases were endometrial polyps while the remaining six were fibroid polyps. Five of the sessile cases were fibroid, two were endometrial hyperplasia, and the last one endometrial carcinoma. The other 44 out of the 98 patients also underwent transvaginal hysterosonography. No pathology could be detected in these patients, but they were noted to have atrophic endometrium after dilatation and curettage. CONCLUSION: The combination of transvaginal sonography and transvaginal hysterosonography is both sensitive and specific with regard to detecting and excluding endoluminal masses as the cause of post-menopausal bleeding. Diagnostic dilatation and curettage fails to detect a large percentage of some lesions, so TVS in combination with TVHS should be considered as the initial examination in the evaluation of all women with post-menopausal bleeding.