Abandoning the blind legacy passed on horde of routine intra-abdominal drain insertion in cesarean section.

INTRODUCTION: Cesarean section (CS) delivery is the most common major obstetrical surgical operation carried out in and is increasing in incidence throughout the world. The major involves some risks that might include: infection, coagulation problem, loss of blood, bowel or bladder injury, abnormalities of the placenta in subsequent pregnancies. AIM OF THE STUDY: To evaluate the clinical effectiveness of postoperative CS intra-abdominal drain insertion. MATERIAL AND METHODS: A prospective study was conducted on 245 patients in labor, at the Department of Obstetrics and Gynecology, Jordan University Hospital, between January 2017 and January 2018. Participants were divided into two groups: group I including those who had abdominal drains insertion during surgery and group II including women who had no abdominal drain inserted before closure. All patients on both groups were term pregnancies, underwent elective vs. emergency CS, and had no subcutaneous drains inserted. RESULTS: Clinical and surgical parameters were comparable in both groups. Postoperative hospital stay was significantly shorter in group II, whereas specific postoperative complication rate was significantly higher in group I. Drain site infection was noted in 2 (1.6%), organ herniation in 2 (1.6%), drain avulsion in 2 (1.6%), severe pain at the site of insertion in 2 (1.6%) patients. CONCLUSIONS: Routine prophylactic intra-abdominal drain insertion post CS has no benefits and therefore should be stopped.

Setting priorities in the conventional approaches in managing ectopic pregnancy; is it time to reform? A teaching hospital experience.

THE AIM OF THE STUDY: To review the management approaches of ectopic pregnancy (EP) at the Department of Obstetrics and Gynecology at Jordan University Hospital (JUH). MATERIAL AND METHODS: All patients admitted to our department with the diagnosis of EP treated during the study period extending from January 2017 to June 2019. Data were collected retrospectively using the patients' files anonymously. Main outcome measures: age, parity, ectopic site, presentation, the main risk factor/s and the management plan. RESULTS: In total, 65 cases of EP were managed during the study period. Overall, the mean age was 30 years. EP was located in the right tube in 23 cases, and in the left tube in 14 cases. Eleven patients presented with acute abdomen due to rupture of the EP and underwent urgent laparotomy; 7 of these cases were located on the right side. Conservative surgery (laparoscopy versus laparotomy) was the main line of management with attention to preserving the tube patency, followed by medical therapy when the patient fulfilled the criteria or those with pregnancy of unknown location. CONCLUSIONS: EP is a life-threatening condition. It is time to reform the priorities in the conventional approach to management. Every effort ought to be applied to preserve the reproductivity of women who are diagnosed with EP at the JUH. We would suggest that salpingostomy needs to be considered the surgical treatment of choice for the majority of these cases.