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Biomedical subjects

Ahmad F Bakr

Publications and source records attributed to Ahmad F Bakr.

5 recordsLinked to original sources
PubMed2006

What is the optimal gestational age for twin delivery.

BACKGROUND: The question about outcome in twins delivered early versus late remains unanswered. The objective of this study was to evaluate the association of the timing of delivering twins and the perinatal outcome. METHODS: A prospective cohort study was carried-out in Alexandria University Maternity Hospital. We planned to examine the records of twin deliveries over 2 years. The inclusion criteria were twin deliveries with gestational age at delivery at least 36 completed weeks. Twins of mothers with chronic illness and those with congenital anomalies were excluded. Perinatal outcome parameters (morbidity and mortality) were defined and evaluated. RESULTS: Out of 273 twin sets, 197 (72.2%) met the inclusion criteria. They were classified into 3 groups according to the gestational age at delivery. Neonatal morbidity and maternal complications were higher in those delivered earlier. Twins electively delivered had worse outcome than those delivered spontaneously. In the elective group, there was no difference in the outcome between those delivered earlier or later. CONCLUSION: Twins, when the pregnancy is uncomplicated, continue to grow and mature with advancement of the gestational age. In the absence of significant maternal complications, it is advisable to deliver twins only at 38 completed weeks' gestation or later to avoid neonatal complications.

Journal Article↗
PubMed2006

Severe respiratory distress in term infants born electively at high altitude.

BACKGROUND: We studied the contribution of elective delivery to severe respiratory distress syndrome (RDS) in term babies born at high altitude. METHODS: We prospectively studied the charts of term babies born in Taif Maternity Hospital (1640 m above sea level) between 1/1/2004 and 31/10/2004 who developed RDS and required mechanical ventilation. RESULTS: 8634 deliveries occurred from 37-<41 weeks; 13 (0.15%) had RDS requiring mechanical ventilation. Seven infants delivered at 37-<38 weeks, (OR for RDS = 26 95%CI -4.6 to 5.8), five delivered at 38-<39 weeks, (OR for RDS = 10 95%CI -4.9 to 5.4) and one delivered at >39 weeks. Six of 13 infants were electively delivered without documented lung maturity. CONCLUSION: Infants born at 37 and 38 weeks' gestation remain at significantly increased risk for severe RDS. Elective delivery is responsible for 50% of the potentially avoidable cases. Our data suggest that the altitude does not seem to influence the incidence of severe RDS in term infants born electively.

Journal Article↗
PubMed2005

Normal values of pulse oximetry in newborns at high altitude.

The aim of the study was to establish normal values of pulse oximetry saturation, respiratory rate, heart rate, and blood pressure in healthy newborns at high altitude. Vital signs and oximetry saturation readings were collected from healthy term newborns at birth, at 1 h, and at 24 h of life. These were analyzed and compared with reference ranges at sea level. This study was carried out at altitudes of 1640 m above sea level in Taif city, Saudi Arabia. A total of 6011 term newborns were examined at birth and 1 h and 4274 were examined at 24 h of life. At birth, the mean SpO(2) was 68.6 per cent and 60.3 per cent from the right upper and lower limbs, respectively. Mean SpO(2) was 94.3 per cent and 95.4 per cent at the age of 1 and 24 h, respectively. These values were significantly lower than those reported at sea level. The mean respiratory rate, heart rate, and mean blood pressure at 24 h were 45.7/min, 149.7/min, and 46.9 mmHg, respectively. It is concluded that pulse oximetry saturation for newborn babies is lower at higher altitudes than at sea level. This effect is observable at altitudes of 1600 m above sea level. Cut-off levels lower than those used at sea level should be adopted when dealing with newborns living at high altitudes.

Altitude↗
PubMedDate not supplied

Effect of predelivery vaginal antisepsis on maternal and neonatal morbidity and mortality in Egypt.

OBJECTIVE: The objective of this study was to determine if cleansing the birth canal with an antiseptic solution at delivery reduces infections in mothers and their newborn babies. METHODS: Women giving birth in the University Hospital, Alexandria, and their newborns were studied. No intervention for 3 months was followed by 3 months of intervention. Intervention consisted of manually wiping the maternal birth canal with a 0.25% chlorhexidine solution at admission and at every vaginal examination before delivery. Babies were also wiped with chlorhexidine. RESULTS: The study enrolled 4415 women and 4431 newborns. The nonintervention phase comprised 2128 mothers and 2138 newborns, and 2287 mothers and 2293 babies were enrolled in the intervention phase. There were no adverse reactions related to the intervention among the mothers or their children. There was no difference in the overall number of neonatal admissions in both groups, but the admissions because of infection, deaths, and mortalities from infection were significantly less in the intervention group. Among mothers receiving the intervention, admissions, deaths, and infections were significantly reduced. CONCLUSIONS: Cleansing the birth canal with chlorhexidine reduced neonatal and maternal postpartum infections. The safety, simplicity, and low cost of the procedure suggest that it should be considered standard care for the reduction of infant and maternal morbidity and mortality.

Administration, Intravaginal↗