Ahmed M Kurdi | PubMed Health

PubMed2004

Multiple pregnancy and preterm labor.

OBJECTIVE: Multiple gestations are high risk pregnancies, which may be complicated by pre-maturity, low birth weight infants, pre-eclampsia, anemia, postpartum hemorrhage, intrauterine growth restriction, neonatal morbidity and high perinatal, neonatal and infant mortality. This study was carried out to determine the incidence and effect of multiple pregnancies on pre-term labor in tertiary care hospitals. METHODS: Retrospective case record analysis of 375 cases of multiple pregnancies that were reported at Armed Forces Hospital and King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January 2000 and December 2001. The data was analyzed to determine the incidence of multiple pregnancies and its effect on pre-term delivery. RESULTS: The over whole incidence of twins was 14/1000 births. Premature labor in multiple pregnancies was 7 times greater than singletons (42% versus 6.4%). Almost half of multiple pregnancy cases were delivered by cesarean section (49% versus 14%). Pregnancy was induced in 34% of cases. Cervical cerclage was applied in only 8% of cases and betamemetics were administered to only 11% of cases. Fetal distress in labor, abnormal presentation and previous uterine scar were the main indications for cesarean section. Fifty percent had no antenatal complications, gestational diabetes complicated 16%, and anemia was reported in 22% of cases. CONCLUSION: Preterm delivery remains the most serious complication of multiple pregnancies. Multiple gestation children may suffer long term sequel of prenatal complications, including cerebral palsy and hearing disabilities. Every effort should be made to reduce the risk of multiple gestation and pre-term labor through proper control and close monitoring of fertility drugs, limiting number of embryo transfer to maximum of 3 or only 2, improving the socioeconomic status of expectant mothers, reduce cigarette smoking, relieve maternal stress, restriction of maternal activity, frequent contact with health care personnel and treatment of any obstetric or medical disorders.

Adult↗

PubMed2002

Comparison of maternal and infant outcomes between vacuum extraction and forceps deliveries.

OBJECTIVE: To analyze the instrumental deliveries carried out at the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia during the year 2000 and compare the outcome of ventouse and forceps deliveries. METHODS: A retrospective case note review of all instrumental deliveries, carried out at the Armed Forces Hospital, Riyadh, during the year 2000. RESULTS: Three hundred and four vaginal deliveries, of whom 258 were ventouse and 46 were forceps deliveries, were assisted. Seventy percent of forceps deliveries were carried out in primigravida as compared to 49% of ventouse deliveries. Fetal distress was the indication in 81.4% of ventouse deliveries as compared to 76% of forceps deliveries. Prolonged 2nd stage of labor was an indication in 11% of forceps and 2.3% of ventouse deliveries. Consultants and Senior Registrars were more likely to use forceps while registrars use ventouse as their preferred instrument for delivery. Attempted ventouse delivery was successful in 91.4% as compared to 95.7% in forceps. Extension of an episiotomy was more likely to occur with ventouse than forceps deliveries while 3rd degree perineal tear occurred more with forceps deliveries. Babies who had attempted ventouse deliveries have lower apgar score at one minute than attempted forceps. No babies required admission to neonatal intensive care unit. There was only one stillbirth in the ventouse delivery group due to intrapartum asphyxia and true knot in the umbilical cord. CONCLUSION: Forceps is more likely to be used in the primigravida and prolonged 2nd stage of labor and less likely to fail. Ventouse is more likely to be used by registrars. Extension of an episiotomy and low apgar score at one minute is more likely to occur with ventouse deliveries.

Adult↗