Re: Diabetes and perinatal loss, a continuing problem.
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Case-Control Studies↗
Biomedical subjects
R Mesleh
Publications and source records attributed to R Mesleh.
Emergency peripartum hysterectomy.
A total of 54 166 mothers delivered at the Riyadh Armed Forces Hospital between 1990 and 1997, including 6119 (11.3%) caesarean sections. Emergency peripartum hysterectomy for obstetric haemorrhage was carried out in 16 cases (0.3/1000 deliveries). The operation followed major degrees of placenta praevia in 12 (75%) cases and atonic postpartum haemorrhage in four (25%). All patients required blood transfusion. There was one neonatal death and no maternal deaths. Although the operation was straightforward, bladder injury occurred in five (31%) cases which was repaired with no residual damage. Placenta accreta was confirmed histologically in 12 (75%) patients. In conclusion, all obstetricians should be aware of the strong association between a scarred uterus, placenta praevia and placenta accreta which can be very adherent and difficult to remove causing bleeding and necessitating hysterectomy. The operation should be performed by an experienced obstetrician before the patient's condition is extreme.
Journal Article↗
Transabdominal cervicoisthmic cerclage: the Riyadh Armed Forces Hospital experience.
Between 1985 and 1996, 17 transabdominal cervicoisthmic cerclage procedures were performed and followed up through 28 pregnancies at Riyadh Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia. Fourteen procedures were carried out during pregnancy and three preconceptionally. Twenty-four pregnancies continued beyond 36 weeks of gestation and three were premature deliveries. The material used was an infant feeding tube size 6 and the knot was tied posteriorly. The sole miscarriage was at 6 weeks' gestation. All deliveries were by caesarean section. Fetal survival was 92%. In conclusion, abdominal cerclage is an effective and safe operation which helped the pattern of pregnancy wastage to be restored to normal in selected patients.
Journal Article↗