In the UK, 20% of all women, and 30% in the USA, have a hysterectomy before the age of 60; menorrhagia is the main presenting problem in at least 50-70%. In approximately 50% of cases, no organic pathology is determined, and dysfunctional uterine bleeding is diagnosed. Diagnosis and management of bleeding disorders may possibly reduce the need for surgical intervention, leading to a positive impact on women and the health service.

A full-term abdominal pregnancy culminating in the birth of a live healthy baby by laparotomy is described.

Objective: To assess the effects of various stages of pregnancy as well as pregnant women age on the level of pulmonary artery systolic pressure. Methods: One hundred and thirty five healthy pregnant women, aged 18 to 42 years, were included in this study. They underwent voluntary transthoracic echocardiogram measurements of pulmonary artery systolic pressure at rest. Three groups of pregnant women were designed according to gestational age; Group 1 included pregnancies less than 13 weeks of gestation and considered as control group. Group II included pregnancies equal to 13 weeks gestation and less than 28 weeks. Group III included those pregnancies with 28 weeks of gestation up to term. Each group included 45 women. The mean pulmonary artery systolic pressure was calculated for each group. Results for groups two and three were compared separately to the control group. The study population was then regrouped according to women's age; Group A included women aged less than 35 years (n=95), Group B included women aged 35 years and above (n=40). Difference in mean pulmonary artery systolic pressure between groups A and B were studied. Results: Lower and upper limits of pulmonary artery systolic pressure during pregnancy were found to be 14 and 45 mmHg. Pulmonary artery systolic pressure during pregnancy showed an increase with maternal age after 35. Marginal change was also noted with gestational age; however that was of no statistical significance. Conclusion: During the different stages of pregnancy, mean pulmonary artery systolic pressure does not alter; however, it may reach high values in healthy asymptomatic women. When interpreting pulmonary artery systolic pressure in pregnancy, age correction may be required since pulmonary artery systolic pressure is found to physiologically increase with increasing pregnant women's age.

Objectives: To assess pregnancy course and perinatal bleeding in women with severe autoimmune thrombocytopenic purpura. Material and methods: We collected data of 38 pregnancies in 24 women, who were on treatment for autoimmune thrombocytopenic purpura early in pregnancy. Indication for treatment was platelets count 50.000/mm 3 or less. We looked for premature rupture of membranes, premature delivery, intrauterine growth restriction and significant blood loss at delivery. Those women were the study group, (group 1). The same variables were looked for in 100 healthy pregnancies taken as control (group 2). Data was compared between the two groups. Information was obtained prospectively from the woman's follow up visits at maternal medicine clinic, King Hussein Medical Center as well as data gathered from women with previous pregnancies complicated by autoimmune thrombocytopenia. Women who had thrombocytopenia secondary to other conditions such as systemic lupus, bone marrow diseases and other causes, were not included in the study. Results: The study group 1 had nine premature ruptures of membranes in 38 pregnancies, whereas only ten women ruptured their membranes out of 100 in control group 2 with an odds ratio 2.9. Four women had significant blood loss at delivery in group 1 and eight women in group 2 which presents marginal increase for group 1 (odds ratio 1.3). No increase in growth restricted babies nor in premature delivery was noticed. Conclusion: Pregnant women with autoimmune thrombocytopenic purpura on treatment, have significant higher risk to rupture their membranes prematurely. No increase in growth restricted babies and premature deliveries. With good care they can deliver safely with minimum hazard of bleeding.