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The presence of advanced anterior vaginal wall prolapse, prior vaginal repair and a lack of mesh augmentation of the anterior compartment are significant risk factors for the surgical failure of sacrospinous suspension surgery.

Introduction Emergency peripartum hysterectomy (EPH) is a foremost operation and is perpetually implemented in the presence of life intimidating hemorrhage during or immediately after abdominal or vaginal deliveries. The aim of this study was to review cases managed at the Department of Gynecology and Obstetrics at Jordan University Hospital (JUH). Material and methods All women who underwent EPH due to any cause in the period from January 2010, to December 2017 were included in the study. Data were collected retrospectively using the patients’ files namelessly. Main measures: age, gravidity, parity, number of previous cesarean sections, previous uterine surgeries, indication for hysterectomy, complications, antepartum bleeding and the need for blood transfusion. Results In total, 74 cases of EPH were managed during the study period. The incidence of EPH ranged from 0.24 to 8.7 per 1000 deliveries. EPH was found to be more common following cesarean sections than vaginal deliveries. The prime indication was abnormal placentation, uterine atony, and uterine rupture. The risk factors included previous cesarean sections, scarred uteruses, multiparity, older age group. Maternal morbidity ranged from 26.5 to 31.5% and mortality from 0 to 12.5% with a mean of 4.8%. Conclusions EPH is the most demanding obstetric surgery performed in very tiresome circumstances of life threatening hemorrhage. The indication for EPH in recent years has changed from outdated uterine atony to abnormal placentation. Antenatal eagerness of the risk factors, engrossment of proficient obstetricians at an early stage of management and a prompt hysterectomy after adequate resuscitation would go a long way in tumbling morbidity and mortality.

Coronavirus disease 2019 (COVID-19) adds more challenges to the perioperative management of parturients. The aim of this study is to examine perioperative adverse events and hemodynamic stability among COVID-19 positive parturients undergoing spinal anesthesia. This prospective observational investigation was conducted at a tertiary teaching hospital in Jordan between January and June 2021, during which 31 COVID-19 positive parturients were identified. Each COVID-19 positive parturient was matched with a COVID-19 negative parturient who received anesthesia under similar operating conditions as a control group. Of the 31 COVID-19 patients, 22 (71%) were otherwise medically free, 8 (25.8%) were emergency cesarean sections. The sensory level of spinal block after 10 min was T8 (T6–T10) among COVID-19 positive group, compared to T4 (T4–T6) among control group (p = 0.001). There were no significant differences in heart rate, SBP, DBP, and MAP intraoperatively (p > 0.05). Twelve (36.4%) neonates born to COVID-19 positive patients were admitted to NICU, compared to four (11.8%) among control group (p = 0.018). There was no statistically significant difference in postoperative complications. In conclusion, spinal anesthesia is considered a safe anesthetic technique in COVID-19 parturients, and therefore it is the anesthetic method of choice for cesarean deliveries among COVID-19 patients.

Background:Mother to infant bonding is the most important process in the puerperium, where many instruments have been designed to screen for mother-infant bonding issues. In this study, we will translate and validate the Postpartum Bonding Questionnaire (PBQ) to the Arabic and to measure the mother-infant bonding in a sample of Jordanian mothers. Materials and methods: This sample is a representative sample taken from multiple centers in Amman,Jordan. Post-partum lady who give a birth to a live healthy baby, regardless the mood of the delivery, who have been discharged with their babies home. Women with multiple pregnancies were also included. We calculated reliability indices and relevant statistics using SPSS.Results: A total of 120 participants included in this study. The mean age for the included sample was 28.1 (±6.3) years. Scale internal consistency measured via Cronbach's alpha is 0. 720. Average intraclass correlation coefficient for single measure is 0.067 (CI 0.045 to 0.097). Mean score for the 4 factors of the questionnaire were: Factor 1: 17.43 (±3.95), factor 2: 4.10 (±3.98), factor 3: 7.99 (±2.39), factor 4: 0.37 (±0.94). Conclusion: We translated and validated an Arabic version of the Postpartum Bonding Questionnaire(PBQ), an easy and widely used instrument to measure mother-infant bonding disorders. We observed a high frequency of bonding disorder among a Jordanian sample.