Objective:The purpose of this study is to compare the success rate of vaginal birth after cesarean (VBAC) in spontaneous and induced labor.Design:This is an 8-year retrospective comparative study.Setting:University hospital.Population:Five hundred and ninety-four women who had one previous lower segment cesarean delivery.Materials and Methods:This is a retrospective study of all women, who had lower segment cesarean section, admitted for trial of labor between April 2010 and November 2016. Five hundred and sixty-seven women who elected to have trial of labor after one previous cesarean were included in the study, of these 477 (84.13%) had spontaneous onset of labor (control group) and 90 (15.87%) had induction of labor (IOL) (study group). Two hundred and seventy-seven women had no previous vaginal delivery, and 297 had one previous vaginal delivery.Results:We compared the success rates of VBAC in women who had IOL with those who came with spontaneous labor. The rate of vaginal delivery after CS (VBAC) was 50.0% and 66.6% in the study and control groups, respectively. There was a significant increase in the rate of cesarean delivery due to fetal distress in the study group (P = 0.016). There were no cases of uterine rupture in the control group and one case in the study group. Patients who had spontaneous labor and at least one previous vaginal delivery have higher success rate of vaginal delivery.Conclusion:Women with one previous CS, who undergo IOL, have lower success rates of vaginal delivery compared with those who presented in spontaneous labor. They also have higher risk of CS delivery due to fetal distress. Previous normal vaginal delivery increases the success rate of VBAC.

Every obstetrician is bound to face the challenge of uterine rupture or women with prior uterine rupture. Those women should have a favorable maternal and perinatal outcome when managed in a tertiary center.

Diabetes mellitus (DM) is a growing health issue that has been reaching epidemic proportions in the recent years. Low intake of some nutrients like vitamin D may increase the risk of gestational diabetes mellitus (GDM). This study was to investigate the association between the dietary intake of Vitamin D and GDM among women in the Eastern Region of Saudi Arabia. A case-control study was conducted in a sample of 121 women, among those 72 were with GDM and 49 were controls. Vitamin D was estimated using food frequency questionnaire. Also, the 24-h’s dietary recall was carried out for 3 days to determine the nutrient intake as well as biochemical analysis for blood glucose level. In this study, GDM subjects were consuming significantly more eggs ( P = .040). Vitamin D and vitamin C intakes in GDM and control pregnant women were lower than recommended dietary allowances (RDA). It was also found that low-fat milk, full-fat milk, fortified yogurt, and fortified orange juice were significantly associated with GDM ( P < 0.05). Saudi women with GDM need a well-organized dietary counseling before, during pregnancy, and after delivery especially for vitamin D sources.

Background:The presence of group B streptococcus in the genital area during pregnancy and labor is associated with high neonatal morbidity and mortality. However, the exact prevalence of group B streptococcus among Saudi women has not yet been established.Objective:The aim of this study was to determine the prevalence of group B streptococcal colonization in Saudi pregnant women as a primary end-point and neonatal complications as a secondary end-point.Materials and Methods:A prospective, observational, cross-sectional study was conducted to estimate the prevalence of group B streptococcal colonization among Saudi women admitted in labor to the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. A total of 1371 maternal specimens (vaginal swabs, rectal swabs and midstream urine) were collected from 457 patients between October 2011 and September 2016. Neonatal specimens (urine, blood and cerebrospinal fluid) were collected if clinically indicated.Results:Of the 457 women enrolled in this study, 87 (19%) had positive cultures for group B streptococcus either in the vaginal or rectal swab or both. Group B streptococcus was also found to be the most commonly isolated organism. In total, there were five cases of neonatal sepsis, of which one early-onset neonatal sepsis was caused by group B streptococcus.Conclusions:This study found that the prevalence of group B streptococcal colonization is 19% among Saudi women admitted in labor to the King Fahd Hospital of the University.

Objective: To review the outcome of prostaglandin induction of labor in term pregnant women with previous one ce-sarean section compared to those without previous Cesarean section. Design: 18 years retrospective review of hospital records and case note review of index cases. Setting: University hospital. Population: Three hundred and twenty two women who had their labor induced with prostaglandin E2. One hundred and sixty one women had one previous Ce-sarean section. Methods: This study was conducted at King Fahad University Hospital, University of Dammam. It is a tertiary referral center with approximately 2300 births per year. We searched the hospital's records of deliveries from January 1992 to December 2009 and reviewed all indications and outcomes of prostaglandin induction of labor in women with one previous Cesarean section. The control group was composed of women who had their labor induced with prostaglandin but without previous Cesarean section. Main outcome measures: Labor outcome and uterine rup-ture Results: Three hundred and twenty two women were included. All received prostaglandin E2 for induction of labor. One hundred and sixty one women had one previous Cesarean section (study group) and the rest had no previous Ce-sarean section (control group). There was no difference in the rate of vaginal delivery between study and control group, 68.3% and 79.5% (p value 0.3), respectively. The rate of uterine rupture was 30 times higher in study group (2.5% Vs 0.033%). Conclusion: In women with one previous Cesarean section, induction of labor with prostaglandin leads to comparable rate of vaginal delivery similar to those without prior Cesarean section but with relatively high risk of uter-ine rupture