Introduction: Cesarean section (CS) delivery is the most common major obstetrical surgical operation carried out in and is increasing in incidence throughout the world. The major involves some risks that might include: infection, coagulation problem, loss of blood, bowel or bladder injury, abnormalities of the placenta in subsequent pregnancies.Aim of the study: To evaluate the clinical effectiveness of postoperative CS intra-abdominal drain insertion.
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 The indication for EPH in recent years has changed from outdated uterine atony to abnormal placentation.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.
Objective: The purpose of this audit is to analyze the indications, complications, and the final histopathology reports of all hysterectomies done under our care during the study period at Jordan University Hospital. The ultimate goal of the study is to clarify the importance of acquiring brain surgical skills during practice and follow-up. It should be a target present in teaching hospitals that adopt educational residency programs. Methods: This is a retrospective study involving all patients who underwent hysterectomy from January 2017 till January 2020. Results: a total of 245 patients underwent hysterectomy (regardless of the type) during the study period. The most common indication was abnormal vaginal bleeding followed by malignancy. The most common intraoperative complication was bladder injury followed by bleeding. The most common postoperative complication was wound infection followed by hematoma. The most common histopathology was benignly followed by malignancy. Conclusion: hysterectomy is a surgical procedure commonly performed to alleviate health welfare; nevertheless, in some situ, actions it is portrayed as a lifesaving procedure. Unsurprisingly, the significance and consequences of related complications mandate for patients planned for the procedure to be appraised thoroughly and adequately before surgery. The aim and art of refining and improving acquired surgical skills and experience portrayed intraoperatively errors a decline in complications rate. Time and practice aid to the ascending linear curve of gained surgical skills, which mirrors a gradual drop in the complications rate.
Introduction: This study aims to assess the attitude, knowledge, and behaviour of Jordanian women toward cervical cancer screening and its phenomenal role in preventing the disease, and to identify the defects and obstacles in the national screening programs for early detection of this manageable kind of malignancy.Material and methods: A prospective study via a questionnaire that included the demographic data, knowledge, behaviour, and attitude among Jordanian women about the cervical screening program using face-to-face interviews.Results: Among 655 women who responded to the questionnaire, 340 (51.9%) reported having no idea about the smear, 350 (53.4%) had completed higher education, 84 (12.84%) were not happy to be screened, and 53 (8.09%) were afraid of the result being positive for malignancy. The shocking and scandalous upshots reported that 600 women (91.6%) had no idea about the role of vaccination against this threatening disease.Conclusions: Screening programs occupy a limited space among the health care provider's priorities. The health education and national awareness strategy regarding cervical cancer should be adopted and implemented in primary health care units. The media with its different facets and platforms must take responsibility and share this national cancer education battle. The once-in-a-lifetime screening test should be adopted urgently, being the most important step, because it represents the minimum correct starting point to lessen the future burden on the national healthcare system and benefit the health of the target groups.
Introduction To review the malignant potential of the stump after subtotal abdominal hysterectomy. Material and methods: Thirty-three patients with stump malignancy were diagnosed and treated between January 2018 and January 2022. All patients primarily underwent subtotal hysterectomy (STH) outside our hospital due to different indications, most of which seemed non-convincing. Upon presentation, they were evaluated properly and offered the best management plan. Results The presenting symptoms were abnormal histopathology report in 8 patients (24.24%), abnormal bleeding in 7 patients (21.21%), and postcoital bleeding and abnormal Pap smear in 6 patients (18.18%). The primary site of malignancy was endometrial in 17 patients (51.51%), on top of fibroid in 6 patients (18.18%), and cervical in 5 patients (15.15%). Eighteen patients (54.54%) underwent proper surgery, 9 patients (27.277%) were referred for chemoradiation, and 6 patients (18.18%) were candidates for palliative therapy. Conclusions Stump cancer cases show a worse stage silhouette compared with cancer cases in intact uteruses. The high prevalence of cervical stump problems should be taken into account before a change in surgical approach from total to STH is deemed possible. Further prospective studies with prolonged follow-up periods are needed to evaluate the risks and benefits of retaining the cervix at hysterectomy. Subtotal hysterectomy is easier, does not require distinct skills that lead to experience and follow-up, and must be limited to the narrowest limits of practice, provided that the woman knows that there are no health benefits to keeping the cervix in place.
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