Vol 43 # 3 September 2011 - Kma.org.kw

More documents

Recommendations

Info

188 Osteoarthritis of the Knee: Review of Risk Factors and Treatment Programs ... September 2011 pain in osteoarthritis patients?--a meta-analysis of randomized controlled trials. Osteoarthritis Cartilage 2008; 16:965-972. 88. Fidelix TS, Soares BG, Trevisani VF. Diacerein for osteoarthritis. Cochrane Database Syst Rev 2006: CD005117. 89. Soeken KL, Lee WL, Bausell RB, Agelli M, Berman BM. Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis. J Fam Pract 2002; 51:425- 430. 90. Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil’s claw (Harpagophytum procumbens DC.). Phytother Res 2003; 17:1165-1172. 91. Hansson EE, Sorensson E, Ronnheden AM, Lundgren M, Bjarnung A, Dahlberg LE. Arthritis school in primary health care. A pilot study of 14 years of experience from Malmo. Lakartidningen 2008; 105:2175-177. 92. Moseley JB, O’Malley K, Petersen NJ, et al. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 2002; 347:81-88. 93. Kirkley A, Birmingham TB, Litchfield RB, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 2008; 359:1097-1107. 94. Herrlin S, Hallander M, Wange P, Weidenhielm L, Werner S. Arthroscopic or conservative treatment of degenerative medial meniscal tears: a prospective randomised trial. Knee Surg Sports Traumatol Arthrosc 2007; 15:393-401. 95. Magyar G, Toksvig-Larsen S, Lindstrand A. Changes in osseous correction after proximal tibial osteotomy: radiostereometry of closed- and open-wedge osteotomy in 33 patients. Acta Orthop Scand 1999; 70:473-477. 96. Magyar G, Ahl TL, Vibe P, Toksvig-Larsen S, Lindstrand A. Open-wedge osteotomy by hemicallotasis or the closed-wedge technique for osteoarthritis of the knee. A randomised study of 50 operations. J Bone Joint Surg Br 1999; 81:444-448. 97. Magyar G, Toksvig-Larsen S, Lindstrand A. Open wedge tibial osteotomy by callus distraction in gonarthrosis. Operative technique and early results in 36 patients. Acta Orthop Scand 1998; 69:147-151. 98. Magyar G, Toksvig-Larsen S, Lindstrand A. Hemicallotasis open-wedge osteotomy for osteoarthritis of the knee. Complications in 308 operations. J Bone Joint Surg Br 1999; 81:449-451. 99. Lindstrand A, Al Mukaimi A. Knee Arthroplasty. Kuwait Med J 2008; 40:267-268. 100. Insall J, Scott WN, Ranawat CS. The total condylar knee prosthesis. A report of two hundred and twenty cases. J Bone Joint Surg Am 1979; 61:173-180. 101. Al-Rowaih A, Pospula W, Abdul-Moez O, Lindstrand A. Duracon total knee replacement in Kuwait: A clinical and radiographic analysis of 52 knees followed for 2 - 5 years. . Med Princ Pract 1999; 8:98-104.
September 2011 KUWAIT MEDICAL JOURNAL 189 Original Article Re-appraisal of Vaginal Delivery after Previous Two Cesarean Sections Lulu Abdullah Al Nuaim Department of Obstetrics and Gynecology, King Khalid University Hospital, Riyadh, Saudi Arabia Kuwait Medical Journal 2011; 43 (3): 189 -195 ABSTRACT Objective: To study the outcome of offering a trial of labor to women with history of two previous cesarean sections (CS) after appropriate counseling Design: Retrospective Setting: Obstetric Unit at King Khalid University Hospital, Riyadh, Saudi Arabia, over a period of seven years (1993 – 1999) Subjects: A total of 40 women with two previous CS requested a trial of labor Intervention: Trial of labor despite having two previous CS based on specific predetermined criteria Main Outcome Measure(s): (1) The rate of vaginal delivery, (2) The rate of repeat CS and (3) Neonatal outcome Results: This group represents 8% of women with a history of two previous CS out of which 50% had primary CS and 25% had repeated CS in their previous pregnancies. Spontaneous labor occurred in 95% and augmentation in 45%. There was no uterine dehiscence or rupture in this study. There were five intrauterine deaths, six babies admitted to the NICU; four for prematurity and breech delivery and two for grunting. There was no birth asphyxia or neonatal death. Five of these cases are presented in detail. Conclusion: The favorable outcome in this study shows that trial of labor can be safely offered to a selected group of women with two previous CS after proper counseling. This goal can be achieved without limiting childbirth options for women who sincerely wish to avoid multiple cesarean deliveries. Larger trials are needed in our community to support finding in this study. KEY WORDS: pregnancy outcome, repeat CS, vaginal birth after cesarean INTRODUCTION The rate of cesarean delivery has increased steadily over the past 30 years world wide, with current rates of > 25% [1-4] and the repeat cesarean section (CS) rate for low risk women of all ages and racial groups is now 88.7% [5] . Studies conducted in 1980’s have shown that the primary reason for the continuing escalation of cesarean delivery rate is the performance of elective repeat CS [6] , since the relative safety of cesarean delivery had promoted a more liberal approach to its use [7] . However, this has resulted in considerable concern as a public health issue. Studies conducted later have reported that the procedure though common, presents a high maternal morbidity and mortality [8-10] . Attention had been focused on the alternative to cesarean birth for some time [11] . Several studies performed in the 1970’s and 1980’s confirmed the safety of vaginal birth after a CS (VBAC) [12-13] . In addition, studies in the 1990’s have supported that VBAC is an acceptable option to routine elective repeat surgery [14-16] . This has been approved by the American College of Obstetricians and Gynecologists, provided certain criteria are fulfilled [3] . Most authorities now agree that VBAC should be encouraged, in order to reduce the rising cesarean delivery rate [6] . The success rate for VBAC is up to 79% [17] . The benefits of VBAC, in terms of reduced costs and maternal morbidity, without jeopardizing fetal outcome have been welldocumented [18] . Women with previous cesarean births now represent a relatively large proportion of the obstetric population and this is likely to increase even more, if the present cesarean birth rate continues. Since women’s and physicians’ interest in VBAC is increasing, the obvious question of whether such management alternative should be extended to women with two previous cesarean deliveries is being raised more frequently [19,20] , especially for women whose initial CS were performed for clearly non-repetitive indications. Data is now accumulating on vaginal birth after two CS [19-25] . Uterine scar separation does not appear to be affected by the number of previous uterine incisions Address correspondence to: Dr. Lulu A. Al Nuaim, MRCOG, MSc, Associate Professor and Consultant, Department of Obstetrics and Gynecology, College of Medicine & King Khalid University Hospital, King Saud University, P O Box 2925, Riyadh, 11461, KSA. Tel: + 966 (1) 4920260, Fax: + 966 (1) 4920520 E-mail: lulu.alnuaim@gmail.com
Page 1 and 2: VOLUME 43 NUMBER 3 KMJ KUWAIT MEDIC
Page 3 and 4: Kuwait Medical Journal (KMJ) Publis
Page 5 and 6: Instructions for Authors five), fol
Page 7 and 8: September 2011 KUWAIT MEDICAL JOURN
Page 21: September 2011 KUWAIT MEDICAL JOURN
Page 53 and 54: September 2011 their cases with an
Page 73 and 74:
September 2011 KUWAIT MEDICAL JOURN
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
September 2011 urea 4.3 mmol/l, cre
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
show all

Vol 43 # 3 September 2011 - Kma.org.kw

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?