RESUMO
INTRODUCTION: Obstetric anesthesia provides several methods for the analgesia of labor pain. The neuraxial technique is considered the standard of care for parturient women. The epidural block is widely used in vaginal delivery while the spinal block is the preferred method for cesarean section (C-section). We aim to know the practice of obstetric anesthesia in our center. METHODS: A retrospective cross-sectional study was conducted at a tertiary center in Riyadh, Saudi Arabia. The data of all delivery cases from 1/7/2019 to 30/9/2019 were reviewed. RESULTS: We identified a total of 2,140 cases during the 3 months, vaginal delivery was the most common with 72.4% (1550) while the C-section cases were 27.6% (590). Regarding the type of analgesia/anesthesia for vaginal deliveries, intramuscular analgesia was the commonest group with 34.8% (540), followed by the group of ladies who did not receive any analgesia/anesthesia with 31.9% (495), thirdly was epidural cases with 31.8% (493), and the fourth type was spinal 0.6% (10). Regarding C-section, the emergency cases were 65.4% (386). The types of anesthesia for all C-sections were as follows spinal 63.5% (375), GA 23.8% (141), and epidural 12% (74). Regarding anesthesia for elective cases, spinal was 85% (174), GA 14% (28), and epidural 1% (2). Regarding anesthesia for emergency cases, spinal was 52% (201), GA 29% (113), and epidural 19% (72). CONCLUSIONS: The use of epidural was low, and the spinal use was relatively on par if we compare with leading western countries. More focused studies and multicenter studies are needed in the country.
RESUMO
Coronavirus (cov) disease 2019 pandemic caused by severe acute respiratory syndrome cov 2 has imposed significant demands on healthcare systems across the world. These demands were more significant on obstetrics and gynecology (obgyn) patients, who required services that had to continue despite the closure of other services. This paper describes the change management of an obgyn department at a tertiary health-care center. That experience resulted in a complete management shift in the institution and the formation of an infectious disease epidemic plan for respiratory infections. Description of the change management performed, difficulties encountered, and achievements obtained can assist other departments change management when they face similar situations.
RESUMO
OBJECTIVE: To investigate whether postmenopausal bleeding (PMB) in our postmenopausal patients is a significant early symptom of uterine cancer (UC) and to assess risk factors for developing the disease in our population. METHODS: A retrospective observational study conducted at King Fahad National Guard Hospital (KFNGH), Riyadh, Kingdom of Saudi Arabia. A review of documents was carried out from PMB patients who were admitted to the hospital from January 1990 through to December 2000. Factors that are usually associated with UC were studied (age, body mass index, parity, menopausal duration, past medical history, ultrasound endometrial thickness, and number of PMB episodes). RESULTS: Forty-seven/one hundred and ninety-five patients (24.1%) were found to have UC. One hundred and forty-eight/one hundred and ninety-five patients (75.9%) had no pathology or a benign pathology. After adjustment for confounding variables, patient's is age >60-years and occurrence of >/=2 episodes of PMB were the risk factors significantly related to UC development. Age 61-70-years P=0.02, odds ratio (OR) 6.8, 95% confidence interval (CI) 1.4-32.9. Age >70-years P=0.001, OR 28.4, 95% CI 3.5-156.3. Occurrence of >/= 2 episodes of PMB P=0.005, OR 4.5, 95% CI 1.6-11.8. Endometrial thickness >5mm, diabetes, hypertension and obesity were not found to be among the risk factors associated with UC development. CONCLUSION: Patient's age >60-years and occurrence of >/=2 episodes of PMB were the risk factors significantly related to UC development in saudi patients with PMB. National risk factors assessment though case control study is required.
