Understanding perspectives on neural tube defect management: insights from Jordanian parents.

INTRODUCTION: Neural tube defects (NTDs) represent a spectrum of heterogeneous birth anomalies characterized by the incomplete closure of the neural tube. In Jordan, NTDs are estimated to occur in approximately one out of every 1000 live births. Timely identification of NTDs during the 18-22 weeks of gestation period offers parents various management options, including intrauterine NTD repair and termination of pregnancy (TOP). This study aims to assess and compare parental knowledge and perceptions of these management modalities between parents of affected children and those with healthy offspring. MATERIALS AND METHODS: This retrospective case-control study was conducted at Jordan University Hospital (JUH) using telephone-administered questionnaires. Categorical variables were summarized using counts and percentages, while continuous variables were analyzed using mean and standard deviation. The association between exposure variables and outcomes was explored using binary logistic regression. Data analysis was performed using SPSS for Windows version 26 (SPSS Inc., Chicago, IL). RESULTS: The study sample comprised 143 participants, with 49.7% being parents of children with NTDs. The majority of NTD cases were associated with unplanned pregnancies, lack of folic acid supplementation, and postnatal diagnosis. Concerning parental knowledge of TOP in Jordan, 86% believed it to be legally permissible in certain situations. However, there was no statistically significant difference between cases and controls regarding attitudes toward TOP. While the majority of parents with NTD-affected children (88.7%) expressed a willingness to consider intrauterine surgery, this percentage decreased significantly (to 77.6%) after receiving detailed information about the procedure's risks and benefits (p = .013). CONCLUSIONS: This study represents the first case-control investigational study in Jordan focusing on parental perspectives regarding TOP versus intrauterine repair of myelomeningocele following a diagnosis of an NTD-affected fetus. Based on our findings, we urge the implementation of a national and international surveillance program for NTDs, assessing the disease burden, facilitating resource allocation toward prevention strategies, and promoting early diagnosis initiatives either by using newly suggested diagnostic biomarkers or early Antenatal ultrasonography.

Gynecologists and pelvic inflammatory disease: do we actually know what to do?: A cross-sectional study in Jordan.

Pelvic inflammatory disease (PID) is an upper genital tract infection caused by a variety of aerobic and anaerobic microorganisms ascending from the cervix or vagina. Though PID is mainly a sexually transmitted disease; 15% are non-sexually transmitted.[1] In our study, we aim to assess gynecologists' understanding and awareness of PID; as it presents an important health issue affecting the Jordanian community and similar communities with the same cultural and religious backgrounds. A cross-sectional study was conducted using an online questionnaire that received responses from 172 gynecologists in Jordan. The questionnaire aimed at testing gynecologists' knowledge of different aspects of PID starting with diagnosis and ending with management. 68.6% of gynecologists acknowledged that PID is a problem in Jordan. However, obvious confusion was observed in the scopes of clinical presentation, choosing the most reliable PID investigations, and treatment. PID is not being addressed properly in a sexually conservative community that has low rates of sexually transmitted diseases like Jordan, which is misleading and dangerous. In addition, we think there is a lack of certain standards on how to define PID and acknowledge its effect on the community as well as the disappointing level of knowledge about different aspects of PID gynecologists show, starting with its prevalence and ending with treatment policy. Clearer guidelines for the diagnosis, management, and prevention of PID should be adopted. These findings should be acknowledged by all doctors from neighboring countries as well as those within similar communities to Jordan.

Distribution of ABO and Rh blood groups among pregnant women attending the obstetrics and gynecology clinic at the Jordan University Hospital.

The ABO and D antigen status of red blood cells (Rh blood grouping systems) are important hematological classification systems that categorize blood groups according to the presence or absence of certain erythrocytic antigens. These antigens affect the outcomes of blood transfusions as well as various hematological and immunological diseases. We aimed to study ABO and Rh blood group distribution among pregnant women visiting the antenatal care clinic at Jordan University Hospital (JUH) in Amman, Jordan. A retrospective analysis of all pregnant women delivering at the Jordan University Hospital (JUH) between October 1, 2016, and September 31, 2021. ABO and D antigen status of red blood cells (Rh blood groups) were summarized and documented. 20,136 pregnant women data were analyzed, the O blood group was the most prevalent (n = 7840, 38.9%), followed by A (n = 7506, 37.3%). For the D antigen status, the Rh-positive (Rh+) category was the most common (n = 18,159, 90.2%). For the (O) blood group; O-Rh+ type was the most prevalent (90.1%). Determining the blood group type accurately helps eliminate the critical consequences of both ABO and Rh incompatibility and offers clinicians an opportunity to take timely prophylactic measures. In our analyses O and Rh+ blood groups were the most prevalent.

Correlates of higher anxiety scores reported by women admitted for elective caesarean section.

Background: An elective caesarean section (CS) has been associated with high anxiety scores, and there are associations between higher anxiety scores and younger age, primigravidae, higher educational level, and previous experience with anaesthesia. In this study, the aim is to measure anxiety scores associated with an elective CS using two measuring scales and identify women's characteristics and obstetrics variables that are associated with higher scores. Methods: A cross-sectional study was conducted between Nov 15, 2019 and Nov 15, 2020. Women were included if they were 18 years of age or more, had viable pregnancies, and were admitted for an elective CS. Anxiety scores were measured on admission using the visual analogue scale for anxiety (VASA) and then the State-Trait Anxiety Inventory (STAI-Y). Associated factors were studied using logistic regression analyses. Results: Three hundred women were recruited. Means (SD) for the participant's age and gestation age were 30.5 (5.7) years and 37.6 (1.4) weeks, respectively. Additionally, 29.3% of the participants having a CS were primigravidae and 62.3% were for maternal indications. Furthermore, 55%, 59%, and 61% of the women had scores above the means of VASA and STAI-S components 1 and 2, respectively.Variables that showed statistically significant associations with higher anxiety scores were that the woman's age was 25-34, the CS was for foetal indications, the choice of anaesthesia was general, and the source of information for the choice of anaesthesia was a layperson. Conclusion: Higher anxiety scores are prevalent among women admitted for an elective CS. STAI-Y and VASA correlated well, and the short VASA may replace the lengthy STAI-Y in clinical practice. Identification of women with risk factors may help in implementing strategies to reduce anxiety.

Determinants of breastfeeding attitudes of mothers in Jordan: A cross-sectional study.

Breastfeeding provides the optimal nutrition for an infant. However, breastfeeding practice is on decline globally. Attitude toward breastfeeding may determine the practice. This study aimed to examine postnatal mothers' attitude to breastfeeding and its determinants. A cross-sectional study was conducted, and data on attitude were collected using the Iowa Infant Feeding Attitude Scale (IIFAS). A convenience sample of 301 postnatal women were recruited from a major referral hospital in Jordan. Data on sociodemographic characteristics, pregnancy and delivery outcomes were collected. SPSS was used to analyze the data and identify the determinants of attitudes to breastfeeding. The mean total attitude score for participants was 65.0 ±7.15, which is close to the upper limit of the neutral attitude range. Factors associated with attitude that is positive to breastfeeding were high income (p = 0.048), pregnancy complications (p = 0.049), delivery complications (p = 0.008), prematurity (p = 0.042), intention to breastfeed (p = 0.002) and willingness to breastfeed (p = 0.005). With binary logistic regression modelling, determinants of attitude positive to breastfeeding were highest income level and willingness to breastfeed exclusively (OR = 14.77, 95%CI = 2.25-99.64 and OR = 3.41, 95%CI = 1.35-8.63 respectively). We conclude that mothers in Jordan have neutral attitude to breastfeeding. Breastfeeding promotion programs and initiatives should target low-income mothers and the general population. Policymakers and health care professionals can use the results of this study to encourage breastfeeding and improve breastfeeding rate in Jordan.

Short Term Effect of Corona Virus Diseases Vaccine on the Menstrual Cycles.

Background: The latest threat to world health is coronavirus disease-2019 (COVID-19), and the exact death rate of SARS-CoV-2 infection is still to be explored and varies widely throughout the world. Inactivated virus vaccines, recombinant viral vaccines, subunit vaccines, DNA vaccines, and attenuated vaccinations have all been investigated in the hunt for an optimal SARS-CoV vaccine. Some women had menstrual abnormalities after immunisation, including heavy menstrual bleeding (menorrhagia), frequent bleeding (metrorrhagia/polymenorrhea), and postmenopausal haemorrhage. Vaccine-induced thrombocytopenia might be one of the underlying reasons. Purpose: The aim to carry out this study was to survey by recruiting the female participants who were vaccinated with one or two shots of the available vaccine and observe short-term menstrual changes. Patients and Methods: This web-based survey cross-sectional study included women who were above 18 years, had the vaccine at least one month (one menstrual period) before participating in the study, had access to social media platforms and were willing to take part in the study. Women were excluded if, at the time of the study, they were pregnant or had amenorrhea of more than 6 months. Results: Analysing the menstrual flow more, we saw that 24.5% of the patients had increased flow, while 15.5% had reduced flow which for both changes in the flow, the p-value was 0.017. However, 23.65 showed delayed periods, and 51.6% showed no changes. The changes in the timing were significant, indicating a p-value of 0.008. The study will be a significant contribution to the literature as this pandemic is new, and the vaccination against COVID-19 is still in the trial phase. Conclusion: We observed in our study that there was a change in the menstruation timings and flow after vaccination. However, further longitudinal studies are needed to conclude the impact of the COVID-19 vaccine on the menstruation cycle.

Organophosphate pesticide exposure prenatally influence on pregnancy outcomes.

BACKGROUND: Organophosphorus (OP) pesticides are widely used worldwide. The effect of OP exposure during pregnancy on the offspring is inconsistent in the current literature. Moreover, similar studies in the Middle East are lacking. PURPOSE: To examine the effects of OP exposure in utero on the outcome of pregnancies in an agricultural region in Jordan. METHOD: A prospective study, employing a questionnaire to collect women demographic data. Hospital records were collected for newborns' birth data. In addition, urine samples during the third trimester were collected from pregnant women and then analyzed for six OP metabolites to measure exposure. RESULTS: One of the metabolites, DEDTP, was negatively correlated with gestational age and Apgar scores 1 and 5. There were no other significant associations. CONCLUSIONS: Exposure to OP during pregnancy is not highly associated with any negative anthropometric characteristics of the newborns; it is probably offset by other factors.

How prevalent are symptoms and risk factors of pelvic inflammatory disease in a sexually conservative population.

BACKGROUND: Pelvic inflammatory disease (PID) is the inflammation of the adnexa of the uterus, that mainly manifests in a subclinical/chronic context and goes largely underreported. However, it poses a major threat to women's health, as it is responsible for infertility and ectopic pregnancies, as well as chronic pelvic pain. Previous studies in Jordan have not reported PID, attributed mainly to the social structure of the country which largely represents a sexually conservative population. Our study aims to report the clinical symptoms that point towards PID and investigate the major risk determinants for the Jordanian population, in a cross-sectional study, using our scoring system based only on clinical data and examination. METHODS: One hundred sixty-eight consecutive adult women that came in the Outpatient Clinics of Gynaecological Department of the Jordan University Hospital were interviewed and their medical history and symptoms were registered and analysed. A Score for PID symptoms, we developed, was given to each woman. Results and correlations were then statistically tested. RESULTS: Our study population consisted of relatively young women (37.7 ± 11) that had their first child at an average age of 24.1 (± 4.8) and a mean parity of 3.1 (± 2.2). Fifty-eight women (34.5%) reported having undergone at least one CS, while the mean PID Symptom Score was 3.3 (± 2.3). The women in our study exhibited 8 symptoms of PID, namely dysmenorrhea and vaginal discharge; being the commonest (45.2% and 44.6% respectively), in addition to chronic pelvic pain, pelvic heaviness, menorrhagia, dyspareunia, urinary symptoms, and smelly urine. They also reported history of 3 conditions that can be attributed to PID, that is infertility, preterm labour, and miscarriages. CONCLUSIONS: Our PID Scoring System seems to identify the risk factors of PID and predict well the PID likelihood. This score predicts that women with higher parity, who used contraceptives and underwent any invasive medical procedure are expected to score higher in the PID Symptom Score. Our data also suggest that PID should not be ruled out in the Jordanian population when symptoms are compatible to this diagnosis.

As a sexually conservative country, Jordan is thought to have a low prevalence of pelvic inflammatory disease. The prevalence of STD pathogens is very low, however many patients present symptoms of PID, so we randomly interviewed 168 healthy participants and investigated symptoms related to PID. Surprisingly the percentage of participants who had symptoms of PID was high, reaching up to 64% for some symptoms. We then created a PID symptom score; where every symptom gets one mark (1­11), and tested it for association against independent factors. As a result, it can be predicted that a woman with higher parity, who used contraceptives, and underwent E & C, D & C, HSG, or Hysteroscopy is expected to score higher in the PID Symptom Score.This result draws the attention to PID incidence in similar conservative communities, and therefore further research is needed to confirm the prevalence of PID and identify the causative factors.

H1N1 Infection in Pregnancy; A Retrospective Study of Feto-Maternal Outcome and Impact of the Timing of Antiviral Therapy.

BACKGROUND AND OBJECTIVE: H1N1 infection carries an increased risk in pregnancy. Our aim was to study the feto-maternal outcome and the effect of early initiation of therapy. METHODS: This is a retrospective descriptive study. Confirmed infected cases were included. Maternal age, parity, gestational age at diagnosis, presenting symptoms, the time between presentation and starting therapy, ICU admission, and maternal and perinatal outcome were evaluated. RESULTS: Nineteen confirmed patients were included. Most patients are 31 years old or more. Multiparous patients were 73.68%, and 57.89% were in the third trimester. Most of our patients presented with cough, fever, and chills. Two patients were admitted to the ICU. One of them was a case of maternal mortality. 42.10% of patients were started on therapy only one day after the clinical onset of symptoms. 26.31% delivered before 37 completed weeks. 73.68% delivered beyond term. Around one third delivered vaginally. 45% of babies weighed more than 3 kg. Four babies weighed less than 2 kg. Ninety percent had APGAR scores more than 8 at 1 and 5 minutes after delivery. Twenty-five percent were admitted to the NICU with no neonatal mortalities. CONCLUSIONS: H1N1 influenza A infection in pregnancy is associated with adverse maternal and perinatal outcomes. Medical and public awareness, low threshold for testing suspected pregnant patients, very early initiation of antiviral therapy, and a multidisciplinary approach in our series decreased the overall adverse effects of this infection.

Post-Partum Thrombotic Thrombocytopenic Purpura (TTP) in a Patient with known Idiopathic (Immune) Thrombocytopenic Purpura: a case report and review of the literature.

BACKGROUND: Incidences of immune thrombocytopenic purpura occur in 1 in every 1000-10,000 pregnancies accounting for 3% of all thrombocytopenic pregnancies. A pre-existing immune thrombocytopenic purpura is known to be a risk factor for developing thrombocytopenia during pregnancy. We present here the treatment regime and management of a patient with known immune thrombocytopenic purpura who developed postpartum thrombotic thrombocytopenia with atypical response to traditional therapy. Pregnant women are more vulnerable to immune thrombocytopenic purpura or thrombotic thrombocytopenia. Pregnancy or postpartum thrombotic thrombocytopenia accounts for 10-25% of all thrombotic thrombocytopenia. CASE PRESENTATION: This case report deals with the treatment regime and management of a patient with known immune thrombocytopenic purpura who developed postpartum thrombotic thrombocytopenia. A 30-year-old Middle Eastern woman, with a prior diagnosis of chronic immune thrombocytopenic purpura had remained off-the-treatment for many years. After primary unexplained infertility for 8 years, for which she underwent six failed trials of in vitro fertilization, she delivered a healthy baby through caesarean section. Two days post-surgery, she had persistent thrombocytopenia, ecchymoses, bruises, and hemolysis. Her blood film revealed leukoerythroblastic anemia. Her blood tests also revealed a very low level of haptoglobin, and low level of ADAMTS13. A diagnosis of thrombotic thrombocytopenia was suspected. Plasma exchange therapy was started with partial response. We showed that rituximab in conjunction with mycophenolate mofetil following plasma exchange therapy was effective in controlling the low platelet count in our patient. CONCLUSIONS: Rituximab in conjunction with mycophenolate mofetil following plasma exchange therapy was effective in controlling the low platelet count in our patient. Only two doses of rituximab were sufficient to normalize our patient. We present here a case of safe and effective use of rituximab in pregnancy-induced thrombotic thrombocytopenia.

Postpartum acute fatty liver of pregnancy: a case report.

BACKGROUND: Acute fatty liver of pregnancy can be a very dramatic clinical event with significant risk of mortality to healthy women. The pathogenesis is still unknown. It usually occurs in the third trimester or in the immediate postpartum period. The clinical presentation is very variable. Medical staff have to be very cautious even regarding a minor complaint of feeling unwell. Skin rash has not been reported as one of the initial presentations of acute fatty liver of pregnancy. It is best treated in a center with a multidisciplinary approach. Admission to the intensive care unit is recommended. CASE PRESENTATION: We report a case of a 20-year-old Middle Eastern Arabic woman who developed an acute fatty liver of pregnancy. She was not known to have any medical disease. She had had two previous uncomplicated deliveries. She developed acute fatty liver of pregnancy on the first day after an uncomplicated normal vaginal delivery of a healthy male newborn. She started to have nonitchy skin rash over her abdomen and upper limbs. Then she started to feel unwell. Twelve hours later, she developed epigastric and right upper quadrant abdominal pain, followed by jaundice, nausea, and vomiting. She developed recurrent hypoglycemic attacks, hemolytic anemia, coagulopathy, and hepatorenal syndrome. CONCLUSIONS: The clinical presentation of acute fatty liver of pregnancy is very variable and nonspecific. Skin rash can be a new presenting symptom of acute fatty liver of pregnancy. Immediate suspicion of the diagnosis, appropriate investigations, and urgent initiation of therapy in an intensive care unit and by a multidisciplinary team resulted in a good outcome with no adverse health consequences for our patient.

Is age of menarche related to urinary symptoms in young Jordanian girls? A prospective cross-sectional study.

OBJECTIVES: Urinary incontinence (UI) is highly prevalent worldwide, especially in women. This study hypothesized that the age of menarche, a developmental landmark, may be a risk factor for the development of UI. METHODS: This prospective, cross-sectional study was conducted on girls presenting to the gynaecology outpatient clinic at King Abdullah University Hospital, Jordan, from 2013 to 2014. Medical history and demographic data were collected, and associations between age of menarche and urinary problems were examined. RESULTS: The study enrolled 360 girls (mean age 17.60 ± 4.01 years). Of the participants, 101 (28.9%) reported experiencing urgency in urination, 23 (6.6%) had UI, 17 (4.9%) reported using urine pads at night, 23 (6.6%) had recurrent urinary infections, 61 (12.3%) had received treatment for UI, and 43 (12.3%) had been treated for urinary infections. Nocturia was significantly more frequently reported in younger girls at their first period (p = 0.02). Other urinary problems during menstruation, such as urge incontinence, were significantly associated with older age at first period (p = 0.05). CONCLUSION: Age of menarche represents an important risk indicator for later development of UI in women.

Is there a relationship between children's behaviour and food cravings during pregnancy?

OBJECTIVES: Food craving is a well-known phenomenon during pregnancy that is driven by nutritional requirements for optimal foetal development. This mechanism plays a vital role in ensuring normal prenatal and postnatal development. The goal of the present study is to assess whether cravings experienced during pregnancy are related to children's behaviour. METHODS: A retrospective study was conducted in the gynaecology outpatient unit of a local hospital on healthy non-pregnant women, with children aged between 18 months and 5 years. Eligible women completed a questionnaire regarding their child's behaviours and cravings experienced during their pregnancy. Chi-square tests were used to examine relationships between cravings and behaviour. RESULTS: A total of 336 women were included in the study (child mean age = 44.11 ± 15.65 months; 55.7% females). Food cravings were experienced by 83.1% (n = 304/366) of the participants. The most commonly reported food craving was for fruit (n = 112, 33.3%). Other cravings included salty crackers (n = 40, 10.9%), sweets (n = 35, 9.6%), meat (n = 32, 8.7%), and vegetables (n = 29, 7.9%). There was variation in frequency of the children's behavioural problems: always (more than 50% of the occasions), sometimes (10-50% of the occasions), and none. CONCLUSIONS: Our analyses showed that most behavioural issues were not associated with cravings during pregnancy. Further investigation into how diet and foetal development may impact childhood behaviour is warranted.

Maternal anemia in rural jordan: room for improvement.

The objectives of this cross-sectional study were to estimate the prevalence and determine factors associated with anemia among pregnant women in rural Jordan. A cohort of 700 pregnant women from a National Health Service hospital and ten health centers completed a questionnaire. Of the total, 243 (34.7%) had anemia. The prevalence was the highest for women in their 3rd trimester (42.5%) compared to those in 2nd trimester (32.7%) and 1st trimester (18.9%). Gestational age, body mass index, history of previous surgery, and multivitamin intake during pregnancy were significantly associated with anemia. Women in the 2nd and 3rd trimesters had higher odds of anemia (OR = 2.2 and 3.3, resp.). Underweight women had higher odds of anemia (OR = 2.9). History of previous surgery and multivitamin intake during pregnancy were associated with higher odds of anemia (OR = 1.6 and 1.9, resp.).

Gestational nutrition improves outcomes of vaginal deliveries in Jordan: an epidemiologic screening.

Adequate and balanced nutrition during gestation is essential for achieving healthy pregnancy outcomes. This retrospective survey tested the hypothesis that maternal nutrition (macronutrients intake, micronutrients intake, and weight gain) during gestation will impact gestational outcomes (gestational age, birth weight, and labor spontaneity). The objectives of this study were to test the impact of macronutrients and micronutrients consumed during gestation, pregestational weight and weight gain during gestation on gestational age, birth weight, and labor spontaneity among Jordanian women. Study participants (n = 700) were recruited from a women's hospital in northern Jordan. Data were collected using structured interviews. Dietary determinants examined in the study included daily intake of macronutrients (energy, carbohydrate, protein, fat, and n-3 and n-6 fatty acids) and micronutrients (zinc, calcium, folate, vitamin C, vitamin A, and vitamin B6), pregestational body mass index, total weight gain, and weight gain pattern during pregnancy. Dietary data were obtained from a semiquantitative food frequency questionnaire. Mean (SEM) daily intakes of energy, carbohydrate, and protein were 10894 (138) Kj, 320 (3.8) g, and 90 (0.95) g, respectively; with fat contributing 36% of total energy. Average daily energy and carbohydrate intake during pregnancy were related negatively to gestational age (P < .05). Pregestational body mass index was associated positively with gestational age and birth weight (P < .05). Intakes of vitamin A and calcium had significant relationships with birth weight. Daily intakes of zinc, calcium, vitamin B6, and n-3 and n-6 fatty acids were associated with labor spontaneity. Dietary factors consumed during pregnancy are associated with pregnancy outcomes.

Jordanian obstetricians' personal preference regarding mode of delivery.

The personal preference of Jordanian obstetricians regarding mode of delivery in uncomplicated pregnancy with singleton cephalic presentation at term was surveyed by an anonymous structured questionnaire distributed at five conferences/scientific meetings on obstetrics and gynecology held in Jordan in 2007. The response rate was 70% (n=315), and 22 (7%) of the respondents chose elective cesarean section (CS). Respondents <45 years seemed to be more in favor of elective CS than those >or=55 years (14.1% vs. 3.7%). In multivariate analysis, increased age was inversely associated with the odds of choosing elective CS (OR = 0.93, 95% CI: 0.88-0.99, p=0.024) after adjusting for gender, sector, and duration of practice. The main reasons for preferring abdominal delivery were the fear of long-term sequel (stress incontinence and anal sphincter damage) and the wish to preserve sexual function (86.4 and 50.0%, respectively). The majority of Jordanian obstetricians and gynecologists preferred vaginal delivery in uncomplicated pregnancy for themselves or their wives.

Prevalence and frequency of severity of urinary incontinence symptoms in late pregnancy: a prospective study in the north of Jordan.

OBJECTIVE: To determine the frequency of urinary urge, stress incontinence and bothersome urinary symptoms in late pregnancy in Jordan. METHOD: Women admitted in spontaneous labor to labor suite at three covering hospitals in the north of Jordan and at least 36 weeks gestational age were eligible for survey to ascertain data on current pregnancies and past pregnancy. Data analyzed for 181 women. RESULT: Mean gestational age was 39.5 weeks. 85% had normal vaginal delivery. 35% of women reported symptoms of urgency, 30% of whom described symptoms frequency as moderate or severe, and 45% reported stress incontinence, 29% of whom described symptoms frequency as moderate or severe during the current pregnancy. Symptoms in previous pregnancies were reported by 20 and 30% of women for urge and stress incontinence, respectively. Urgency and urge incontinence increased in relation to parity. CONCLUSION: The frequency of urinary incontinence and bothersome symptoms was relatively similar compared to other countries.

Pelvic abscess complicating an in vitro fertilization pregnancy and review of the literature.

INTRODUCTION: In vitro fertilisation has become a very common procedure in the infertility practice due to both accessibility and good success rates. DISCUSSION: Complications, however, are constant reminders that no procedure is totally safe. In this paper, we present a case of IVF pregnancy that presented with pelvic abscess, and despite two laparotomies the triplet pregnancy was lost at 22 weeks gestation. CONCLUSION: This case highlights the fact that the progression of pelvic infection in pregnancy can be slow.