Muataz Al-Ramahi

Delay of ovulation by meloxicam in healthy cycling volunteers: A placebo-controlled, double-blind, crossover study.

This study aimed to assess the effect of meloxicam on female ovulation. Twenty consented fertile females were monitored for 4 menstrual cycles: a baseline cycle, 2 treatment cycles, and a washout cycle between treatment cycles. In the first cycle visit, transvaginal ultrasound was performed, a blood sample for progesterone and meloxicam analysis was withdrawn, and volunteers were given a luteinizing hormone (LH) urine test kit and meloxicam or placebo. Volunteers started the treatment on the following day and asked to return the day the LH kit was positive to detect the dominant follicle. At subsequent visits, transvaginal ultrasound and progesterone and meloxicam levels were investigated. Compared to placebo, a 5‐day delay in follicle rupture, a 55.7% increase in the mean maximum follicle diameter, and 33.5% decrease of plasma progesterone level were observed in the meloxicam‐treated group. Such demonstrated meloxicam effects were reversed in participants who were randomized to meloxicam first and then placebo. Only minor side effects were reported by volunteers during the course of treatment. It is concluded that meloxicam resulted in a reversible delay of ovulation, an increase in follicular diameter, and a decrease in plasma progesterone level.

Outcome of adolescent pregnancy at a university hospital in Jordan

Objective: To determine whether adolescent pregnancies are associated with increased risk of adverse obstetrical outcome. Materials and methods: This is a retrospective study comparing the obstetric outcome of 267 adolescent pregnancies to 500 adult women pregnancies during the same period at a university hospital. Results: Medical and obstetric complications including pregnancy-induced hypertension, diabetes mellitus, anemia, placenta praevia, abruptio placenta and multiple pregnancy were not different in both groups, where there was a significant increase of preterm labor in adolescent pregnancies compared to adult pregnancies (14.6 and 8%, respectively). Moreover, adolescent pregnancies when compared to adult pregnancies, were associated with a significantly higher incidence of forceps delivery (4.5 and 1.4%, respectively), neonatal intensive care unit admission (22.7 and 13.5%, respectively) and a lower incidence of caesarean section (7.1 and 16.8%, respectively). Conclusion: Adolescent pregnancies are associated with a favorable obstetric outcome apart from the higher incidence of preterm labor.

Prevalence of Sexually Transmitted Infections Among Sexually Active Jordanian Females

Objectives: To determine the prevalence of the most important sexually transmitted infections among women of child bearing age in Jordan. Goal: To assess the need for screening programs to detect sexually transmitted infections. Study Design: This is a cross-sectional study wherein consecutive symptomatic and asymptomatic women presenting to gynecology and family planning clinics from different areas in Jordan were tested for reproductive tract infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and Trichomonas vaginalis. Results: The prevalence of C. trachomatis infection was 0.6% and 0.5%, among symptomatic and asymptomatic women respectively, that of N. gonorrhoeae was 0.9% and 2.2%, that of T. pallidum 0.0% and 0.0%, and that of Tr. vaginalis was 0.7% and 0.5%. These prevalence rates did not differ significantly between symptomatic and asymptomatic women. Conclusions: Based on the low prevalence of sexually transmitted infections detected in this study among Jordanian women, the need for screening programs for such infections is questioned.

Comparison of serum progesterone as an indicator of pregnancy nonviability in spontaneously pregnant emergency room and infertility clinic patient populations.

OBJECTIVE To compare the predictive value of serum progesterone in identifying nonviable pregnancy in symptomatic spontaneously pregnant emergency department patients and asymptomatic patients attending an infertility clinic. DESIGN Retrospective study. SETTING Tertiary-care academic health center. PATIENT(S) One hundred thirty-seven pregnant patients who presented to the emergency department for whom clinical outcomes were available, and 123 consecutive patients who became pregnant during treatment at the infertility clinic. INTERVENTION(S) Serum progesterone measurement. MAIN OUTCOME MEASURE(S) The sensitivity, specificity, and predictive value of serum progesterone <45 nmol/L in identifying nonviable pregnancies were determined for each of the groups. RESULT(S) Sensitivity and specificity of serum progesterone <45 nmol/L in predicting nonviable pregnancies were 88.6% and 87.5%, respectively, in spontaneously pregnant patients who presented to the emergency department with pain or bleeding and 58.8% and 100% in infertility patients who had undergone controlled ovarian hyperstimulation for in vitro fertilization or intrauterine insemination. Sensitivity and specificity for all other infertility clinic patients were variable. CONCLUSION(S) The predictive value of low serum progesterone in identifying nonviable pregnancies varies with patient populations.

Atosiban and nifedipine in the suppression of pre-term labour: A comparative study

This is a retrospective study comparing the efficacy and safety of atosiban and nifedipine in the suppression of pre-term labour. A total of 75 patients were included in this study; 34 received atosiban and 41 received nifedipine. There were no statistically significant differences in the baseline characteristics for both groups. A total of 68.3% of women in the atosiban group remained undelivered at 7 days or more, compared with 64.7% in the nifedipine group, which was not statistically significant. Average birth weight, admission to the neonatal intensive care unit and mode of delivery were similar in both groups. However, the gestational age at delivery was significantly higher in the nifedipine group. We concluded that atosiban and nifedipine are effective in delaying delivery for 7 days or more in women presenting with pre-term labour. They have the same efficacy and associated minor side-effects. However, flushing, palpitation and hypotension were significantly higher in the nifedipine group.

The value of frozen section Pipelle endometrial biopsy as an outpatient procedure in the diagnosis of ectopic pregnancy

Summary This is a prospective study evaluating 28 patients who were suspected to have ectopic pregnancy. Frozen section Pipelle endometrial biopsy was performed as an outpatient procedure to look for the presence of chorionic villi in the specimen. The sensitivity of the frozen section endometrial biopsy in detecting the presence of chorionic villi was 13.3% and the specificity was 100%. The positive predictive value was 100% and the negative predictive value was 50%. We concluded that frozen section endometrial biopsy was not helpful in predicting intrauterine gestational process; therefore, it has a limited application in patients suspected to have ectopic pregnancy.