Tariq Y. Khashoggi

Down’s Syndrome in Saudi Arabia: Incidence and Cytogenetics

A study has been carried out in Riyadh to determine the incidence and distribution of Downs syndrome births during a 9-year period from July 1982 to June 1991. Downs syndrome was ascertained in 42 (23 females and 19 males) of 23,261 consecutive babies born alive to Saudi women, giving an incidence of 1 in 554 live births (1.8 per 1,000). A trend towards an increased incidence of Downs syndrome with advanced maternal age or increased maternal parity was found. Cytogenetic studies were performed on 37 cases of which all but 1 were non-disjunction trisomy 21, while the remaining infant had a translocation. This study provides the first step for further epidemiological surveys of Downs syndrome in the Kingdom of Saudi Arabia in order to prepare the ground for an effective antenatal screening programme for chromosomal disorders.

Accuracy of hysterosalpingography and laparoscopic hydrotubation in diagnosis of tubal patency

OBJECTIVE To compare the diagnostic accuracy of two methods of assessment of tubal patency, viz, hysterosalpingography (HSG) and laparoscopic hydrotubation. DESIGN One hundred four infertile women who were investigated with both HSG and laparoscopy in King Khalid University Hospital were selected for the study. Complete history of factors that may predispose to tubal occlusion was obtained. Patients with problems of ovulatory failure or poor semen analysis that may contribute to their infertility were excluded. RESULTS The overall agreement between the two methods was 62.5%. However, the diagnostic accuracy of the two methods differed significantly. CONCLUSION It would appear that laparoscopic hydrotubation, despite its invasive nature, had an edge in diagnostic accuracy when compared with HSG. It would be advantageous to subject patients in whom HSG has shown tubal blockage to laparoscopy or any of the newer techniques of hysteroscopy or sonographic hydrotubation.

Total and free tissue factor pathway inhibitor in pregnancy hypertension

To clarify the role played by tissue factor pathway inhibitor (TFPI) in pregnancy hypertension.

Sequelae of repeat cesarean sections

Objectives: To study and analyze the factors related to repeat cesarean section and to highlight the problems that may be associated with it. Methods: The study was carried out in the Department of Obstetrics and Gynaecology, King Khalid University Hospital, Riyadh, Saudi Arabia, and involved 395 patients who had had two or more previous cesarean sections prior to the current pregnancy. Various factors which may be associated with repeat cesarean sections, as well as the outcome of the operations, were assessed and analyzed. The χ2‐test and other analyses were used to examine the association between the number of cesarean sections and the various variables. Results: Four or more previous cesarean sections was significantly associated with dense adhesions. On the other hand, height, parity, antenatal clinic attendance, postoperative complications, fetal weight and fetal outcome had no significant effect on, nor influenced, the multiplicity of cesarean sections. Conclusion: No specific risk is associated with repeat cesarean sections that is not normally associated with single cesarean sections.