Meta-analysis of prevalence and prognosis of AHF in patients admitted with myocardial infarction: role of invasive management in determining patients' outcomes

OBJECTIVE

This meta-analysis aimed to reveal the prevalence and prognosis of heart failure in myocardial patients. This study further sought to explore the role of treatment in determining outcomes.

MATERIALS AND METHODS

This systematic analysis was performed on the principles of the pre-designed protocol of meta-analysis and systematic reviews statement. Online search articles were accessed for analysis. Studies from January 2012 to August 2020 were considered to identify the prognosis and prevalence of acute heart failure and myocardial infarction. Cochran's Q-test and I2-test were used to measure heterogeneity across the studies. Meta-regression was also performed to identify the potential source of heterogeneity.

RESULTS

For the final analysis, 30 studies were included. No significant publication bias was reported on the funnel plot. However, a 0.462 value was reported for short-term mortality, whereas 0.274 was reported for the long term while performing Egger's tests. Meanwhile, the Begg test showed a value of 0.274 for publication bias. However, an asymmetrical funnel plot suggested potential publication bias.

CONCLUSIONS

After adjustment of clinical and cardiovascular baseline, significant results related to the impact of sex differences on mortality could be obtained. Disease prognosis may be affected by co-morbidities, especially diabetes Mellitus, kidney disease, hypertension, and COPD worsening the situation of patients.

Experience with selective external cephalic version at term in Saudi Arabia: a three year review

Thirty-six patients were selected for external cephalic version at term in an attempt to reduce the number of caesarean sections performed for breech presentation. All had the option of elective caesarean section on account of a big fetus or small maternal pelvis. Our results showed that 20 fetuses out of 24 (83.3%) who had a successful external cephalic version went on to vaginal delivery.

Outcome of induced labour in pregnancies at 41 weeks gestation and over in Saudi Arabia

A retrospective, descriptive cohort study was conducted at King Faisal Military Hospital, Saudi Arabia, to compare pregnancy outcomes in patients induced with prostaglandin E2 from 41 weeks gestation. A total of 450 women whose antenatal care and delivery were conducted at the hospital during 1995-99 were studied. The main outcome measures used were caesarean section rate and perinatal morbidity and mortality. In otherwise normal pregnancies, the caesarean section rate was not significantly increased when induction of labour was carried out at 41 weeks gestation compared with > or =42 weeks. Although more perinatal complications occurred when induction was carried out at 42 weeks, the results were not statistically significant. A large prospective clinical trial is indicated.

Induced labour with prostaglandin E2 in different parity groups after premature rupture of membranes

The study compared the outcome of induction of labour with prostaglandin E2 vaginal tablets in patients with premature rupture of membranes (PROM) at term in different parity groups. A retrospective review was made of the hospital records of 169 women attending the maternity unit of King Faisal Military Hospital, Saudi Arabia. There were no statistically significant differences between the 3 groups (parity 0, parity 1-4 and parity 5+) in rates of labour augmentation, caesarean sections, neonatal intensive care admissions or low Apgar scores. There were no serious complications of induction of labour such as infection or uterine hyperstimulation or rupture. Prostaglandin E2 may be used with care for labour induction in women with PROM at term, even grand multiparas, unless there is history of previous caesarean delivery.

Changing patterns in the management and outcome of breech presentation over a 7-year period. Review from a referral hospital in Saudi Arabia

A retrospective study that was conducted on 755 singleton breech deliveries over a 7-year period between January 1994 and December 2000 at a referral hospital in Saudi Arabia showed that it represented 3.35% of all deliveries. There was a statistically significant trend in caesarean section (P = 0.001) accompanied by a modest linear trend in perinatal mortality (P = 0.049). There were no statistically significant differences in the mean age, parity and birth weight when the women delivered during each year were compared (P > 0.05), but there were statistically significant differences in the gestation at delivery (P < 0.05). Furthermore, statistically significant differences were found in the trends of the preterm breech deliveries and booking status over the period of study (P > 0.05). However, there was no statistically significant linear trend in the birth trauma (P > 0.05). Nineteen cases of the fetal birth trauma (67.8%) were associated with vaginal breech delivery while nine cases (32.2%) were reported from caesarean section. This was statistically significant (P = 0.00074). The role of selective external cephalic version as a way of reducing the caesarean section rate and also trauma during vaginal breech delivery at term in our community is discussed.

Measles in pregnancy: maternal morbidity and perinatal outcome

OBJECTIVE

In this article, we studied the maternal morbidity and the perinatal outcome of 40 women who had measles in pregnancy and that was compared to 120 women who had pregnancy without measles and 37 women who had measles without pregnancy.

METHOD

The medical records of all the case and control subjects were reviewed and significance was tested at the 5% level.

RESULTS

The 40 cases of measles with pregnancy had significantly more hospital admission for pneumonia and fever when compared to cases of measles with no pregnancy (P < 0.001). The perinatal morbidity is significantly higher in cases of measles with pregnancy as expressed by the higher incidence of prematurity, neonatal hospital admission and length of stay in hospital (P < 0.003, P < 0.0005 and P < 0.0001, respectively).

CONCLUSION

Formulation of an appropriate strategy utilizing the available resources for measles vaccination is mandatory.