BackgroundAlthough the exact pathophysiology of preeclampsia is not completely understood, the utility of different platelets indices can be utilized to predict preeclampsia.ObjectiveTo compare platelet indices, namely platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), and PC to MPV ratio in women with preeclampsia compared with healthy controls.SettingQassim Hospital, Kingdom of Saudi Arabia.DesignA case–control study. Sixty preeclamptic women were the cases and an equal number of healthy pregnant women were the controls.ResultsThere was no significant difference in age, parity, and body mass index between the study groups. Sixteen and 44 of the cases were severe and mild preeclampsia, respectively. There was no significant difference in PDW and MPV between the preeclamptic and control women. Both PC and PC to MPV ratios were significantly lower in the women with preeclampsia compared with the controls. There was no significant difference in the PC, PDW, MPV, and PC to MPV ratio when women with mild and severe preeclampsia were compared. Using receiver operating characteristic (ROC) curves, the PC cutoff was 248.0×103/µL for diagnosis of pre-eclampsia (P=0.019; the area under the ROC curve was 62.4%). Binary regression suggests that women with PC <248.010×103/µL were at higher risk of preeclampsia (odds ratio =2.2, 95% confidence interval =1.08–4.6, P=0.03). The PC/MPV cutoff was 31.2 for diagnosis of preeclampsia (P=0.035, the area under the ROC curve was 62.2%).ConclusionPC <248.010×103/µL and PC to MPV ratio 31.2 are valid predictors of preeclampsia.

BACKGROUND:There is a global increase in the rate of cesarean deliveries, with the higher morbidity and mortality. Few published data on cesarean delivery exist in Qassim, Kingdom Saudi Arabia (KSA).OBJECTIVES:To investigate the incidence, type, indications, maternal and perinatal outcomes of cesarean delivery.METHODS:A retrospective study was conducted during three months (August-October 2016) at Maternity and Children’s Hospital (MCH), Buraidah, Qassim, KSA. The medical files of parturient women during the period were revised and the data extracted through questionnaires.RESULTS:There were 936 deliveries during the study period. The mean (SD) of their age, parity and gestational age were 28.6 (6.3) years, 3.0 (2.1) and 38.8 (1.6) weeks, respectively. Out of these 936 deliveries, 396 (42.3%), 21 (2.2%), 114 (12.2%), 405 (43.3%) were vaginal, instrumental, elective and emergency cesarean deliveries, respectively. The indications of the cesarean delivery were; repeated cesarean deliveries (201, 21.5%), failure to progress (87, 9.3%), fetal distress (72, 7.7%); breach (60, 6.4%), antepartum hemorrhage (54, 5.8%), hypertension (36, 3.8%) and diabetes mellitus (9, 1.0%) and more than one indication (6; 0.6%). In binary regression, while age, parity, birth weight and newborn gender were not associated with cesarean delivery, education ≤ secondary level (OR = 2.40, 95% CI = 1.59-3.61, P < 0.001), obesity (OR = 2.30, 95% CI = 1.51-3.48, P < 0.001 and morbid obesity (OR = 3.48, 95% CI = 2.16-5.60, P < 0.001) were associated with cesarean delivery. Nine (2.2%) vs three (0.6%), P = 0.03 women in the group of the cesarean and vaginal delivery respectively developed endometritis. Apgar score at one minute was significantly lower in newborn delivered by cesarean. There were three stillbirths (all of them were delivered by emergency cesarean), P = 0.120. Fifty-four of the newborn was admitted to the nursery; 39 (7.5%) vs.15 (3.6%) were delivery by cesareans vs vaginal delivery; P = 0.010.CONCLUSION:There is a high incidence of cesarean delivery in this hospital; most of them were due to repeated cesarean delivery. Obese women were at higher risk of cesarean delivery.

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Mild to moderate chronic hypertension could be managed expectantly up to 41 weeks if SPE did not develop.

Cervical cancer is a common and an important public health problem for adult women in developing countries. In contrast, cervical cancer incidence is low in Saudi Arabia. High-risk types of human papilloma viruses (HPV16 and HPV18) are the most significant risk factors for cervical cancer. HPV16/18-E6 oncoprotein is associated with HPV etiology, viral persistence and epithelial transformation. Cell cycle protein p16 INK4a (p16) plays an important role in the pathophysiology of cervical carcinomas. The aims of this study were to investigate the expression of HPV16/18-E6 and p16 in uterine cervical carcinomas in Qassim Region--Saudi Arabia, and to relate the results to the established clinicopathological prognostic parameters (age of the patient, educational level, birth control methods, number of pregnancy, smoking status, degree of histological differentiation, clinical stage, and lymph node metastasis) The study included 40 specimens of uterine cervical squamous cell carcinomas diagnosed and confirmed by biopsy. Histopathological classification of cervical tumors cases was performed according to the International Federation of Gynecology and Obstetrics (FIGO). Immunohistochemical analysis for HPV16/18-E6 and p16 were carried out on formalin-fixed paraffin-embedded sections of cervical tissues using avidin-biotin peroxidase method. There was a significant statistical correlation between HPV16/18-E6 expression in cervical carcinoma and nationality, smoking status and size of the tumor. HPV16/18-E6 oncoprotein expression in normal lymphocytes and endothelial cells in the tumor tissues and the adjacent normal cervical tissues suggest the possibility that HPV infection might spread to other organs through blood circulation. P16 expression has been correlated with high grade, stage of cervical SCC and HPV16/18-E6 expression. The current study supports the critical function of p16 and HPV16/18-E6 as specific markers for cervical carcinoma. However the potential for usage of p16 and HPV16/18-E6 as prognostic markers will require detailed follow data for a larger group of patients.