Papers by Hassan Ba'aqeel
Annals of Saudi Medicine, Mar 1, 1989
Annals of Saudi Medicine, Nov 1, 1988
ABSTRACT
Reproductive Health, Apr 12, 2013
Background: In 2001, the WHO Antenatal Care Trial (WHOACT) concluded that an antenatal care packa... more Background: In 2001, the WHO Antenatal Care Trial (WHOACT) concluded that an antenatal care package of evidence-based screening, therapeutic interventions and education across four antenatal visits for low-risk women was not inferior to standard antenatal care and may reduce cost. However, an updated Cochrane review in 2010 identified an increased risk of perinatal mortality of borderline statistical significance in three cluster-randomized trials (including the WHOACT) in developing countries. We conducted a secondary analysis of the WHOACT data to determine the relationship between the reduced visits, goal-oriented antenatal care package and perinatal mortality. Methods: Exploratory analyses were conducted to assess the effect of baseline risk and timing of perinatal death. Women were stratified by baseline risk to assess differences between intervention and control groups. We used linear modeling and Poisson regression to determine the relative risk of fetal death, neonatal death and perinatal mortality by gestational age. Results: 12,568 women attended the 27 intervention clinics and 11,958 women attended the 26 control clinics. 6,160 women were high risk and 18,365 women were low risk. There were 161 fetal deaths (1.4%) in the intervention group compared to 119 fetal deaths in the control group (1.1%) with an increased overall adjusted relative risk of fetal death (Adjusted RR 1.27; 95% CI 1.03, 1.58). This was attributable to an increased relative risk of fetal death between 32 and 36 weeks of gestation (Adjusted RR 2.24; 95% CI 1.42, 3.53) which was statistically significant for high and low risk groups. Conclusion: It is plausible the increased risk of fetal death between 32 and 36 weeks gestation could be due to reduced number of visits, however heterogeneity in study populations or differences in quality of care and timing of visits could also be playing a role. Monitoring maternal, fetal and neonatal outcomes when implementing antenatal care protocols is essential. Implementing reduced visit antenatal care packages demands careful monitoring of maternal and perinatal outcomes, especially fetal death.
Middle East Fertility Society Journal, Jul 1, 2010
American Journal of Obstetrics and Gynecology, Sep 1, 2001
OBJECTIVE: To document the occurrence of long-term sequelae after type I female genital mutilatio... more OBJECTIVE: To document the occurrence of long-term sequelae after type I female genital mutilation (FGM) and describe the surgical treatment of epidermal clitoral inclusion cyst.
Annals of Saudi Medicine, Mar 1, 1989
European Journal of Obstetrics & Gynecology and Reproductive Biology, Oct 1, 1994
Preterm birth (< 37 weeks completed gestation), the primary predictor of infant morbidity ... more Preterm birth (< 37 weeks completed gestation), the primary predictor of infant morbidity and mortality, can result from diverse biologic and sociodemographic variables. A case-control study was undertaken to determine risk factors that were significantly associated with preterm birth in our population. Pertinent data were collected by structured interviews with eligible subjects and by medical record abstraction. The study population consisted of 118 mothers of singleton, preterm, appropriate for gestational age infants (cases) and 118 mothers of singleton, term, appropriate for gestational age infants (controls). A multiple logistic regression analysis indicated that significant risk factors for preterm birth were first or second trimester vaginal bleeding during current pregnancy, a previous preterm birth, inadequate prenatal care, consanguinity, maternal body mass index of < 23, and short inter-pregnancy interval. Awareness of such risk factors is essential in planning public education programs and in considering appropriate perinatal care options for women at potentially higher risk for preterm delivery.
Annals of Saudi Medicine, Jul 1, 1990
Annals of Saudi Medicine, Mar 1, 1989
Annals of Tropical Paediatrics, 1991
SUInInary In a multicentre prospective study, we have determined the incidence of low birthweight... more SUInInary In a multicentre prospective study, we have determined the incidence of low birthweight (LBW) and the main predisposing risk factors. Among 4651 consecutive births over a 5-month period in five hospitals in Riyadh, the overall incidence of LBW was 8.4%. When stillbirths were excluded the incidence ofLBW was 7.4% of all live births. Statistical analysis was performed among 638 births (319 LBW infants, i.e. ::::; 2499 g and 319 babies weighing 2500 g or more). Of the 28 antenatal risk variables analysed, 13 were found to be significant when studied separately. Of these 13 variables, six were found to be significant predictors of LBW, using stepwise multiple logistic regression. These six variables together correctly predicted 72% and 88% of the LBW babies or normal birthweight babies, respectively. The risk factors thus identified were (i) short gestation, (ii) multiple gestation, (iii) low maternal body mass index, (iv) nulliparity, (v) availability of housework help, and (vi) absence of consanguinity. Measures for reducing these factors are also discussed.
Annals of Saudi Medicine, May 1, 2009
C esarean delivery (CD) is one of the most comm m monly performed surgical procedures in Saudi Ar... more C esarean delivery (CD) is one of the most comm m monly performed surgical procedures in Saudi Arabia. As reported by the Ministry Of Health (MOH) in 2006, there were a total of 784 145 surgim m cal procedures in all government and private hospitals, of which 86 197 were CDs (11%). 1 Indications for CD range from wellmdefined medical indications to lessmdefined indications. In 1985, the World Health Organization suggested that CD should not exceed 15% of the total deliveries. 2 Globally, there is an alarmm m ing increase in the CD rate. In developed countries the rate went from about 2.5% to 6% in the 1970s to about 12% to 22% in the late 1990s. 3 In 2004, the rate in the United States reached 29.1%. 4 Data on CD rates in dem m veloping countries are not as easily available. A recent estimate of the overall rates in developing countries is 12% based on nationally representative data from 82 countries. 5 Annual increases in the rates of CD has been reported for some developing countries, ranging from 5% to 11%. 6 The increase in CD rate is of concern not only bem m
Obstetric Anesthesia Digest, Sep 1, 2014
parturients suspected of having a placenta accreta to a tertiary care center early in the third t... more parturients suspected of having a placenta accreta to a tertiary care center early in the third trimester, with delivery planned at that center. At the present moment, the most useful management strategy for placenta accreta, as well as the optimal timing of delivery, remains to be clarified by further studies. The usefulness of autologous blood transfusion or cell salvage blood is still controversial. 8 Although randomized-controlled studies would be ideal for the resolution of these unsolved issues, it is virtually impossible to perform these studies due to ethical and logistical reasons.
Acta Obstetricia et Gynecologica Scandinavica, 2003
To identify the risk factors for failed instrumental vaginal delivery, and to compare maternal an... more To identify the risk factors for failed instrumental vaginal delivery, and to compare maternal and neonatal morbidity associated with failed individual and sequential instruments used. A retrospective case-control study. From January 1995 to June 2001, there were 39 508 live births at >37 weeks' gestation of which 2628 (6.7%) instrumental vaginal deliveries were performed, 1723 (4.4%) were vacuum extractions and 905 (2.3%) were forceps. A total of 155/2628 (5.9%) patients who had failed instrumental delivery were matched with 204 patients who had successful instrumental delivery. The patients were divided into five groups. Group I (n = 129) had failed vacuum extraction, group II (n = 13) failed forceps, group III (n = 13) failed both (i.e. failed attempt at both instruments sequentially), group IV (n = 138) had successful vacuum extraction and group V (n = 66) successful forceps. The failure rate for vacuum extractions 129/1723 (7.5%) was significantly higher than that for forceps 13/905 (1.4%) [odds ratio (OR) = 5.6, 95% CI 3-10.3]. There were no significant differences in all maternal complications (25.5% vs. 26.6%) between vacuum (groups I and IV) and forceps (groups II and V) assisted deliveries. There were more maternal complications in group III (46.2%) than in groups I (35.7%), II (23.1%) and V (27.3%) that did not reach statistical significance but were significantly higher than in group IV (15.9%, OR = 4.5, 95% CI 1.2-16.9). There was a significantly higher rate of all fetal complications in group III [11/13 (84.6%)] than in groups I [69/129 (53.5%)], II [7/13 (53.8%)], IV [35/138 (25.4%)] and V [22/66 (33.3%)] (OR = 4.8, 95% CI 0.9-19.9). Applying the instrument at < or =0 fetal station, nulliparous women, history of previous cesarean section and fetal head other than occipitoanterior position were risk factors for failed instrumental delivery. Sequential use of instrumental delivery carries a significantly higher neonatal morbidity than when a single instrument is used.
Annals of tropical paediatrics, 1991
In a multicentre prospective study, we have determined the incidence of low birthweight (LBW) and... more In a multicentre prospective study, we have determined the incidence of low birthweight (LBW) and the main predisposing risk factors. Among 4651 consecutive births over a 5-month period in five hospitals in Riyadh, the overall incidence of LBW was 8.4%. When stillbirths were excluded the incidence of LBW was 7.4% of all live births. Statistical analysis was performed among 638 births (319 LBW infants, i.e. less than or equal to 2499 g and 319 babies weighing 2500 g or more). Of the 28 antenatal risk variables analysed, 13 were found to be significant when studied separately. Of these 13 variables, six were found to be significant predictors of LBW, using stepwise multiple logistic regression. These six variables together correctly predicted 72% and 88% of the LBW babies or normal birthweight babies, respectively. The risk factors thus identified were (i) short gestation, (ii) multiple gestation, (iii) low maternal body mass index, (iv) nulliparity, (v) availability of housework help...
Statistics in Medicine, 2001
Paediatric and Perinatal Epidemiology, 1998
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Papers by Hassan Ba'aqeel