Deliveries in Lebanon, the Country with the Highest Refugee Density in the World: A Descriptive Review.

Purpose: The aim of this study is to analyze obstetrical and reproductive health parameters in Lebanon from 2015 until 2018 in the setting of the Syrian refugee influx in order to evaluate potential risks and provide a management plan to improve outcomes.

Description: Data from the Lebanese Ministry of Public Health (LMPH) on all obstetrical deliveries that occurred in Lebanon between 2015 and 2018 was screened and analyzed. Number and mode of delivery as well as maternal and neonatal outcomes were included.

Vaccination in pregnancy.

The evidence indicates that pregnancy is associated with increased severity of some infectious diseases. Given the high maternal morbidity associated with influenza in pregnancy and the high neonatal morbidity and mortality associated with pertussis, the traditionally two recommended vaccines during pregnancy were those against influenza and Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis) vaccines. The recent COVID-19 pandemic introduced a third vaccine that after much debate is now recommended for all pregnant women.

Borderline ovarian tumors: a retrospective cohort study on single institution experience, practice patterns and outcomes.

Borderline ovarian tumours (BOTs) commonly affect young nulliparous women, thus making fertility-preserving approaches more desirable. Women who opt for conservative management should be counselled about disease recurrence. In this retrospective study, the medical records of 57 women with BOT treated at the American University of Beirut Medical Centre between January 1986 and May 2018 were reviewed.

Appropriateness of hysterectomies at the time of surgical removal of presumed benign adnexal masses.

Objective: To evaluate factors that affect a gynecologist's decision to remove an asymptomatic uterus at the time of removal of a presumed benign adnexal mass.

Methods: Retrospective chart review of hysterectomies conducted when removing presumed benign adnexal masses at a tertiary-care academic center. Primary outcome was the final pathology of the adnexal mass to determine whether the hysterectomy was medically indicated.

The clinical utility of intrapartum screening urinalysis for the prevention of postpartum pyelonephritis.

Objectives: Urinary tract infection (UTI) is the most common bacterial infection to complicate pregnancy. Medical authorities recommend screening for asymptomatic bacteriuria (ASB) in pregnancy; albeit there is no consensus on ideal timing and frequency for testing. Due to the persistent physiologic changes of pregnancy postpartum, a recent trend to perform urinalysis upon presentation for delivery has been adopted at our institution and various satellite hospitals to putatively minimize cases of postpartum pyelonephritis.

Effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures: a randomized clinical trial.

Background: Laparoscopic surgery has become a standard of care for many gynecological surgeries due to its lower morbidity, pain and cost compared to open techniques. Unfortunately, the use of carbon dioxide (CO) to insufflate the abdomen is the main contributor to post-operative shoulder pain.

Methods: We aim to assess the effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures.

Use of Uterine Characteristics to Improve Fertility-Sparing Diagnosis of Adenomyosis.

To describe patient demographics, determine accuracy of clinical diagnosis, and evaluate reliability of laparoscopic uterine characteristics in the diagnosis of adenomyosis. Enrollment included 117 patients undergoing laparoscopic hysterectomy for benign indications. Intraoperatively, the attending surgeon predicted uterine weight; evaluated the presence of fibroids; and commented on the uterus' shape, color, and consistency while probing it with a blunt instrument.

Pityriasis rosea-like eruption associated with ondansetron use in pregnancy.

A 30-year-old pregnant female presented with a 2-week history of pityriasis rosea-like eruption. The rash started 2 days after the patient had started taking ondansetron 8 mg for alleviation of moderate-to-severe nausea and vomiting of pregnancy. Physical examination revealed erythematous papulosquamous lesions characterized by annular scaly margins and a dusky centre over the arms, chest, abdomen, lower back and legs.

The use of barbed suture for bladder and bowel repair.

Study Objective: To describe the laparoscopic repair of bladder and bowel injuries using barbed suture and review postoperative outcomes.

Design: Retrospective medical chart review (Canadian Task Force classification II-3).

Setting: Large academic medical institution.

Laparoscopic excision of sacrocolpopexy mesh.

Study Objective: To demonstrate surgical maneuvers to facilitate laparoscopic excision of sacrocolpopexy mesh and prevent potential complications.

Design: Step-by-step illustration of various surgical techniques using a video compiled from 3 laparoscopic sacrocolpopexy mesh excision procedures performed at Magee-Womens Hospital for various indications (Canadian Task Force classification xx-xx).

Setting: Mesh complications such as infection and erosion are frequently managed conservatively but often necessitate mesh excision for symptom relief.

Clinical utility of postoperative hemoglobin level testing following total laparoscopic hysterectomy.

Objective: To determine the clinical utility of hemoglobin level testing in guiding postoperative care following total laparoscopic hysterectomies performed for benign indications.

Study Design: Retrospective cohort study.

Results: A total of 629 women underwent total laparoscopic hysterectomies during the 24 month study period.

Perforated intraperitoneal intrauterine contraceptive devices: diagnosis, management, and clinical outcomes.

Study Objective: To describe a series of intraperitoneal perforated intrauterine contraception devices (IUDs) and to discuss associated findings, methods for diagnosis, and management of this complication.

Design: Retrospective review of surgical database between 1998 and 2012 (Canadian Task Force classification II-2).

Setting: University medical center.

The use of barbed suture in bladder and bowel surgery.

A new class of suturing material, barbed suture, was recently added to the surgeon's armamentarium. It was initially used in open surgery for soft tissue approximation. Its applications in laparoscopic surgery quickly flourished because it eliminates the time-consuming process of extracorporeal and intracorporeal knot tying.

Thoracic endometriosis: a case report.

Background: Endometriosis is a benign gynecologic disorder that affects women of reproductive age. It can be asymptomatic or can cause pelvic pain or subfertility. On rare occasions it may manifest outside of the pelvis, leading to a multitude of symptoms that can be life-threatening if proper diagnosis is delayed.