Bridging women's emergency and primary healthcare: Factors associated with prolonged obstetrics and gynecology emergency room stay in a Saudi university hospital Nouf A. AlShamlan, Reem S. AlOmar, Nourah H. Al Qahtani, Fatimah S. Badghaish, Rehab F. Alghamdi, Omar Y. Almukhadhib, Nurah Salham Alnuaimi, Amani M. AlQarni, Adam F. Aldhawyan, Amani S. AlOtaibi, Abdullah H. Alreedy International Journal of Gynecology and Obstetrics, 2026 ObjectiveLength of stay (LoS) is a significant performance indicator in healthcare systems. Prolonged LoS in the obstetrics and gynecology emergency rooms (OB‐GYN ERs) contributes to ER congestion and resource inefficiencies. The aim of this epidemiological study was to identify factors associated with prolonged LoS among patients attending a university hospital OB‐GYN ER in Saudi Arabia.MethodsA retrospective analysis was conducted on 7987 OB‐GYN ER visits from January to December 2022. Variables analyzed included patient age, triage level, visit timing and season, discharge status, and chief complaint. Predictors of prolonged LoS were assessed using a multivariable linear regression analysis.ResultsProlonged LoS was observed in 19.62% of visits. Higher‐acuity triage levels were associated with shorter LoS. Patients who were admitted or referred had shorter LoS than those discharged routinely, while absconded patients and those not located had significantly longer stays. Visits for non‐obstetric complaints such as cardiovascular or neurologic issues were associated with longer LoS than obstetric‐related complaints. Seasonal and temporal factors were also significant, with shorter durations noted in summer and nighttime visits.ConclusionMultiple factors contribute to variation in LoS in OB‐GYN ER settings, including triage severity, time of visit, and type of complaint. Strengthening the integration of women's health subspecialties within family medicine at the primary healthcare level can play a pivotal role in managing non‐urgent cases more efficiently. These improvements align with the goals of Saudi Vision 2030 by enhancing healthcare delivery, optimizing resource utilization, and expanding access to specialized women's health services outside hospital‐based OB‐GYN ER settings.
Sick leave issuance in an obstetrics and gynecology emergency room in Saudi Arabia: Insights for public health and family medicine Nouf A. AlShamlan, Reem S. AlOmar, Nourah H. Al Qahtani, Fatimah S. Badghaish, Rehab F. Alghamdi, Omar Y. Almukhadhib, Nurah Salham Alnuaimi, Assim M. AlAbdulKader, Amani S. AlOtaibi, Abdullah H. Alreedy, Malak A. Al Shammari Sage Open Medicine, 2025 Introduction: Sick leave documentation is a routine component of emergency visits but remains understudied in obstetrics and gynecology emergency room settings. Understanding the factors associated with sick leave issuance can inform better resource allocation and highlight opportunities for integration into primary healthcare services, particularly in the context of women’s health. The purpose of this study was to evaluate the trends, features, and associated factors of sick leave issued in the obstetrics and gynecology emergency room at a major teaching hospital in Saudi Arabia. Methods: This record-based retrospective epidemiological study was conducted on all obstetrics and gynecology emergency room visits of females aged ⩽60 years between January and December 2022 at a Saudi teaching hospital. Sociodemographic, clinical, and operational variables were extracted. Logistic regression was used to identify predictors of sick leave issuance. Results: Of the 8743 visits, 7.61% resulted in sick leave. Older age, non-Saudi nationality, musculoskeletal and gynecological complaints, the autumn season, and morning visits were significantly associated with higher odds of sick leave. Among those issued with sick leave, only 4.36% received more than 3 days, which were mostly associated with hospital admission, the winter season, and longer emergency room stays. Conclusion: A sick leave is often requested for non-urgent complaints that can be managed in the primary healthcare settings. From a public health standpoint, integrating sick leave documentation and women’s health services into primary healthcare may reduce unnecessary emergency room visits, optimize healthcare delivery, and support national healthcare transformation goals.
Primary versus secondary infertility: Epidemiology and characteristics from a referral hospital in Saudi Arabia Nouf A AlShamlan, Reem S AlOmar, Abdulrahman Abdulrazzaq Alfryyan, Abdulsalam Essam Almuhanna, AlJawhara Raed AlSaadoun, Halah Raaed AlMuhaidib, Mohammad Ghazi Alhaidari, Rakan Saud Alharbi, Abdullah H Alreedy, Nouf A AlTooq, Amani S AlOtaibi Sage Open Medicine, 2025 Objective: This study aimed to explore the epidemiology and characteristics of primary versus secondary infertility cases referred to infertility clinics at a major Saudi Arabian referral hospital, as well as potential correlations between patients’ characteristics and infertility types. Methods: All female patients who visited the infertility clinics between January 2020 and December 2022 were included in this retrospective chart review study. Data were collected on medical histories, medications, diagnostic tests, reproductive characteristics, and the type and cause of infertility. Results: During the study period, a total of 667 female patients attended the infertility clinic. The mean age was 33.64 ± 6.56 years. The mean marriage duration was 79.92 ± 57.17 months, and the mean duration of infertility was 59.80 ± 49.71 months. Of the total patients, 56.07% had secondary infertility, whereas 43.93% had primary infertility. The most frequently defined causes were unexplained, followed by combined factors. Temporal patterns show a gradual, but significant decrease in cases during the COVID-19 pandemic peak months (25.82% reduction between January and April). Results from diagnostic tests were generally normal for most patients. Females with secondary infertility tended to be older (Mean age = 34.64 vs 32.37 years) and had been married for longer (Mean duration 96.18 vs 68.86 months; p -value < 0.001). The duration of infertility was longer for patients with primary infertility. An irregular menstrual cycle was more common in females with the primary type of infertility. Individuals with secondary infertility were significantly more likely to have had previous surgery. Conclusion: Crucial information in the epidemiology of infertility has been found. The older age among secondary infertility, as well as the high proportion of unknown causes warrants further research. Women’s health consultants and family physicians should initiate investigations and manage underlying causes during the waiting period for specialized clinic appointments.
High Insulin Resistance in Saudi Women with Unexplained Recurrent Pregnancy Loss: A Case–control Study AhlamA Alghamdi, AmaniS Alotaibi Saudi Journal of Medicine and Medical Sciences, 2023 Background: Unexplained recurrent pregnancy loss (RPL) accounts for >50% of the patients with RPL. Insulin resistance (IR) is a potential cause of unexplained RPL. Objectives: To evaluate the relationship between insulin resistance (IR) and unexplained RPL among Saudi women. Methods: This is a single-center, case–control study conducted at a tertiary hospital in the Eastern Province of Saudi Arabia. The study group comprised Saudi women with unexplained RPL, while the control group had Saudi women with at least one live birth and no RPL. Blood samples were taken to determine the fasting glucose (FG) and fasting insulin (FI) levels. Women with diabetes mellitus and polycystic ovarian syndrome were excluded. A homeostatic model assessment of insulin resistance index (HOMA-IR) value ≥3 was considered as IR. Results: The study and control groups comprised 43 and 56 women, respectively. Between the groups, there was a significant difference in the mean age (case: 37.9 ± 5.4 years; control: 32.2 ± 5.9 years; P ˂ 0.0001) and the mean BMI (case: 31.5 ± 6.0; control: 26.1 ± 2.8; P ˂ 0.0001). FG level was slightly higher in the control group (90.9 mg/dL vs 88.7 mg/dL; P = 0.068). FI level was significantly higher in the study group (16.33 μU/mL vs. 6.17 μU/mL; P ˂ 0.0001). HOMA-IR of ≥3 was significantly more common in the study group (n = 22; 51.2%) than the control group (4; 7.1%) (P < 0.0001). After adjusting for age and BMI, IR ≥3 was found to be independently associated with unexplained RPL (aOR: 13.2; 95% CI: 3.77–46.36). Conclusions: This study showed that Saudi women with unexplained RPL had significantly higher levels of fasting insulin and insulin resistance than those without a history of RPL. Therefore, it is recommended to assess IR in women with RPL.
The Epidemiology, Associated Factors and Bacterial Profile of Asymptomatic Bacteriuria in Pregnant Women: A Retrospective Chart Review Study in Saudi Arabia Nouf A AlShamlan, Reem S AlOmar, Roba Aldossary, Maha Alahmari, Asma Alghamdi, Mawaddah AlGhamdi, Najla Alkanaan, Abdullah H AlReedy, Amani S AlOtaibi, Nada S Alghamdi International Journal of Women S Health, 2022 Purpose Asymptomatic bacteriuria (ASB) is the presence of significant amounts of bacteria within the urinary tract in the absence of urinary tract infection (UTI) symptoms, resulting in negative neonatal and pregnancy consequences. This study determined the prevalence, bacteriology patterns, and associated factors with ASB among pregnant women in both primary and hospital levels of care in the Eastern Province of Saudi Arabia. Methods This retrospective chart review study included pregnant women between 18 and 50 years who performed the screening urine culture test during their first antenatal visit between 2017 and 2021, without UTI symptoms. The collected data involved the demographic, medical, and obstetric characteristics, and urine culture results. T-tests and chi-squared tests were used for bivariate associations followed by binary logistic regression models. Results ASB was positive among 03.42% of the 6471 pregnant women included in the study. Logistic regression revealed that the risk of positive ASB increased in pregnant women in the first and second trimesters (OR = 2.04, 95% CI = 1.41–2.93 and OR= 1.50, 95% CI = 1.03–2.19, respectively), as well as pregnant women with a history of previous UTI (OR = 2.98, 95% CI = 2.14–4.15). The predominant organism isolates were E. coli, followed by GBS, Klebsiella pneumoniae, and Enterococcus faecalis. Conclusion With limited data on ASB among pregnant women in Saudi Arabia, findings from the current study could help decision-makers in the country assess the epidemiological characteristics of the condition. Further study is recommended to investigate the susceptibility patterns of commonly prescribed antibiotics with different uropathogens to guide the clinicians who deal with these cases. Additionally, a large national study across the other regions in the kingdom is suggested to calculate the prevalence of ASB in Saudi Arabia.
Seroprevalence of rubella virus among pregnant women: A 4-year registered-based study from family medicine and obstetric clinics in Saudi Arabia Nouf A. AlShamlan, Reem S. AlOmar, Amani S. AlOtaibi, Omar Y. Almukhadhib, Abeer A. AlShamlan, Abdullah H. Alreedy, Najwa A. Zabeeri, Magdy A. Darwish, Malak A. Al Shammri International Journal of Clinical Practice, 2021 This study aimed to determine rubella virus infectivity and immune status in pregnant females who visited the family medicine and obstetrics clinics at a large hospital in Saudi Arabia, and to identify the possible predictors of rubella susceptibility.
