Maternity Teaching Hospital Research Articles

ASSOCIATION BETWEEN ANTI-THYROID PEROXIDASE ANTIBODY AND RECURRENT MISCARRIAGE

Background Thyroid disease is the second most commonly affected disease in childbearing women, after diabetes, and thyroid autoimmunity in pregnancy has been connected with adverse pregnancy outcomes such as miscarriage, recurrent miscarriage, preterm birth, and low intelligence.
 Objectives The study seeks to determine whether there is a significant correlation between anti-thyroid peroxidase antibodies and unexplained recurrent miscarriages.
 Patients and MethodsA Case-control study was conducted on 124 participants, 62 women who had experienced unexplained recurrent miscarriage and 62 healthy women without a history of miscarriage, from 11.9.2021 until 10.6.2022 in the outpatient and emergency department of Sulaimani Maternity Teaching Hospital and some private clinics in Sulaimani City/Kurdistan Region /Iraq, and screening for TSH and anti–thyroid peroxidase antibody are done for both groups.
 ResultsThe prevalence of positive anti-thyroid peroxidase antibody in women with recurrent miscarriage was 19.4 %, while in women without miscarriage was 6.5% (which is considerably higher in cases than in women without recurrent miscarriage with a p-value of 0.03 and an odd ratio of 3.48 (95% CI; 1.06-11.48).
 ConclusionThere is a statistically significant relationship between anti-thyroid peroxidase antibodies and recurrent miscarriage. We recommend screening for TSH and thyroid antibodies for women with recurrent miscarriages and further studies on the effect of levothyroxine therapy for euthyroid women with antibody positive.

Indications and Neonatal Outcomes of Caesarean Delivery among Women Attending Maternity Teaching Hospital, Sulaimaniyah City, Iraq

Background: Cesarean section is the most commonly performed surgical procedure in obstetrics, defined as the birth of a fetus via a surgically created incision in the anterior uterine wall. Over the past two decades, there has been a steady rise in the rate of cesarean section delivery globally. As a result, short-term and long-term maternal and neonatal complications are rising.
 
 Objective: This study aimed to investigate the indications and neonatal outcomes of CS among women attending the Maternity Teaching Hospital in Sulaimaniyah city, Iraq.
 
 Materials and Methods: This descriptive cross-sectional research was performed on 100 women from 12th December 2021 to 12th April 2022.
 
 Results: Among participants, 50% were aged >30 years, and three-quarters were housewives. Nearly half of the mothers were multigravida and multipara, in which 64% were emergency, but only 10% underwent CS after delivery induction failure. The utmost common indications of CS were preeclampsia (16%), followed by meconium-stained liquor (12%), non-reassuring fetal heart rate pattern (10%), malpresentation, malposition, and previous C/S (8%). In most newborn babies, Apgar score level was seven and <7 minutes.
 
 Conclusions: Most CS were emergency and performed for babies at full and post-term. NICU admission was associated with a low Apgar score, respiratory distress syndrome and all indications of CS.

The effects of dual-strain probiotics on the weight gain in premature neonates of Kabul City: A randomized clinical trial

BackgroundPrematurity is prevalent worldwide and accounts for the leading cause of neonatal death. Preterm neonates face numerous challenges, including slow weight gain, prolonged hospital stays, and high mortality. Dual-strain probiotics containing Bifidobacterium bifidum and Clostridium butyricum can manage such complications of prematurity. Therefore, the present study was conducted to evaluate the effectiveness of dual-strain probiotics consisting of Bifidobacterium bifidum and Clostridium butyricum on the weight gain of preterm neonates in Kabul City. MethodsThis randomized clinical trial was conducted at the Neonatal Units of Malalai Maternity and Maiwand Teaching Hospitals in Kabul City. Finally, 84 preterm neonates were assessed for the effects of dual-strain probiotics. The clinical parameters were daily weight gain and the risks of feeding intolerance and neonatal mortality. Statistical analysis was performed by SPSS 26. ResultsForty-two premature neonates in the probiotics group and another forty-two preterm babies in the control group were investigated. In the probiotic group, 250 mg or 25 × 108 CFU of dual-strain probiotics dissolved in 1–3 ml milk were given twice daily for three weeks. At the time of intervention, the preterm neonates in the probiotics versus control group had a mean age of (7 ± 3.3 vs 6.8 ± 3.3 days; P = 0.69), weight of (1497.5 ± 272 vs 1483.3 ± 271 g; P = 0.8) and gestational age of (33.6 ± 2 vs 33 ± 2.4 weeks; p = 0.31). Gender distribution in the probiotics group was (boys 54.8%, girls 45.2%) and in the control group it was (boys 50%, girl 50%). The premature newborns in the probiotics versus control group had a higher mean daily weight gain (15.5 ± 9.4 vs 10 ± 7.9 g; P = 0.001), lower mean age to reach full enteral feeds (8.74 ± 3.08 vs 10.81 ± 3.43 days, P = 0.005) and lower mean hospital stays (10.02 ± 4.68 vs 12.81 ± 4.86 days, P = 0.009) . The risk ratios of feeding intolerance and mortality during the hospital stays were (RR=0.59, P = 0.71) and (RR=0.67, P = 0.5) in probiotics and non-probiotics groups respectively. ConclusionDual-strain probiotics consisting of Bifidobacterium bifidum and Clostridium butyricum significantly improved the daily weight gain, and decreased the time to full enteral feeding and admission days for premature neonates.

Evaluation of peripheral cannulation technique among nurses in maternity and Dr. Jamal Ahmad Rashid pediatric teaching hospitals in Sulaimaniyah, Iraq

BackgroundObedience to the excellent standards of nursing practice is the ultimate attitude to develop patient outcomes and avoid nursing process related-infections. Inserting the peripheral intravenous cannula is the utmost mutual aggressive technique achieved in nursing care for patients. Therefore, nurses must have adequate knowledge and practice to ensure the procedure’s success.ObjectivesTo determine the peripheral cannulation technique evaluation among nurses working in the emergency departments.MethodsThis descriptive-analytical study was conducted at Maternity and Pediatric Teaching Hospitals in Sulaimaniyah, Iraq on 101 randomly selected nurses, from 14th December 2021 to 16th March 2022. Data collection was carried out through a structured interview questionnaire aimed to gather the nurses’ general characteristics and an observational checklist to assess the nurses’ pre, during and post practices regarding peripheral cannulation technique.ResultsAccording to general practice, 43.6% of nurses had an average level, 29.7% had a good level, and 26.7% had a poor level of practice in the evaluation of the peripheral cannulation technique. Our study also showed a positive association between socio-demographic characteristics of the studied samples with the overall level of practice regarding peripheral cannulation technique.ConclusionsNurses were not practised peripheral cannulation technique appropriately; however, half of the nurses’ had an average level of practice, although their practices were not followed the standard protocols.

Pregnancy and Delivery Complications Between Adolescent and Adult Women at Mosul Maternity Teaching Hospitals: A Comparative Study

Background: Adolescent pregnancy is one of the common public health problems worldwide today, with harmful health effects to the foetus, mother and the neonate. Aims of the study: To identify the demographical characteristics of the study sample and to compare the complications of pregnancy and delivery between adolescent and adult pregnant women and to find out the relationship between demographical characteristics and study variables Patients and Methods: A quantitative cross-sectional observational study design was conducted in four maternity teaching hospitals in Mosul, Iraq, from the 10th of December 2021, until the 1st of March 2022. The study group included 100 pregnant adolescents aged 10–19 years, and the comparable group included 157 pregnant women aged between 20 and 45 years. Result: In comparison to adult women, adolescent women are more likely to suffer from anemia (77%), IUGR (13%), abruptio placenta (15%), psychological problems (24%), cervical insufficiency (20%), preterm labor (26%), obstructed labor (41%), prolonged labor (29%), postdate (30%), neonatal death (6%), and episiotomy (36%). Conclusion: There is a statistically significant difference (p<0.05) between the two groups in terms of anemia, gestational diabetes, urinary tract infection, intrauterine growth restriction, abruptio placenta, psychological problem, incompetence cervix, preterm labour, prolong labour, postdate, obstructed labour, dead newborn, episiotomy, and there is a direct and positive correlation between a husband's job with H.T and between BMI with (UTI, IUGR, preterm labour, prolonged labor) and between educational level with (abruptio placenta, CPD, postdate) and occupation with abruptio placenta. Recommendation: Instructing the Iraqi courts and the Ministry of Justice to legislate a law prohibiting the adolescent marriage and encourage the Iraqi Ministry of Health to activate family planning programs to delay pregnancy until the young girl's reach maturity. Keyword: adolescent, pregnancy, delivery, complication, adult

Comparing Non-Stress Test versus Umbilical Artery Doppler Velocimetry among Aample of High-risk Pregnant Women in Erbil City

Background: The mainstay of care for lowering maternal and perinatal mortality and morbidity is antepartum foetal surveillance. Numerous techniques are used, including fetal movements, Vibroacoustic stimulation tests, contraction stress tests, biophysical profiles of the fetus, modified biophysical profiles, non-stress testing and Doppler Umbilical artery of the fetus's. The fetal heart reaction to internal and extrinsic stimuli is seen on electronic fetal monitoring devices. The benefit of high resolution dynamic ultrasonography and Doppler imaging is that it allows for the visualization of the fetus and its surroundings as well as the monitoring of fetal health by measuring utero-placental circulation. Patients and techniques: The cross-sectional investigation including 120 pregnant women who visited the Maternity Teaching Hospital between 26 June and 31 August 2022 and complained of decreased uterine contractions have been included. The questionnaire included sociodemographic data, obstetrical data, information on the fetal outcome and method of delivery. In accordance with the American Academy of Obstetricians and Gynecologists, cardiotopography was utilized to conduct a non-stress test, and the outcomes were categorized as reactive and non-reactive. Cardiotopography was used to perform a non-stress test, and the results were classified as reactive or non-reactive in accordance with the American Academy of Obstetricians and Gynecologists. Also, during 32 weeks or more of gestation, the inferior vena cava was not compressed by the gravid uterus during ultrasonography of the umbilical arteries, which was performed in a semi-recumbent position with a slight lateral tilt. Result: Based on NST and Doppler velocimetry of the umbilical artery, all cases were classified into two groups. The outcomes of the two tests didn't significantly differ from one another. The rate of Cesarean section (CS) was 46.1% among women with non-reactive (abnormal) CTG, compared with 25% among women with normal CTG (p = 0.0316). Only one neonate (1.3%) died among women with normal CTG, while none of the neonates died among women with abnormal CTG. The rate of CS among women with abnormal ultrasonography was 80% compared to women (11%) with normal ultrasonography. Furthermore, one neonate (2.1%) in the group of abnormal doppler, compared with 0% in the normal group. Conclusion: NST and umbilical artery Doppler of are sensitive and specific tests with strong positive prognostic value to suggest a poor prognosis for the newborn. Doppler velocimetry of umbilical artery is more important than a non-stress test because it lowers the likelihood of a CS birth in non-reactive non-stress test situations without increasing the risk of perinatal morbidity and mortality. Bangladesh Journal of Medical Science Vol.22 (Special Issue) 2023 p.10-17

The effect of consanguinity on reproductive outcomes in Maternity Teaching Hospital in Erbil city

Background and objectives: Consanguinity is a wide spread practice, increases the incidence of multifactorial disorders such as diabetes, cardiovascular disorders, obesity has been associated with stillbirths, low birth weight, preterm delivery, abortion, infant and child mortality, congenital birth defects and malformations. The objective of this study is to evaluate the impact of consanguinity on maternal and neonatal health measurement. Methods: This case control study was carried out in Maternity Teaching Hospital in Erbil city, Kurdistan region, Iraq. The study duration was from 1st April 2020 to 1st April 2021. Data obtained from group I, two hundred fifty women had consanguineous marriage and group II, 250 women had non consanguineous marriage, regarding their pregnancy outcomes such as full term or premature live birth or still birth and miscarriage and any obvious congenital malformation. Results: The mean age of women of Group I (26.9 years) was significantly less than the mean age of women of group II (28.1 years). No significant differences were detected between the two study groups regarding the gestational age ,parity, antenatal care, stillbirth, miscarriage and rate of preterm deliveries. The rate of Cesarean section in Group I (26.8%) was significantly less than the rate of Group II (37.2%). Conclusions: Pregnant women with history of consanguinity had lower mean age than those without consanguinity without important differences in their parity, educational level and mean gestational age. Consanguinity had not resulted in increased rates of stillbirth, preterm labor, miscarriages or twin pregnancies in the studied sample.

Relation of Helicobacter Pylori and Hyperemesis Gravidarum in sample of pregnant women in Maternity Teaching Hospital of Erbil city

Background and objectives: Nausea and vomiting in early pregnancy are accompanied by great impact on general health status of pregnant women especially if presented as hyperemesis gravidarum. The helicobacter pylori infection is predominant in Iraqi community. The aim of the study is to find out whether sero-positivity for immunoglobulin G antibodies to Helicobacter pylori is related to hyperemesis gravidarum. Methods: A study carried out in Maternity Teaching Hospital in Erbil city, Kurdistan region-Iraq from 1st of May, 2019 to 30th of April, 2020 on a sample of 80 pregnant women; 40 pregnant women with hyperemesis gravidarum and 40 pregnant women as controls. Diagnosis of hyperemesis gravidarum was done depending on clinical presentations and investigations findings. Serum electrolytes and immunoglobulin G antibody tests were done for the studied women. Results: In the current study, 60% of pregnant women with hyperemesis gravidarum pregnant women had positive immunoglobulin G of Helicobacter Pylori as compared to 35% of control group. The serum levels of sodium, potassium and chloride were significantly lower in 40%, 50% and 25% of pregnant women with hyperemesis gravidarum respectively compared to 10%, 17.5% and 7.5% in control group. Low educational level and socioeconomic status of pregnant women were significantly associated with hyperemesis gravidarum. Hyperemesis gravidarum was more common in pregnant women with normal body mass index. Conclusions: Helicobacter pylori infection is more common in pregnant women with hyperemesis gravidarum. The development of hyperemesis gravidarum in pregnancy leads to obvious electrolyte imbalance.

Effect of progesterone on preventing preterm birth and adverse perinatal outcomes in women in the risk group: A prospective clinical trial

Background and Objective: Preterm labor is a significant reason for perinatal mortality and morbidity. This study was conducted to determine the effect of two regimens of progesterone to avoid preterm labor and the adverse perinatal outcomes in the two groups. Methods: A prospective clinical trial was performed in Maternity Teaching Hospital and Hawler Private Hospital in Erbil city, Kurdistan region, Iraq over a one-year period from 1 May 2019 until 1 May 2020. The study sample was 200 pregnant women with a short cervix and a risk of preterm birth; the sample was divided into two groups. Group I of 100 pregnant women received 400 mg progesterone vaginally once daily, and group II of 100 pregnant women received it twice daily, started from 16 weeks of gestation up to the time of delivery in both groups. Results: The rate of term pregnancy (? 37 weeks) was 87% among women in group II and 55% in women in group I. Accordingly, the rate of neonatal intensive care admission was significantly higher in group I than in group II (30% and 11%, respectively). The rate of respiratory distress syndrome was also significantly higher in group I (31%) than in group II (7%). Conclusion: The administration of progesterone 400 mg vaginally twice a day appears to be more effective than progesterone 400 mg vaginally once a day in preventing preterm birth and reducing the risk of adverse neonatal complications.

Factors Associated with Gastroenteritis Disease among Children Age 2-5 Years in Qaladze and Ranya City

Acute gastroenteritis is a major cause of pediatric morbidity and death worldwide, with high healthcare utilization, ongoing practice variation, and significant family burden, especially in developing countries, and young children under the age of five are the most vulnerable. The objectives of the study are to: To assess the factors associated with gastroenteritis in children 2-5 years of age and also to investigate if there is a correlation between socio-demographic data with some of the factors of gastroenteritis A quantitative /descriptive study was conducted, with A non-probability /convenience sampling, The sample size was (111) children who had gastroenteritis and were admitted in Ranya maternity and pediatric teaching hospital and pediatric ward in Shahidan Qaladze Teaching Hospital. The data was collected by modifying the questionnaire that was asked from the patient’s parents by interview (face to face) method. The results of the study indicate that most of the cases were between the age (of 24-28) months 22%, (29-33) months 14%, (32-38) months14% and (59and more) months 28% with the (Mean =42) months. The male was more affected (58%) than the female (42%). Most of the patients were from urban areas (67%). According to the findings, there is a correlation between BMI (body mass index) with gastroenteritis because the P-value is less than 0.05, (P-value =0.04566), there is a significant correlation between Type of feeding and eating Type with Gastroenteritis because the p-value for both of these correlations is less than (0.05), the p-value of correlation between Feeding type and Gastroenteritis is (0.0374). There is a correlation between making the water safer to drink with gastroenteritis because the P-value less than 0.05, and the P-value is (0.0423). Children under 5 years of age are vulnerable to suffering gastroenteritis, the factors, including BMI (body mass index) ،methods that are used to clean water safer, feeding type, and eating type; are those factors that make clients vulnerable to suffer gastroenteritis.

Comparing efficacy and safety of stair step protocols for clomiphene citrate and letrozole in ovulation induction for women with polycystic ovary syndrome (PCOS): a randomized controlled clinical trial.

Polycystic ovary syndrome (PCOS) is characterized by menstrual irregularities, high androgen levels, and ovarian cysts. Clomiphene citrate (Clomid) and letrozole have both been investigated as ovulation induction therapies for PCOS. This interventional study aimed to compare the efficacy and safety of a stairstep practice of letrozole versus clomiphene citrate in women with PCOS. A total of 100 women diagnosed with PCOS and infertility participated in the study, which took place from March 2021 to July 2022 at the Maternity and Children Teaching Hospital in Adiwaniyah Province, Iraq. Participants were randomly assigned to one of two groups (each with 50 women): the first group received clomiphene citrate in a stair step pattern (single dose of 50 mg, 100 mg, and 150 mg) for five days, for a maximum of three cycles; the second group received letrozole in a stair step pattern (single dose of 2.5, 5, and 7.5 mg) for five days, for a maximum of three cycles. Follicle size was monitored using ultrasound to achieve a follicle size >18 mm. The ovulation rate was higher in the letrozole group (86.0%) compared to the clomiphene citrate group (72.0%), although the difference was not statistically significant (p=0.086). The pregnancy rate was slightly higher in the letrozole group (22.0% vs 18.0%), but also not statistically significant (p=0.617). However, the mean time from menstruation to ovulation was significantly shorter in the letrozole group (17.20±1.32 days) compared to the clomiphene citrate group (24.08 ± 1.56 days, p<0.001). There were no significant differences in common side effects between the two groups. Overall, letrozole was found to be as safe as clomiphene citrate but demonstrated a shorter time to ovulation. Further studies with larger sample sizes are necessary to validate these findings and determine their clinical implications.

Outcomes of nursing monitoring for pregnant women under tocolytic therapies: a comparative study

Background Preterm birth (PTB) is the most common cause of neonatal morbidity and mortality worldwide. Tocolytic drugs had not been shown to improve fetal outcome, but were used to postpone delivery for 48 h to allow for maximal effect of parenteral steroids administered to the mother. The aim of the current study was to evaluate the outcomes of nursing monitoring for the pregnant mother under tocolytic therapy. Design An observational, comparative design was used to achieve the aim of the study. Setting The study was conducted at El Manial University Hosbital and El Galaa Maternity Teaching Hospital. Sample A convenience sample collected throughout one year of 30 preterm pregnant mothers under tocolytic therapy in each hospital. Tools Four tools were used: tool (1) Structured interviewing questionnaire, (2) Tocolytic monitoring, (3) Partograph, and (4) Apgar score. Result The study findings showed that 53.4% of mothers in group A as compared with 63.3% in group B received Epilate as a tocolytic agent. It shows that there were no statistically significant differences among both groups related to mean frequency of uterine contractions and mean duration of U.C, P=(0.329 and 0.189, respectively). It also shows that the side effects of tocolytic drugs in the first 24 h were dizziness, headache, tachycardia, and hypotension in group A (3.3%, 10%, 3.3%, and 6.7, respectively) as compared with (0%, 6.7%, 0%, and 10%, respectively). While only one 3.3% mother in group A had a fetus with bradycardia as a side effect of tocolytic drugs. In all, 93% and 96.7% of mothers in both groups had inhibition of uterine contractions and prolonged their pregnancy for 24 h. Conclusion Based on the results of this study, it could be concluded that tocolytic agents that were administered for 48 h reduced the uterine contractions and increased the period of pregnancy for preterm pregnant mother and improved neonatal outcomes by giving corticosteroids, but they had minimal side effects that occurred for mother and fetus in both groups. Recommendation (1) Close monitoring for all preterm pregnant women who are under tocolytic agents, (2) the newborn for women under tocolytic agents should be under close monitoring, and (3) provide education in the same strain to all nurses working in the maternity hospital with regard to care of women under tocolytic agents.

Comparison between different dose regimens of misoprostol in termination of early pregnancy

Objective: compares efficacy &amp; side effects of vaginal put of 400 or 600 microgram of cytotic in repeated doses in termination of first trimester gestational age. Desgn: Randomized prospect study. Setting and duration of study: Maternity teaching hospital in Sulaimani from 1st of January to the end of June 2009. Patients and methods: This study was included 90 pregnant women admitted during first trimester of gestation, requiring termination of pregnancy because of fetal demise. These patient are divided into two groups: (45) women received 600 mcg of misoprostol vaginally and other group 45 were received 400 mcg of it also vaginally. Misoprostol was given every 6hr for three doses. They were observed and evaluated in 24 hours.Result: Group1 had a complete abortion rate of 35.6% while group2 abortion rate of 13.3% this was significant. The time interval from put abortion was 8.04 ± 4.280 hours in group1 and 9.62 ± 5.237 hours in group2. Side effects such as diarrhea, nausea and headache showed no statistically significant difference in both patients.

Indicators of Spousal Support for Good Pregnancy Outcome among Women Attending Antenatal Clinic at Adeoyo Maternity Teaching Hospital, Ibadan, Oyo State, Nigeria

Aims: Spousal support in prenatal care is an important factor in promoting both maternal and infant health This study assessed the indicators (physical, financial, emotional and social support) that is considered to be important for good pregnancy outcome among pregnant women.&#x0D; Study Design: The study was a descriptive cross sectional design which involved women attending antenatal clinic at Adeoyo Maternity Teaching Hospital, Ibadan, Oyo State, Nigeria.&#x0D; Place and Duration of Study: Women attending antenatal clinic at Adeoyo Maternity Teaching Hospital, Ibadan, Oyo, State, Nigeria were sampled for this study, between December 2020 and January, 2021.&#x0D; Methodology: A total of three hundred and ninety-eight (398) pregnant women were randomly sampled for the purpose of this study. Data were collected from the respondents through the use of semi-structured questionnaire. Descriptive and inferential statistics were used for data analysis.&#x0D; Results: Findings reveals that the mean age of respondents was 30±5.6years and 90.7% of them were married. In respect to occupation, 62.3% of the respondents were business women. Findings showed that 53% of the respondents specified that their pregnancy were multiparous while 47% stated that their pregnancy were primiparous. Result showed that 7.3%,8.1%,4.2% and 7.8% considered physical support only, financial support only, emotional support only and social support only as important indicators for spousal support. However, 72.6% of the respondents specified that all the indicators (physical, financial, emotional and social support) are considered to be important for good pregnancy outcome support with pregnancy outcome.&#x0D; Conclusion: Based on the findings, it was concluded that physical, social, financial and emotional support were considered important for good pregnancy outcome. It is recommended that spouse should give their wives necessary supports required during pregnancy and child birth.

The Association of Anti-Mullerian Hormone and Infertility Hormonal Imbalance with Polycystic Ovarian Syndrome Among Iraqi Patients.

&lt;b&gt;Background and Objective:&lt;/b&gt; The pathogenesis of PCOS, which affects 5-15% of women of reproductive age, is still poorly understood and which characteristic might be considered essential for its diagnosis is still unknown. This study aimed to determine the significance and relationship between Anti-Mullerian Hormone (AMH) and other infertility hormones in the Polycystic Ovarian Syndrome (PCOS) diagnosis. &lt;b&gt;Materials and Methods:&lt;/b&gt; This study involves 200 women who visited Al-Ramadi Maternity and Child Teaching Hospital in Al-Ramadi, Iraq from October, 2022 to May, 2023. Study participants included 50 women as controls and 150 women with PCOS who were diagnosed using the Rotterdam criteria. The clinical history included oligomenorrhea and BMI. Laboratory investigations included blood tests for FSH, LH, prolactin and AMH levels done for all women who participated in this study. &lt;b&gt;Results:&lt;/b&gt; Age and BMI were comparable for PCOS cases and controls. The AMH levels in women with PCOS increased statistically with severity compared to controls, with the mean AMH level found to be 3.53 ng mL&lt;sup&gt;1&lt;/sup&gt; in controls, whereas it ranged from 6.19 for mild cases to 7.49 for moderate cases to 12.83 for severe cases in PCOS cases. The AMH alone had the highest diagnostic sensitivity (78.6%) and specificity (97.6%) for PCOS at a cut-off of 5.82 ng mL&lt;sup&gt;1&lt;/sup&gt;. All study participants had a positive correlation between AMH and LH (R&lt;sup&gt;2&lt;/sup&gt; = 0.391, p = 0.0031). &lt;b&gt;Conclusion:&lt;/b&gt; The AMH levels were noticeably higher in PCOS patients compared to controls. The AMH could not accurately diagnose PCOS when used as an independent marker. The AMH levels did, however, have good diagnostic potential in combination with current Rotterdam criteria for PCOS diagnosis.

Emergency Obstetric Complications During Labour And Delivery Among Mothers Attending Maternity Teaching Hospital /Erbil City/ Iraq. A Cross-Sectional Study

Background: Every year, over half a million women continue to lose their lives during pregnancy, childbirth and postpartum. Although, pregnancy and childbirth are a normal process Pregnancy can sometimes present life-threatening health problems for a mother and her baby. These problems are called obstetric emergencies. An obstetric emergency may arise at any time during pregnancy, labor and birth. This study aimed to determine the emergency obstetric complications which occurred during labor and delivery, and evaluate their associations with socio-demographic, obstetrical characteristics and fetal complications.&#x0D; Methods: A descriptive cross-sectional study was conducted on 200 women who attended the delivery room of Maternity Teaching Hospital. The tool that used was an examiners-made questionnaire, containing 3 parts: demographic characteristics, obstetrical history, and emergency obstetrical complications which occurred during labor and delivery. The data were analyzed through frequency, percentage and Chi-Square test using the SPSS statistical program. &#x0D; Results: Mean age of respondents was 30.15 years. We have found that the 39% of cases developed complication. Among the complications, most common problems: high blood pressure, postdated delivery, bleeding before delivery, difficult labor, premature rupture of membranes and prolonged labor respectively.&#x0D; Conclusions: The burden of emergency obstetric complications during labor and delivery is high. Efforts should be made at both the community and hospital levels to increase awareness regarding emergency obstetrical problems and reduce its associated morbidity and mortality.

Phylogenic study of toxoplasmosis in aborted women in Al- Diwnaniya province

The current study included the detection of Toxoplasma gondii from aborted women attented to the Maternity and Childhood Teaching Hospital to detected the rate of abortion due to toxoplasmosis using PCR technique, the samples which was used placenta and fetus, this study also identify the differentiation between it by phylogenic with SAG3 gene.&#x0D; A total of 60 ( placenta and fetus) samples were collected randomly from aborted women who received to the Maternity and Childhood Teaching Hospital.&#x0D; The present study include molecular method to detected small subunit ribosomal RNA ( ssRNA) using Nested Polymerase Chain Reaction ( nPCR) ,the results of the nPCR for ssRNA gene, the result showed that the rate of toxoplasmosis in the aborted women was Positive 60%. (There is a statistically significant between species in P &lt;0.05).&#x0D; The present study also detected for Surface Antigen (SAG3) gene to conform the nPCP result and to send the samples for sequences.&#x0D; The SAGA gene showed 100% positive results according to the ssRNA gene .&#x0D; T.gondii isolates surface Ag SAG3 gene with NCBI BLAST Toxoplasma gondii isolates, and the DNA nucleotides sequencing analysis of surface Ag SAG3 complete gene was show clear gentic variation between isolates from different host. &#x0D;

Polymorphism Of Virulence Genes Of Enterococcus Faecalis Associated With Aerobic Vaginitis

The aim of the current study is to determine the virulence genes of E. faecalis and polymorphism in these bacteria. A total of 300 females who visited the outpatient clinics in the Maternity and Pediatrics Teaching Hospital in Al-Diwaniya city, Iraq were enrolled. For twenty isolates of E. faecalis that showed dense growth when cultured on the specified culture media, then the sensitivity to antibiotics was tested, and then the virulence genes were determined for each isolate, where the results were shown there are statistically significant differences (P&lt;0.05) in the presence of virulence genes in the tested bacterial isolates. (where the genetic analysis by PCR showed the presence of all virulence genes, except for isolate 3 of the gene esp (Enterococcal surface production protein), and isolates 11, 12, 15, 16 and 19 of the hly gene (haemolysin production). ERlC results showed the most of the isolates share a DNA segment of length 1500, 1000 bp, and 2000 pb. The curve also shows that most of the isolates lack the presence of the segment of length 500 pb. As for the pieces of 700, 600 and 400 bp, they showed a very high heterogeneity between the isolates. ln conclusion, most genes responsible for virulence factors were positive, except for hly, which showed positive results for nearly more than half of the isolates, that the virulence factors of said bacteria are a major focus of infection in said bacteria, and if these genes are not available, they are unable to hit or stick to the surface of the vagina. There were two types of genetic polymorphism in strains, one of which is caused by horizontal transmission between strains via plasmids and other horizontal transmission methods, and the other is caused by vertical transmission through mutations that occur between generations, causing high resistance to some antibiotics. vitality.

CESAREAN SCAR ECTOPIC PREGNANCY IN RELATION TO PREVIOUS OBSTETRICAL HISTORY

Background &#x0D; Cesarean scar ectopic pregnancy (CSEP) is the implantation of a gestational sac inside the scar of a previous cesarean section (C/S). CSEP is a life-threatening condition that needs early management.&#x0D; Objectives &#x0D; The study aimed to know the associations between CSEP and previous obstetrical history.&#x0D; Patients and Methods&#x0D; Twenty-seven women with CSEP who were admitted to the Sulaimani Maternity Teaching Hospital from September 2019 to October 2021 were collected for this cross-sectional study. Complete obstetrical history, clinical features, the interval between the last C/S and CSEP, mode of diagnosis, and types of management were recorded.&#x0D; Results&#x0D; The mean of maternal age, gravidity and parity were 32.14±4.63 years (range, 24 to 40 years), 3.73±1.75 (range, 1 to 8) and 2.36±1.33 (range, 1 to 6), respectively. The majority (74.1%) had no significant medical diseases. The mean interval between the last C/S and CSEP was 2.6±1.8 years, and 92.6% complained of vaginal bleeding. The association of gravidity with CSEP presentation was statistically significant. Only 22.2% had a history of one prior C/S alone; however, 74.1, 14.8%, and 3.7% of patients had two, three, and four previous C/Ss, respectively. Besides, the associations of first and second C/Ss with obstetricians’ experience who performed the C/Ss were statistically significant. &#x0D; Conclusion&#x0D; The risk of CSEP increases when the frequency of gravidity and previous C/S increases.

Uterine artery Doppler and Sub-Endometrial blood flow and Serum Progesterone level in patients with Unexplained Recurrent Miscarriage

Background: Unexplained Miscarriage that occurs repeatedly is still a difficult issue for couples and professionals. It affects 2–5% of females attempting to conceive and represents a considerable challenge for physicians. Aim of the Work: This study compares women who have unexplained recurrent miscarriages to healthy, fertile women in order to assess uterine artery blood flow, sub-endometrial blood flow, and serum progesterone levels in these women. Patients and Methods: At Al-Galaa Maternity Teaching Hospital, our research was carried out, and patients were divided into two groups. The case group: 50 individuals disclosed a history of recurrent, unexplained miscarriages, and the control group: 50 individuals who had at least one term birth and no history of miscarriage. Results: pulstility index of the uterine artery especially the mean value, and flow index, vascular index and vascular flow index of the endometrial and sub-endometrial area, in addition to the serum progesterone level are crucial factors in case of unexplained recurrent miscarriage. They affect unexplained recurrent miscarriage incidence significantly. The pulstility index of the uterine artery has its influence on unexplained recurrent miscarriage with 74% accuracy. The flow index has 95% accuracy, and the vascular flow index has 86% accuracy in case unexplained recurrent miscarriage. The serum progesterone level has 70% accuracy effect on unexplained recurrent miscarriage. Conclusion: the study documented that the uterine artery Doppler, endometrial and sub-endometrial blood flow level and serum progesterone level affect the incidence of unexplained recurrent miscarriage with accuracy ranging between 70% and 95%.