Maternity Teaching Hospital Research Articles

Assessment of Pregnancy Outcome in Gestational Diabetes Milletus Patient in Maternity Teaching Hospital in Sulaimani City

The current study was undertaken to assess of pregnancy outcome in gestational diabetes
 milletus patient. This study was carried out for the period of 10th March to 12th May of 2014, 
 sample of (100) pregnant women who have been attended the maternity teaching
 hospital in Sulaimani city, to identify the assessment of pregnancy outcome in
 Gestational Diabetes Milletus and explore association between some sociodemographic
 characteristic of the sample baby outcome and reproductive history, the results show that
 there is a strong association between reproductive history and Gestational Diabetes
 Milletus.

A prospective comparison of transvaginal, transabdominal ultrasound and diagnostic curettage in the evaluation of endometrial pathology

Background and objective: Abnormal uterine bleeding due to endometrial abnormalities is a common diagnostic challenge facing the radiologist and referring gynecologist. This study was aimed to compare the diagnostic performance of transvaginal ultrasound, transabdominal ultrasound and diagnostic curettage in the detection of endometrial pathologies in symptomatic women. Methods: A prospective comparison study of transvaginal ultrasound, transabdominal ultrasound and diagnostic curettage was conducted for evaluation of endometrial pathology in Maternity Teaching Hospital, Erbil city,Kurdistan region of Iraq, from September13th, 2013 to September14th, 2014. The study included 100 women presenting with abnormal uterine bleeding.Ultrasound findings were compared with histopathological results. The statistical package for the social sciences (version 17) was used for data entry and analysis. Results: The mean age (± SD) of sample size was 47 ±8.57 years. The mean parity was 5.17 ± 2.71. The highest percentages of women were in age group 40-59 years (73%). Of the total sample, more than half (52%) had regular cycles, 25% had irregular cycles and 23% were in menopausal state. In more than half of cases the indication for ultrasounds was for menorrhagia, followed by postmenapousal and intermenstrual bleeding (23% and 21%, respectively). Of 98 women (2 women were excluded from analysis), 19% had atrophic endometrium and 67% had endometrial hyperplasia in histopathological finding. Transvaginal ultrasound sensitivity and specificity were 100% and 92.9%, respectively while transabdominal ultrasound sensitivity and specificity were 92.8% and 65%, respectively. Conclusion: Transvaginal ultrasound scanning is an excellent tool for the determination of whether further investigation with histopathological examination of endometrial biopsy is necessary or not for women presented with abnormal uterine bleeding.

A comparison between two different doses of sublingual misoprostol in the management of first trimester incomplete miscarriage

*Department of Obstetrics & Gynecology, College of medicine, Hawler Medical University, Erbil, Iraq **Erbil directory of health, Erbil, Iraq. Introduction The term is synonymous to spontaneous and is often used with patients, because the word abortion is associated with elective termination.1 Miscarriage or is variably defined as the expulsion or extraction of a fetus (embryo) weighing less than 500 grams equivalent to approximately 20-22 weeks gestation or as termination before 24 weeks of gestation with no evidence of life.2 Incomplete miscarriage is a type of miscarriage in which some, but not all of the products of conception have been passed. Retained products may be part of the fetus, placenta, or membranes. It can result from either spontaneous or induced pregnancy loss.3 Incomplete miscarriage continues to contribute to maternal morbidity and mortality in much of the developing world.4 The complications which arise from incomplete miscarriage are hemorrhage and infection which occur because of remained tissue of conception or instrumentation through the cervix.2 So safe and effective treatment for incomplete miscarriage is an important way to reduce related morbidity and mortality.3’4 Incomplete miscarriage can be treated with expectant management, or active management using medical or surgical methods.5 Medical treatment of incomplete miscarriage has been categorized as a noninvasive option as it Background and objective: Various methods have been described for management of first trimester incomplete miscarriage. The active methods include surgical methods that are highly effective but are associated with anesthetics and surgical risks. Medical methods by Misoprostol had been shown to be effective, acceptable and widely used treatment for incomplete miscarriage. The aim of this study was to compare the efficacy, patients' acceptability and the side effects of sublingual administration of single dose of 400mcg with single dose of 600mcg of misoprostol in the treatment of first trimester incomplete miscarriage. Methods: This study was conducted from April 1, 2011 to February 1, 2012 in the Maternity Teaching Hospital in Erbil city, Kurdistan region, Iraq. The study included 120 patients with incomplete miscarriage at a gestational age ≤12 weeks. They randomly received either single dose of 400mcg or 600mcg of misoprostol sublingually. Patients returned for follow-up and re-evaluation of status after 7 days. Patients with a continuous incomplete miscarriage underwent surgical evacuation. Results: The success rate in the first and second group was 90% and 91.7%, respectively, while patients' acceptability in the first and second group was 96.7% and 95%, respectively with no difference between both groups. Gastrointestinal side effects like nausea and diarrhea were more in the second group. Conclusion: Single dose of 400 mcg of sublingual misoprostol is preferred on 600mcg of sublingual misoprostol regarding the development of side effects.

Midwives' perspectives regarding episiotomy practice in Kurdistan region/Iraq

Background and objective: Local professional norms, experiences in tainting, and individual provider preference may lead to wide practice variation in rate and practice of episiotomy by midwives. The aim of this study was to find out the midwives' perspectives regarding practicing of episiotomy in three main cities of Kurdistan region/Iraq. Methods: A cross-sectional, descriptive study was conducted on 53 midwives working in delivery room in three maternity teaching hospitals in the three biggest cities of Kurdistan Region of Iraq. A questionnaire was constructed for the purpose of the study and data were collected by interview with midwives. F test and Chi-square test were used for analyzing the data. Results: The majority (88.7%) of midwives thought that the rate of episiotomy were high in their hospitals that were attributed to five factors; maternal (77.35%), fetal (39.62%), midwives (37.73%), obstetricians (30.18%) and hospital policy and health system (20.75%). The opinion of midwives regarding how to decrease the rate of episiotomy included improving midwifery care during delivery (77.35%), reforming health system (60.37%), reforming hospital policy (50.94%) and improving maternal care during pregnancy (26.41%). Conclusion: Taking into consideration the midwives' perspectives and views regarding episiotomy and providing training courses may help in decreasing the rate of episiotomy and its practice in correct way in Kurdistan's maternity hospitals.

Assessment of Nurse Midwive’s Knowledge Concerning Effect of Early Timing of Umbilical Cord Clamping on Maternal and Neonatal outcomes at Delivery Rooms in Maternity Hospitals in Baghdad City.

Background: Delaying umbilical cord clamping allows blood flow between the placenta, the umbilical cord and the baby to continue. The blood which transfers to the baby between birth and cord clamping is called placental transfusion. Placental transfusion may improve circulating volume at birth, which may in turn improve outcome for preterm infants. Early clamping allows for immediate transfer of the infant to the neonatologist. Objectives: to assess the knowledge of nurse – midwives about early timing of umbilical cord clamping, to identify the effect of early timing of umbilical cord clamping on mother and neonate, to identify the relationship between knowledge and socio-demographic variables. Methodology: A descriptive analytic design study was carried out in Baghdad Teaching Hospital, Al-Karkh Maternity Hospital, Ibn Al-Balady for Women and Children, Fatima Zahra Hospital for Women and Children, Al-Elwia Maternity Teaching Hospital, and Al-Yarmouk Teaching Hospital, the study starting from 12th November 2015 to 4th August 2016. A purposive sample consisted of (81) nurse-midwives who work in delivery room exclusively, Working in day and night shifts. The questionnaire was consisted of : Part one: General information and socio demographic data, nurse- midwives experience, training courses and time of clamping the umbilical Part two: knowledge of nurse-midwives concerning early cord clamping. Validity of the instrument was established through a panel of (13) experts, and reliability was employed through the computation of alpha correlation coefficient. Data were analyzed by using descriptive, and inferential data analysis. Result: : the results of study reveal that 71(87.6%) of nurse- midwives age are less than 50 years old, 76(93.8%) were midwifery school graduates, 64(79.0%) were married, 56(69.1%) had less than ten years of service, and 62(76.6%) had less than ten years of experiences in the delivery rooms, 67(82.7%) of Nursemidwives had hospital practicing delivery, 48(59.3%) of studied sample having training course, 35(72.9%) had short time (less than week). Time of clamping the umbilical cord, are focused at direct clamping. In the light of early clamping of the umbilical cord shows moderate response. The finding obtain no significant differences at P>0.05 between (Knowledge) concerning effect of early timing of umbilical cord clamping and demographical characteristics, as well as general information variables.

Maternal satisfaction regarding quality of nursing care during labor and delivery in Sulaimani teaching hospital

For many women, labour and childbirth is a time of excitement and anticipation alongside uncertainty, anxiety, fear and pain. The memories and experiences of childbirth remain with the woman throughout her life. Clearly, the support and care they receive during this period is critical. The study aims to assess quality of nursing care offered during intrapartum and postpartum periods, patient satisfaction with care and to find the relationship between maternal satisfaction and some variables example, maternal age, education, duration of labor and reproductive history. A descriptive study was carried out from 22 April, 2013 through 15 February, 2014. A purposive sample of (200) postpartum women, delivered at the maternity teaching hospital. A questionnaire was comprised of two parts: socio-demographic characteristics and History of pregnancy and Women's views of birth Labor Satisfaction Questionnaire (WQBLS4). Data were collected through interview and analyzed through the application of descriptive and inferential statistical approaches by statisitical package for social sciences (SPSS) (17.0) program. ANOVA (F) test was used in the statistical assessment and the figure of p<0.05 was considered as the statistically significant. The study findings, indicate that women were satisfied regarding their expectations of the childbirth process, length and holding their baby, support from husband and their relative, in addition they were strongly satisfied with items related to professional support, environment and general satisfaction. The study concludes that the main factors identified as influencing satisfaction and dissatisfaction were, caregivers and client interaction, the characteristics of the setting, the involvement of clients in the caring process, the nurses’ perception of client characteristics, the outcome of labour for both mother and baby. Key words: Satisfaction, nursing care, labour.

Effect of maternal body mass index on maternal and fetal outcome in Maternity Teaching Hospital in Sulaimani

The current study was undertaken to evaluate the effect of body mass index on birthoutcome. This study was carried out for the period of 20 th February to 18 th April of 2014,sample of (50) pregnant women who have been attended maternity teaching hospital inSulaimani city, to determine the effect of body mass index on birth outcome, and toexplore association between some socio-demographic and obstetrics characteristics withoutcome of birth. The result shows that there is no significant association between bodymass index and outcome of labor or delivery.

Determinants of postnatal depression in Sudanese women at 3 months postpartum: a cross-sectional study

ObjectivesMaternal mental health is a neglected issue in Sudanese healthcare. The aim of this study was to explore the factors associated with postnatal depression (PND) at 3 months postpartum in...

Assessment of Postpartum Depression among Mothers at Maternity Teaching Hospital in Erbil City-Iraq

Background and aim: Postpartum period is the period that is associated with intense physical and emotional changes leading to anxiety and mood disturbances. The study aimed to assess the level of postpartum depression and to find out the association between levels of postpartum depression with demographic characteristics of mothers. Materials and method: A quantitative descriptive study, deals with 150 mothers who attending to the Maternity Teaching Hospital in Erbil City-Iraq. A questionnaire was used to collect the data from the period of 5th May 2015 to 4th August 2015. Data were analyzed by using descriptive and inferential statistical (percentage, frequency, and chi –square). Results: the study shows that the majority of mothers age between (24-32) years was 46%, shows that the majority of sample (66%) was postpartum depressed also there were high significant relationship between some of demographic characteristics of mothers. Conclusion: The study concludes that there majority of sample was Postpartum depressed and significant relationship with their some demographic characters of mothers at P ≥ 0.5. Recommendation: The present study recommends that health education programs should be carried out for postnatal mothers apply by nurses.

Abstract C77: Cervical cancer screening knowledge and practice among women at Adeoyo Teaching Hospital in Nigeria: A prevention tool for cervical cancer

Abstract Cervical cancer is one of the leading cancer killers among women all over the world. Cervical cancer is the most common female cancer in developing countries, a woman die of cervical cancer every two minutes. Its contribution to cancer burden is significant across all cultures and economies. However in Nigeria this disease is still killing up to 8,000 women annually. Fortunately, this cancer is preventable by screening for premalignant lesions but this is rarely provided and hardly utilised. The aim of this research is to assess the knowledge of cervical cancer screening among Nigerian women. A descriptive cross-sectional survey was adopted to assess the knowledge of cervical cancer screening among women attending Adeoyo Maternity Teaching Hospital in Ibadan North Local Government of Oyo State. The sampling technique adopted in the study was the simple random sampling. The respondents were reassured of the confidentiality of the data. The instrument used basically was self-structured questionnaire. Data were analyzed using descriptive statistics and chi-square. Respondents' mean age was 26.0 1.5 years,40.8% had primary education,54% of the respondents were self-employed,55% were Muslim by religion, majority were Yoruba (51.5% ) had between 1 and 2 children, 26% of them practice polygamy. 55.4% of the respondents understood that it is a malignant growth of the cell. Common sources of information were clinics (48.5%) and media (23.1%).52.3% of the respondents were not aware that the screening centre was at their locality. Thirty-eight (38%) of the respondents reported that pap smear should be done between 1 to 3 years, only 26(20%) out of 130 respondents have done pap smear before. 75.4% had poor knowledge of prevention of cervical cancer. The relationship between source of awareness of cervical cancer and knowledge of pap smear was not significant (p&amp;gt;0.72), 73.7% of the respondents that had poor knowledge of prevention had primary educational background but there was no significant relationship between the educational status and the knowledge of the prevention of cervical cancer (p&amp;gt;0.86). Knowledge about the cervical cancer was fair, but respondents had poor knowledge about the pap smear and the overall uptake of the cervical screening was low among the respondents. Incoporating periodic health publicity programmes in the market, religious setting and working places will improve the knowledge and uptake of the cervical screening. Note: This abstract was not presented at the conference. Citation Format: Olubunmi O. Adetule, O. A. Jolaoye. Cervical cancer screening knowledge and practice among women at Adeoyo Teaching Hospital in Nigeria: A prevention tool for cervical cancer. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr C77.

Isosorbide Mononitrate and Misoprostol for Cervical Ripening in Induction of Labor

Background: The most favorable method for cervical ripening is not fully agreed upon by practitioners; however, isosorbide mononitrate administration is considered a low-risk method of labor induction for pregnant women at full term. Objective: To evaluate the safety and effectiveness of adding isosorbide mononitrate to misoprostol for cervical ripening in prelabor induction of full term pregnant women in comparison with misoprostol alone. Design: Randomized study. Setting: Ain Shams Maternity teaching hospital. Patients and methods: 120 women were divided randomly into two equal arms of 60 women in each one. Intervention: Patients admitted through the reception room or out patient clinic and they scheduled for induction of labor. Group I were given intravaginal isosorbide mononitrate with misoprostol while group II were given placebo with misoprostol intravaginally.

Episiotomy preventing approaches among midwives in Kurdistan region

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Objectives: This study aimed to findout approaches which used by midwives for avoiding episiotomy and assess their knowledge regarding complications of episiotomy in three main cities of Kurdistan region. Methodology: A cross-sectional study was conducted between 1st January and 15th April 2014 in the three biggest maternity teaching hospitals. The study population included all the midwives (n=53) working in delivery rooms. Data were collected through interview with midwives. Results: The Midwives stated the followings as complications of episiotomy: tear into the rectum muscle or rectum itself (52.8%), bleeding (60.3%), infection and/or swelling of episiotomy area (62.2%), defect in wound closer (35.8%), local pain (32%). There was significant difference between knowledge of midwives in three cities regarding complications of episiotomy. Midwives used Good position, good vaginal support (35.8%), using Castor oil (32%), performing episiotomy only in indicated case (13.2%), no pushing without contraction (18.8%), giving enough time to mother (26.4%), using gel (15%), as episiotomy avoiding approaches. There was highly significant difference between three cities regarding episiotomy preventing approaches. Recommendations: training courses, developing guideline and establish clear and unified policy regarding episiotomy preventing approaches are necessary to decrease rate of episiotomy.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Effects of Spontaneous Abortion upon Women's Physical and Spiritual Status

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Background: Spontaneous abortion means that a pregnancy is lost prior to viability, the loss of a fetus weighing less than 500 g, and the loss of an embryo or fetus at 20 weeks gestation or less (WHO, 2001). Glenville, (2001) has reported that suffering a miscarriage is one of the most devastating things that can happen to a woman, and to her husband. Many women conceive easily and are not emotionally or physically prepared for the shock of losing a baby. Objective: To know effects of spontaneous abortion upon physical status and spiritual beliefs , also find out the association between physical status and spiritual beliefs with study variable (demographic &amp; reproductive). Methodology: A descriptive Analytical study was conducted on Non-probability (purposive sample) of (200) women who have suffering from spontaneous abortion in maternity unit from four hospitals at Baghdad City which include Al-Elwiya maternity teaching hospital, and Baghdad teaching hospital , Al –karckh maternity hospital ,and Al-Yarmook teaching hospital. A questionnaire was used as a tool of data collection for the period of February 3rd 2013 to April 26th 2013 to fulfill with objective of the study and consisted of four parts, including demographic, reproductive characteristics, and physical status and spiritual beliefs. A pilot study was carried out to test the reliability of the questionnaire and content validity was carried out through the 20 experts. Descriptive and inferential statistical analyses were used to analyze the data. Results :The results of the study revealed that (26.5%) of women their age range (25-29) years ,(27.5%) graduated from primary school, (25%) of their husband graduated from college or institute, (80%) of study sample were housewives, (54.5%) of their husband were employee, (48%) of study sample is within low category of socioeconomic status. And about the reproductive information (66%) of women were primi and multi gravida, and (25%) of women having at least previous two delivery, and (52.5%) have previous one abortion, also this study present there is no association between physical status and study variables ,but there is a correlation between spiritual beliefs and socio-demographic characteristics (women and husband educational level, women's occupation and their socioeconomic status), but there is no association between spiritual beliefs and reproductive data. Recommendations: The study recommends that structured teaching program can be presented to women during pregnancy with history of miscarriage which includes meaning, causes, and prevention of miscarriage. The study recommends that collaborative action can be taken by Ministry of Health to publish awareness between women towards the problem by presenting a booklet or lectures about miscarriage.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Vaginal birth after caesarean section with less than two years delivery interval

Background and objective: A dramatic rise in caesarean deliveries has been occurring over the past three decades. The old myth of “once a caesarean always a caesarean” is no longer acceptable as this increases maternal morbidity. The aim of this study was to evaluate the safety and success of vaginal birth after caesarean section performed before less than two years. Methods: A cross-sectional study was conducted in the Maternity Teaching Hospital in Erbil, Iraq from May to October 2012. Ninety two patients meeting the inclusion criteria were included in this study and followed up during their labour. Patients monitored for vaginal bleeding, scar tenderness and tachycardia. Results: Of 92 patients with single lower segment caesarean section that underwent trial of labour; 52 (56.5%) patients had successful trial of labour and 40 (43.5%) had a repeated caesarean section. Factors found to be significantly affecting trial of labour were parity (P = 0.01), inter-delivery interval (P <0.001) and cervical dilatation (P = 0.015). Conclusion: Vaginal birth after caesarean section is a reasonable choice for women with single lower segment caesarean section with good monitoring of mother and baby during labour. Short inter-delivery period does not preclude vaginal delivery in a woman with single lower segment caesarean section providing that there is no contraindication for vaginal delivery.

Maternal mortality at the Maternity Teaching Hospital in Erbil, Kurdistan: A hospital-based data 2011-2013

Maternal mortality at the Maternity Teaching Hospital in Erbil, Kurdistan: A hospital-based data 2011-2013

Incidence and probable risk factors of stillbirth in Maternity Teaching Hospital in Erbil city

Incidence and probable risk factors of stillbirth in Maternity Teaching Hospital in Erbil city

C-reactive protein as a biochemical marker for idiopathic preterm delivery

Background and objective: Estimation of C-reactive protein is a simple method and could be helpful in detecting cases at risk for pre-term delivery. In this study we examined the association of maternal C-reactive protein in second trimester with risk of occurrence of preterm delivery later on. Methods: A prospective case-cohort study was conducted between June 2011 and July 2012 at Maternity Teaching Hospital Iraq- Erbil. The sample size was 205 women at gestational age of 20+0 weeks to 26+6 weeks and after exclusion of all risk factors for preterm delivery. High-sensitivity C-reactive protein assays were performed on serum samples. Results: Median concentration of C-reactive protein was 4.7 mg/liter. No significant association was found between high level of C-reactive protein and occurrence of preterm delivery (P = 0.78). Conclusion: Measurement of C-reactive protein in second trimester cannot be used as an indicator for pre-term delivery.

Determinants of utilization of antenatal care services in Erbil city

Background and objective: Antenatal care is the care of the woman during pregnancy. The aim of this study was to determine the factors affecting the utilization of antenatal care among reproductive age group women (15-49 years) in Erbil city. Methods: A cross-sectional study was conducted between April 1st, 2012 till April 1st, 2013 in Erbil city at the Birth and Death Certification Registration Center and the Maternity Teaching Hospital. Data from a sample of 500 women among reproductive age group (15-49 years) was collected by using a questionnaire through direct interview. Statistical package for the social sciences (version 18) was used for data entry and analysis. Results: Antenatal care service utilization in the study area was 82.4%. From those who attended antenatal care service, 45.8% started antenatal care visit during the first trimester of pregnancy and 41% had less than four visits. Utilization of antenatal care services was significantly associated with high educational level, professional job, having least number of children, highly tetanus toxoid vaccine receivers and near distance to antenatal care services. Conclusion: Nearly 49.5% of antenatal care user women did not receive adequate number of visits as recommended by the World Health Organization. Women’s education and occupation, socioeconomic status, number of children, tetanus toxoid vaccine, far distance to ANC service are significantly associated with percentage of receiving antenatal care.

Post episiotomy care instructions among midwives in Kurdistan region, Iraq

Background and objective: One of the main responsibilities of midwives is the provision of post episiotomy care instructions for women who have episiotomy before discharge from the hospital after delivery. This study aimed to assess the post episiotomy care instructions provided by midwives and compare the instructions of midwives of the three main cities of Kurdistan region. Methods: This cross-sectional study was conducted between July 1st, 2013 and July 10th, 2014 in the three governorates of Kurdistan Region of Iraq (Erbil, Dohuk and Suleimanya). All the midwives (n=53) working in the delivery room of the three maternity teaching hospitals were included in the study. A questionnaire was designed for the purpose of the study. Data were collected through interview with midwives. ANOVA and Chi-square test were used for data analysis. Results: The midwives in Erbil didn’t provide post episiotomy care instructions at all. Most of midwives of Duhok and Sulemanyia didn't provide proper instructions to mothers who have episiotomy, and there was highly significant difference between their instructions regarding some topics. Conclusion: Midwives do not properly instruct the mothers who have episiotomy regarding care during postpartum period. The practice of midwives was different in the three cities of Kurdistan region. Hospital policy and the job descriptions of midwives regarding post episiotomy instruction should be reevaluated.

Syphilis serology in pregnancy: an eight-year study (2005-2012) in a large teaching maternity hospital in Dublin, Ireland.

All cases of positive syphilis serology detected in antenatal and peripartum screening in a large teaching maternity hospital in inner city Dublin, Ireland over an eight-year period (2005-2012 inclusive) were reviewed and included in our study. Demographic, antenatal registration, laboratory (including co-infections), partner serology, treatment and delivery data were recorded in our database. Infant follow-up, treatment and outcome data were also collected. During this period, 194 women had positive syphilis serology, of which 182 completed their pregnancies at the institution. This accounts for 0.28% of the total number of women completing their pregnancies during this time (N = 66038); 79 had no previous diagnosis of infection. There was one case of re-infection during pregnancy. Thirty-two women were co-infected with human immunodeficiency virus, hepatitis B or hepatitis C. There was one case suggestive of congenital syphilis infection. Our study is a comprehensive analysis of the diagnosis, management and clinical outcomes of women testing positive for syphilis infection in pregnancy. It reveals the relatively high prevalence of syphilis infection in the population utilising the maternity services in north inner-city Dublin. It re-enforces the importance of continued active surveillance to prevent morbidity and mortality associated with maternal syphilis infection. It also highlights the importance of strategies such as re-testing high-risk groups and definitive screening of spouse serology.