Maternity Teaching Hospital Research Articles

Demographic and Clinicohistological Profiles of Women Diagnosed with Breast Cancer at Al-El Wiya Maternity Teaching Hospital / Baghdad: A Retrospective Study

Knowing the incidence of, breast cancer, diagnosis, and treatment methods given a strategic approach forcommunity awareness and rapid management. This study was aimed to: Estimate the demographic patternincluding age, marital status, number of children, mass location, lactation, using contraceptive and smokinghabit and to estimate the pattern of BC risk factors including family history, histological type, grading, andstaging. The retrospective cross-sectional descriptive design was utilized. A total of 282 confirmed breastcancer female patients for the years 2016 to 2018 were included. Overall result showed that the age ofBreast cancer female patients ranged from (25-80) years with a mean (49.12±0.67). Most Breast Cancercases were diagnosed with infiltrating ductal carcinoma (73.4%). The percentage of the discovered tumorwas dominating the right side of the breast (52.8%). Also, 11% of BC females were diagnosed with stageIIa. And 31.2 % of BC cases were diagnosed as grade II. However, 20.2% of the cases were having a familyhistory with breast cancer. Most of the cases (94.7%) were did not checked for biomarker testing, just 12cases (4.3%) were positive ER. And 3.9% of cases tested for PR only 11 cases were positive. While negativeresults for HER2/neu was only in 9 cases (3.2%). Current study validates scientific knowledge about BC inBaghdad. Each year, the incidence rates increase especially for age above 49.

Family Planning Methods Knowledge, Attitude And Usage Among Married Women In Reproductive Age In Mosul City.

The aim of present study is to explore knowledge, attitude and usage of family planning methods among married women in reproductive age in Mosul City. Subjects and Methods A descriptive cross-sectional study design was adopted to accomplish the aim of the current study. Data was collected from a convenient sample of 300 married women at child bearing age who visiting a maternity and child teaching hospital in Mosul City during a period of three months. Direct interview by using reformed standardized questionnaire form was used for data collection. Results Out of 300 participants 69.3% % heard about family planning but only Less than half (48.7%) give a correct concept of family planning and 28.7% have no idea . The prevalence of current contraceptive usage among participates was 61.3%. Traditional methods were rated as the most common contraceptive methods formerly used by 67.3% of the sample fallowed oral contraceptive pills by 31%. Fear from side effect was the main cause that prohibiting women to use contraceptives as ranked by 42%. Women in this study had a favorable attitude towards family planning. Conclusion and recommendations Married women in reproductive age in Mosul City had incomplete and inconsistent information about family planning. Although, contraceptive usage prevalence was within worldwide range but traditional methods were the most commonly used methods. Well-organized strategies should be adopted to promote family planning programs by depending on practical health education programs.

Obstetric nurse and the factors that influence care in the delivery process.

To identify the factors that influence the improvement of obstetric nurse care in the delivery process. Descriptive exploratory study with a qualitative approach conducted at a teaching maternity hospital located in the city of Salvador, Bahia, Brazil with 20 obstetric nurses from the Obstetric Center. Data was collected through semi-structured interviews between June and September 2017 and was then subjected to the Thematic-Categorical Content Analysis proposed by Franco. Six categories emerged from the analysis, which presented factors that favor the improvement of obstetric care in the delivery process and factors unfavorable to this care. These factors address power and gender relations among health professionals; recognition of obstetric nurses; physical space and bed occupation; interaction between woman/ companion, among others. The factors indicated by obstetric nurses reveal the need for improvements in the working conditions by managers and changes of behavior and codes of conduct of health professionals.

Investigating Immunological Parameters and Quantification of Rhoptry Pseudokinases Gene Expression in Toxoplasmosis

Toxoplasma affects about one-third of the world’s population and is a common disease between humans and animals. The most common cause of toxoplasmosis is infection with Toxoplasma gondii. The main virulence factors of Toxoplasma gondii in toxoplasmosis are rhoptry pseudokinases. The aim of this study was to evaluate the seroprevalence and immunological parameters of toxoplasmosis and investigate the expression of rhoptry protein 5, rhoptry protein 16 and rhoptry protein 18 genes in women in Erbil. Also, evaluation of the serum levels of interleukin-12 and interleukin-6 in women with recurrent miscarriage were performed. In this study, 300 women at their reproductive age who referred to Maternity Teaching Hospital of Erbil were registered. Enzyme linked immunosorbent assay technique has been applied to detect anti toxoplasma immunoglobulin G and immunoglobulin M. Statistical analysis was done via statistical package for the social sciences version 21.0 and the p value of ≤0.05 was considered as statistically significant. A total of 50 seropositive samples with and without history of miscarriage were tested by polymerase chain reaction for detection of rhoptry protein 5, rhoptry protein 16 and rhoptry protein 18 genes using home designed primers. A significant association was found between toxoplasmosis and history of abortion, but no association was found between toxoplasmosis and education level, socioeconomic status, age and residence. According to the results, the interleukin-6 level was non-significantly (p>0.05) changed in infected women. Nevertheless, serum interleukin-12 level was remarkably (p<0.05) elevated in infected women compared to control group. Polymerase chain reaction targeting both toxoplasma genes detected more abortive cases than non-abortive one among anti-toxoplasma seropositive women. The results of quantification and detection of rhoptry protein 5, rhoptry protein 16 and rhoptry protein 18 genes of Toxoplasma gondii among 50 samples by polymerase chain reaction, confirmed the expression of these genes in toxoplasmosis condition. Finally, it was concluded that the prevalence of toxoplasmosis has increased in Erbil women and the level of interleukin-12 in the serum of women infected with Toxoplasma gondii has increased significantly. Also, rhoptry protein 5, rhoptry protein 16 and rhoptry protein 18 genes can be used as markers in the first level of toxoplasmosis. Therefore, quantification of these genes can help in determining Toxoplasma gondii strain virulence.

Maternal and Neonatal Outcome of Teenage Pregnancy at Al-Galaa Maternity Teaching Hospital, Cairo, Egypt

Backgrounds: Teenage pregnancies are generally considered as a high-risk however, sufficient data is lacking in the area, Cairo Egypt. We attempted to determine whether teenage pregnancies show poorer outcomes than adult-age pregnancies. Objectives: Finding out the prevalence of teenage pregnancy and its maternal and fetal outcome in comparison. Subjects and methods: A retrospective analytical case-control study was conducted on patients who had attended for delivery at Al-Galaa Maternity Teaching Hospital during the period of one year from March 2015 to February 2016. A total of included 538 patients aged 16 - 19 years as study group and adult age group: included 609 patients aged 25 - 29 years as the control group. The only primigravid was enrolled. The study records were retrieved for review. Comparisons were made between the two groups regarding maternal demographics, socioeconomic status, medical disorders, major antenatal complications, the outcome of labor, mode of delivery, and perinatal complications. Results: The prevalence of teenage pregnancy, was 46.9%. Teenage group, compared with the adult group, P-value Conclusions: Teenager primigravid women should be considered as a high-risk pregnancy and thus require special medical attention to avoid adverse maternal and neonatal outcomes.

Risk factors related to neonatal bacterial septicemia in Al-Elwiya maternity teaching hospital.

Background: Neonatal septicemia is a major cause of morbidity and mortality worldwide. We analyzed the spectrum of pathogens causing neonatal septicemia in various Arabic countries as Iraq. Materials and Methods: The study was conducted in the Neonatal Care Unit (NCU) at Al-Elwiya maternity teaching hospital, a total of (50) neonate admitted to NICU during the period January 2021 to June 2021. The case records were reviewed and information regarding gestational age, and medical history of the mother, bacterial isolate isolated from newborn and management procedures were collected. Blood cultures were used to establish the diagnosis of bacterial infection as well as (25) control group without neonatal septicemia (healthy). Results: Current study appeared 30 (60%) males and 20 (40%) females, so about 31 (62%) in age (>7) day compare to age group (7-28 and 28 ≤) day as (22%, 16%) respectively, so the early onset sepsis (58%)more than late onset sepsis (42%), and most common pathogens were gram negative bacilli causing both early onset septicemia and late onset sepsis as percentage (28%, 34%) respectively compare to gram positive bacteria (30%, 8%), also most common pathogenic organisms were E. coli 13 cases (26%), both Klebsiella and Pseudomonas species 7 cases (14%), Staphylococcus epidermedis (11 cases or 22%) in both early and late onset neonatal septicemia. Results of current study showed, 36 cases (72%)were delivered at hospital and 14 (28%) at home, about to residency are a urban was 31 cases (62%) and 29 cases (58%) rural, also education of mothers as primary school (27%, 54%) compare to control (11%, 44%) and secondary school as (8%, 16%) compare to control (10%, 40%), whilst the mother as housewife and employer as (44%, 40%) respectively compare to control. Conclusion: Current study appeared the males with septicemia more than females so about 31 (62%) in age >7 day compare to age group (7-28 and 28 ≤) day as (62%, 22%) respectively, early onset sepsis more than late onset sepsis. So most common pathogens were gram-negative bacilli causing both early-onset septicemia and late onset sepsis, as well as most common pathogenic organisms were E. coli, followed both Klebsiella and Pseudomonas species. Socio demographic characteristics play important role in neonatal septicemia.

Comparative assessment of off-label and unlicensed drug prescription in neonatal intensive care: FDA versus Brazilian guidelines

IntroductionRegulatory agencies are responsible for defining the use of off-label (OL) and unlicensed (UL) drug prescription in neonatal intensive care. However, these regulatory criteria may differ between agencies in different countries. The aim of this study was to establish the frequency of OL and UL drug prescription in a sample of patients in a neonatal intensive care unit applying the criteria of the Food and Drug Administration (FDA) of the United States and the Agência Nacional de Vigilância Sanitária (ANVISA) of Brazil, analysing the differences observed in the results based on the applied criteria. MethodsProspective cohort study in neonates admitted for more than 24h to the NICU of a teaching maternity hospital between August 2017 and July 2018. We obtained information concerning the drugs included in the analysis of OL and UL prescriptions from the DrugDex-Micromedex® and official information on pharmaceutical products in Brazil. We used the kappa correlation coefficient to assess the agreement between the FDA and ANVISA criteria. We defined disagreement as a kappa value of less than 0.200. ResultsWe evaluated 220 neonates admitted to the NICU and 17,421 items prescribed during the study period. We did not find a difference in the proportion of neonates in which at least 1 drug was prescribed under OL conditions applying the FDA versus the ANVISA criteria (96.4% vs. 98.6%). We found differences between the FDA and ANVISA in the OL classification based on the authorized age of use and indications for prescription, mainly in systemic antimicrobials and cardiovascular drugs. When we compared the prescribing information provided by the FDA and the ANVISA, we found that the criteria of the ANVISA were less specific. ConclusionOff-label and unlicensed drug prescription are frequent in neonatal intensive care applying the criteria of either agency, although the FDA has established more detailed criteria in terms of the ages and indications for which prescription is authorized.

Fetal malposition and malpresentation: Mode of delivery and perinatal outcomes at Maternity Teaching Hospital in Erbil city

Background and objective: Delivering a malpositioned and malpresenting fetus remains uncertainty, despite advances in obstetric practice. This study aimed to determine the mode of delivery and neonatal outcome in cases of fetal malposition and malpresentation. Methods: A cross-sectional study of women delivering malpositioned and malpresenting fetuses was conducted at Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq, from the 1st of June, to the 30th of November, 2018. Three hundred women and their newborns were followed for seven days of life. Results: The total rate of malposition and malpresentation was 4.8%. Most women (87.3%) delivered by cesarean section, 25% of the neonates were admitted to the neonatal intensive care unit, where 69.3% of these infants stayed for seven days. There were three early neonatal deaths (1.0%), all of them were in occipito-posterior, or occipito-transverse position and were delivered abdominally. Among occipito-posterior and occipito-transverse deliveries, 2.2% ended with the death of the fetus (P = 0.360). An Apgar score of 7 was recorded after 5 minutes for 97.7% of the infants. Around 11% of the women had postpartum hemorrhage. Conclusion: Fetal malpresentation and malposition are not uncommon during labor, and most cases are delivered by cesarean section. Neonatal morbidity and mortality are dependent on the type of presentation and the mode of delivery. Keywords: Malposition; Malpresentation; Perinatal outcome; Breech presentation.

Oligohydramnios and fetal outcome in term pregnancy

Background and objective: Oligohydramnios is defined as an amniotic fluid index less than 5th centile for gestation. It presents a threat to the fetus and has been correlated with increased risk of intrauterine growth retardation, meconium aspiration syndrome, severe birth asphyxia, low APGAR scores, and congenital abnormalities. It is associated with perinatal morbidity and mortality and maternal morbidity in a significant number of cases. Therefore, early detection of oligohydramnios and its management is important. This study aimed to determine the perinatal and maternal outcomes in oligohydramnios. Methods: This retrospective cohort study was carried out at the Maternity Teaching Hospital in Erbil from March 2018 to March 2019. A total of 300 patients were recruited, including 150 pregnant women with oligohydramnios and 150 with normal amniotic fluid index. Results: There was a significant difference between the oligohydramnios group and the comparison group in relation to parity and gestational age. Oligohydramnios was more among primigravids. The rate of cesarean section was higher in oligohydramnios group compared to the comparison group. Intrauterine growth retardation among oligohydramnios group was 13%. Oligohydramnios was associated with birth weight &lt;2500 gm (21.3%). Conclusion: Antepartum diagnosis of severe oligohydramnios at term was associated with an increased cesarean section rate, a higher rate of admission of neonatal care unit, and low birth weight. Therefore, antepartum oligohydramnios is associated with increased perinatal morbidity and mortality. Keywords: Amniotic fluid index; Maternal outcome; Fetal outcome; Oligohydramnios.

Detection of Antichlamydial Antibody in Patients With Ectopic Pregnancy and Normal Pregnancy

Aim of the current research is to assess the Chlamydia Trachomatis infection role in the development of early pregnancy complication including ectopic pregnancy and miscarriage in Sulaimanyia Maternity Teaching Hospital. It is a comparative study conducted in Gynecology Clinic and Emergency department of Sulaimanyia Maternity Teaching Hospital during the period from 1st of September 2018 to 31st of March 2019. The study groups included of 70 pregnant women; the first group included 35 ectopic pregnant women and the second group included 35 normal pregnant women that both groups had been selected randomly. Pregnant women with history of ectopic pregnancies, women used intrauterine device, in vitro fertilization, assisted reproduction and history of pelvic surgery. Blood sample (2 ml venous blood) collected to test for antibodies level for Chlamydia Trachomatis by Alegria test system for both studied groups and patients with ectopic pregnancy detected by beta human chorionic gonadotropin and ultrasound scanning. The collected data analyzed by SPSS program and for compare between means of two variables independent sample t-test was used while for comparison of categorical variables Chi square test was used with considering ? 0.05 P-value as significant level. The results shows that the mean age of normal pregnancy were (28.3±4.6) group compared with mean age ectopic pregnancy (29.5±4.9) group. The mean IgG (6.3±5.1) of patients with ectopic pregnancy was found to be significantly higher than mean IgG (2.8±1.1) for normal pregnant patients (P-value 0.01) and IgM mean (4.5±2.4) of patients with ectopic pregnancy was significantly higher than mean IgM (1.6±1.2) for normal pregnant patients with P-value 0.01. In conclusion, infection of Chlamydia Trachomatis has a significant relationship with the development of ectopic pregnancy therefor screening and treatment of Chlamydia infection may reduce ectopic pregnancy rate with low cost

Risk scoring in predicting preterm birth of women receiving cervical cerclage

Background: Cervical incompetence is primarily a clinical diagnosis, which is characterized by recurrent painless dilation of cervix and spontaneous second trimester loss and preterm delivery. Despite recent advances, the indications and efficacy of cervical cerclage have been remained controversial. This study was performed with the aim of evaluating the risk factors of preterm birth among women who underwent cervical cerclage and establishing a scoring system to predict preterm labor in this group of women.Material and Methods: This retrospective cohort study was performed on 95 women who had undergone cervical cerclage from January 2016 to January 2018 in Maternity Teaching Hospital of Sulaimaniyah, Iraq. A total of 66 women who delivered after 34 weeks were used as control group, compared to 29 cases who delivered before 34 weeks.Results: According to the findings of the present study, there was a significant association between the preterm birth before the 34 weeks of pregnancy and the risk factors of pathological vaginal discharge, cervical length less than 25 mm prior to cerclage placement, and passive smoking. The positive predictive value was calculated using the prediction model was %99 with a risk score of 3, 47.6% with risk score 2 and 28.2 % with risk score 1.Conclusion: The prediction model can be used as a tool to identify patients at a higher risk for PTD &lt;34 weeks and to recognize those that could benefit from cerclage and deliver after 34 weeks. It could also be a useful tool for identifying those high risk women with cerclage who require increased surveillance.

Relationship between Vulvovaginitis in Women with the Candida Species

Background: Vulvovaginal candidiasis refers to the vaginal infection that is caused most commonly by candida species, especially candida albicans, women in their lifetime at risk to infect by candida species. The objectives of this study were to determine the relationship of Vulvovaginal infection with Candidiasis and its association with some risk factors and the incidence of different species of Candida among patients with vulvovaginitis. Methods: 300 samples from high vaginal swabs obtained from females attending maternity teaching hospital in Erbil City complained from signs and symptoms of valvovaginitis from the period September 2019 to February 2020. A questionnaire form prepared for each patient, who includes: age, clinical presentation and history of pregnancy, diabetes, and history of using contraceptives and the type of contraceptives. High vaginal swabs collected from patients and direct microscopic examination performed, cultured onto Sabouraud Dextrose Agar (SDA), Blood agar and Macconkey agar and species identification done by using an automated VITEK 2 compact system. Results: From the total of 300 high vaginal swabs collected at Maternity hospital in Erbil city and prevalence of vulvovaginal candidiasis was (57%). The highest prevalence of positive cases were in the age range (30-34) years and the positive culture among pregnant women was 73(63.4%) and also the incidence of vulvovaginal candidiasis was higher among diabetic females 49(80.3%), The incidence of positive cultures of Candida spp. in the antibiotic users group were 61(64.4%) and also the positive culture for candida spp was higher among the contraceptive pills 40(60.6%) however for IUCD user the positive culture was 31(68.9%). The species of Candida species which identified by using Vitek system were distribute as follow: Candida albicans was 147(86%) Candida glabrata16 (9.4%),CandidaParapsilosis 6(3.5%)and, Candida krusei 2(1.2%). Conclusion: In the present study, vulvovaginal candidiasis is more in the young age group and more frequent in the pregnant ladies and the diabetic patients and those using antibiotic and contraceptives, either the pills or Intrauterine contraceptive device. Candida albicans had the highest percentage among other positive isolated from high vaginal swab and there was a significant relation between clinical presentation of the patient with the result of culture.

Epidemiology of Cryptococcal antigenemia among HIV infected patients in South-western Nigeria

Background: Cryptococcosis is a life-threatening fungal infection that presents diversely with no specific pathognomonic features. Cryptococcal disease is one of the most important opportunistic infections, and a major contributor to early mortality in HIV infected subjects. Cryptococcal antigenemia occurs in Nigeria, but the magnitude of this disease remains unclear. This study was carried out to determine the prevalence of CrAg among HIV seropositive and seronegative individuals attending Adeoyo Maternity Teaching Hospital (AMTH), Yemetu, Ibadan. Methods and materials: This was a case-control study in which 114 cases and 228 controls were recruited. Cases were HIV seropositive individuals while controls were HIV seronegative individuals receiving care at AMTH. Adult male and female (age range: 18–65 years) who agree to participate in the study were recruited. Simple random sampling was used to select subjects. Semi-structured interviewer administered questionnaire was used to collect data from subjects and retrospective review of CD4 count records in HIV infected subjects. Five millilitres venous blood was collected from each participant. Serum Cryptococcal antigen testing was done using CrAg Lateral Flow Assay. Data was analyzed using descriptive statistics and bivariate analysis at 5% level of significance. Results: Mean age of cases was 41.2 ± 10.0 years and 85 (74.6%) were females while mean age of control subjects was 38.9 ± 13.7 years 156 (68.4%) were females. The cumulative prevalence of CrAg was 8.5%. However, the prevalence of CrAg among cases was 11.4% and 7.0% among controls. Age groups 41-50 years and 21-30 years were the most affected among cases and controls respectively. HIV positive subjects were about two times more likely to test positive for CrAg. Individuals with CD4 counts of ≤100cells/μl were 20 times more likely to have positive serum cryptococcal antigen than individuals with CD4 counts >100 cells/μl (OR: 20.3, 95%CI: 5.23-78.9). Conclusion: Cryptococcal antigen was present among both cases and controls; however, the prevalence was higher among cases. Since asymptomatic cryptococcal antigenemia predicts impending cryptococcal infection (pneumonia and meningitis) with probable mortality, screening for CrAg should be part of the routine tests amongst all confirmed HIV seropositive cases

The Consequence of Teenage Pregnancy on the Primigravida Health Outcome Delivers at Sulaymaniyah Maternity Teaching Hospital-Kurdistan Region-Iraq

Background and Objectives: Teenage first pregnancy is a significant public health problem as it often occurs in the context of poor social support and maternal wellbeing. It is consid-ered high risk for both the mother and infant. This study aimed to find out the effect of teenage pregnancy on neonatal health outcomes. Methods: A descriptive, cross-sectional, prospective study was conducted in Sulaymaniyah in the Kurdistan Region of Iraq and involved all pregnant teenage mothers admitted to Sulaymaniyah Maternity Teaching Hospital from January 1, 2019, to June 30, 2019. Results: 332 of mothers aged ≤19 years and their newborns were studied. A higher pro-portion of teenage mothers were from rural areas than the urban areas (59.3% vs 40.7%). The percentage of teenage mothers who did not attend antenatal care was 11.14%, and irregular attendees represented 9.94 %. Compared with teenage mothers aged 14–16 years, teenage mothers aged 17–19 years had higher risks of anaemia, systemic infections, coincidental condition, low birth weight, preterm delivery and low Apgar score. The risk of aspiration of meconium and stillbirth among infants born to teenage mothers was statisti-cally not significant after adjustment for gestational age and birth weight, in addition to maternal characteristics and mode of delivery. Teenage pregnancy was associated with higher risks of adverse pregnancy outcomes. Conclusion: Prevention strategies and the improvement of healthcare are essential to re-duce the consequences of teenage pregnancy on maternal and neonatal health outcomes. Teenage women were less likely to receive antenatal care services. Use of community- and health facility-based education programs are necessary to prevent teenage pregnancy and thus reduce adverse maternal and neonatal outcomes.

The Effect of Kangaroo Mother Care Intervention on the Newborns Health Outcome Delivers at Sulaymaniyah Maternity Teaching Hospital

Background and Objectives: Kangaroo mother care is an intervention for all newborns but especially for premature and low birth weight infants. The method involves babies being carried, usually by the mother, with skin-to-skin contact. It is the most achievable way for decreasing neonatal morbidity and mortality and is practical, inexpensive especially for developing countries. This study intended to assess the effect of kangaroo mother care on the newborns’ health outcome at Sulaymaniyah Maternity Teaching Hospital in Sulaymani-yah, Kurdistan Region, Iraq. Methods: A quasi-experimental, pre-post intervention study was conducted in the Neona-tal Intensive Care Unit and Baby Friend Unit of the hospital. One hundred newborn-mother pairs participated in the Kangaroo mother care procedure. The newborns were physiologically monitored before, in the middle and after the procedure. Result: The highest mean of newborn temperature was 37 ̊C after Kangaroo mother care in the visit three and the lowest mean temperature was 36.1 ̊C before Kangaroo mother care. There were statistically significant differences between the before, middle and after-procedure measurements in temperature, heart rate and respiratory rate (p-value &lt;0.05) on all three visits, while there was no significant difference between the means of the oxy-gen saturation at all three visits (p-value was more than the standard alpha 0.05 F-test=0.961). There was a highly significant association between oxygen saturation and newborn birth weight and gestational age. Individual vital signs abnormalities were often corrected during the Kangaroo mother care sessions. Newborns involved in the procedure showed steady and statistically significant improvement in vital physiological parameters during three sessions on all three days. Conclusion: Majority of babies who received Kangaroo mother care showed significant im-provement in vital physiological parameters on all three days without using special equip-ment showing that this strategy can offer improved care to newborn infants. These find-ings support wider implementation of this strategy.

Indications and Complications of Tracheostomy in Pediatric Age group in Hilla, Babylon province, Iraq: Cross sectional Study

Background: The procedure tracheostomy involves making an opening in the airways and introductionof tube into tracheal rings in order to bypass obstruction and allowing air to reach the lungs. The survivalof neonates and children witnessed substantial improvement following implementation of such procedure;therefore, the rate of performing tracheostomy in children has become high. Little information is availableabout complications of tracheostomy in Hilla general teaching hospital.Aim of the study: to highlight the main indications and complications in association with tracheostomy inpediatric age group in Hilla, Babylon province, Iraq.Patients and methods: The current prospective study included 41 children less than 12 years of age formthe pool of patients admitted to intensive care unit at Hilla General Teaching Hospital and the intensive careunit at Babel Pediatric and Maternity Teaching Hospital. The study extended from March 2018 to September2019. All those children underwent tracheostomy for a variety of reasons. They were followed up for oneyear for recoding any possible complication in association with tracheostomy procedure.Results: After one year of follow up, the time until decannulation was ranging between 45 to 365 days with amean of 61.73 days. Upper air way obstruction was seen in 12 cases while assisting ventilation in prolongedintubation was seen in the majority, 30 cases. Causes of upper airway obstruction were Craniofacial anomaly,Subglottic stenosis, Laryngotracheal stenosis, Vocal fold paralysis and Subglottic hemangioma. The reasonsfor prolonged intubation included Neuromuscular disease, Postoperative period following major surgery,Respiratory failure, Trauma and Subglottic hemangioma.Conclusion: The main indications for tracheostomy in children were congenital upper air way obstructionand the need for prolonged mechanical ventilation and the main complications are either intermediatecannula loss or late subglotic obstruction.

Nurses – Midwifes Knowledge Concerning Polycystic Ovary Syndrome in Baghdad Hospitals

Background: Polycystic ovary syndrome is the most common ovary disorder characterize by complexof health problems that affects women of reproductive age due to hormonal imbalance and metabolicproblems, so nurses have an important role in providing counseling and health education for women inreproductive age.Objectives: To assess nurses knowledge about Polycystic ovary syndrome.Methodology: A descriptive study was conducted on probability sample (systematic random) of (100) nursesand midwife who work in obstetric and gynecological departments from three hospitals at Baghdad City:AL-Karkh maternity Hospital, Al-Elwia Maternity Teaching Hospital and Baghdad Teaching Hospital.Study implemented for the period of February 24th 2015 to April 25th 2015. A questionnaire was usedas a tool of data collection to fulfill with objective of the study and consisted of three parts, includingdemographic characteristics, personal experience with polycystic ovary syndrome, sources of knowledgeregarding polycystic ovary syndrome and knowledge regarding polycystic ovary syndrome. A pilot studywas carried out to test the reliability of the questionnaire and content validity was carried out through the 17experts. Descriptive statistical analyses were used to analyze the data.Results: In general the results of the study revealed that half of nurses were at age group (30-39) years ,(35%) of study sample was Institute of medical technology/nursing, half of study sample work at obstetricand gynecological ward, (55%) of study sample were married and the highest percentage (93%) theirsources of knowledge about Polycystic ovary syndrome from syllabus. Most of the study sample had highassessment level of knowledge about polycystic ovary syndrome.Conclusions: Nurses had high level of knowledge regarding the polycystic ovary syndrome, the reason forthis is due to nursing curriculum was effective in giving scientific knowledge about it.

Comparing Parity, Socio-demographic and Serum Vitamin D among Pregnant Women with and Without GDM

Background: Gestational diabetes mellitus can affect pregnancy in short and long term, for both mother andher offspring. Nearly 1% to 28% of all pregnancies are complicated by GDM. Knowing the risk factors canprevent the onset of GDM and early detection of GDM, which is important to prevent or minimize the GDMconsequences and optimum treatment.Objective: To compare the parity, socio-demographic and serum vitamin D state of pregnant women withand without gestational diabetes mellitus.Method: This is a descriptive analytic study conducted in the Maternity Teaching Hospital in Sulaimani cityfrom December 2018 to January 2019 among 100 pregnant women with GDM and 162 healthy pregnantwomen. The face-to-face interview was used to collect the information regarding socio-demographic andobstetric history through a specific written questionnaire. At the same time serum vitamin D state wasexamined using the Roche Elecsys vitamin D3 assay.Result: The study found that body mass index, educational state, age at marriage, parity and graviditysignificantly higher in the GDM group compare to the non-GDM group. Socioeconomic state does not differsignificantly in both group p=0.069.

The Impact of Breastfeeding on the Total Duration of the Third Stage of Labour among Women Attending Maternity Teaching Hospital in Sulaimani City

Background: Quick breastfeeding during the third stage of labour is considered the safest and most effectiveintervention to reduce the blood loss associated with labour, as it can naturally release the oxytocin tostimulate the uterine contraction. These contractions make it easier to dislodge the placenta and help reducethe total duration of the third stage of labour.Aim of the Study: To evaluate the impacts of breastfeeding immediately after birth for the total duration ofthe third stage of labour.Study Design: A quasi-experimental study, post-test only control design.Material and Method: 300 pregnant women from the labour ward in their third stage of labour participatedin this study, carried out between 26th of February 2020 and 30th of July 2020. Samples were selectedby using a convenient sampling technique through the structured observation record sheet, onto whichthe beginning of breastfeeding time and placental delivery was recorded. The data were analyzed usingdescriptive and inferential statistics.Results: Among the 300 mothers (34%) had delivered the placenta within 5 minutes, (46%) within 8-10minutes, (13.3%) within 11-13 minutes and (6.7%) had 14-16 minutes in the experimental groups. While,in the control group the duration was longer (46.7%) between 11 and 13 minutes, (20%) within 14 and 16minutes.Conclusion: The study results show that early initiation of breastfeeding is an effective intervention toreduce the total duration of the third stage among the mothers during the third stage of labour.

Maternal Hemoglobin Concentration and Pregnancy Outcome in a Sample of Iraqi Women

Aim of study: To analyze the maternal and perinatal outcome in varying degree of anemia and assess whichlevel of hemoglobin concentration has best pregnancy outcome in Iraqi women.Patients and Method: A cohort study that was conducted at Al-Elwiya Maternity Teaching Hospital duringthe period from 1st of Dec 2017 till end of Dec 2019. It included 500 pregnant women who were followedup in labor until delivery and their maternal and perinatal outcome were noted. Hemoglobin and MCV ofeach pregnant woman were measured at late second and third trimester. Hemoglobin groups were relatedto the maternal characteristics, delivery characteristics and pregnancy outcome. The patients underwent acomplete blood count, blood film examination and hematocrit estimation.Results: In this study, 33.4 % of study participants had mild anemia and 22% of them had normal hemoglobinand MCV. Incidence of adverse perinatal outcome was 32.6% and adverse maternal outcome was 11.8%.Maternal hemoglobin and MCV levels are significantly affected by mother’s age. Hemoglobin level is alsoaffected by parity while MCV level doesn’t. Low maternal hemoglobin was associated with increased riskof poor birth outcomes including LBW, preterm birth and adverse maternal health outcomes, includingcesarean section and induction of labor.Conclusion: Maternal anemia is strongly associated with several different types of maternal morbidity andperinatal morbidity.