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Article
Human Chorionic Gonadotropin in Treatment of Preterm Labour

Authors: Ibtissam Yousif AL- Saffar --- Hala Ibrahim Salih
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 3 Pages: 288-292
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Preterm labour is a major healthcare problem throughout the world, it is a major cause of perinatal morbidity and mortality, that is not significantly altered by the current drug therapies, most of which are associated with significant maternal or fetal side effects. OBJECTIVE: To evaluate the role of human chorionic gonadotrophin (HCG ) in the treatment of preterm labour. METHODS: Fifty-seven women with preterm labour were enrolled in this clinical trial at Al- Yarmouk Teaching Hospital/ department of Obstetrics and Gynaecology – Baghdad /Iraq during the period from April, 1st 2006 till November, 30th 2006, and were assigned to receive a single intramuscular injection of 5000 units of HCG followed by a drip of 10000 units of HCG in 500 ml 5% dextrose over 6 hours. 30 women continued the study and the mean prolongation of the pregnancy was calculated for all of them. RESULTS: The mean prolongation of pregnancy was 32.97 ± 17.6 days and it was highest among gestational ages of 29-30 weeks ( 43.3± 19.85 days ), with the mean gestational age at birth was 35.7 ± 2.8 weeks. All babies born to these women had weight appropriate for their gestational age at birth with a mean birth weight of 2.7 ± 0.64 kg and 60% of babies weighed > 2.5 Kg at birth. CONCLUSION: It was shown through this trial that human chorionic gonadotropin was effective in exhibiting potent tocolysis and prolonging pregnancy in preterm labour without causing adverse effects to the mothers or their babies. This can make a major contribution to the management of this common obstetrical complication.

Keywords

HCG --- preterm labour --- treatment


Article
Whether Selective or Routine Episiotomy is More Useful to Protect Anal Sphincter in Primiparous Women

Author: Adulrazak H. Alnakash
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 1 Pages: 26-32
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Perineal trauma is a common event, affecting up to 90% of first time mothers. It is a cause forconcern for many women and in some countries has led to a large increase in the numbers ofwomen requesting elective caesarean section.OBJECTIVE:To highlight when episiotomy can be useful in preventing anal sphincter injury in primiparouswomen.MATERIALS AND METHODS:This study is a prospective interventional clinical study conducted at AL-Elwiya MaternityTeaching Hospital in Baghdad throughout the period between Jan. 2009- Dec. 2009.Three hundred term primiparous ladies at time of their delivery with cephalic presentation werecollected and subdivided into 3 equal groups randomly.The first group, women who were subjected to routine mediolateral episiotomy, while the secondgroup of the participants were delivered without doing episiotomy, and the third group, amediolateral episiotomy was done selectively to them when we found it is necessary (selectiveepisiotomy).State of the perineum, length of 2nd stage, weight of the baby, fetal head position and theoccurrence of anal sphincter injury were all notified and carefully recorded on special formdesigned for the study.RESULTS:Selective episiotomy was found to be more useful than routine episiotomy in preventing analsphincter injury (the incidence of anal sphincter injury was 2% for those in whom episiotomy wasperformed selectively, while it is 8% for those with routine episiotomy and 7% for those deliveredwithout episiotomy), and the difference is statistically significant (P value 0.045).There was a significant effect of the length of second stage of labour on the incidence of analsphincter injury (P value 0.017), similarly for the weight of baby (P value 0.017).CONCLUSION:Selective episiotomy is more useful intervention than routine episiotomy in protecting the analsphincter when delivering a primiparous lady.


Article
Whether Selective or Routine Episiotomy is more Useful to Protect Anal Sphincter in Primiparous Women

Authors: Abdulrazak H. Alnakash --- Shaema Jafar --- Yousef Abdul-Raheem
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 4 Pages: 519-525
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BACKGROUND:Perineal trauma is a common event, affecting up to 90% of first time mothers. It is a cause for concernfor many women and in some countries has led to a large increase in the numbers of womenrequesting elective caesarean section.OBJECTIVE:To highlight when episiotomy can be useful in preventing anal sphincter injury in primiparouswomen.MATERIALS AND METHODS:This study is a prospective interventional clinical study conducted at AL-Elwiya Maternity TeachingHospital in Baghdad throughout the period between Jan. 2009- Dec. 2009.Three hundred term primiparous ladies at time of their delivery with cephalic presentation werecollected and subdivided into 3 equal groups randomly.The first group, women who were subjected to routine mediolateral episiotomy, while the secondgroup of the participants were delivered without doing episiotomy, and the third group, a mediolateralepisiotomy was done selectively to them when we found it is necessary (selective episiotomy).State of the perineum, length of 2nd stage, weight of the baby, fetal head position and the occurrenceof anal sphincter injury were all notified and carefully recorded on special form designed for thestudy.RESULTS:Selective episiotomy was found to be more useful than routine episiotomy in preventing analsphincter injury (the incidence of anal sphincter injury was 2% for those in whom episiotomy wasperformed selectively, while it is 8% for those with routine episiotomy and 7% for those deliveredwithout episiotomy), and the difference is statistically significant (P value 0.045).There was a significant effect of the length of second stage of labour on the incidence of analsphincter injury (P value 0.017), similarly for the weight of baby (P value 0.017).CONCLUSION:Selective episiotomy is more useful intervention than routine episiotomy in protecting the analsphincter when delivering a primiparous lady.


Article
Whether Selective or Routine Episiotomy is more Useful to Protect Anal Sphincter in Primiparous Women

Authors: Abdulrazak H. Alnakash --- Shaema Jafar --- Yousef Abdul-Raheem
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 4 Pages: 519-525
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Perineal trauma is a common event, affecting up to 90% of first time mothers. It is a cause for concernfor many women and in some countries has led to a large increase in the numbers of womenrequesting elective caesarean section.OBJECTIVE:To highlight when episiotomy can be useful in preventing anal sphincter injury in primiparouswomen.MATERIALS AND METHODS:This study is a prospective interventional clinical study conducted at AL-Elwiya Maternity TeachingHospital in Baghdad throughout the period between Jan. 2009- Dec. 2009.Three hundred term primiparous ladies at time of their delivery with cephalic presentation werecollected and subdivided into 3 equal groups randomly.The first group, women who were subjected to routine mediolateral episiotomy, while the secondgroup of the participants were delivered without doing episiotomy, and the third group, a mediolateralepisiotomy was done selectively to them when we found it is necessary (selective episiotomy).State of the perineum, length of 2nd stage, weight of the baby, fetal head position and the occurrenceof anal sphincter injury were all notified and carefully recorded on special form designed for thestudy.RESULTS:Selective episiotomy was found to be more useful than routine episiotomy in preventing analsphincter injury (the incidence of anal sphincter injury was 2% for those in whom episiotomy wasperformed selectively, while it is 8% for those with routine episiotomy and 7% for those deliveredwithout episiotomy), and the difference is statistically significant (P value 0.045).There was a significant effect of the length of second stage of labour on the incidence of analsphincter injury (P value 0.017), similarly for the weight of baby (P value 0.017).CONCLUSION:Selective episiotomy is more useful interv


Article
12-INFLUENCE OF BODY MASS INDEX ON THE INCIDENCE OF PRETERM LABOUR

Authors: Khilud Salim Al-Salami --- Zaineb T Alyasin --- Ragad Nasir HussainSAINN
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 2 Pages: 72-77
Publisher: Basrah University جامعة البصرة

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Abstract

Nutritional status of the women has been considered as an important prognostic indicator ofpregnancy outcome and risk of preterm birth. Few studies have evaluated the patterns of bodymass index in developing regions where malnutrition and poor weight gain as well as maternalobesity have significant influences on the pregnancy outcome. This study aims to show theeffect of pregnancy body mass index on the incidence of preterm labour.This is a prospective descriptive study of 200 women attended Basrah Maternity and ChildHospital who were diagnosed with preterm labour were recruited in the study. Patients wereclassified into categories that were based on their body mass index (BMI) according to thenational institute of health guidelines. Rate of spontaneous preterm birth were determined.Women with body mass index <19 kg/m2 had 34.5% of spontaneous preterm labour, with BMI19-24.9 kg/m2 had 28.5% of spontaneous preterm labour, while those with BMI 25-29.9 kg/m2had 21% of spontaneous preterm labour, women with BMI 30-34.9 kg/m2 had 14% ofspontaneous preterm labour and with BMI >/35kg/m2 had 2%of spontaneous preterm labour.Risk of spontaneous preterm labour tend to progressively decrease with increasing body massindex.Thinner women who have preterm delivery tend to deliver at earlier gestational age than womenwho were obese 42.3% of non obese women deliver before 30 weeks of gestation compared to25% of the obese, 44% of non obese deliver at gestational age 30-40 weeks compared to 28.25of the obese.In conclusion, high body mass index is associated with a lower rate of spontaneous pretermbirth.

Keywords

BODY MASS INDEX --- PRETERM --- LABOUR


Article
The Incidence of Listeriosis among Abortion and Preterm Labour in Bghdad
نسبة الإصابة بمرض (الليستريا) في حالات الإجهاض و الولادة المبكرة في بغداد

Authors: Riadh M. Salih رياض محمد --- Bashar Y. Fatoohi بشار يوسف --- Miamy Abdul-Hassan ميامي عبد الحسن
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2005 Volume: 18 Issue: 3 Pages: 254-265
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract:Objective: To find the incidence of Listeriosis among abortion and preterm labor.Setting: Department of obstetric and Gynecology in AL –Yarmouk teaching Hospital & Al-Habibia Maternity Hospital, in cooperation with the Department of Pathology ,College of Veterinary Medicine ,Baghdad University .Design: Tests for isolation of L. Monocytogenes from (200) women, (50) of them presented with abortion either incomplete or inevitable abortion or other (50) women presented with preterm labour and comparising them with (100) women with term labor as control. Isolation done by culture of placental tissue, maternal blood, cord blood and amniotic fluid in routine and selective culture media, then taking suspected colonies for gram stain. If gram stain positive then tested for catalase if positive catalase test, taken for biochemical test and for examination for haemolysis .Then tested for Api Listeria test which is identifiable test for Listeria. Then inject these colonies into experimental mice to confirm that it is virulent and taking biopsy from different organs of mice for histopathological study, also taking pieces from placental tissue for histopathological study.Results: The results showed (3) positive cases of listeriosis one of them for woman presented with inevitable abortion and she was (22) weeks pregnant. The second positive case for women presented with preterm labor and she was (24) weeks pregnant. While the third +ve case was for woman presented with preterm labor & was (28) weeks pregnant.Conclusion: Listeriosis is dangerous disease, is present in Iraqi pregnant woman, from this study we concluded the presence of listeriosis among Iraqi pregnant patients which may contribute to miscarriage, preterm labor & still birth, inspite of its rarity and to find the true incidence, larger number of patients are needed to be studied.

الملخص:اجري هذا البحث في قسم النسائية و التوليد في مستشفى اليرموك التعليمي و مستشفى الولادة في الحبيبية للفترة ما بين شباط 2002 الى شباط 2003 ، تتضمن هذه الدراسة البحث عن الإصابة بمرض اللستيريا في (50) امرأة في حالة إجهاض و (50) امرأة في حالة ولادة مبكرة ، و مقارنتها بـ(100) امرأة في حالة ولادة في أوانها و ذلك عن طريق اخذ عينات من المشيمة و عينات من دم جميع النساء المشمولات بهذه الدراسة و عينات من السائل الامينوسي و من دم الحبل السري في حالة الولادة المبكرة ، و الولادة التي في أوانها للزرع الجرثومي ثم تم بعد عملية الزرع اخذ مسحات من هذه الجراثيم لصبغة الگرام حيث إن بكتريا الـ لستريا مونوسايتوجينس موجبة بصبغة الگرام حيث تظهر هذه البكتريا تحت المجهر على شكل عصيات او عصيات كروية مختلفة الإشكال، و تكون مُحلِّلة للدم (نوع بيتا).و أيضا تم اخذ جزء من هذه المستعمرات لإجراء اختبارات الكيمياء الحياتية عليها و لاختبار الـ اپي الخاص باللستريا.ثم حقنت هذه البكتريا في فئران الاختبار تحت الجلد للتأكد من مقدار حدة الجرثومة. ثم أخذت عينات من أعضاء مختلفة من هذه الفئران للفحص النسيجي، كذلك أخذت عينات من المشيمة للفحص النسيجي.كانت النتيجة وجود (3) إصابات بمرض اللستريا الأولى كانت لامرأة حامل في الأسبوع الثاني و العشرين و كانت قد أدخلت إلى المستشفى بعد أن شخصت إنها في حالة إسقاط محتم و كانت المرآة غير مصابة بإمراض مزمنة كالسكر أو ارتفاع ضغط الدم و لم يكن لديها ولادة مبكرة سابقاً و لم يكن لديها حالة ولادة طفل مشوه سابقا، .... الخ و لكنها كانت مصابة بنحول و حمى و الم بالعضلات و بعد إدخالها إلى المستشفى أجهضت و كان الجنين متوفى (وفاة حديثة). أما الإصابة الثانية فكانت لامرأة حامل في الأسبوع الرابع و العشرين و كانت في حالة ولادة مبكرة و لم يكن لديها ولادة لطفل مشوه سابقا و لا لديها أمراض مزمنة كالسكر أو ارتفاع ضغط الدم و أمراض الكلى و القلب و لم تكن حامل لأكثر من جنين واحد و ليس لديها تشوهات بالرحم أو توسع في عنق الرحم، أو تقدم المشيمة أو انفصال المشيمة أو لديها ولادة مبكرة سابقاً. و كانت المرآة في حالة حمى و الآم في المفاصل و الرأس و تم تشخيصها على إنها مصابة بالأنفلونزا و قد ولدت جنين ميت (وفاة حديث).أما في الإصابة الثالثة فكانت المرآة حامل بالأسبوع الثامن و العشرين و أيضا لم تكن مصابة بجميع الأمراض التي ذكرناها في أعلاه و كانت في حالة ولادة مبكرة و كانت أيضا مصابة بالإسهال مع حمى و أيضا ولدت جنين ميت (وفاة حديث أيضا).في الدراسة أعلاه وجدنا أن الحالات قليلة جدا ربما يعود ذلك لعدد النساء المشمولات بالدراسة حيث ان العدد قليل و ريما يعود لان مرض اللستريا هو مرض غير واسع الانتشار حسب الدراسات التي اطلعنا عليها خلال أجراءنا لهذه الدراسة و أيضا وجدنا أن جميع المصابات كُنَّ مصابات بحمى و جميعهن أجهضن او ولدن اجنة ميتة و الإصابة كانت في فترة الحمل ما بين (22-28) أسبوع.و كانت نسبة الإصابة في حالة الإجهاض 2% و في حالة الولادة المبكرة 4%.


Article
Comparison of Extraamniotic Corticosteroids Injection versus Extraamniotic Saline Infusion for Ripening of the Cervix
مقياس السائل الامنيوتي للتنبؤ بنتائج الولادة عند النساء اللائي تطول فترة ولادتهن

Author: Maha Mohamed Al-Bayati د. مها محمد البياتي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2008 Volume: 21 Issue: 1 Pages: 30-34
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Objective: To compare the effectiveness, safety and patient acceptability of extraamniotic corticosteroids injection versus; extraamniotic saline infusion for ripening of the cervix in induction of labour. Study design: An interventional randomized comparative clinical study.Patients & methods: This study was conducted in Gynaecology and Obstetric department of Al-Kadimyia teaching hospital. The study includes 100 pregnant women with a gestational age of 36-42 weeks, an unfavorable cervix and obstetric indication for induction of labour. The patients were divided into group A and group B. Group A received dexamethasone in saline solution, and group B received saline solution only with a concentration of (0.9%) administered extraamniotically through an intracervical inflated Foley's catheter. Results: Group A achieved the higher post-ripening Bishop's score. The mean priming and the induction-delivery interval times were significantly shorter in-group A compared with those of group B (2.61 ± 0.42 h versus 4.38 ± 0.32 h with a P value = 0.0001 and 6.38 ± 1.57h versus 9.15 ± 0.99 h with a P value = 0.0001 respectively). Conclusion: Extraamniotic corticosteroids injection was found to be superior method for induction of labour in comparison with extraamniotic saline infusion. Key words: Induction of labour, Bishop's score, Corticosteroids

الاهداف :- لمعرفة إمكانية التنبؤ بنتائج الولادة سريريا مقارنة بمقاييس السائل الامنيوتي. طريقة البحث :- دراسة سريرية وبالاعتماد على نتائج الامواج فوق الصوتية تم فحص خمسون مريضة حامل ومتابعة ولادتهن ( جميعهن طالت فترة ولادتهن ). تم إخضاعهن للفحص بالسونار لمعرفة معيار السائل الامنيوتي ومقارنتها بمجريات الولادة لكل مريضة .اجري البحث في مستشفى الكاظمية التعليمي – قسم النسائية والتوليد للفترة من حزيران 2001 إلى آيار 2002. تم قياس نشاط الوليد باستعمال مقياس أبكار Agar score ( لتقييم الجنين بعد ولادته ), وزن الوليد, وجود Me conium (عقي), استنشاق Me conium , مداخلة للولادة بسبب حدوث اعياء لدى الجنين , وفاة الجنين اثناء الولادة او ادخاله في وحدة الخدج . النتائج :- الحمل الطويل مع وجود معامل الامنيوتي منخفض اقل من 5 سم كانت له علاقة ارتباطية بمعنى احصاءي دال مع كل من الاستنشاق العقي أو العملية القيصرية بسبب اعياء الطفل اثناء الولادة. الاحتمالية كانت 0,009 و 0,030 على التوالي . الاستنتاج :- معامل الامنيوتي يعتبر مهم للاستقصاء عن المضاعفات التي تصيب الجنين لدى النساء اللائي تطول فترة حملهن.


Article
Neonatal Nucleated Red Cell Count and It’s Relation with Histologic Chorioamnionitis in Preterm Labour
تقييم وظائف الغده الدرقيه في مصل مرضى السرطان الدم اللمفاوي الحاد والمزمن

Authors: Maha M. Al-Bayati مها البياتي --- Faiza A. Al-Rawi فائزه الراوي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2005 Volume: 18 Issue: 3 Pages: 277-282
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract Objective: To see if cord blood nucleated red blood cell count correlates with histological chorioamnionitis in preterm labour.Setting: Al-Kadimiyah Teaching Hospital – Department of Obstetrics and Gynecology. Study design: Cord blood samples of 100 preterm newborn babies were obtained immediately after preterm labour for complete blood cell count including nucleated red blood cell count. Randomized pieces from placental membranes were taken for histological examination. Patients were divided into those with and without clinical and histological chorioamnionitis.Results: Among 100 patients evaluated (54) had positive histological evidence of chorioamnionitis and (46) had no evidence of histological examination. nucleated red blood cell count increased in the presence of histological chorioamnionitis, the increase was statistically significant (P<0.000001). There was no significant relation between nucleated red blood cell count and clinical chorioamnionitis (P=0.189). Histological chorioamnionitis produces an erythropoietic response in the fetus and cord blood.Conclusion: Histological chorioamnionitis is associated with a rise in nucleated red blood cell count in the fetus which means that histological chorioamnionitis produces an erythropoietic response in the fetus and cord blood. Nucleated red blood cell count is correlated more significantly to histological chorioamnionitis than to clinical chorioamnionitis.

الملخص:اجري هذا البحث في مستشفى الكاظمية التعليمي / قسم النسائية والتوليد للفترة ما بين آذار إلى تشرين الأول عام 1999 .إن هدف هذه الدراسة هو البحث عن العلاقة بين عدد كريات الدم الحمراء المنواة في الأطفال الخدج حديثي الولادة والالتهاب النسيجي للأغشية المحيطة بالجنين في الولادة المبتسرة. شملت الدراسة مائة ( 100 ) سيدة في حالة ولادة مبتسرة. في خمسين ( 50 ) منهن كانت الأغشية المحيطة بالجنين قد تمزقت قبل البدء بالولادة بينما كانت الأغشية المحيطة بالجنين ما تزال سليمة في الخمسين (50 ) سيدة الأخريات.تم أخذ عينات من الأغشية المحيطة بالجنين للفحص النسيجي وذلك لإثبات وجود الالتهاب كما تم أخذ عينات من دم الحبل السري بعد الولادة مباشرة لأجراء فحص دم شامل عليها بما في ذلك فحص كريات الدم الحمراء المنواة. تمت مقارنة عدد كريات الدم الحمراء المنواة بين الأطفال الخدج حديثي الولادة الذين تم تشخيص أمهاتهم بالإصابة بالالتهاب النسيجي للأغشية المحيطة بالجنين والذين لم يتم تشخيص أمهاتهم بالتهاب الأغشية المحيطة بالجنين نسيجيا كما تمت مقارنة عدد كريات الدم الحمراء المنواة بين الأطفال الخدج حديثي الولادة الذين كانت أعراض التهاب الأغشية المحيطة بالجنين ظاهرة على أمهاتهم والذين لم تكن أعراض التهاب الأغشية المحيطة ظاهرة عليهم.وجدنا إن هنالك زيادة كبيرة في عدد كريات الدم الحمراء المنواة في دم الحبل السري للأطفال الخدج الذين ثبتت إصابة أمهاتهم بالتهاب الأغشية المحيطة نسيجيا. كانت هذه العلاقة ذات دلالة إحصائية كبيرة ( P=0.000001 ) بينما لم نجد زيادة ذات أهمية إحصائية ( P=0.189 ) في عدد كريات الدم الحمراء المنواة لدى الأطفال الخدج حديثي الولادة الذين ظهرت لدى أمهاتهم أعراض دالة على وجود التهاب الأغشية المحيطة بالجنين.


Article
The value of middle cerebral artery to umbilical artery ratio by Doppler velocimetry in low risk postdate pregnancies
قيمة الشريان الدماغي الأوسط إلى نسبة الشريان السري عن طريق قياس سرعة دوبلر في حالات الحمل المتأخرة الولادة و منخفضة المخاطر

Authors: Chea Nofel N --- Chro N Fattah
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 2 Pages: 164-171
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Placental insufficiency is the primary cause of intrauterine growth restriction in normally formed fetuses and can be identified using middle cerebral artery to umbilical artery ratio Doppler velocimetry, and provide an estimate of downstream placental vascular resistance and placental blood flow. There is a strong association between reduced end-diastolic umbilical artery blood flow velocity and increased vascular resistance in umbilical placental microcirculation. Doppler ultrasound can assess the uteroplacental blood flow just before labor. This study aimed to investigate the use of the fetal cerebroumbilical ratio to predict the intrapartum fetal compromise in appropriately grown fetuses.Methods: A comparative cross-sectional study set at Sulaimania Maternity Teaching Hospital, Sulaimania, Iraq, from January to June 2015. The study recruited 121 cases, fetal biometry and Doppler indices were measured before established labor. The intrapartum and neonatal outcome details recorded.Results: Infants delivered by cesarean section for fetal compromise had significantly lower cerebroumbilical ratio than those born by spontaneous normal (none assisted) vaginal delivery and by cesarean section for other intrapartum causes. Infants with cerebroumbilical ratio <10th percentile were more likely to be delivered by cesarean section for fetal compromised than those with a cerebroumbilical ratio > 10th percentile. A cerebroumbilical ratio >90th percentile appears protective against cesarean section for fetal compromise. Amniotic fluid index of < 5 was associated with an increased cesarean section for fetal indication.Conclusion The cerebroumbilical ratio can identify fetuses at high risk of intrapartum fetal compromise. As a confounding variable, the amniotic fluid index was a useful tool for surveillance in prolonged pregnancy.


Article
Vaginal birth after caesarean section with less than two years delivery interval
الولادة المهبلية بعد الولادة القيصرية مع فترة الولادة أقل من عامين

Authors: Raida Mala Fatah --- Ghada Alsakkal
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2015 Volume: 19 Issue: 3 Pages: 1063-1068
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

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.

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