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ABSTRACT: BACKGROUND: Eclampsia is a life-threatening complication of pregnancy for both the baby and the mother. Research isunderway to understand this complex condition and to improve the treatments that are currently used tocontrol it as it is a preventable complication of pre-eclampsia.OBJECTIVE: The study reviews the cases of eclampsia managed at Elwiya teaching Hospital with respect toincidence, management, maternal and perinatal outcome. METHODS: This prospective observational study was carried out in the department of Obstetrics and Gynaecologyat Elwiya Teaching Hospital – Baghdad-Iraq. Fifty two cases of eclamptic fits were dealt with from the1st of January till the 31st of December 2008. Pregnant patients with other convulsive disorders andmore than 7 days postpartum were excluded from the study. All the patients included were evaluated bydetailed history (taken from the attendants). Management was according to basic protocol foreclampsia; stabilization of patients, anticonvulsive therapy Magnesium sulfate, phenytoin and/ordiazepam and early delivery. A team of specialists and trained nurses were needed in the intensive careunit to deal with eclamptic mothers.RESULTS: During the year 2008, total number of deliveries from the 1INTRODUCTION: Eclampsia is one of the fatal complications of preeclampsiawhich is a multisystem disorder; itpresents a challenge to obstetricians and otherphysicians. Eclampsia is defined as seizure activityunrelated to other cerebral conditions in a pregnantwoman with pre-eclampsia. The condition wasknown to the ancient Greeks, who named it eclampsia. It has been prevalent since the time ofHippocrates; it remains an important cause ofmaternal mortality throughout the world,accounting for about 50000 deaths worldwide.Department of Obstetrics and Gynecology atElwiya Teaching Hospital – Baghdad . (1)st of January till the 31An eclamptic seizure occurs in 0.5% of mildly preeclampticpregnancies and 2% of severe preeclamptics.(2) st of December was12154, of these patients 52 presented with eclamptic fit with incidence rate of 4.28 per 1000 deliveries.The distribution of cases regarding the seasons was more in winter. 35 patients (67.31%) had poorantenatal care, 17 (32.69%) had good antenatal care. Four patients had history of eclampsia in theirprevious pregnancies. All the patients gave history of imminent eclampsia; two of them had blindnessalso; albumin in urine was negative in two cases only. Serious maternal complications occurred in28(53.84%) cases. Eight of the neonates died due to severe RDS.CONCLUSION: Eclampsia is still present and common in our locality; we need better antenatal care to predict pregnantladies liable to develop eclamptic fit in order to decrease the incidence of eclampsia complicatingpregnanc

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Background: The role of amniotic fluid is to provide a protective environment for fetus growth. The low volume of amnioticfluid (oligohydramnios) has been reported to associate with perinatal and neonatal outcomes. Objectives: The aim of this study was to explorethe effect of oligohydramnios on fetal outcomes at intrapartum and early neonate, including fetal distress. Materials and Methods: In the presentinvestigation, the pregnant women who attended the labor ward of Duhok Maternity Hospital were consecutively screened for eligibility criteria.The patients presented with oligohydramnios from 37 to 40 weeks of gestation to labor room were included in this study and were followedup for neonatal outcomes. The diagnosis of oligohydramnios was established as an amniotic fluid index of 5 cm or less by the ultrasoundexamination. Results: The mean age of the women with oligohydramnios was 26.10 ± 5.20 years ranged between 16 and 40. The mean ageof the gestational age was 38.54 ± 1.13 weeks ranging from 37 to 40. The previous history of a dead newborn was so low (mean: 0.02 ± 0.14).Half of the patients delivered their pregnancies by cesarean section (C/S) (50.5%), and most of them had a good Apgar score value (98.8%).The study showed that women who had a past medical history or delivered by C/S, their newborns were more likely to admit to neonatalintensive care unit (NICU), 36.8% versus 12.1% (P = 0.017) and 78.9% versus 21.1% (P = 0.010), respectively. Conclusions: The presentstudy recommends that pregnant patients diagnosed with oligohydramnios are at a higher risk of C/S and NICU admission.

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Background: In many societies, adverse outcomes in pregnancy and labour have often be ascribed to male fetal gender, so, In recent years, many investigators try to find any relationship between fetal gender and pregnancy outcome.Objective: To evaluate the role of fetal gender on pregnancy and neonatal outcome.Subjects and methods: A cross sectional study was done at a labour ward in Al-Batool Teaching hospital for maternity and children in Diyala Governorate, Iraq during the period from 1st of August till 31st of October 2013. One hundred one pregnant women were eligible for enrollment in the study according to inclusion criteria. The effect of fetal gender on both maternal and fetal parameters were all recorded.Results: A total of 101 neonate were born, of whom 53 were males and 48 were females, there was no significant differences noticed between male and female regarding to the maternal age and parity. Also the result showed that preterm and post term pregnancies more frequently in male bearing pregnancies than in female bearing pregnancies (4.95%, 0.99% respectively), despite these findings were significant statistically, while fetal gender has no positive correlation to the weeks of gestation. Pregnant women with a male fetus had a higher rate of cesarean section (8.91%) than with female fetuses (4.95%) which is statistically significant but there is no positive correlation between fetal gender and cesarean section, the results of this study find that there is no correlation between neonate gender and birth weight. By studying the correlation between neonate gender and other neonatal parameters like Apgar score <7 at 5 mint, admission to NICU, clear liquor, and Meconium liquor it was proved that there is no correlation between fetal gender and these parameters except there is a positive correlation between male gender and Apgar score <7 at 1 mint.Conclusions: There is a positive correlation between male gender and Apgar score <7 at 1 minute but no correlation found between fetal gender and other maternal or neonatal parameters.

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Background:Acute peritoneal dialysis is commonly practiced in IRAQ. Objective:To evaluate and improve the management of peritoneal dialysis in Al-Kindi Teaching Hospital.Methods:Six hundred and sixty nine patients underwent peritoneal dialysis during the period from January 2011 to June 2012. The mean age of patients was 54±13.9 years. Among the patients, there were 168 cases of acute renal failure, and 501 cases of chronic renal failure requiring acute dialysis.Results:Acute peritoneal dialysis performed on patients admitted in dialysis unit of Al-Kindi Teaching Hospital was safe, a simple procedure, easily tolerated by the patient and requiring less expertise than hemodialysis and had complication rates nearly comparable to other established centers.Complications occurred in 349 patients (52%). The most common complication was bleed¬ing in the peritoneal cavity (30%) while dialysis solution leak was the second most common complication (25%). Dialysis episodes complicated by peritonitis was (2.5%). Death rate was 15%.Conclusion:Acute peritoneal dialysis was performed safely and effectively in Al-Kindi Teaching Hospital. Improvements are possible through closer supervision of new doctors and tighter nursing precaution.Key Words:Acute peritoneal dialysis, outcome.

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AbstractObjective: To determine whether homocysteine, a relatively new risk factor for possible endothelial cell dysfunction and premature vascular disease, is elevated in pregnant women with preeclampsia.Methods: A case-control study design conducted at Al-kadimiya teaching hospital for the period from September 2000 through April 2001. The study sample consisted of 100 pregnant women in labour subdivided into three groups (40 pregnant women with severe preeclampsia, 30 pregnant women with mild preeclampsia and 30 normotensive pregnant women as a control). Plasma homocysteine concentration measurement and observation of the maternal and fetal outcome was done for all groups.Results: The incidence of hyperhomocysteinemia was significantly higher among patients with severe preeclampsia (80%) compared to those with mild preeclampsia (67%) and the normotensive group (7%) and the incidence of adverse maternal and neonatal outcome is significantly higher among patients with severe preeclampsia compared to the others.Conclusion: Plasma total homocysteine concentration is elevated in pregnant women with preeclampsia during labour being significantly higher in cases with severe preeclampsia so hyperhomocysteinemia is considered a risk factor for adverse maternal and neonatal outcome.

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ABSTRACT:BACKGROUND:Profound hemodynamic alterations occur during pregnancy, labour and in the postpartum period. These changes can adversely affect both maternal and fetal outcome, if a women encounter a valvular heart disease during her pregnancy.OBJECTIVE:We try to evaluate the effect of valvular heart disease on maternal and fetal outcome of pregnancy.METHODS:This is a cross section descriptive study, carried out in Baghdad teaching hospital, throughout the period from September 2007 to October 2008. Seventy eight pregnant women with valvular heart diseases, in labour, were enrolled in this study. Their medical and obstetrical records were reviewed on admission. We looked for maternal outcome after delivery (method of delivery, heart failure, arrhythmia, need for medication and period of hospitalization), additional to fetal outcome (prematurity, viability and birth weight).RESULTS:Mitral valve disease is predominate valvular heart disease in pregnancy, most of them of mild severity. All maternal and fetal outcome parameters adversely increase among pregnant women with valvular heart diseases.CONCLUSION:Valvular heart diseases carried a higher risk for both mother and fetus. The risk related directly to severity of valvular heart diseases.

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Background and Objectives: preterm labor complicates 5-10% of pregnancies and is a leading cause of neonatal morbidity and mortality worldwide and 70-80% of perinatal deaths occur in preterm infants. The aim of this study is to compare the effectiveness, safety and adverse effects of the oxytocin antagonist medication(atosiban) with those of beta-adrenergic agonist (salbutamol) in the treatment of patients with preterm labor.Patients and Methods: one hundred pregnant women with preterm labor were enrolled in this study from the period of( January 2014 – January 2015) at Al-Diwaniya Maternity and Pediatrics Teaching Hospital-Iraq with a gestational age of 24-34 weeks, they were randomly assigned to receive tocolytics either salbutamol (n=50) or atosiban (n=50).Salbutamol was given by(intravenous infusion 10-50 microgram)for up to 48 hour. Atosiban was given by (intravenous bolus dose of 6.75 mg then 300microgram/minute for 3 hour and 100microgram/minute for up to 48hour). Retreatment with the study drugs or alternative tocolytic agents was allowed. Main outcome measures included were tocolytic effectiveness, which was assessed in terms of number of women undelivered after 48hour and 7 days. Tocolytic safety was assessed in terms of maternal and fetal side effects and neonatal morbidity.Results: there were no significant differences between the salbutamol and the atosiban group in prolongation of pregnancy for 48 hour (44% versus67746%;p=0841)and 7 days(20% versus 32%;p=0.171) ,respectively. Maternal adverse events , including tachycardia occurred more frequently in the salbutamol group(22% versus 8%;p=0.050).Neonatal outcomes and complications were comparable between the two study groups(42% versus 32%;p=0.30).Conclusions: the oxytocin antagonist (atosiban) was as effective as beta-agonist(salbutamol) in delaying threatened preterm birth , and found to be better tolerated by both the mother and fetus than salbutamol , with a comparable neonatal safety profil.This study supports the clinical use of atosiban as a first line tocolytic in the treatment of preterm labor

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Objectives: This study aims to determine the disease’s patterns and outcomes of admission among neonates hospitalized at the neonatal care unit in Erbil City, and using the findings as a baseline for neonate’s morbidity and mortality assessment in the future. Methodology: A retrospective study carried out at neonatal care unit of Raparin pediatric teaching hospital. An instrument for data collection developed by researcher included (age, gender, cause of admission, diagnosis and outcome upon discharge and causes of death). Content validity of the instrument was determined through the use of panel experts and reliability of the instrument was determined through a pilot study. The data were obtained by review the medical records of all newborns admitted to neonatal care unit during 2013. Data were analyzed through the application of descriptive and inferential statistical approaches by using Statistical Package for Social Science (SPSS) version 19.Results: During 1st January to 31st December of 2013 the total number of neonates admitted to Raparin pediatric teaching hospital was 3880. Highest percentages (58%) of neonates were male and majorities (76.26%) were admitted during the first week of life. Jaundice was the main cause 54.1% of neonates admission .The neonate deaths rate was 5.4% of the sample, and the first cause of death was for prematurity 35.6%, then infections 25.5%, congenital anomalies18.8% and Respiratory dysfunction 10.1%. Majority 87.9% of neonates were discharged with unspecified discharge outcome. And the study found high significant association between neonate’s diseases and neonate’s age.Recommendations: The study recommended improving statistical recording skills for health care team and conducting further studies regarding neonatal care at neonatal care unit of Raparin pediatric teaching hospital.

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To find out the impact of maternal risk factors on the outcome of pregnancy in Baghdad city. A descriptive purposive study was carried out on 100 postpartum women who had delivered for 1 hr. to 24 hrs. ago . the study sample was selected from three hospitals in Baghdad city ( Baghdad teaching hospital ,Fatima Al-Zahra'a maternity and pediatric teaching hospital and Al-Yarmook teaching hospital),during the period from 25 Jan. to 25 Feb. 2006. The data were collected through the use of questionnaire format reviewing pregnants' records and personal interview and were analyzed by using descriptive and inferential statistical approaches. The finding revealed that maternal pregnancy complications had weak effects on pregnancy outcome , while maternal employment & spouse's consanguinity were predictors for poor pregnancy outcome . The study recommended the necessity of establishing health education programs for pregnant to be self monitoring & early detection of complications that associate the pregnancy . In addition promote the system of follow up care during antenatal ,perinatal,& postnatal.

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ABSTRACT:BACKGROUND :Neonatal septicemia is a major cause of morbidity and mortality in developing countries.OBJECTIVE:The study is to determine the prevalence , the pattern of organisms and the mortality of neonatalsepticemia in a neonatal care unit.PATIENTS AND METHODS:All the cases of neonatal septicemia diagnosed and treated in the neonatal care unit at al-kadimiyateaching hospital for the period january-june 2010 were included in this study. The collected datawere : Gender, Birth weight, Gestational age, Onset of sepsis, Place of delivery and Outcome ofdisease.RESULTS:Out of 589 newborns admitted, 73(12.4%) were confirmed cases of neonatal septicemia. Themortality from neonatal sepsis was 16.4%.Low birth weight and prematurity were independentfactors associated with death (P value=0.004 and 0.020 respectively).There were 24 cases (32.9%)of early onset sepsis and 49 cases (67.1%) cases of late onset sepsis. The most common pathogenswere gram- negative bacilli causing early-onset sepsis (54%) and late onset sepsis (59%). Only 6cases out of the total 73 cases of neonatal septicemia were caused by staphylococus aureus (8.2%) .Over 50% of gram-negative bacilli are antibiotic resistant.CONCLUSION:The high rate of gram-negative septicemia and the antibiotic resistance to both ampicillin andgentamycin indicate that the infection was most probably nosocomial in origin.

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