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Article
Assessment of Pregnant Women's Knowledge about Placenta Previa in Kirkuk Governorate Hospitals

Authors: Fatin Abdul Amir AL-Saffar --- Rabab Hamodee Hanon
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2012 Volume: 2 Issue: 3 Pages: 41-48
Publisher: University of Kufa جامعة الكوفة

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Abstract

Objective: to Assess Pregnant Women's Knowledge about Placenta Previa in Kirkuk GovernorateHospitals.Methodology: A descriptive analytic study was used to assess the pregnant women's knowledgeabout placenta previa in kirkuk governorate hospitals from February 2012 to may 2012. Apurposive sample consist of (62) pregnant women with placenta previa in four hospital (Azady,Kirkuk, Al-Hawiga, and Dakuk). The data was collected by using interview technique, patientchart, and constructed questionnaire, which consist of three parts. Part one: consist of demographicinformation Part two: consist of reproductive information Part three: consist of question regardingpregnant women knowledge about placenta previa, it comprise of four domains which are: DomainI: general information concerning placenta previa. Domain II: causes and predisposing factors.Domain III: signs and symptoms, domain IV: diagnostic methods. Reliability of the questionnaireis determined through the pilot study and the validity through a panel of (19) experts. Descriptivestatistical analysis procedures and inferential statistical analysis procedures were employed fordata analysis, all the statistic procedures were tested at P≤ 0.05.Results: the result revealed that the majority of the study sample 90.46% has good knowledgeconcerning placenta previa, it could be concluded that from previous history with PP, or fromprenatal visited to the primary health care center or private clinic. The assessment of knowledge isnot affected by demographic characteristic and reproductive history factors that mean that thestudied questionnaire can be amend for all individuals of the studied population.Recommendations: The study recommended to increase pregnant women awareness throughmass media about pregnancy complications particularly ante partum bleeding, ( placenta previa) asone of these complications, importance of frequent prenatal care visits early in pregnancy, andencouraged pregnant women to attempt deliveries at hospital for the availability of specialtymedical and nursing staff, as well as the availability of necessary equipments for cesarean section

الھدف : تقیم معارف النساء الحوامل حول المشیمة المنزاحة في مستشفیات محافظة كركوك.المنھجیة : دراسة وصفیة لتقیم معارف النساء الحوامل حول المشیمة المنزاحة في مستشفیات محافظة كركوك للمدة من شباط-2012 أیار 2012 . اختیرت عینة غرضیة شملت ( 62 ) أمراءه حامل مصابة بالمشیمة المنزاحة في المستشفیات الأربعةالرئیسیة في كركوك ( أزادي – كركوك - الحویجة – داقوق ).تم جمع البیانات من خلال .استعمال أسلوب المقابلة وطبلةالمریضة واستبانھ مصححة ومكونة من ثلاث أجزاء الجزء الأول : یتألف من الخصائص الدیموغرافیة للعینة و الجزء الثاني :یتألف من الخصائص الإنجابیة والتي تشمل بعض المتغیرات والمشاكل الصحیة السابقة والجزء الثالث : یتألف من أسئلة حولمعرفة النساء الحوامل بالمشیمة المنزاحة، ویتألف من اربع محاور، المحور الأول معلومات عامة عن المشیمة المنزاحةوالمحور الثاني العوامل والأسباب المؤدیة إلى إزاحة المشیمة والمحور الثالث الأعراض والعلامات والمحور الرابع طرق( التشخیص .تم تحدید ثبات الاستبانة من خلال دراسة تجریبیة (استطلاعیة) و صحتھا حددت من خلال لجنة مكونة من ( 19% خبیرا. إجراءات التحلیل الإحصائي الوصفي و إجراءات التحلیل الإحصائي ألاستنتاجي لتحلیل البیانات و بمستوى دلالة 5أو اقل.النتائج: أظھرت النتائج أن معظم أفراد العینة 90.46 % كانت معارفھم جیدة حول المشیمة المنزاحة ممكن استنتاج ذلك منخلال تجربة سابقة بھذا المرض أو عن طریق زیارات النساء الحوامل إلى مراكز الرعایة الصحیة الأولیة أو العیاداتالخاصة.إن تقییم المعارف لم یتأثر بالخصائص الدیموغرافیة وبعض الخصائص الإنجابیة للعینة، وھذا یعني إن استمارةالاستبیان ھذه یمكن تعمیمھا لجمیع الحوامل لتحقیق أھداف البحث.التوصیات : أوصت الدراسة بضرورة زیادة وعي الأمھات من خلال وسائل الإعلام حول مضاعفات الحمل وخصوصا النزفخلال الحمل (المشیمة المنزاحة ) كأحد تلك المضاعفات، وأھمیة زیارة رعایة الحوامل في مراحل الحمل المبكرة والتشجیععلى الولادة في المستشفیات وذلك لتوفر الكوادر الطبیة والتمریضیة المتخصصة و توفر المستلزمات الضروریة للعملیةالقیصریة .

Keywords

pregnant --- placenta


Article
The Effects of Preeclampsia On The Enzymatic Activity Of Full Term Placentae:Histochemical Study

Author: Maha A. Al-Sammak* MBChB , MSc ,PhD د. مها السماك
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 4 Pages: 442-445
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:Background: This study is concerned with the effects of preeclampsia on the availability of the important enzymes in the full term placenta.For this purpose 2 groups of placentae were taken from the full term pregnant women immediately after labour, each group consists of 10 placentae, the first group are those placentae obtained from pregnant women having uneventful pregnancy with no history of any disease or complication (as a control group) while the second group includes those pregnant women having a history of preeclampsia, the results showed significant histochemical changes in the placentae of the second group when compared with the first group, such changes result from syncytial damage and destruction affecting the preeclamptic placentae of the second group, thus loss of alkaline phosphatase enzyme with increase in the amount of the degenerating acid phosphatase enzyme were observed in the placentae obtained from the preeclamptic group. the placentae have been implicated in the pathophysiology of preeclampsia.Patients & Methods: The specimens were obtained from Al-Batool & Al-Khansaa Teaching Hospital in Mosul between February and July (2006) and studied in the Department of Anatomy, College of Medicine,University of Mosul. Two groups of placentae were taken from the full tem pregnant women immediately after labour, each group consists of 10 placentae, the first group was obtained from healthy pregnant women (control group) while the second group was obtained from pregnant women with history of preeclampsia (10 patients).Results: the placental alkaline phosphatase enzyme is very important in trophoblastic transfer mechanism, this enzyme is abundant at term normal placenta. The human placenta contains this enzyme which is produced mainly by syncytiotropholast cells thus destruction of these cells which occurs in preeclampsia will lead to decrease in this enzyme activity and increase in degenerating acid phosphatase enzyme activity.Conclusion: there is a disturbance in the level of acid and alkaline phosphatase enzymes in the preeclamptic full term placentae. Key Words: Enzyme, Placenta.

Keywords

Enzyme --- Placenta


Article
Maternal and Perinatal Outcomes in Placenta Previa

Authors: Saba Jassim Al Hashimi --- Aqeela Haider Majeed --- Ahmed Majed Shayal
Journal: Misan Journal of Acodemic Studies مجلة ميسان للدراسات الاكاديمية ISSN: 1994697X Year: 2017 Volume: 16 Issue: 32 Pages: 68-77
Publisher: Misan University جامعة ميسان

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Abstract

Background: detection of the Sociodemographic pattern and maternal, perinatal outcomes of pregnant mothers with placenta previa. Setting: This prospective research done at government General Hospital (Al-Sadder Teaching Hospital), Misan, Iraq during the period of October 2016 to April 2017. Patients & methods: all Women who complaint of painless vaginal bleeding or those diagnosed as having placenta previa on routine ultrasound examination after 28 weeks of gestational age were included in this research and were evaluated with demographic profile, comprehensive maternal history, clinical examination, laboratory investigation, type of placenta previa on ultrasound examination, impact of previous mode of delivery and present mode of delivery, maternal and perinatal complications, the incidence of primary postpartum hemorrhage and the need for transfusion of blood were noted. Results: Incidence of Placenta previa was 0.6% (40/6512). Mean age of presentation was 31yrs. Multigravida (90%), (82.5%) presented between 28-36+6 weeks gestational age and (17.5%) presented between 37 - 42 weeks, Antepartum hemorrhage (62.5%), malpresentation (20%), women with previous history of surgical intervention (55%), (25%) with previous cesarean delivery, (12.5%) with dilatation and Curettage for abortion, and (17.5%) with both. (22.2%) had Postpartum hemorrhage, (42.5%) needed blood transfusion, (2.5%) abdominal hysterectomy was done, Neonatal intensive care unit admission (30.5%) because of (jaundice, preterm baby, dyspnea and cyanosis, hydrops Fetalis), maternal mortality was nil and neonatal mortality was (5.5%). Conclusion: The presence of placenta previa carries a great danger to the mother & her baby with a high risk of adverse maternal & perinatal outcomes if not treated in the proper time .

Keywords

Placenta Previa


Article
Prevalence of placenta accreta in Diyala governorate during 2010-2012 years
انتشار أكرتا المشيمة في محافظة ديالى خلال السنوات 2010-2012

Author: Sawsan Talib Salman،Ali Hassan Mohammed،Nadhim Ghazal Noaman،Huda Khaleel Ibrahim
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2013 Volume: 19 Issue: 2 Pages: 286-295
Publisher: Tikrit University جامعة تكريت

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Abstract

Background:- Although the incidence of placenta accreta is rare but it has a serious complications which may end with hysterectomy so early diagnosis is important to prevent this complications. Objective:- this study aim to assess the problem of the obstetrician about the magnitude of this serious health problem. Patient and methods:- this study was conducted in Al-Batoul teaching hospital (in the center of Diyala governorate by studying the patient records as a retrospective study, study the record from June 2010 during July 2012 including all patients with placenta accreta. Results:- Showed the rate of placenta accreta among all deliveries was (0.12) and (0.14), (0.78) among normal vaginal deliveries and caesarean sections respectively and more among those women with previous two pregnancies and above (83.33%), regarding blood groups it showed (56.66%) among O blood group while it was (23.3%), (16.66%), (3.33%) among B, A and AB respectively. The association with placenta previa was (40%) with grade I while it was (20%) with grade II, (16.66%) grade III and (13.3%) grade IV. It was (16.66%) among women with history of curettage and (76.66%) among those with history of pelvic inflammatory diseases . Regarding the management (56.66%) was managed by packing and repair during caesarean section and (43%) were ended by hysterectomy. Conclusion:- placenta accreta was more common previous caesarean sections and pelvic inflammatory diseases management may be ended by hysterectomy. Recommendation:- Early diagnosis is important to minimize complications.

الخلفية : - على الرغم من أن حدوث المشيمة أكرتا أمر نادر الحدوث لكنه لا يملك المضاعفات الخطيرة التي قد تنتهي مع استئصال الرحم حتى التشخيص المبكر مهم لمنع هذه المضاعفات. الهدف : - هذا الهدف دراسة لتقييم مشكلة التوليد حول حجم هذه المشكلة الصحية الخطيرة . المريض وطرق : - أجريت هذه الدراسة في البتول تعليم المستشفى ( في وسط محافظة ديالى من خلال دراسة سجلات المرضى كدراسة بأثر رجعي ، ودراسة السجل من يونيو 2010 خلال يوليو 2012 بما في ذلك جميع المرضى الذين يعانون من المشيمة أكرتا النتائج: - أظهرت أن معدل المشيمة أكرتا بين جميع الولادات ( 0.12) و ( 0.14) ، ( 0.78 ) بين الولادات المهبلية الطبيعية و القيصرية على التوالي و أكثر بين هؤلاء النساء مع الحمل السابق و اثنين أعلاه ( 83.33 ٪ ) ، فيما فصائل الدم فإنه أظهرت ( 56.66 ٪ ) بين فصيلة الدم O بينما كانت ( 23.3 ٪ ) ، ( 16.66 ٪ ) ، ( 3.33 ٪ ) بين B ، A و AB على التوالي. وكانت العلاقة مع المشيمة المنزاحة ( 40 ٪ ) مع الصف الأول في حين كان ( 20 ٪ ) مع الصف الثاني ، ( 16.66 ٪ ) الصف الثالث و ( 13.3 ٪ ) الصف الرابع ، وكانت ( 16.66 ٪ ) بين النساء مع التاريخ من كشط و ( 76.66 ٪ ) من بين أولئك الذين لديهم تاريخ من أمراض التهابات الحوض. وفيما يتعلق وقد تمكنت إدارة ( 56.66 ٪ ) من خلال التعبئة والإصلاح خلال عملية قيصرية و ( 43 ٪ ) و انتهت استئصال الرحم. الاستنتاج : - كان أكرتا المشيمة أكثر شيوعا العمليات القيصرية السابقة، و أمراض التهاب الحوض الإدارة قد انتهت من قبل استئصال الرحم. التوصية : - التشخيص المبكر مهم للحد من المضاعفات.


Article
Antenatal diagnosis of myometrial invasion in anterior placenta previa by transabdominal color Doppler ultra sound

Author: Jwan N. Sulaiman جوان نجيب سليمان
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2011 Volume: 7 Issue: 1 Pages: 27-32
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: The incidence of maternal mortality inplacenta previa accrete is 7%,and its preoperativediagnosis is of a great value.Objective: to evaluate the efficacy of transabdominalcolor Doppler ultrasound in diagnosing placentaprevia accreta and inccreta. Color Doppler imagingcriteria used in: includes diffuse parenchymalplacental lacunar flow, focal intra parenchymalplacental lacunar flow and bladder uterine serosainterphase hyper-vascularity.Design: Prospective study on patients fromJanuary2007 to January 2008.Patients and method: 48patients with one caesareansection or more and with persistent anterior placentaprevia diagnosed by transabdominal ultrasound wereexamined by color Doppler at 32 or more weeks ofgestation to determine the possibility of myometrialinvasion depending on the above color Dopplercriteria.Results: Out of 48 patients eleven exhibitedcharacteristic Doppler imaging pattern highly specificfor placenta accreta and inccreta according topreceding criteria , one patient had false positive colorDoppler imaging result, 5 patients underwentcaesarian hysterectomy , the remaining five weretreated conservatively by uterine artery ligation andother conservative measures because of bleedingfrom the lower uterine segment.Conclusion Color Doppler sonography is highlysensitive andspecific in the antenatal diagnosis of placenta previaaccreta .If a strong suspicion is found before delivery,appropriate location and timing for delivery should beconsidered ,to allow access to adequate surgicalpersonel and equipment ,preoperative bloodpreparation to reduce morbidity and mortality.Journal titleUltrasound in obstetric and gynecology ISSUN 0960-7692 Source 2000 Vol 15 In 1 PP. 28-35 (22rel)


Article
MicroRNA 210 expression profile from human placentas of preeclamptic

Author: Miami A. Ali FICOG
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2012 Volume: 11 Issue: 2 Pages: 29-33
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Pre-eclampsia (PE) is a common pregnancy specificsyndrome that is characterized by hypertension and proteinuria.Evidence shows that pre-eclampsia is associated with alterations inplacental microRNA expression. Aims: The purpose of this study was tocompare the expression of the microRNA 210 in placentas from preeclampticpregnancies versus normal placentas.Patients and Methods: The study was carried out in the department ofGynecology and Obstetrics at Al-Yarmouk Teaching Hospital for theperiod from December 2009 to December 2010. Hundred pregnantwomen of age ranging from fifteen to forty years old, their gestationalage ranging between twenty nine to forty weeks were divided into threegroups: first group: mild Pre-eclampsia (twenty), second group: severepre-eclampsia (thirty) & third group (fifty) normotensive pregnantwomen of comparable gestation were taken as a control . After deliverythe Placentas from all patients (the study and the control groups) wereobtained and studied for the microRNA 210 expression which wasassessed by microRNA microarray and real-time reverse transcriptasepolymerasechain reaction analysis.Results: MicroRNA 210 was over expressed in the placentas of preeclampticpregnancies compared with normal placentas. In mild preeclampsiagroup the mean micro RNA-210 activity was 1.68±0.25, insevere pre-eclampsia group the mean microRNA-210 activity was1.89±0.13 and for the control group the mean microRNA-210 activity was0.99±015. There was highly statistical significance in microRNA-210activity of the studied groups since the P value for the mild preeclampsiaversus the control was 0.0001. For the severe pre-eclampsiaversus the control it was 0.0001 and for the severe pre-eclampsia versusmild pre-eclampsia was 0.0001.Conclusions: The results showed that microRNA 210 was over expressedin pre-eclamptic pregnancies (mild and severe), which suggests itsinvolvement in the pathogenesis of pre-eclampsia.

Keywords

MicroRNA --- Placenta --- Pre-eclampsia


Article
Placenta Accreta

Author: Zahida Al-Saadi * M RCOG زاهدة السعدي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2007 Volume: 49 Issue: 2 Pages: 1-4
Publisher: Baghdad University جامعة بغداد

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Abstract

Placenta accrete is defined as an abnormally adherent placenta that is directly attached to the myometrium because of inadequate development of the fibrinoid layer (Nitabuch layer) and absence of decidua basilis either partially or totally. (1) Three degrees of placenta accrete exist depending on the depth of villous invasion: placenta accreta is when villi become attached to myometrium, placenta increta: the villi invade the myometrium, placenta percreta represents the greatest degree of severity where placental villi penetrate throughout myometrium and peritoneum extending sometimes to adjacent structure such as the bladder. (1, 2, 3)Placenta accreta accounts for 78% of cases, increta for 17% and percreta 5-7 %.( 4) Massive obstetric hemorrhage is still the leading cause of pregnancy related deaths, and placenta previa accreta remains one of the serious predisposing factors. (5)The problem occurs when there is abnormal separation of placenta in 3rd stage of labor, and attempts to deliver the placenta may provoke massive blood loss that may necessitate hysterectomy. (2)With the increasing rate of cesarean section the incidence of both placenta previa and placenta accreta is steadily increasing in frequency, (3, 4) we therefore anticipate more cases of placenta previa accreta.In several recent series, placenta accreta has emerged as the major indication for peripartum hysterectomy, accounted for 40-60% of cases. (7),It is not always clinically possible to differentiate between the three types of placenta accreta.Placenta accreta is not usually suspected when the placenta is normally situated, but antenatal diagnosis is possible when placenta accreta is previa. Accreta invasion may involve whole placental cotyledons, or partial (several cotyledons), or focal as one or two cotyledons.


Article
Maternal–Placental Growth Factor and the Identification of Fetuses with Placental Intrauterine Growth Restriction

Authors: Henan Dh Skheel Al Jebory --- Asmaa Zubaid Alazzawy
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2018 Volume: 17 Issue: 1 Pages: 36-41
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Objective: This study was designed to discriminate between fetal growth restriction that is placentally mediated and constitutionally smallfetuses depending on the measurement of placental growth factor (PlGF) in the maternal circulation. Study Design: This was a prospectivecase–control study. Settings: This study was conducted at the Department of Gynecology and Obstetrics at Al‑Yarmouk Teaching Hospital.Patients and Methods: The study included 100 cases (11 placental intrauterine growth restriction [IUGR] and 89 constitutionally small)with singleton pregnancies. Serum PlGF was measured by ELISA technique. Concentration less than the 5th percentile for normal pregnancywas considered a positive PlGF test. Results: A positive PlGF test was found in 10 out of the 11 placental growth restriction cases and in4 out of the 89 constitutionally small fetuses. PlGF can differentiate between IUGR due to placental dysfunction from constitutionally smallfetuses with 90.1% sensitivity and 95.5% specificity. Conclusion: PlGF may serve as a promising tool to identify placental IUGR antenatally

Keywords

Fetus --- growth --- placenta


Article
Ultrasonographically Observed Grade III Placenta at 36 Weeks’ Gestation: Maternal and Fetal Outcomes

Author: Lilyan W. Sersam
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 1 Pages: 67-72
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Current ultrasound assessment of placental calcification relies on Grannum grading. The ultrasonographic appearance of grade III placental maturation, if it occurs before 37 weeks, may signify placental dysfunction and is found to be associated with development of pre-eclampsia and low birth weight.OBJECTIVE:To look at the prevalence of a grade III placenta at 36 weeks’ gestation in a low-risk obstetric population, and to explore the association between premature aging observed ultrasonographically and pregnancy outcome.METHODS:Scans were performed at 36 weeks’ gestation in 591 low-risk pregnant women to determine placental maturity. The prevalence of grade III placenta at 36 weeks’ gestation was determined. Follow-up was performed for the group of women demonstrating a grade III placenta in comparison to those not demonstrating a grade III placenta for determining pregnancy outcome.RESULTS:The prevalence of grade III placenta at 36 weeks’ gestation was 3.9%. A grade III placenta at 36 weeks’ gestation was significantly associated with young maternal age P = 0.01. The Grannum grade III of the placenta at 36 weeks’ gestation was statistically associated with increased risk for development of proteinuric pregnancy-induced hypertention (PIH) later in pregnancy (RR 4.94; 95% CI 1.15-21.26), P = 0.021. Women demonstrating a grade III placenta at 36 weeks’ gestation had a significant high risk of induction of labour for suspected fetal compromise (RR 4.7; 95% CI 1.76-12.59), P = 0.001. The risk for delivering a baby with a weight <10th centile at birth was significantly higher in women with grade III placentas in comparison to those with grades 0-II (RR 3.19; 95% CI 1.23-8.27), P = 0.017.CONCLUSION:In a low-risk obstetric population, ultrasound detection of Grannum grade III placenta at 36 weeks’ gestation helps to identify at risk pregnancy. It appears to predict subsequent development of proteinuric PIH and may help in identifying the growth-restricted baby

Keywords

ultrasound --- grade III --- placenta --- outcomes


Article
Morphological changes of the placentae from anaemic pregnant women associated with intrauterine growth restriction

Author: Mareb H. Ahmed, Dr. Abduljaber Y. Alhubaity
Journal: The Medical Journal of Tikrit مجلة تكريت الطبية ISSN: 16831813 Year: 2016 Volume: 2 Issue: 2
Publisher: Tikrit University جامعة تكريت

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