Background: Obesity has been recognized by the World Health Organization as a pandemic nutritional disorder. Egypt has the highest levels of overweight and obesity in Africa with 44% and 39% respectively. This study was done to assess the effect of the nutritional health education program on changing knowledge and attitude and practice towards nutrition of mothers during pregnancy and its role on gaining optimal weight. Methods: An interventional study (pre-posttest), in Zagazig University Antenatal Care Outpatient Clinic. Patients' criteria: 115 pregnant women in the first trimester, aged 18-35 years, Nonsmokers, take no medication and don't have any chronic medical disorder with Body mass index (BMI) between 18.5 and 24.9 kg/m 2 . Procedures: Data collection through a questionnaire of three parts; women's characteristics, pretest and posttest, the health education sessions were applied on the pregnant women and the change was detected. Results: There was statistically significant difference in total knowledge from (66.5±28.9) to (117.6±25.3) and total attitude from (3.3±2.1) to (9.5±2.8) scores in the pregnant women after the nutritional education sessions with improvement from 45.5% to 80.5% and from 27.3% to 79.2% in knowledge and attitude respectively (p-value <0.001). The change in habits and practice was statistically significant (p-value <0.001). The average weight gain of the studied group was (16.1±8.5) kg ranged from 9 to 18 kg. Conclusion: The health education sessions were effective in improving pregnant women's knowledge, attitude and practice. The healthy diet succeeded in improving gestational weight gain.

Objective: The aim of this research is to detect the role of eradication of Helicobacter pylori in pregnant women with hyperemesis gravidarum (HG) using modified, high dose, non-teratogenic dual therapy. Study design: Randomized controlled trial. Patients and methods:The study included 156 pregnant women suffering from HG with positive fecal antigen test for Helicobacter pylori. Participants were divided randomly into two groups: group A that received the traditional management for HG (diet instructions, intravenous fluids, electrolyte replacement, antiemetics and vitamins supplementation), and group B that received the previous management for HG plus adding eradication dual therapy for Helicobacter pylori in form of Lansoprazole 30 mg TID + Amoxicillin 1 g TID for 2 weeks and the clinical response to both lines of management was evaluated in both groups two weeks after the start of management. Results: There is a statistically significant difference between both groups as regard clinical response to the used regimen with more clinical improvement in group B. Conclusion: There is an association between Helicobacter pylori infection and hyperemesis gravidarum, allowing us to conclude that Helicobacter pylori should be considered as one of the risk factors of HG. Screening for Helicobacter pylori should be added to the investigations of HG, especially if prolonged or refractory to the traditional management. Modified, high dose, non-teratogenic dual therapy for eradication of Helicobacter pylori could be considered to relieve HG in intractable cases with negligible side effects.

Background: Nutrition during pregnancy is an important element for the pregnant women and their developing fetus, they must take enough calories and nutrients to provide the essential requirements for both themselves and their fetus and to prevent complications of abnormal weight gain in pregnancy. Objectives: To determine the effect of the nutritional health education program on changing knowledge, attitude, and practice towards a healthy lifestyle during pregnancy, obtaining optimal weight gain and consequently its effect on maternal and fetal outcomes. Subjects and Methods: An interventional study (pre-post test), in Zagazig university antenatal care outpatient clinic was conducted. Subjects' Criteria: 135 pregnant females in the first trimester aged 18-35 years who did not have any chronic medical disorder with Body Mass Index between 18.5 and 24.9 kg/m2 were enrolled. Methods: Data collection was done using a semi-structured questionnaire about females’ socio-demographic characteristics, obstetric, family and clinical history. Health education sessions were applied to the pregnant females and their knowledge, attitude, and practice about healthy nutrition were assessed before and after the intervention. Ultrasound was performed, maternal and fetal outcomes were detected. Results: This study was conducted on 135 pregnant females from whom 9 cases had excluded at the time of delivery due to the detection of ultrasound abnormalities and 16 women were dropped out during the follow-up period. After the nutritional education program, the proportions of adequate knowledge, attitude, and practice were increased from (28.2% to 77.3%), (8.2% to 75.5%) and (32.7% to 77.3%) respectively (p-value <0.001). There was a statistically significant higher cesarean section, Intra and post-partum complications (85.7%vs 42.9%p<0.001), (71.4% vs17.2% p<0.001) and (25.7%vs7.1% p=0.008) [Odds (95% C.I); 8 (6.7-11.3), 12.1(11.7-13.9) and 4.5(1.2-8.7)], higher neonatal weight and neonatal blood glucose (p<0.001& 0.009) in over-weight versus optimal weight gain groups respectively. Conclusion: The intervention was effective in increasing pregnant females’ knowledge, attitude, and practice towards healthy nutrition during pregnancy, obtaining optimal weight gain and improving maternal and fetal outcomes.

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Background: Post-cesarean section (CS) infections, namely, endometritis, fever and wound infection are considered a major health problem which necessitates effective interventions. Antibiotic prophylaxis before CS cannot completely eliminate the risk of postpartum infections. Preoperative antiseptic vaginal cleansing is one of the commonest methods to reduce infectious morbidities after CS. Aim of the work: The aim of this work is to evaluate the effect of prophylactic administration of clindamycin vaginal suppository before elective CS on postpartum infectious morbidity. Methods: 196 patients were included in this intervention. They were divided equally into two groups (each 98 patients); intervention group (which received clindamycin 100 mg vaginal suppository at bedtime for 3 nights before CS) and control group (which received nothing). Both groups were followed till the end of puerperium for the development of postpartum infections namely, endometritis, fever, and wound infection. Results: There was statistically significant decrease in the frequency of endometritis, fever, and wound infection in the intervention group when compared to control group. Also, there was highly statistically significant decrease in the frequency of overall post-CS infectious morbidity in the intervention group when compared to control group. There was statistically significant difference between both groups as regard white blood cells count and C-reactive protein level 24 hours after cesarean section. Conclusion: Prophylactic administration of clindamycin vaginal suppository before elective CS reduces the risk of postpartum infections namely endometritis, fever, wound infection and overall post-CS infectious morbidity. Preoperative clindamycin vaginal suppository could be protective against post-CS infectious morbidities.