Objective: To determine the prevalence and level of anxiety and depression among mothers of newborns admitted to neonatal intensive care units in Gaza Strip. Methods: It is a cross-sectional study including 195 mothers who’s their neonates has been admitted to NICU at the three governmental hospitals in Gaza Strip between November 2017 to September 2018. Two psychological tests were applied, the Hamilton Anxiety Rating Scale and the Beck Depression Inventory. Collected data include sociodemographic profile for mother and neonates who include characteristic of mothers, number and types of deliveries, level of education, work status and family income. In addition, characteristics of neonates, gender, gestational age and birth weight, cause of admission and length of stay. Results: The results of our study indicated that 50.8% of mothers have severe to very severe symptoms of anxiety, 38.5% of mothers have severe to very severe symptoms of depression. There was a statistically significant differences in levels of anxiety (p = 0.044) and levels of depression (p = 0.005) among mothers related to hospital. The mothers of preterm and low birth weight babies had higher levels of anxiety (p = 0.010, 0.026), but there were insignificant differences in levels of depression, while there were no insignificant differences in levels of anxiety and depression among mothers related to gender of neonate, cause of admission, and length of stay in NICU. Conclusion: The effect of different maternal and neonatal factors on levels of anxiety and depression were examined and most of them revealed insignificant differences, which means that admission to NICU as a stressful event caused elevation in levels of anxiety and depression among mothers regardless of any other factors.

Most maternal and neonatal deaths occur during the postnatal period. Therefore, the quality of care provided by healthcare professionals at this critical time is crucial in reducing complications, morbidity, and mortality rates. Objective: The present study aimed to determine the perceptions of Palestinian women living in the Gaza Strip considering the quality of care they received in the early postpartum period. Materials and Methods: An analytical cross-sectional study was conducted using a selfadministered questionnaire developed by the researchers. A total of 200 pregnant women were selected by convenience sampling method from 4 governmental hospitals in the Gaza Strip, Palestine providing postnatal care. Descriptive statistics, including frequency, mean, and standard deviations, were used to describe the variables. Analysis of Variance (ANOVA) and Independent Samples t-test was used to compare the collected mean scores. Results: The study participants rated the postnatal services they received as high-quality care. High mean scores were achieved for all study domains. The "quality of postnatal care provided by midwives" received the highest Mean±SD score of 4.16±0.60, followed by the domain "quality of postnatal baby care" with a Mean±SD score of 3.89±0.85. The other two domains of "quality of provided health education" and "quality of provided communication and psychological support" received the lowest mean scores of 3.81 with standard deviations of 0.90 and 0.80, respectively. Patient-perceived postnatal care quality was not affected by many variables, such as age, parity, and gravidity. It was only affected by the subjects' level of education (P=0.001) and the place of delivery (P=0.017). Conclusion: The obtained results posed a challenge for healthcare policymakers and professionals working in maternity departments. A new policy and leadership directions are required in this critical and vulnerable clinical area. To improve the quality of postnatal care, health policymakers must collaborate with midwifery staff. It is important to identify and eliminate any barriers that impede the provision of better care. This will be reflected by reducing maternal and neonatal morbidity and mortality rates and reducing the number of hospitalization days.

Premature rupture of membrane (PROM) is produced when amniotic membranes tear before labor onset and is recorded in around 8 % of full-term gestations. Preterm PROMs (PPROMs) take place before the 37th week of gestation, with an incidence of 2–4 % of pregnancies, and it is associated with higher maternal and perinatal morbidity and mortality, mainly related to infectious processes and prematurity. Among maternal complications, which include postpartum infection, premature placental detachment, and maternal sepsis, we highlight clinical chorioamnionitis for its incidence and severity. Of decreasing frequency, perinatal complications include respiratory distress, neonatal sepsis, intraventricular hemorrhage, necrotizing enterocolitis, and neurological lesions. Full-term PROM frequently has a physiological cause and is a consequence of uterine contractions; however, PPROM usually has a multifactorial etiology that is often unknown, although the most frequently reported cause is an infection, observed in up to 60 % of cases. Therefore, the etiology of PPROM, although probably infectious, remains unknown in most cases. The obstetric approach varies as a function of gestational age, actively inducing the pregnancy in full-term PROM but performing an overall evaluation of maternal-fetal status in PPROM. In the latter situation, an assessment is made of the relative risks and benefits of a wait-and-see attitude versus pregnancy induction, considering signs of infection and/or prematurity, and ordering antibiotic treatment when PPROM is diagnosed . Multiple combinations of antimicrobial drugs have been proposed and better perinatal and maternal outcomes have been reported for the prophylactic administration of some new combinations. This study describes a case of PPROM caused by urinary tract infection.

BACKGROUNDProstaglandin E1 (oral misoprostol) and the other Prostaglandin E2 (Dinoprostone gel) are promising agents for cervical ripening and induction of labor.AIMS OF STUDYTo compare the efficiency and safety on maternal-fetal outcomes using 25 micrograms oral misoprostol PGE1 with 50 micrograms of intra-vaginal PGE2 for induction of labor.METHODSThis was a retrospective study design reviewing medical records of induced labor at Al Shifa hospital in Gaza Strip.RESULTSIn general, the results showed that women who used oral misoprostol with an age less than 30 years and parity less than 3 was effective for delivery and safe outcomes with an odds ratio (OR) of 15.8 (CI 6.9–39.8) and OR 29.2 (CI 10.7–80.3) respectively. The most common indication for labor induction in both methods was reputure of the membrane (ROM) more than 24 hours, postdates, and a medical disorder. However, the total interval hours for both methods was 8.4 hours. The mode of delivery was similar in both groups as vaginal delivery outcome was 73.6% for oral misoprostol E1 and 75% for prostaglandin E2 cases. However, PGE2 induction showed a higher cesarean delivery 25% rate versus 18.4%. Clinically the use of oral misoprostol showed a higher percentage of birth canal injury, failed induction, uterine rupture by 9.3%, 8%, 1.3% respectively. Fetal distress was found as the most common fetal complication and the most common cause for cesarean section.CONCLUSIONThe study recommended more research is needed as present evidence does not support use of oral misoprostol versus Prostaglandin E2.