Background Pre-eclampsia is the major cause of maternal morbidity and mortality, preterm birth, perinatal death, and intrauterine growth restriction. The incidence of pre-eclampsia globally varies widely from 5-15 percentages. Studies result’s find correlation of essential hypertension with alteration of serum cholesterol, triglycerides and HDL-C, various studies claim that abnormal lipid synthesis leading to increase of thromboxane level and the decrease of prostaglandin levels. Objectives To assess changes in lipid profile in pre-eclampsia and if these changes can be used as a marker of severity of the condition. Patients and Methods Case-control Study at Sulaimani Maternity Teaching Hospital from 01. Feb. 2017 to 01. Aug. 2017, it includes 100 pregnant women divided into three groups. Control group who remained normotensive during study period and case group who subdivided to two group including those cases who developed mild and sever pre-eclampsia during study period. Results There was significant rise in the serum TC, TG, LDL and VLDL and decrease in HDL in pre-eclamptic groups compared to normal healthy pregnant women. When we compare patient with sever pre-eclampsia with patient with mild pre-eclampsia we found that women with sever pre-eclampsia has significantly higher level of TG (334.9 ± 97.8vs 250.2 ± 31.5) and VLDL (66.4 ± 19.8vs45.4 ± 12.7 only. Conclusion Maternal dyslipidemia early in second trimester may be an indicator for development of future pre-eclampsia.
Background and objectives: cesarean section is estimated for about 30% of child births worldwide and it is one of the most common surgical procedures. Pain relief after cesarean delivery is especially important as the consequences of inadequate pain relief are expressed not only by the mother but by the newborn as well. Magnesium has been reported to produce important analgesic effects including the potentiation of morphine analgesia, attenuation of morphine tolerance and the suppression of neuropathic pain. The objectives of this study were to determine the efficacy of intra-incisional injection of magnesium sulfate for post cesarean pain management as in patient underwent elective cesarean section and the reduced need for extra analgesic use postoperatively. Methods: a randomized, placebo controlled, single-blinded study with a total of 200 pregnant participants scheduled for cesarean section in Sulaimani maternity teaching hospital, from 1st of May 2016 to 15th of August 2016. Patients were randomly allocated to two groups, those with odd numbers were assigned to case group (100) received 750mg of magnesium sulfate and patients with even numbers assigned to the placebo group (100) received 20mg of normal saline. Results: The mean Visual Analogue Score after 4 hours, 8 hours, 12 hours and 24hours was significantly less for the intervention (Magnesium sulfate) group when compared with the control (Normal Saline). Conclusions: Subcutaneous administration of magnesium sulfate in post cesarean section pain management can be used as a successful modality or method for pain management.
Background The third stage of labor is timed from the delivery of the baby to the expulsion of the placenta and membranes. This normally takes five and fifteen minutes. It may be complicated with retained placenta. Consequently, intervention should be started promptly. Objectives We aimed to evaluate the effectiveness of umbilical vein injection of misoprostol (800 Microgram) versus oxytocin (20 units) for the treatment of retained placenta. Materials and Methods This is a double-blinded randomized clinical trial, conducted at the Maternity Teaching Hospital, Sulaimani, Kurdistan Region, Iraq, from October 1, 2016 to December 31, 2017. Fifty patients whom delivered vaginally and complicated by retained placenta were randomly allocated into two groups;group1 received 800 mcg of misoprostol (four Misotac® 200 mcg, Pfizer) and, group2 received 20 IU of oxytocin (NOVARTIS) each diluted in 20 ml of normal saline were infused through umbilical vein for the two groups respectively. The outcome was measured by using time interval of placental separation and amount of blood loss. Results The mean ± SD age was (30.5 ± 5.8) and (27.8 ± 5) for the oxytocin and misoprostol groups respectively. There were a statistically significant relationship between the type of drug injections and a statistically very highly significant difference between the type of drug injections and time interval for the placental separation (P-value of 0.04 and P-value of <0.001 respectively). There was also a statistical significant difference in the mean vaginal blood loss between the two groups (169.3 ± 88.1 ml, 150 ± 89.4 ml) in oxytocin and misoprostol groups respectively), (P-value = 0.03). Conclusions The intraumbilical vein injection of misoprostol was better than oxytocin for the reduction of time needed till placental separation and associated with less blood loss.
Background Caesarean section (C-section) is a frequent obstetric intervention for saving the lives of women and their newborns from childbirth-related complications. Objectives The aim was to know the rate and indications of C-section in the Kurdistan-Iraq. Patients and Methods Retrospectively-collected data from a single large public institution, Maternity Teaching Hospital, in Kurdistan-Iraq was analysed. All women giving birth in 2016 with a known birth outcome were included. Those who underwent C-section were identified, and indications were recorded. Data analysed using descriptive statistics. A review of literature looking at rate and indication of C-section was performed. Results Five thousand and eight hundred sixty (38.4%) of mothers who gave birth from 15235, required C-section. The total number of born-baby was 18573; of them, 259 babies died (1.4%)—(192, 74.1%) following Normal Vaginal Delivery and (67, 25.9%) during C-section. 27% of mothers were primigravida, and the rest were multigravida. Emergency C-section was performed in 4106 (70.1%). The history of ≥2 C-sections was the main indication for C-section (25.7%) followed by breech presentation (13.9%), fetal distress (12.5%), failure of progress (11.9%), failure of induction (11.8%), antepartum haemorrhage (8.3%) and pre-eclampsia (6.8%). There were three maternal mortalities (0.01%), but no maternal mortality following C-section Conclusion With the continued war against the Islamic state and economic turmoil, health service in Kurdistan suffered most, but with the goodwill of healthcare professionals, our institution showed comparable results to places elsewhere. Monitoring of clinical indications of C-section is needed to ensure the rational use of the procedure.
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