Background: Human umbilical cord blood has proven to be a successful alternate source of hematopoietic stem cells for pediatric patients with major hematologic disorders. Toxoplasma gondii is a global opportunistic protozoan which cause fatal complications in immunocompromised individuals. Aim:Our goal is to study the prevalence of toxoplasmosis in umbilical cord blood (UCB) and to assess the sensitivity of ELISA and PCR for Toxoplasma infection screening. Material and Methods:One hundred cord blood samples were collected immediately after delivery. Anti-Toxoplasma IgG and IgM antibodies were determined using ELISA method; Toxoplasma DNA was detected using nested PCR technique. Total nucleated cells (TNC) and HB were also determined. Demographic data and risk factors data related to the transmission of toxoplasmosis, were collected from mothers. Results:Among 100 cord blood samples, 36 (36%) were positive for anti-Toxoplasma IgG antibodies and 6 (6%) were positive for anti-Toxoplasma IgM antibodies. The nested PCR showed 11 (11%) samples containing Toxoplasma DNA from which, 6 (55%) samples were IgM positive. There was no significant association between the risk of Toxoplasma transmission and cord blood positivity for toxoplasmosis. Conclusion:Owing to the prevalence of toxoplasmosis, its rapid progression and its fatal outcome in immunocompromised patients, cord blood screening for toxoplasmosis with nested PCR should be incorporated into cord blood bank screening protocols. K E Y W O R D Sbank, cord blood, diagnosis, screening, Toxoplasma

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Background: Preeclampsia (PE) is one of the most common pregnancy complications affecting approximately 5-7% of pregnant women worldwide. Pathogenesis of PE is still mysterious. Literature studies reported differences between early and late onset PE. Also, whether placenta of late-onset PE without fetal growth restriction (FGR) is different from normal one needs further declaration. Objective: This study aims at evaluating the placental microvessel density (MVD), apoptosis and endoglin (CD105) expression in late-onset PE without FGR. Patients and Methods: Placentae of 15 PE and 15 matched control ones were evaluated grossly, microscopically and by immunohistochemistry for caspase-3, CD 34 and CD105. Results: Placentas in PE group showed a statistically significant difference as regard size, syncytial knots, perivillous fibrin deposition, villous infarction increased apoptosis, and endoglin (CD105) expression. However, the percentage of terminal villi and microvessel density (MVD) were comparable in both groups. Conclusion: Placenta from late onset PE without FGR is still different from the normal placenta whatever time onset of PE pathogenesis may be similar. Absence of changes in MVD may explain good fetal outcome.

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Background: Preeclampsia continues to affect 5% to 8% of all pregnancies throughout the world. It is a pregnancy-specific multisystem disorder and a leading cause of maternal and perinatal morbidity and mortality. The exact pathogenesis of preeclampsia remains poorly defined. Features of severe preeclampsia include severe proteinuria, hypertension, symptoms of central nervous system dysfunction, hepatocellular injury thrombocytopenia, oliguria, pulmonary edema, cerebrovascular accident, and IUGR. Women with severe preeclampsia must be hospitalized to try to stabilize the disease. Aim of work: To evaluate maternal, fetal and neonatal outcomes of severe preeclampsia in Mansoura university Hospitals. Methods: This was a prospective study for one year, from September 2019 till September 2020, included all gravid women with severe preeclampsia who were managed at Mansoura University hospitals, Department of Obstetrics and Gynecology. Results: This study included 204 patients. Regarding maternal outcomes, the percentages of Placental abruption, Acute renal failure, ICU admission, DIC, HELLP and PPH were 7.8%, 4.9%, 15.7%, 0.5%, 8.3% and 3.4%, respectively. Considering fetal outcomes, IUGR developed in 13% of cases, and 13% of cases ended with IUFD. With regard to neonatal outcomes, the percentages of preterm delivery, NICU admission low APGAR score were 69%, 62% and 47%, respectively. Gestational age was the only significant factor to affect incidence of IUFD, NICU admission and low APGAR score (P<0.001). Conclusion: Pre-eclampsia tends to threaten maternal health and fetal viability adding to maternal and neonatal mortality and morbidity. In addition, gestational age was the only significant factor to affect incidence of IUFD, NICU admission and low APGAR score.

Background: Preeclampsia AKA PE was defined based on NICE guidelines as new hypertension presenting after 20 weeks with significant proteinuria. Severe pre-eclampsia is pre-eclampsia with severe hypertension and/or with symptoms, and/or biochemical and/or hematological impairment. Nifedipine is used for control of blood pressure in cases with preeclampsia aiming to prevent rise of blood pressure during expectant management of these cases. Objective: To evaluate changes in uterine artery and middle cerebral artery Doppler indices before and a week after Nifedipine administration for control of blood pressure in PE patients. Design: Prospective observational study over six months that started to recruit patients from Mansoura university hospitals antenatal care clinics from May, 2019 to December, 2019. Methods: Doppler on uterine and middle cerebral artery was done before and a week after administration of Nifedipine. Dose of nifedipine: starting dose 10 mg orally twice daily increased after 48hs according to response. Maximum safe dose is 60 mg per day in dividing doses 8 hours apart. Drug stopped immediately if severe side effects like sudden hypotension where IV fluids and corticosteroid to support blood pressure will be commenced immediately. If no respons after maximum dose of medication conservative management was abandoned and delivery took place. Main Outcome Measure: Changes in uterine and middle cerebral artery Doppler indices before and after Nifedipine administration. Use of these changes to evaluate decisions for conservative management in preeclampsia patients. Conclusion: Nifedipine is a valid option to treat hypertensive patients, however more extended studies on fetal effects are required.