Background: Maternal anemia is frequently associated with premature delivery, reduced neonatal weight, infant iron deficiency, neonatal death, and low Apgar scores at 1 min. It is also suspected to reduce the oxygen supply to the growing fetus, leading to the redistribution of fetal blood flow. This study aims to evaluate the effect of the different types of iron medications given to anemic patients on fetal Doppler indices namely umbilical artery and middle cerebral artery in the late second trimester of pregnancy. Materials and Methods: This cohort prospective study. This study conducted at department of obstetrics and gynecology at Tanta university hospital. Participants consisted of 90 pregnant women during their gestational age (20-28 weeks) they were attended or admitted to obstetric unit.divided into 3 groups. Lactoferrin group included 30 cases received 250 mg lactoferrin capsules once daily for 4 weeks. Iron amino acid chelated group included 30 cases received ferrous bis – glycine chelate (FeBC) 15 mg/day for 4 weeks. Ferrous fumarate group included 30 cases received 350 mg dried ferrous fumarate capsules once daily for 4 weeks. Pre-and post-treatment Doppler measurement of umbilical artery and middle cerebral artery parameter compared 4 weeks after the start of treatment for patients whose anemia successfully treated. Results: Post hoc analysis of maternal serum hemoglobin of the studied groups show insignificant different between the groups. Pre- and Post-treatment follow-up of resistance index (RI) of the studied groups, Pre- and Post-treatment follow-up of pulsatility index (PI) of the studied groups, Post hoc analysis of pulsatility index (PI) of the studied groups and Post hoc analysis of resistance index (RI) of the studied groups show insignificant different between groups. Conclusion: Based on our results, it can be concluded that cerebral vasodilatation due to severe maternal anemia is a reversible condition that can be corrected through the prompt treatment of anemia. Additionally, the three therapeutics tested in the current study showed a comparable effect in treating maternal anemia, with subsequent improvement of doppler indices.

Blood loss of over 40 percent of total blood volume (approx. 2800 ml) is typically considered a’ life danger.’ It seems rational to introduce PPH protocols at an average blood loss far below this level, as the aim of management is to prevent hemorrhage from rising to the point that it is life-threatening Objectives Caesarean anesthetic treatment, which involves general anesthesia and spinal / epidural anesthesia, was seldom examined for the risks associated with postpartum hemorrhage and was focused on only a small number of cases from single hospital data sets. The function of different types of anesthesia in postpartum hemorrhage therefore needs to be further explained. Patients and methods This are a retrospective study on patients complicated by postpartum hemorrhage after cesarean section with history of type of anesthesia used; general or spinal or epidural to improve outcome of cesarean section. We included all women complicated by postpartum hemorrhage after cesarean section and collect data about the anesthesia used during cesarean section and also recorded other risk factors for postpartum hemorrhage if recorded in files in antenatal care sheet and the intraoperative circumstances as recorded in the operative sheet of the patient. Heart rates and blood pressures of patients of both groups were measured before delivery and at 1 min interval for 15 min after injection of oxytocin. Uterine contractility was assessed for both groups at 1,2,4,6,8,10 and 15 min after oxytocin injection. Results Our results showed that the age of the studied group ranged from 18 to 40 years with mean 23.97 years. Regarding parity 44.5% of them had one child and 36.7% of them had two, 42.3% of the studied group had general anesthesia and 57.7% of them had spinal. Also 82.2% of the cases were previous and 17.8% of them were emergent. Conclusion Anesthetic techniques might be affected by the possibility of bleeding or concern. We found that women who have undergone general anesthesia have a higher risk of postpartum hemorrhage compared with women who have received epidural, spinal anesthesia

Blood loss of over 40 percent of total blood volume (approx. 2800 ml) is typically considered a’ life danger.’ It seems rational to introduce PPH protocols at an average blood loss far below this level, as the aim of management is to prevent hemorrhage from rising to the point that it is life-threatening Objectives Caesarean anesthetic treatment, which involves general anesthesia and spinal / epidural anesthesia, was seldom examined for the risks associated with postpartum hemorrhage and was focused on only a small number of cases from single hospital data sets. The function of different types of anesthesia in postpartum hemorrhage therefore needs to be further explained. Patients and methods This are a retrospective study on patients complicated by postpartum hemorrhage after cesarean section with history of type of anesthesia used; general or spinal or epidural to improve outcome of cesarean section. We included all women complicated by postpartum hemorrhage after cesarean section and collect data about the anesthesia used during cesarean section and also recorded other risk factors for postpartum hemorrhage if recorded in files in antenatal care sheet and the intraoperative circumstances as recorded in the operative sheet of the patient. Heart rates and blood pressures of patients of both groups were measured before delivery and at 1 min interval for 15 min after injection of oxytocin. Uterine contractility was assessed for both groups at 1,2,4,6,8,10 and 15 min after oxytocin injection. Results Our results showed that the age of the studied group ranged from 18 to 40 years with mean 23.97 years. Regarding parity 44.5% of them had one child and 36.7% of them had two, 42.3% of the studied group had general anesthesia and 57.7% of them had spinal. Also 82.2% of the cases were previous and 17.8% of them were emergent. Conclusion Anesthetic techniques might be affected by the possibility of bleeding or concern. We found that women who have undergone general anesthesia have a higher risk of postpartum hemorrhage compared with women who have received epidural, spinal anesthesia.

Background: Spontaneous abortion is defined as a clinically recognized pregnancy loss before the 20th week of gestation, or an expulsion of an embryo weighing 500 g or less. .Pregnancy is a condition of hypercoagulation. study aimed to evaluate the change of platelet indices namely platelet count, platelet crit , platelet distribution width and mean platelet volume among patients . Methods: This study is observational case control study . participants were 135 and divided into three groups Group1: 45 women with spontaneous abortion. Group2: 45 women with recurrent pregnancy loss.Group3: 45 normally pregnant women Results At cut off 14.12, platelet distribution width diagnose abortion (P=0.008) with sensitivity, specificity, PPV, NPV and accuracy of 74.4%, 53.3%, 76.1%, 51.1%, 67.4% respectively.At cut off 6.98, Mean platelet volume diagnose abortion (P=0.002) with sensitivity, specificity, PPV, NPV and accuracy of 76.7%, 44.4%, 75.0%, 57.1%, 70.4% respectively. At cut off 0.31, Platelet crit diagnose abortion with sensitivity, specificity, PPV, NPV and accuracy of 31.1%, 97.8%, 96.6%, 41.5%, 53.3% respectively. There were univariate regression for value of platelet indices in prediction of abortion in the studied sample. Conclusions: Platelet indices are markers for the prediction of spontaneous abortion and recurrent pregnancy loss

Background: The severe form of nausea and vomiting of pregnancy called hyperemesis gravidarum (HG) that if left untreated may lead to significant maternal morbidity and adverse birth outcomes. Helicobacter pylori (H. pylori) is a prevalent gram-negative flagellated spiral bacterium that colonizes the stomach of half of the world’s population. Researchers have hypothesized that maternal hormonal and immunological changes during pregnancy that prevent allogenic rejection of fetus reactivates the bacterium. Aim of the work is to compare between patients with hyperemesis gravidarum and normal pregnancy regarding presence of Helicobacter pylori antibodies for proper management. Materials and Methods: A case-control study was carried out on ninety pregnant women at 5-15 weeks of gestation, thirty pregnant females with single living fetus complaining of HG (Group A), Thirty pregnant females who were multiple pregnancy and/or trophoblastic disorders complaining of HG (Group B) and Thirty pregnant females with normal pregnancy (Group C). Serum test for H. pylori IgG antibody titer was done for all patients and controls using enzyme immunoassay-based kit. Results: H. pylori were noted in 32 hyperemetic cases and 6 control subjects. The presence of H. pylori increased the risk of HG more than two fold (OR = 2.923, 95% CI: 1.326-6.446, P < 0.05). Conclusion: There is powerful correlation between H. pylori and hyperemesis gravidarum which proved in single, multiple pregnancy and/or trophoblastic disorders.