Background Pre-eclampsia is a pregnancy-specific syndrome that affects virtually every organ system, characterized by the new onset of hypertension and proteinuria after 20th week of gestation. The exact cause of preeclampsia is not known. Recent epidemiological studies have emphasized the role of vitamin D deficiency in immunomodulation and placental development and thus, they put the emphasis on vitamin D deficiency, regarding its possible role in the pathophysiology of pre-eclampsia. Objectives To assess the frequency of vitamin D deficiency among pregnant women in the study groups and to find any relationship between vitamin D deficiency and pre-eclampsia. Patients and Methods A case -control study conducted at Sulaimani Maternity Teaching Hospital. A total of one hundred primigravid women with singleton pregnancy without any medical problem were included in the study, fifty women with pre-eclampsia (the study group) and the other fifty women with healthy pregnancy without preeclampsia (the control group). Serum vitamin D level estimation was done for all women in the study and comparison done between the two groups. Vitamin D level < 20 ng/ml. were considered insufficient, while level < 10 ng/ml considered significant deficiency. Results All women who participated in the study had vitamin D level below normal (< 20 ng/ml). With the majority of women in both groups have significant deficiency (level <10ng/ml) which was 45 (90%) women in the study group compared to 40 (80 %) women in the control group with a P- value = 0.6. The mean vitamin D level was not statistically different between the pre-eclampsia group and healthy women (5.87± 3.37 versus 6.5± 3.67) with P- value =0.25. Conclusion Vitamin D deficiency was very common among the studied women. No statistical significant association between vitamin D deficiency and pre-eclampsia was found in this study.
Background Pre-eclampsia is a hypertensive disorder of pregnancy which may cause morbidity and even mortality for both the mother and the fetus. Blood pressure elevation is the most visible sign of pre-eclampsia; however, the disease is multi-systemic affecting almost all systems of the body. CA125 has been found to be elevated in normal and pre-eclamptic pregnancies. Objectives To assess the level of CA-125 in normal and pre-eclamptic pregnancies to find out whether this marker is significantly elevated in women with pre-eclampsia, also to find out any correlation between the severity of pre-eclampsia and the serum concentration of CA 125. Patients and Methods This was a case control study, carried out in Sulaimani Maternity teaching hospital over a period of one year starting from the 1st of May 2015 to the 30th of April 2016. The study included 150 pregnant women, with singleton pregnancy in their 3rd trimester, these women were categorized into three group, fifty women with healthy pregnancy (the control group). Fifty women with mild pre-eclampsia and fifty women with severe pre-eclampsia (the study groups). The serum CA125 level was measured for the women in the three groups and comparison was made among them. Results Mean serum CA-125 and mean arterial pressure were significantly higher in the pre-eclamptic groups compared to the control group (P- value =0.0001). There was a direct correlation between CA-125 and mean arterial pressure in pregnant women with severe pre-eclampsia. The sensitivity and specificity of CA- 125 level were 94% for the detection of pre-eclamptic pregnancies. Conclusion Serum CA-125 was significantly higher in pre-eclampsia groups in comparison to the control group and the level was directly correlated with the severity of pre-eclampsia.
Background Induction of labor (IOL) refers to the stimulation or artificially initiating uterine contractions before its spontaneous onset, to effect progressive effacement and dilatation of the cervix and, ultimately, delivery of a baby. The Bishop’s Score also known as the cervical score is a pre-labor scoring system to assist in predicting the success of labor induction. Objectives To assess the outcome of induction of labor (whether vaginal delivery or Cesarean Section) concerning Bishop Score. Patients and Methods This is a prospective cohort study, conducted at Sulaimani maternity teaching hospital for 10months startingfrom 1st April 2019 till 30th of January 2020. The study included 152 pregnant nulliparous women with singleton viable fetus, cephalic presentation, and intact membranes with no medical disease who were admitted to hospital for induction of labor because of postdate pregnancy (gestational age> 40 weeks). The studied women were divided into two groups according to their Bishop Score on admission. Group (1) are women with Bishop Score < 6 who underwent Labour induction with 25 microgram misoprostol followed by oxytocin drip. Group (2) are womenwhose Bishop Score ≥ 6 underwent induction of labor by oxytocin drip. Women in both groups were followed up throughout induction till delivery and the outcome of labor was compared between the two groups. Results There was statistically significant association between the bishop score at time of induction and mode of delivery since (40.4%) of women in group (1) delivered by C/S and (59.6%) delivered vaginally, while the majority (80.9%) of women in group (2) had successful induction of labor and delivered vaginally and only 19.1% delivered by C/S, (P value = 0.005). The main cause of C/S in group(1)was failure of progress in first stage of labor (38.8%), followed by meconium stained liquor (27.7%) and fetal distress (25.2%). While for group (2), the main cause of C/S was meconium stained liquor (50.0%), followed by fetal distress (33.4%) .The difference was statistically highly significant (p-value =0.01) also the duration of labor was significantly related to bishop score, women with bishop score < 6 has longer duration of labor compared to women with bishop score ≥ 6 in spite of using misoprostol as a ripening agent (p- value=0.05). Conclusion Assessment of bishop score at the time of induction of labor can predict the outcome of induction. Nulliparous woman with a low bishop score (<6) at the time of IOL is at risk of failure of induction and delivery by C/S despite using cervical ripening agents.
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