Background and objectives: Infertility is inability to conceive after one year of regular unprotected intercourse. Unexplained infertility is present if the basic fertility investigations are normal. The objective of this study is to investigate the use of uterine artery blood flow as a cause of unexplained infertility (using pulsatility index, resistance index) and compare them to fertile women. Methods: A prospective cohort study was performed on 70 patients (35 fertile and 35 with unexplained infertility patients) in Sulaymaniyah Maternity Teaching Hospital, Kurdistan Region, Iraq, during October 2016 to December 2017. Transvaginal color Doppler ultrasound was done in the mid luteal phase (day 21 - 24) for uterine artery by using pulsatility index and resistance index. Results: The age of the patients ranged from 20 - 39 years. The uterine artery pulsatility index was significantly higher in the unexplained infertile women (mean ± SD = 2.78 ± 0.615) than fertile women (mean ± SD = 2.42 ± 0.325). The uterine artery blood flow resistance index was significantly higher in unexplained infertile group (mean ± SD = 0.899 ± 0.066) than fertile women (mean ± SD = 0.83 ± 0.054). Conclusions: Unexplained infertility is associated with decreased uterine artery blood flow and increase uterine artery resistance (pulsatility index and resistance index) when compared with fertile women.
Aim of the current research is to assess the Chlamydia Trachomatis infection role in the development of early pregnancy complication including ectopic pregnancy and miscarriage in Sulaimanyia Maternity Teaching Hospital. It is a comparative study conducted in Gynecology Clinic and Emergency department of Sulaimanyia Maternity Teaching Hospital during the period from 1st of September 2018 to 31st of March 2019. The study groups included of 70 pregnant women; the first group included 35 ectopic pregnant women and the second group included 35 normal pregnant women that both groups had been selected randomly. Pregnant women with history of ectopic pregnancies, women used intrauterine device, in vitro fertilization, assisted reproduction and history of pelvic surgery. Blood sample (2 ml venous blood) collected to test for antibodies level for Chlamydia Trachomatis by Alegria test system for both studied groups and patients with ectopic pregnancy detected by beta human chorionic gonadotropin and ultrasound scanning. The collected data analyzed by SPSS program and for compare between means of two variables independent sample t-test was used while for comparison of categorical variables Chi square test was used with considering ≤ 0.05 P-value as significant level. The results shows that the mean age of normal pregnancy were (28.3±4.6) group compared with mean age ectopic pregnancy (29.5±4.9) group. The mean IgG (6.3±5.1) of patients with ectopic pregnancy was found to be significantly higher than mean IgG (2.8±1.1) for normal pregnant patients (P-value 0.01) and IgM mean (4.5±2.4) of patients with ectopic pregnancy was significantly higher than mean IgM (1.6±1.2) for normal pregnant patients with P-value 0.01. In conclusion, infection of Chlamydia Trachomatis has a significant relationship with the development of ectopic pregnancy therefor screening and treatment of Chlamydia infection may reduce ectopic pregnancy rate with low cost
Enhanced recovery program (ERP) for cesarean section (C/S) is improving patient health and is cost-effective for healthcare providers. We aimed to assess how ERP improves patient satisfaction, ambulation time, severity of pain, decrease hospital stay among patients attending Sulaimani Maternity Teaching Hospital and fetal outcome. A quasi-experimental study was performed on 200 patients in Sulaimani from June 2019 to December 2019. The participants divided into two equal groups. The intervention group was 100 women who underwent elective C/S in Sulaimani Maternity Teaching Hospital and subjected to ERP. While the control group was the other 100 women who were not subjected to the ERP, and they were from the Emergency Department of the same hospital. The women in the intervention group were supervised by anesthetists from preoperatively, intraoperatively, through postoperatively. The intervention group showed significantly better outcome regarding time to ambulate; all patients were able to ambulate 4-5 hours postoperatively. Also, the duration of hospital stay was better in the intervention group; all the patients discharged before 24 hours, but five patients in the control group discharged after 24 hours. Besides, fetal Apgar score after five minutes was also better in the intervention group; at the first minute, the mean±SD (standard deviation) of Apgar score was 8.36±1.38 and 8.08±1.69 for the intervention, and control groups, respectively (P-value = 0.2). While at five minutes, the mean±SD of Apgar score was 9.59±064, and 8.96±1.12 for the intervention, and control groups, respectively (P-value = <0.001). This intervention had favorable outcomes regarding pain, time of ambulation, and fetal Apgar score. We recommend implementing ERP at a broader scale as it gives better outcomes.
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