Keywords : Pregnancy


Preterm Premature Rupture of Membranes and the Value of Serum Ferritin during Pregnancy

Maha Mohamed Jasim Al Bayati; Baidaa Abdullah Mohammed

Iraqi Postgraduate Medical Journal, 2020, Volume 19, Issue 4, Pages 350-355
DOI: 10.52573/ipmj.2020.167330

BACKGROUND:
Preterm premature rupture of membranes occurring from 24-37 weeks gestation. Ferritin is an acute phase reactant as it increases during inflammation that inflammation can predispose to preterm premature rupture of membranes during pregnancy.
OBJECTIVE:
To investigate the value of serum ferritin as a marker for preterm premature rupture of membrane.
PATIENTS AND METHODS:
The study includes 150 pregnant women attending the department of Obstetrics and Gynecology with a gestational age ranging from 28+0 – 36+6 weeks. 50 of them presented with Preterm premature rupture of membrane (group A), 50 women were presented with spontaneous preterm labor (group B), and the other 50 were without any complaint (group C). Venous blood samples of five ml were collected on admission for measurement of serum ferritin level by enzyme-linked immunosorbent assay.
RESULTS:
No statistically significant differences between study groups regarding age, parity, gestational age and hemoglobin level (P ≥ 0.05). The mean of serum ferritin was significantly higher among pregnant women presented with Preterm premature rupture of the membranes than those presented with spontaneous preterm labor and healthy women (45.07 versus 26.22 and 22.83 ng/ml respectively) (P= 0.001). By receiver operating characteristic curve analysis, the cut point of serum ferritin value was 38.6 ng/ml.
CONCLUSION:
Measurement of serum ferritin level is a simple rapid and accurate test. It can be applied as a marker for preterm premature rupture of membrane.
 

Pregnancy with Stroke

Abathar Qahtan

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 4, Pages 490-495

ABSTRACT:
BACKGROUND:
Although stroke in pregnancy is uncommon, the risk of stroke is increased during pregnancy and puerperium, and considered a major contributor to the serious morbidity and mortality of pregnancy
OBJECTIVE:
This study had been designed to find the frequency of stroke in relation to different periods of pregnancy and puerperium, to assess the effect of variable risk factors and their association with stroke and to verify which type of stroke is more frequent among pregnant ladies
METHODS :
This is a cross sectional study that enrolled 30 pregnant patients who had stroke either during pregnancy or puerperium and being admitted to the Neurology words of Al-Yarmouk, Baghdad and Al-kadhemia teaching hospitals during the period from the 1st of January, 2001, to the 31st of December, 2002. All of the patients, who had been included in this study, had been subjected to detailed history, physical and neurological examinations and investigations.
RESULTS:
19 patients (63.3%) of the sample included in this study acquired stroke during pregnancy while 11 patients (36.3%) had developed stroke during puerperium. 2/3rd of the sample had ischemic stroke. Impaired consciousness was the commonest presenting symptom with a frequency of 50% of the sample, cerebellar signs were the least observed signs, in the other hand; all of the patient included in this study had motor dysfunction during the disease course. 53.3% of the sample was hypertensive 6.7 % was diabetic, while 36.7% of them had no significant past medical history. Oral contraceptive pills had been used by 50% of the sample, 2/3rd of those using oral contraceptive pills had ischemic stroke. 63.3% of the sample had cesarean delivery, 50% of the sample had history of abortion, 60% of whom had positive history of recurrent abortion.
CONCLUSION:
This study revealed that most of stroke happened during the 3rd trimester and early weeks of puerperium. Being hypertensive, whether pregnant related or not, is the most important risk factor, in addition, other recognized risk factors included diabetes mellitus and use of oral contraceptive pills.

“Cytomegalovirus Seroprevelance in Iraqi Pregnant Women”

Sajed Nader; Mohammed Ayad

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 3, Pages 303-307

ABSTRACT:
BACKGROUND:
Cytomegalovirus is the commonest cause of congenital viral infection in the developed and developing countries. It is a symptomatic in 90% of infected females. Forty percent of pregnant females transmit the virus to their fetus. Ten percent of born infants whom gain the virus will get the clinical signs plus its neurological sequelae.
OBJECTIVE:
To outline the relationship between Cytomegalovirus infection among pregnant women and its influence upon their pregnancy outcome.
PATIENTS AND METHODS:
A case-control study was carried out was carried out in the teaching laboratories – medical city, Baghdad through a period from June 2010 till March 2011; upon 165 pregnant women whom taken as a patient group. Blood samples were taken from them and Cytomegalovirus-IgM antibodies plus Cytomegalovirus-IgG antibodies levels were measured via Elisa technique in both to evaluate the viral infection if present or not.
RESULTS:
The usual age whom attended the gynea-obestetric clinics were the age group from 11-19 years old 73 cases (44.24%); Next came the age group from 20-29 years old 66 cases (40.00%), thirdly was the age group from 30-39 years old 20 cases (12.12%), Lastly was the age group from 40-49 years old 6 cases (3.64%). The concentration of CMV-IgG among females whom attended clinics were seropositive in nearly half the included cases 66/165 (40.0%); while the CMV-IgM concentration was within the seronegative limits. Secondly came another group of patients with seronegative limits regarding both the CMV-IgM and CMV-IgG antibodies 56/165 cases (33.94%), next 30/165 cases (18.18%) were seropositive in their results pointing to both CMV-IgM and IgG limits; and this might be a middle point distance between the previous group and the last group were the CMV-IgM was positive and the CMV-IgG concentration was negative 13/165 cases (7.88%).
CONCLUSION:
Cytomegalovirus-IgG antibodies got important role as a protective agent against gestation abortion, if Cytomegalovirus-IgM antibodies are seropositive alone this is a risky factor to the pregnancy outcome

The Effect of Valvular Heart Diseases on Maternal and Fetal Outcome of Pregnancy

Nada Salih Ameen; Nawfal Fawzi Anwer

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 3, Pages 238-241

ABSTRACT:
BACKGROUND:
Profound hemodynamic alterations occur during pregnancy, labour and in the postpartum period. These changes can adversely affect both maternal and fetal outcome, if a women encounter a valvular heart disease during her pregnancy.
OBJECTIVE:
We try to evaluate the effect of valvular heart disease on maternal and fetal outcome of pregnancy.
METHODS:
This is a cross section descriptive study, carried out in Baghdad teaching hospital, throughout the period from September 2007 to October 2008. Seventy eight pregnant women with valvular heart diseases, in labour, were enrolled in this study. Their medical and obstetrical records were reviewed on admission. We looked for maternal outcome after delivery (method of delivery, heart failure, arrhythmia, need for medication and period of hospitalization), additional to fetal outcome (prematurity, viability and birth weight).
RESULTS:
Mitral valve disease is predominate valvular heart disease in pregnancy, most of them of mild severity. All maternal and fetal outcome parameters adversely increase among pregnant women with valvular heart diseases.
CONCLUSION:
Valvular heart diseases carried a higher risk for both mother and fetus. The risk related directly to severity of valvular heart diseases.

Breast Lesions During Pregnancy Diagnosed by Fine Needle Aspiration Cytology

Sazan A. M. Al-Atrooshi; Lubab Fadhil Talal

Iraqi Postgraduate Medical Journal, 2009, Volume 8, Issue 2, Pages 184-190

ABSTRACT:
BACKGROUND:
The breast functions as a secretory gland during pregnancy due to the interaction of estrogen and progesterone, where the secretory unit is the lobule.
OBJECTIVE:
Is to highlight breast lesions during pregnancy and to show the importance of fine needle aspiration cytology in the diagnosis of these breast lesions.
PATIENTS AND METHOD:
This study was carried out within the Main Referral Training Center for Early Detection of Breast Tumors, Medical City Teaching Hospital, Baghdad (from the beginning of May 2006 till the end of August 2008). Fifty eight pregnant ladies presenting with different breast lesions were included, all were subjected to physical breast examination, ultrasonography of the breast and fine needle aspiration with 10 ml disposable syringe (20-22 gauge), spread on glass slides and fixed in 95% alcohol, stained with Pap stain and examined under light microscope.
RESULT:
Clinicopathological study of 58 pregnant ladies presented with breast lesions including the age (range between 17-42 years), chief complaint (pain 10(17.2%)cases, mass 30(51.8%) cases, discharge 3(5.2%) cases, painful mass 11(18.9%) cases, axillary mass 3(5.2%) cases and pain and discharge in 1(1.7%) case) , site of the lesion (left side 24(41.4%) cases, right side 27(46.5%) cases and bilateral in 7(12.1%) cases.), the time of presentation during pregnancy (first trimester 19(32.8%) cases, second trimester 26(44.8%) and third trimester 13(22.4%) cases.) Our results show that breast lesions presented during pregnancy were benign in 54 (93.1%) cases, and malignant in 4 (6.9%) cases (all were breast carcinoma), the benign lesions include: fibroadenoma 15(25.9%) cases, inflammatory lesions 13(22.4%) cases, galactocele 8(13.8%) cases, fibrocystic changes 6(10.3%) cases, pregnancy related changes 5(8.6%) cases, lactating adenoma 3(5.2%) cases, 2(3.5%) cases lipoma, and papilloma one (1.7%) case , and one case was diagnosed as accessory axillary breast tissue.
CONCLUSION:
The majority of breast lesions during pregnancy are benign; however, a small percentage of these lesions prove to be malignant. Aspiration cytology has a place in the work up of abnormal areas found in pregnant breasts but an experienced cytologist with knowledge of the clinical setting is required.