Hala Razzaq Jasim Abozaid

Introduction. Assessment of the fetal heart rate become a routine manner and was found to be helpful in making important clinical decisions. In the available literature there are no any information about fetal heart rate in twin pregnan- cy and it usefulness in predicting pregnancy outcome. Objective. The aim of our study was to evaluate a range of heart rates in the first trimester in twin pregnancy and the influence of the rate of fetal heart on the outcome of the pregnancy. Material and methods. The study included 89 twin pregnan- cies between 6 and 11 weeks SUMARY Collection · (C) Statistical Analysis · (D) Data Interpre- tation · (E) Manuscript Preparation · (F) Literature Se- arch · (G) Funds Collection In the past and nowadays the fetal heart rate is being used as a confirmation of the embryo/ fetal life. Large group studies have reported changes in the heart rate in early stage of pre- gnancy [1-10]. Furthermore, miscarriages were observed in pregnancies with abnormal fetal heart rate [1-7,11]. Therefore assessment of the fetal heart rate become a routine manner and was found to be helpful in making important clinical decisions. However in the available li- enter the pelvis [1]. It is a common concern leading to an increased risk of morbidity and mortality to mother and fetus. Epidemiologically, breech presentationcan be found in a 3% to 4% of the pregnancies representing a meaningful percentage worldwide [2]. There are controversial reports highlighted the location of placenta at cornual-fundal part that could be potential causative factor to develop the breech presentation [3,4]. Hence, this study aims to explore the incidence of cornual-fundal placenta in patients with breech presentation. Breech presentation represents a global burden among pregnant women comprising around 4% of pregnancies. Much debated question is whether the incidence of placenta in the cornual-fundal region or placenta praevia can be a causative factor for developing breech presentation. Hence, the current study aims to investigate the incidence of presence of placenta in cornual-fundal region or placenta praevia in patients with breech presentation. The study enrolled 300 women as follows: 100 women with breech presentation and 200 women with cephalic presentation (control). The relationship between site of placental implantation and breech presentation was examined by ultrasonography and by cesarean at or near term. The results of this study showed that placenta was found in cornual-fundal site in a 70% of breech presentation cases as compared with 10% of cephalic presentation cases (control). The findings of this study suggest that site of placental implantation could have an impact on the presentation of fetus.

The existence of vitamin D metabolizing enzymes and receptors in female tissues of reproductive origin has been documented by a list of studies. In addition, low levels of vitamin D have been observed in women with polycystic ovary syndrome with sub-fertility, and vitamin D supplementation for those women has been associated with improved menstrual irregularities, metabolic derangements, and fertility outcomes.

Recurrent abortion affects 1-2% of women. Serum Amyloid A belongs to a family of apolipoproteins produced in response to cytokines released by activated monocytes and macrophages, isolated in the last 50 years. Our current study emphasizes human SAA protein as a sensitive biochemical marker for primary unexplained recurrent miscarriage. The aim of the current study is to examine the hypothesis that primary unexplained REPL might be associated with high maternal serum levels of SAA, which in turn could lead to defective trophoblastic invasion into the decidua, and subsequent pregnancy failure and miscarriage. Patients and Method: A prospective study (case control study) in Al-Zahraa Maternity Hospital, Najaf, Iraq, from first of January to the first of December of 2019. The study was conducted among 91 who were divided into two groups Group 1: women with missed miscarriage in the first trimester with at least two consecutive primary unexplained REPLs and no previous live births were enrolled. Group 2: A control group was formed of women with miscarriage no history of REPL who had at least one previous uneventful pregnancy with no adverse outcomes. Serum samples were collected to measure SAA levels. Result: The main outcome was the association between SAA and primary unexplained REPL. A total number of 91 participants. Mean SAA level was significantly higher among women with REPL than among women in the control group (P<0.001). The SAA level was dependent indicator of primary unexplained REPL, P<0.001 Elevated SAA levels found among women with primary unexplained REPL could represent biomarker for this complication of pregnancy. Conclusions: The present findings suggest that SAA is potentially a novel marker for primary unexplained REPL that warrants further investigation. For example, studies could be conducted to compare SAA levels among women with a history of primary unexplained REPL during the pregnant and non-pregnant states, as well as before and after miscarriage. In future, such studies might guide the timing for initiation of new treatments, such as gene therapy or the use of immune-receptor antagonists.