Back ground:the third stage of labour begins immediately after the birth of the baby and ends with the expulsion of the placenta and fetal membranes.It is preceded by contraction and retraction of the uterus to reduce uterine size and expel the placenta with minimal haemorrhage. Placental cord drainage involves clamping and cutting of the umbilical cord after the birth of a baby and then, immediately unclamping the maternal side of the cord so the blood can drain freely into a container. Aim of the work:the aim of this study is to assess the effect of placental cord drainage during active management of the third stage of labour on reducing both blood loss and the length of the third stage. Materials and Methods:a randomized controlled trial was carried out on180 patients who underwent vaginal delivery at Ain Shams University Maternity Hospital labour ward.Population of this study were randomly assigned to either:Group A: 90 patients was the study group(cord drainage).Group B: 90 patients was the control group(no cord drainage). Moreover,the duration of third stage was compared as the primary outcome. The incidence of postpartum hemorrhage, retained placenta, manual removal of placenta, and the need for blood transfusion were compared. Results:the duration and amount of blood loss of third stage of labour was significantly lower in study group than control group.Furthermore,the Postoperative pulse rate,Systolic Blood Pressure, Diastolic Blood Pressure,Hemoglobin and hematocrit value were significantly higher in study group than control group. The retained placenta (manual removal),Postpartum hemorrhageand Blood transfusion were non-significantly less frequent among study group than among control group. Conclusion:active management of the third stage of labour with the cord drainage method significantly reduced postpartum hemorrhage and the duration of the third stage.

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Background: Anemia is a major health problem. Iron deficiency is the most common cause of anemia during pregnancy. Suboptimal iron content in the average mother's diet and the presence of insufficient iron stores during the reproductive years are causes for this predominance. In many developing countries, iron deficiency anemia (IDA) in pregnancy is more of a rule than an exception with a prevalence of 52%. In the Western societies, the frequency of IDA is approximately 25% in pregnant women not taking iron supplements and less than 5% in women taking iron supplements. Anemia has a significant impact on the health of the fetus and the mother. It can be associated with increased preterm labour, preeclampsia, and maternal sepsis. It can also lead to fetal loss or even perinatal deaths. Aim: To find out whether there is a difference between amino acid chelated iron and iron salts (ferrous fumarate) in effect, safety, adverse effects and outcomes in treatment of iron deficiency anemia during pregnancy. Patients and Methods:The study was conducted on pregnant women attending the antenatal care in the outpatient clinic at Ain-Shams University Maternity Hospital in the period from February 2019 to July 2019, with diagnosis of iron deficiency anemia between 14 -18 weeks with hemoglobin (HB) level 8-10.5g/dL, and serum ferritin <15µg/l. One hundred fifty pregnant women who met the criteria were randomized in to 2 groups (iron chelated amino acid "IAAC" group and ferrous fumarate "FF" group). Hemoglobin level, blood indices, serum iron and serum ferritin levels were measured in both groups at 4, 8, 12 weeks of treatment. Results: There was a significant hematological improvement (mean HB level, blood indices, serum iron and ferritin levels) in both groups which was significantly higher in IAAC group. Conclusion: Iron amino acid chelate achieves faster cure rate than ferrous fumarate in women with iron deficiency anemia in pregnancy as regards mean HB and serum ferritin level. Iron amino acid chelate is associated with fewer side effects than ferrous fumarate.

Background Induction of labor should be used in the most efficient way possible that will result in a favorable obstetric outcome with minimum fetal morbidity. Objectives The aim of this study is to compare the efficacy and safety of intravaginal misoprostol alone versus intra cervical Foley catheter combined with vaginal misoprostol in induction of labor at term pregnancy. Methods This study was conducted at Obstetrics & Gynecology Department; Ain Shams University, Maternity Hospital in the period between May 2017 to October 2017. The total number of patients studied was 120 patients, divided into two groups; the first group (A) included 60 patients who received vaginal misoprostol, the second group (B) included 60 patients who received vaginal misoprostol combined with trans cervical Foley catheter. Results The current study found that the combined group has a better chance for NVD 88.3% versus 78.3% in misoprostol alone group, a lesser probability to CS 11.7% in combined group versus 21.7% in misoprostol alone group and a shorter induction delivery interval within 12 hours after induction (81.6% in combined group versus 59.5% in misoprostol group). Regarding the effect of both methods on fetal safety, we found that non reassuring FHR was more common in combined group 8.3% than misoprostol alone group 1.7% but it’s statistically non-significant. There was statistically significant increase in tachysystole in combined group 28.3% versus 13.3% in misoprostol alone group. However, dystocia was more common in misoprostol group 15% than combined group 3.3% that is also statistically significant. Conclusion Both methods can be used in induction of labor at term pregnancy without forgetting the precautions and close observation to the mother and the fetus. Combined method results in a shorter induction-to delivery time, but misoprostol alone was safer for the mother and the fetus.