In Iraq, there is no obvious considerable data regarding trimester-specific reference intervals of thyroid hormones despite documented multiple physiological hormonal changes during pregnancy. Thus, this study aimed to determine trimester-specific reference intervals for serum TSH, FT3, and FT4 and assess the incidence of thyroid function test misinterpretation and misdiagnosis among pregnant women using non-pregnant reference intervals. A thyroid function test was performed for 774 enrolled pregnant women. Reference intervals of TSH, FT3, and FT4 were ascertained in each pregnancy trimester. It was then compared to the adult non-pregnant values, and the incidence of misinterpretation was later calculated. TSH and FT4 reference interval values were lower than non-pregnant reference interval values. The application of non-pregnant women references values in pregnant women caused a serious misinterpretation and misdiagnosis in 66 (8.5%) pregnant women regarding TSH, and 34 (4.4%) pregnant women regarding FT4, while no misdiagnosis was noticed regarding FT3. The trimester-specific reference interval values of TSH, FT3, and FT4 in Iraqi pregnant women showed an obvious variation from non-pregnant reference intervals and the urgent advice to use the trimester-specific reference intervals to avoid misclassification of thyroid dysfunction during pregnancy.

Background: Intrauterine devices (IUD) are extensively used as reversible contraceptives. Copper & Levonorgestrel releasing IUD (LNG (are safe, cost-effective over the long term, and just as effective in relation to others with tubal sterilization. Aim of study: To investigate the effect of oral misoprostol on facilitating intrauterine device (IUD) placement in patients with a history of cesarean sections (Cs). Method: It was a randomized clinical trial (RCT) study carried out on 98 women eligible for IUCD inclusion in the private outpatient clinic (obstetrics and gynecology) in search of contraception in the cities of Mosul and Erbil. This study ran from February 2020 to July 2021. All participants who requested an IUD had already had one or more cesarean sections and had never given birth vaginally. Participants were randomized into two equal groups; the first group was given misoprostol orally and the second group was given placebo 3 h before insertion of the IUD. Result: In this clinical trial study, the mean age of the cases was (29 year) and for control group was (34.1year). The (ARR) is (0.2449), which reflects how much misoprostol lessens the risk of difficulties in IUD insertion. Women with cervical misoprostol preparation were found to have much higher abdominal cramps than those with placebo, with P value 0.0135. Inserting the IUD was a lot easier in the misoprostol group than in the placebo group, with P value of 0.0018 (<0.05) very significant. A higher incidence of complications like vaginal bleeding was also observed in the misoprostol group, with P value 0.0381 and the efficacy of the use misoprostol in the study group was (26%). Conclusion: Our study found that a pill of misoprostol was administered orally before the insertion of an IUD in women who had not had a vaginal birth facilitated the insertion process