Objective: The placenta is derived from both maternal and fetal tissue with approximately one fifth derived from fetal tissue at term. The placenta should be examined, as it reflects disease in the mother and the fetus. Aim: The aim is to implement a protocol for improving nursing performance towards placental examination at labor units. Methods: Design: A quasi-experimental design was adopted. Setting: The current study was conducted at the labor unit at Ain Shams maternity hospital and Beni-Suef University hospital. Sample: 42 nurses who were affiliated to labor units (21 nurses of Ain Shams maternity hospital group and 21 nurses of Beni-Suef University hospital group). Tools: Two tools were used for data collection; structured interview questionnaire and an observation checklist. Results: There was no significant difference between both groups in general characteristics. The majority of the studied nurses from Ain Shams and Beni-Suef hospital, respectively, did not attend any training related to placental examination before conducting the study. Meanwhile, there was a significant improvement in nurses' performance towards placental examination after implementing the program. Conclusions: The placental examination program was effective in improving the nurse's performance at labor units. Recommendation: Policymakers should formulate a national plan of continuing education to help nurses already in the labor force to retain and update their knowledge and clinical skills especially in such topic placental examination and encourage nurses to participate in programs in order to maintain a high level of health care in maternity hospitals.

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Background: Rheumatic heart disease is a condition in which the heart valves have been permanently damaged by rheumatic fever and high-alert medications. medications that are most likely to cause significant harm to the pregnant women, even when used as intended.  Aim: This study aimed to evaluate the effect of nursing educational guideline regarding high alert medication for pregnant women suffering from rheumatic heart diseases. Design: A quasi experimental design was used to achieve the aim of the current study one group. Setting: The current study was conducted in the outpatient clinics at obstetrics and Gynecology at Alshohadaa Central Hospital in Menoufia governorate, which belongs to the Ministry of Health and Population-Egypt. Sample: A convenience sample composed of 64 pregnant women among high-alert medication and rheumatic heart disease were included in the study. Tools: Tool 1: Self-Administered Questionnaire consisting of: Socio-demographic characteristics of pregnant women, Obstetrical history, menstrual history and pregnant women knowledge assessment sheet about rheumatic heart disease and high alert medication. Tool 2: Guideline sheet for pregnant women with rheumatic heart diseases & high alert medication. Results: There is statistically significant relation between total knowledge about rheumatic heart diseases and total knowledge about high-alert medications.