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Background Iron deficiency anemia (IDA) is a major public health problem in Egypt, especially among pregnant women. The most commonly used treatment is oral administration of iron as ferrous sulfate which often fails to exert significant effects with many adverse effects. Lactoferrin is a glycoprotein which belongs to proteins capable of binding and transferring iron. This study was done to evaluate the effectiveness, safety and acceptability of lactoferrin in comparison to ferrous sulfate. Methods This randomized clinical trial was conducted in outpatient clinic under supervision of department of Obstetrics and Gynecology, Faculty of medicine, Ain Shams University, Cairo, Egypt from August 2019 to February 2020. 140 women with iron deficiency anemia in second trimester were recruited and randomly assigned to either group. First group received lactoferrin 200 mg sachets once daily and second group received 100 mg of dried ferrous sulfate capsules twice daily for 4 consecutive weeks. Hemoglobin, hematocrit levels, mean corpuscular volume, and serum ferritin were assessed before and after therapy. Results The increase in haemoglobin was significantly higher in lactoferrin group. Number of cases achieved Hb level ≥10.5 was significantly more frequent in lactoferrin group. Compliance was significantly more frequent in lactoferrin group than in ferrous sulfate group. Maternal side effects were significantly less frequent in lactoferrin group than in ferrous sulfate group. Conclusion Oral lactoferrin is well tolerated and effective as compared to traditional treatment by ferrous sulfate.

Background: the optimal timing of clamping of the umbilical cord after birth have been a subject of controversy and debate, However, there is insufficient evidence to date to support a recommendation as regards the impact of DCC on respiratory function in preterm neonates to delay cord clamping. Aim of the work: this study aimed to evaluate the effect of deferred cord clamping on respiratory function in preterm neonates born vaginal. Methods: The study was randomized controlled trial, including 100 Pregnant women (age 20-35 years old) had spontaneous preterm birth vaginal from 34-36 +6 weeks, 50 subjected to ECC and 50 subjected to DCC. Results: neonates in the two-randomization group differed significantly in requirement of O2 and ventilatory support, and neonates in the ECC group had a mean that was higher than neonates in the DCC group in both CPAP and nasal O2 (ECC 6 (12.0%) vs. DCC 1 (2.0%)-ECC 27 (54.0%) vs. DCC 18 (36.0%) in CPAP and O2 requirement respectively. Apgar scores at 1 and 5 min were significantly different in the two groups, and in general higher in DCC than ECC, reflecting better respiratory symptoms in group DCC. Conclusion: the existing literature on delayed cord clamping has consistently demonstrated benefit especially for preterm neonates in facilitating placental transfusion. Improved physiologic stability in transition (blood pressure), better respiratory outcome, reduced need for transfusion is valuable improvements in outcome.

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