Impact of maternal HBsAg carrier status on pregnancy outcomes in Duhok city, Iraq

Objective To investigate the relationship between hepatitis B virus (HBV) positivity and pregnancy outcomes. Also, the association between HBV-related risk factors and HBV status was studied. Methods A total of 100 HBV positive pregnant women were recruited and the pregnancy outcomes were compared with 301 HBV negative women. Blood samples were collected and tested for HBV by HBsAg ELISA. Data were collected for recruited subjects using interview questionnaire. Results Data analysis showed that 51/100 (51%) of the HBV-positive subjects gave a history of HBV in the family which was significantly higher than that of HBV-negative patients [41/301 (13.6%) P = 0.001]. A significant association was found between positive history of surgery and HBsAg positivity (P = 0.009). Then, pregnancy outcomes were stratified according to the HBV positivity. No significant association was found between HBV status and pregnancy outcomes (P > 0.05 for all). Conclusions Positive family history of HBV and previous surgical procedures are associated with higher rate of HBV positivity. No association is found between HBV positivity and pregnancy outcomes.

Homozygosity for the Mediterranean alpha-thalassemic deletion [hemoglobin Baits hydrops fetalis]

Hemoglobin Barts hydrops fetalis syndrome is the most severe and generally fatal clinical phenotype of alpha-thalassemia. We diagnosed a fetus at 23-weeks gestation with having hydrops fetalis, by ultrasound. At 32 weeks, intrauterine death was detected. Molecular studies revealed that the fetus had the hemoglobin Barts hydrops fetalis syndrome due to homozygosity for the Mediterranean alpha-thalassemia deletion. This clinical phenotype is generally rare in the Eastern Mediterranean, and this is the first report of this syndrome from Iraq. Techniques for molecular characterization became available only very recently in this country, in a diagnostic setting. Thus, the detection of further cases might be expected in future

Case report leech infestation presenting as metromenorrhagia

This case s presented to show that leech infestation is still not uncommon in Iraq especially of the genital tract. Leech infestation, could cause menorrhagia in women. A 45 years old multiparous woman from Sinjar's rural areas in Mosul province, attending the out patient department with severe vaginal bleeding, and a history of moderate, continuous vaginal bleeding for four months. She underwent diagnostic curettage three months before, which revealed normal secretory endometrium. The infected woman was pale and hypotensive with features of chronic iron deficiency anemia. Speculum and gynecological examinations demonstrated no abnormalities. Total abdominal hysterectomy as an emergency was done with preservation of both ovaries; bleeding persisted postoperatively; re-assessment by speculum pelvic examination revealed leech infestation of the vagina. The Leech belongs to Phyllum Annelida, class Hirudinea, and order Rhychobdellida. An infestation with leeches should be considered in patients who present with menorrhagia and history of immersion in fresh water lakes or streams in tropical infested areas. Leech infestation is not common in gynecological practice, and is rare nowadays as water supplied to all cities and villages is passing through filtration and disinfection process. Leech infestation should be remembered, as a cause of menorrhagea, in areas where using river water and sitting at riverside is habitual for women in infested rural areas