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Good evening, Old. I am Dr Item of Medicine. I am an internship Doctor graduated from an educational university Today I'm here to talk about my wrist. My graduation project. Research the relationship between high hemoglobin in the first trimester on Big Nancy Complication. It was a cross sectional study, all thanks to my colleagues and supervisors. It started the introduction. Just Asian and David's villages in just a shin and hypertension contribute significantly to maternal fetal noon. It'll morbidity and mortality. Gestational diabetes mellitus. Prevalence is right. It is rising gold wide, ranging from 1 to 20% decisional. David's militants result from the progressive and sodium resistance due to the hormonal effect off a human descent. The lactogen hormone that rises during pregnancy regarding to stational hypertension, decisional hypertension is among the communist obstetric, a complication. It complicate about 2.7% off the oil pregnancy on up to 10% off the U. S. Maternal pregnancy. A previously done study showed that hypertensive disorder of pregnancy is under treated among Palestinian woman on it needed to a serious complication, including cesarean section. Be clumsy, uh, anti and both partum hemorrhage along with chronic hypertension. Why we did this study in Palestine? Palestinian woman has I have a higher risk of pregnancy complication due to the stressful life they live. Additionally, the burden off mortality and morbidity among Palestinian woman is relatively high, suggesting a substandard quality of care. Him a gluten is a protein that the standard don't test for every pregnant woman at almost everybody. Nettle well, visit There's in the w actual and CDC guideline. The cutoff for him, oblivion is 12. Story is 11 for the 1st and 3rd trimester on 10 and hard for the, uh, second trimester. Any any value below that is considered animal on the values from 11 to 12.5 is considered. I know my back to you, the cap off knowledge that there is a scarcity and controversy city and the research regarding this issue on there was no absolute cut off to consider him a blue been high. Additionally, some studies show shows a thinning differences and suggested to conduct this study in different nation. Why our test? Why our research is important. It's important because hemoglobin test is cheap, easy first and save and done at almost every every Internet visit, So it could be used for a really detection off station and day, which maybe this and station and hypertension. So we have with the size that high hemoglobin level above 25 equal or above 12 and heart in the first trimester is associated with increased risk of having elevated fasting blood sugar levels on public pressure reading since our study was conducted since the beginning off 2018 until the end of 2019, covering two years or 28 months. Uh, 24 months The study is a cross section of study was conducted in 2021 at Primary Healthcare sent a primary healthcare centers off the Palestinian Mr Off Health in Nablus. Jinyan Full care um, and the Wasatch All Ethical Approval Waas Ah waas uh taken. And that analysis was done using SBSF. Our valuable in this study is just a shingle Diabetes, which was defined according to the you actually as fasting plasma glucose between toe 29 30 92 the 126 on the weight is milliliters Waas defined as having first investment Locos above 126 stational hypertension was defined as having sister equipped pressure above 140 above all equal 140 on or their stick with pressure above or equal 90 millimeter millimeter off mercury after the 20 weeks off station. So our variable cut off our high hemoglobin normal and low high above 12.5 low below 11, and in between is considered normal. FBS was considered high, if about for equal, 126 impaired is in between 92 on 126 and normal, which is below 92. Cystically pressure was content considered high if equal or above 140 below is normal there so that the pressure was considered high if high or equal to 90 and below, that was considered normal. Our sample size WAAS 5236 subject after excluding the history off Karen Day of its military station and David Smell, it is, or any missing important value. We lost about 2100 subject on after excluding after executing hypertension, stational, hypertension, multiple pregnancy and smoking, we lost another 571 object, so the final sample size waas 2565 let's move to the result first, the general characteristic off a big meant woman. The main maternal age was 26.9. The meaning your ability waas 2.6 The mean hemoglobin A registration was 11.8 on the meaning mobile, been on the mean fasting blood sugar. A 24 weeks gestation was 9.60 systolic at 24 weeks. Gestation was 115. They're Soliqua or 70 for our first objective is to remind the relationship between high hemoglobin on increased fasting. At 20 weeks of gestation, we use multimedia logistic regulation, fasting blood sugar list and 92 was considered as a reference for the other two category. The only statistically significant value in the table was that high hemoglobin Ah, in in in comparison with low hemoglobin found to be significantly associated with increased fasting blood sugar above 126. Our our second objective is to determine the association between high hemoglobin level at registration and increase the BP. We did two table, the first for cystic, and we found a statistically significant value for having high sister that the pressure if you have high hemoglobin Uh huh. On for their strict about the pressure know statistically significant value was found. So our conclusion for objective to is that high hemoglobin above 12.5 at registration is significantly associated with increased systole. Prevent the pressure off 140 in the second trimester. Compare toe, low him so in summary, Women with woman with elevated first trimester hemoglobin are at higher risk for gestational diabetes mellitus and station. And hypertension on this test could be used for addiction off it. Our study phase some limitation as it is at it. Perspective and the records missing urine analysis or a glucose tolerance test weight height. Be, um, my aunt fetal complication, but it has strengthening joint that in a blue bin is routinely done test, and it can be very useful, especially in that developing countries. Our Amanda commendation that high hemoglobin should be considered as a risk factor for having gestational diabetes mellitus and I birth until this order off. Big Nancy on another study is needed to investigate the difference off outcome after consider and get a risk factor. Additionally, farther study is needed for studying the other fetal maternal complication mess on finally, farther. Research need need a is needed about the exact pathophysiology off this relation. Thank you for listening. Go. And if you have any question, do not hesitate.