[ term pregnancy upon complete bed rest in a case with uterine cervical incompetence]

Uterine cervical incompetence is one of the risk factors for preterm labor and it is characterized by painless cervical dilatation and prolapse of membranes into the vagina in the second or third trimester of pregnancy. The aim of this report is to discuss a term pregnancy following complete bed rest in cervical insufficiency. A 24-year old woman with a history of uterine cervical incompetence was admitted to hospital with cervical dilatation and effacement at the 24th week of gestation. She had a successful term pregnancy with bed rest and expectant management at the 39th week of gestation. Expectant management with bed rest in an appropriate position, along with anti-coagulant prophylaxis is an effective and safe method for the management of cervical incompe-tency in advanced stages of pregnancy

Evaluation of the risk factors affecting pelvic floor relaxation

Pelvic relaxation is a common complaint in women admitted to gynecology clinics, with a prevalence of about 50% in the US. In this study, our goal was to identify factors which may contribute to the development of pelvic floor disorders. We conducted a case-control study, with cases selected from all the women who admitted to a gynecology clinic in Mashhad over a four month period. 100 cases who had some type of pelvic floor disorder were studied and compared with 100 controls without any pelvic problem. Each patient filled a questionnaire. Data was analyzed by SPSS, using chi-squared, t-test and logistics regression. P-value < 0/05 was considered as significant. Compared with controls, cases were more likely to have a higher body mass Index [27.6 +/- 3.7 v.s 23.9 +/- 3.7, P<0.001], to be younger at first delivery [18.5 +/- 3.1 v.s 19.7 +/- 3.5, P=0.01], and to have more parity [4.1 +/- 2.9 v.s 2.1 +/- 1.2, P< 0.001]. 14% of cases had a history of gynecology surgery versus 3% of controls [P=0.005], and 12% of cases had a history of operative vaginal delivery versus 2% of controls [P<0.006]. 26% of women who had pelvic organ prolapse had a history of macrosomic infant [weight >/= 4kg], while only 5% of controls had this history [P<0.001]. There were no significant differences in occupation and type of delivery between cases and controls. In our study, difficult delivery, operative vaginal delivery, and history of bearing a macrosomic infant were significantly associated with subsequent development of pelvic floor disorders

Comparison of antiphospholipid between preeclampsia and normal pregnant women

Antiphospholipid antibodies [APLA] may be detected in normal pregnancies and also may cause thrombosis, recurrent fetal loss, placental infarction and preeclampsia. In the present study the possible differences in APLA titer between healthy pregnant women and preeclampsia cases without history of thrombosis was examined. The APLA titer in 50 healthy pregnant women with 50 preeclampsia cases without the history of thrombosis and autoimmune disease was compared. Preeclampcia is defined as hypertension =/>140/90 mmHg after 20 weeks of gestation and proteinuria > 300mg/24h. IgG and IgM anticardiolipin antibodies were measured by immunoassay methods and Teclot kits for lupus-like anticoagulant antibodies were used. In normal pregnant women, 6% had lupus-like anticoagulant antibody, 12% had IgG anticardiolipin antibody, and 26% had IgM anticardiolipid antibodies. In preeclapsia, 8% lupus-like anticoagulant antibody, 4% had IgG anticardiolipin antibody, and 30% had IgM anticardiolipid antibodies. Despite the evidence of prothrombotic state during preeclampsia, it is unlikely that antiphospholipid antibodies represent as a risk factor for preeclampsia among women without the history of thrombosis or autoimmune diseases

relationship between precence of antiphospholipid antibodies in pregnant womens' serum and preeclampsia

Antiphospholipid antibodies may be detected in normal pregnancies and may cause thrombosis, recurrent fetal loss, placental infarction and preeclampsia. In this study the possible differences in antiphospholipid antibody titer between healthy pregnant women and preeclampsic cases was examined. The antiphospholipid antibody titer in 50 healthy pregnant women with 50 preeclampsia cases without the history of thrombosis and autoimmune disease was compared. IgG and IgM anticardiolipin antibody was measured by immunoassay methods. Teclot kits were used for Lupus-like anticoagulant antibodies. Data was analyzed by Chi-square test, p<0/05 was considered significant. There was no association between antiphospholipid antibody titer in healthy and preecalamptic group. In normal pregnant women and preeclamptic cases there was 6% and 8% Lupus like anticoagulant antibody, 12% and 4% IgG anticardiolipin antibody and 26% and 30% IgM anticardiolipin antibodies respectively. Despite the evidence of prothrombotic state during preeclampsia, it is unlikely that antiphospholipid antibodies represent a risk factor for preeclamptic women as compared to healthy pregnant women

comparison of intramuscular and intravaginal suppositoar forms of progesterone for supporting the Luteum phase in ART cycles

Up to seventh week of gestation, progesterone secreted from the ovary is necessary to preserve the pregnancy. In the ART cycles GnRH-a is prescribed and oocytes and granulosa cells or retrieved, both causes corpus luteum insufficiency, so corpus luteum should be supported the best way is progesterone prescription. In this research we compare intramuscular and intravaginal suppositoar forms of progesterone for preserve the pregnancy. A prospective cross sectional evaluation on 193 patients was designed. All of them were on IVF or ICSI cycles. The patients were randomly divided into two groups. Intramuscular progesterone was prescribed in 138 and intravaginal progesterone [supp cyclogest] in 54 patients. The outcome of pregnancy was analyzed using statistical trials including t-test and chi-squre. The two groups were similar duo to age - the ethiology causes of infertility - the doses of proscribed HMG ampule - FSH titrago - the number and grade of transferred embryos. The day after HCG presciption until the end the seventh week in the first group [138 patients] intramuscular progestrone [50 mg/bid] and in the second group [54 Patients] supp of cyclogest [400 mg/bid] was presented. The rate of positive pregnancy test, abortion, successful poegnancy in this two groups were similar. Intramuscular or intravaginal progesterone for supporting corpus luteum in IVF or ICSI cycles have the same effect but the intramuscular route is cheaper

[Outpatient versus inpatient treatment of pyelonephritis in pregnancy]

For comparing outpatient versus inpatient treatment of acute pyelonephritis in pregnancy, a randomized clinical trial was done on 50 cases, who were reffered to Ghaem and Imamreza hospital. Pregnant patients who had the clinical signs and symptoms [fever,shaking chills and aching pain in one or both lumber regions] and laboratory [signs clean voided specimen contaning more than 100,000 organisms per ml] were considered as cases of acute polynephritis during pregnancy. After having obtained informed consent and having provided the patients with the required in formation, they were randomized in two groups. Group 1 [out patient=25 person] received 1 gr of ceftriaxone as a single dose intramuscularly, then they completed a 10 days course of oral cephalexin in a dosage of 500 mg every 6 hours. Inpatients [25 persons received 1 gr keflin IV every 6 hours until fever and other symptoms disappeared for 24 hours following which they were discharged and instructed to continue 500mg oral cephalexin every 6 hourly for a period of 10 days. There were not any statistically significant differences in age, pariety and duration of clinical responses and complications between the two groups. Of those treated as outpatients, 22.2% failed to show a response to treatment compared to 8% in the inpatients group, and the treatment protocols were therefore changed. This study shows that outpatient management of pregnant women with acute pylonephritis is appropriate, and is an effective standard treatment in the prevention of complications of the disease