ABSTRACT
placenta previa [PP] is an obstetric complication that can affect maternal and fetal morbidity and mortality. Its prevalence is rising due to cesarean sections. There is no quantitative data of placenta in PP. In this study, quantitative parameters of placenta in cases with PP in comparison with normally implanted controls were investigated. In this quasi experimental study, placentas from pregnancies with PP and normally implanted controls [n=10] were obtained from women who underwent cesarean section. Three full-thickness columns of each placenta were sampled using systematic uniform random sampling [SURS]. Columns were cut into slices and slices were sectioned with 4 microm thickness. SURS selected sections were stained by Masson's trichrome. Stereological analysis was done on 8-10 SURS microscopic microm fields of each section. Absolute volume and volume density of chorionic villi, inter-villous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. Statistical analysis was done using Mann Whitney-U test and significant level was set at p<0.05. There was a significant reduction in total volume and volume density of fibrin deposits on the surface of chorionic villi [p<0.05], and a significant increment in total volume and volume density of chorionic villous blood vessels in PP group in comparison with C group [p<0.05]. Results showed that impairment in situation of implantation in PP can cause significant changes in the structure of placenta. These changes probably can be influential on the evolution and survival of fetus
ABSTRACT
Considering the fact that breech presentation is the most common abnormal presentation, the present paper compares the preparation of those people who had been born with breech and cephalic presentation. In this cross-sectional study we examines 1847 children in primary schools in Zahedan who had been born in 1994-1999; they were selected randomly from three elementary schools in Zahedan. Questionnaires were used to collect information and information about educational preparation of students were gathered using the standard and approved questionnaires by the Education Department of Iran archived in the patients' profiles. To analyze the data, t-test and chi[2]test had been used and p<0.05 was considered significant. Out of the 1847 examined children, 1446 children [3.78%] were male and 401 ones [7/21%] were female. 1738 patients [94%] had cephalic presentation [evident group] and 109 [6%] had breech presentation [cases]. There was a significant statistical difference among the age averages of the mothers with the fetus presentation [p=0.001] and also among the average marks of the educational preparation of students and the fetus presentation [p=0.017] and children born with the breech presentation had higher scores in preparation. There was no significant difference between the mean score of the educational preparation and child delivery method [p=0.13]. This study showed that school preparation scores, regardless of the mode of delivery, in breech presentation are higher than that in cephalic presentation
ABSTRACT
Postpartum hemorrhage is an important cause of maternal morbidity and mortality after delivery. Active management of postpartum hemorrhage by an uterotonic drug decreases the rate of postpartum hemorrhage. The aim of this study is to evaluate the efficacy of rectal misoprostol for prevention of postpartum hemorrhage. This double blind randomized clinical trial was performed on full term pregnant women candidate for vaginal delivery, referred to Zahedan Imam Ali Hospital during 2008-2009. They were randomly divided into two groups of rectal misoprostol and oxytocin. The women in misoprostol group received 400 micro g rectal misoprostol after delivery and the women in oxytocin group received 3 IU oxytocin in 1 L ringer serum, intravenously. Rate of bleeding, need to any surgery interventions, rate of transfusion and changes in hemoglobin and hematocrite were compared between two groups. A total of 400 patients [200 cases in misoprostol group and 200 in oxytocin group] entered to the study. Rate of bleeding > 500 cc was significantly higher in oxytocin group than misoprostol group [33% vs. 19%] [p = 0.005]. Also, need to excessive oxytocin for management of postpartum hemorrhage was significantly lower in misoprostol group than oxytocin group [18% vs. 30%] [p = 0.003]. Decrease in hematocrite was significantly more observed in oxytocin group than misoprostol group [mean decrease of hematocrite was 1.3 +/- 1.6 in misoprostol group and 1.6 +/- 2.2 in oxytocin group]. Two groups were similar in terms of side-effects. Rectal misoprostol as an uterotonic drug can decrease postpartum hemorrhage and also can prevent from decrease of hemoglobin as compared to oxytocin