[Relationship between human chorionic gonadotrapin [HCG] level in second trimester pregnancy and preeclampsia]

Many researches have shown a relationship between levels of beta HCG in pregnancy and preeclampsia, which can be used as a method for early diagnosis. The aim of this study was to determine relationship between levels of HCG in second trimester of pregnancy and preeclampsia. This study was conducted as a Nested case control study. Blood samples were taken from 1200 pregnant women who were in their second trimester of pregnancy and were admitted for prenatal care in Arak prenatal clinics. After isolation of serums, blood samples were stored in-20°C until delivery time. Finally serum HCG levels, blood pressure, proteinurea, edema, seizure and neonate statue were analyzed in 50 preeclamptic women [case group] and were compared with 50 normotensive women [control group]. All women were complicated with mild preeclampsia. The mean of the beta HCG in preeclamptic women was 43.08 +/- 32.56 Iu/ml and means of HCG in normotensive women was 27.48 +/- 25.97 mu/ml [P<0.05], the mean of systolic blood pressure in case and control groups were 144.09 +/- 11.30 mmHg and 110.26 +/- 8.13 mmHg, respectively [P<0.001]. The mean of diastolic blood pressure in preeclamptic women was higher than normotensive women [90.45 +/- 4.34 mm/hg and 70 +/- 9.80 mm/hg] [P<0.001]. Our data showed a significant relationship between mean levels of HCG preeclampsia in second trimester. Therefore, screening of high risk group with HCG hormone and careful prenatal care should be considered during pregnancy

[Effect of perineal massage during second phase of labor on episiotomy and laceration rates among nulliparous women]

Routine episiotomy is often considered unnecessary. Episiotomy is associated with short- and long-term morbidities such as suturing, possible bleeding, infection, urinary and fecal incontinences, and dyspareunia. It has also adverse effects on self-esteem and mother-infant bonding. This study aimed to determine the effect of perineal massage during second stage of labor on perineal outcome among nulliparous women. This was a randomized controlled clinical trial. At 38-42 weeks of gestation, nulliparous women expecting normal vaginal delivery of a singleton were asked to join the study. Two hundred and four women were randomly allocated into the intervention and control groups. Participants signed the consent forms. In the intervention group, during the pushing time in the second phase of labor, the midwife inserted two fingers inside the vagina and used a sweeping motion gently to stretch the perineum. The control group received routine care. The rates of episiotomy and laceration were calculated. In the intervention group, the rate of intact perineum, episiotomy, and laceration were 43.5%, 16.5%, and 40%, respectively and in the control group, they were 2.4%, 80% and 17.6%, respectively [P<0.001]. In the intervention group, the first- and second-degree lacerations were 28.2% and 11.8%, respectively; but, the third and fourth degree lacerations were not seen. In the control group, first, second, and third degree lacerations were 4.7%, 7.1%, and 5.9%, respectively [P<0.001]. The fourth degree laceration was not seen. The mean duration of the second stage of labor in the intervention and control groups were 40.06 +/- 20.74 and 51.06 +/- 21.23 minutes, respectively [P=0.003]. The Mean of the first minute Apgar score was 8.51 +/- 0.76 and 8.73 +/- 0.60 in the intervention and control groups, respectively. The mean of the five minute Apgar score was 9.58 +/- 0.62 and 9.78 +/- 0.47, respectively [P=0.102]. This study showed that perineal massage reduces the rate of episiotomy and the degree of lacerations in the second stage of labor. Massage may increase blood flow, elasticity, relaxation, and softness of the perineum