[ 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

[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