Placenta: The wonder organ.

Placenta is the only organ to develop in adulthood and is the only one with a defined end date. The structure of placenta has a strong relation with pregnancy length, physical milieu of mother and a resemblance to the concept of ‘Imhotep(regarded as the first medico legal expert) showing relation between Forensic medicine histology, morphology and pathology. Anemia in pregnancy is found to be associated with variable histomorphological changes in placenta, which show a clear reflection for the poor fetal outcome. There is a threshold for the level of haemoglobin and consequently for oxygen transport below which placental function is impaired. This explains the increased frequency of premature births, foetal death and perinatal mortality and morbidity in anemia during pregnancy. The histomorphological findings of placenta in anemic mothers which are an adaptation to maternal hypoxia can correlate with the poor fetal outcome giving a documentary evidence and explanation against false implications of neonatal deaths. This makes placenta as the much required tool of present medico legal scenario.

[Effect of aspirin for prevention of preeclampsia in women with abnormal ultrasonic findings in uterine artery]

Prevention of preeclampsia is very important in reducing maternal and neonatal mortality and morbidity. The purpose of this study was to determine the effectiveness of aspirin in the prevention of preeclampsia in high-risk pregnancies with abnormal findings at uterine artery in doppler ultrasound among women referred to Shabih- Khani hospital in Kashan. In this clinical trial study, women predisposed to preeclampsia at 12-16 weeks of gestation were evaluated by uterine artery doppler ultrasound and in the case of abnormal findings, they were randomly divided into two groups, experimental [n=40] and control [n=40] groups. The experimental group was received aspirin 80 mg/day. Groups were followed up until delivery and pregnancy outcomes [e.g. incidence of preeclampsia, IUGR, preterm labour, 1st and 5th min APGAR less than 5, delivery type and birth weight] were analyzed. The incidence of preeclampsia in experimental [aspirin] group and control group were 2.5%, 22.5%, respectively. In addition, the risk of preeclampsia was 9 folds more than that of control group [P=0.007]. No significant difference was seen between the two groups in the type of delivery, birth weight and gestational age. Aspirin administration during 12-16 weeks of pregnancy can decrease the incidence of preeclampsia in high-risk pregnancy with abnormal findings of uterine artery as a preventive measure

Prevalence of Factors involved in intracranial hemorrhage of premature neonates less than 34 weeks' gestation

Intracranial hemorrhage is one of the major causes of neonatal mortality and morbidity. It is the most severe cranial problem in that period. Those who survive would be affected by hydrocephalus, encephalomalacia, and finally brain atrophy. With accurate knowledge of risk factors, hemorrhage may be diagnosed earlier and the complications managed earlier. This study was performed in Neonatal Intensive Care Unit of Imam Khomeini Hospital. All the neonates less than 34 weeks of gestation were undergone intracranial sonography from Feb 2005 to Feb 2006. Sonography was performed via anterior fontanel with proper probe according to neonatal age. 113 neonates less than 34 weeks of gestation have been studied. Mean gestational age was 32 weeks. Mean neonatal weight were 1566 +/- 734 grams. Intracranial hemorrhage was evident in 21% of them; 16.8% was grade 1, 0.9% grade 2, 2.7% grade 3, 0.9% grade 4. The mean weight of neonates with hemorrhage was 1504.11 grams. Intracranial hemorrhage had correlation with respiratory acidosis and pneumothorax. The latter was also correlated with hemorrhage grade. Supposing the safety and non-invasiveness of intacranial sonography, we suggest performing sonography in all premature neonates with low birth weight, and also in those neonates with pneumothorax and respiratory acidosis

Reasons for Zahedan's women for not referring to delivery ward for child delivery

Maternal and infantile mortality are important health indicators of every society due to pregnancy incidents. Maternal and infant mortality and also neonatal tetanus incidents have direct relation with delivery condition. Neonatal tetanus and mortality among mothers and newborns have direct relation with delivery in non-hygienic condition. Non-hygienic delivery rate is very high in Sistan and Baluchestan province. Even in the city of Zahedan with a population of 450000, where as access to maternity hospital is possible for all residents of this city, 50-60% deliveries take place at home. In this study, the reasons of women were investigated for not referring to maternity hospital for delivery. The method of research was case control. Case group was selected from those women whose last deliveries had not taken place in maternity hospital and referred to health centers to vaccinate their children [no. 482]. Control group was selected randomly among women who referred to hospital to give birth [no. 198]. Hospital's high fee [38%], easy delivery at home [19%], fear from cesarean and drugs adverse reaction [13%] were the most prevalent reason for not giving birth at hospital. Employment and literacy rates of those women who had given birth at home were lower than control group. They were mainly from Suni and Baluch ethnic. In order to minimize the cultural barriers of referring to maternal hospital, we advise the respectful officers, to make insurance public, lower the treatments fee, held training programs and provide hygienic conditions with low cost for out of hospital deliveries

Effects of hypertension of pregnant mothers on neonates, Taleghani Hospital- 1999

Recent studies show that presence of hypertension during pregnancy results to neonatal morbidity and mortality. The aim of this study is to investigate and identify the neonatal out comes, which their mothers were afflicted with hypertension during pregnancy. This was a Cohort type of study and in this regard, 160 pregnant women with hypertension were considered from Obs and Gyn Department of Taleghani Hospital, Shahid Beheshti Medical Sciences University. 80 pregnant women without hypertension were considered as control group. Morbidity and mortality were compared in these neonates. Results of this study showed that in group of mothers afflicted with hypertension, morbidity and mortality of neonates were 7.5 times, low apgar scores, 9 times birth of premature neonate, 3.5 times, low birth weight of neonate [fetal growth retardation] 2 times of control group. Since hypertension in pregnant women has many serious side effects for neonates, therefore it is recommended that there should be improved cares during pregnancy and on time of recognition and control of this disease, which can be lead to serious problems, and mortality of neonates

Experience in childhood mortality

Of 3280 children admitted in NICH during the year 1982, 632 [19.2%] died. The cases were divided into two groups. Of 2536 group A children [0-12 years], 431 [16.99%] died. Seventy percent of deaths occurred under 1 year and 90% under 5 years of age. Main causes of death were protein energy malnutrition [PEM] with diarrhoea [32.7%], P.E.M. with respiratory infection [7.4%] and Encephalitis [10.2%]. Of 744 group B cases [Neonates] 201 died, the mortality being 27.02%. The main causes of death were low birth weight [50.8%], infections [18.4%] and birth injuries [10.4%]