[Obstetric outcomes in pregnant women with and without uterine leiomyoma]

Background: Uterine leiomyomas [myomas] are the most frequent benign uterine tumors, several studies have suggested that each leiomyoma arises from a single neoplastic cell within the smooth muscle of myometrium and in 4 percent of pregnant women, sonographically detectable myomas are present

Methods and Materials: A cohort study done in years of 1385-86 to compare obstetric outcomes between normal pregnant and pregnant women with myomas, 87 pregnant with myoma and 375 normal pregnant selected for pre, intra and post partum complications

Results: Myoma in pregnancy is a risk factor for first trimester bleeding, spontaneous first trimester abortion, placenta previa, noncephalic presentation, post partum hemorrhage and cesarean delivery but frequency of preterm labor, premature rupture of membrane, placental abruption and intra uterine growth restriction were not different between group with myoma and control group. Furthermore the rate of post partum hemorrhage in group with myoma larger than 5cm in diameter was greater than in group with myoma 5cm or smaller in diameter [P=0.02]. After multiple logistic regression analysis, advanced maternal age, nulliparity were independently associated with presence of myoma in pregnancy

Conclusion: Presence of myoma documented by gestational sonography is associated with high risk pregnancies which necessitate patient education and labor staff preparation for intra and post partum probable complications controlling

Risk factors for intraventricular hemorrhage in very low birth weight infants

The purpose of this study was to determine the risk factors which predispose to the development of high grade IVH [grade 3 and 4] in very low birth weight infants. In a retrospective case control clinical study files of all premature infants with birth weights less than 1500 grams admitted between April 2004 and Oct 2005 to the neonatal intensive care unit of Akbar Abadi hospital in Tehran were reviewed. 39 infants with IVH grade 3 and 4 were identified. A control group of 82 VLBW infants matched for gestational age and birth weight were selected. Prenatal data, delivery characteristics, neonatal course data and reports of cranial ultrasonography were carefully collected for both groups. Those variables that achieved significance [p<0.05] in univariate analysis entered to multivariate logistic regression analysis. A total of 325 VLBW infants were evaluated. Mortality rate was 21.5%. Of the remaining the incidence of high grade IVH was 15.5%. Multivariate logistic analysis showed that following factors are associated with greater risk of high grade IVH occurrence: Low gestational age [OR: 3.72; 95% CI: 1.65-8.38], low birth weight [OR: 3.42; 95% CI: 1.65-8.38], low Apgar score at 5 minute [OR:1.58; 95% CI:1.59-6.32], hyaline membrane disease [HMD, OR: 3.16; 95% CI: 1.42-7.45] and maternal tocolytic therapy with magnesium sulfate [OR: 4.40; 95% CI: 1.10-24.5]. Our results showed that maternal tocolytic therapy, mechanical ventilation, low gestational age, low birth weight, apnea, and low 5 minute Apgar score increased the risk of major IVH