[Survey the ratio of random urine protein to creatinine and 24 hours urine protein as a alternative method for diagnosis of preeclampsia]

Abstract Introduction: Preeclampsia is the most common complication of pregnancies and one of the three major causes of maternal mortality. So diagnosis of disease and minimizing the complications on mother and newborn is very important

Objective: Determine the association between the ratio of random urine protein to creatinine and 24-hour urine protein in women with suspected preeclapmsia who referred to Alzahra hospital

Materials and Methods: Sixty women with suspected preeclampsia at>20 weeks of gestation were studied prospectively. The ratio of protein to creatinine and 24-hour urine protein was obtained. Data were analyzed by t-test, Pearson correlation and ROC curve

Results: Thirty five percent of the studied population had significant proteinuria. There was a significant moderate correlation between the ratio of protein to creatinine and 24-hour total protein [r=0.511, p-value< 0.0001]. The area under the curve was 82% [%95 CI, 0.72-0.93]. The data suggest that a cut-off equal or more than 0.22 has the most sensitivity, specifity, and predictive value

Conclusion: According to the results, the ratio of random protein to creatinine was not moderately correlated with the standard test of 24-hour urine protein and can not be performed as the alternative method for diagnosis of preeclampsia

[Lung involvement in early rheumatoid arthritis]

Introduction: Regarding to frequency of prevalence of [RA], Pulmonary involvement is a common and serious complication of rheumatoid arthritis this study was performed

Objectives: Determine the prevalence of pulmonary disease in onset of rheumatoid arthritis base on history, physical examination, radiographic and pulmonary function test

Material and Methods: 52 patients [43 women, 9 men] fulfilling the ACR [American college of Rheumatology] criteria for RA [Rheumatoid arthritis] were consecutively assessed in a cross sectional study. Detailed medical [including respiratory symptoms and the disease activity symptoms] and drug and occupational histories were obtained. All patients underwent a complete pulmonary and rheumatologic examination and conventional chest radiography. All patients underwent PFT that comprised spirometry and body plethsmography. Data were analyzed by SPSS software

Results: Their mean age was 45.8 +/- 11.1 years [range: 21-78] and the duration of the disease was less than 6 months. Rheumatoid factor was positive in 76.9%. All patients were nonsmoker. Base on history: cough in 7.7%, dyspnea in 17.3% and wheezing in 1.9% was detected. Physical examination findings showed expiration wheezing [5.8%] and decreasing breath sound [1.9%], Chest X-ray was abnormal in 51/9% [Interstitial opacities 50% and Air-space densities 1.9%] PFT was abnormal in 30.8% [obstructive 15.4%, restrictive 9.6%, mixed pattern 5.8%]

Conclusion: This study showed a high prevalence of lung involvement in beginning of rheumatoid arthritis, so we recommend to perform diagnostic investigation of pulmonary involvement [PFT, Chest X-ray, …] in beginning of RA

[Study of prevalence and some correlative factors with unwanted pregnancies]

Introduction: unwanted pregnancy is a worldwide problem that affects women, their families and society, and the essential aim of family planning is to prevent women from unwanted pregnancies

Objective: this cross-sectional study was performed for determining prevalence rate of unwanted pregnancy and some correlative factors in urban areas of Guilan

Materials and Methods: 500 pregnant women in urban Health Centers for prenatal care were selected by cluster sampling. Data were collected with questionnaire consisting of 29 closed questions

Results: analysis of the information showed that 27.4% of pregnancies were unwanted. There was a significant relation between unwanted pregnancy and the variants: age of mother [p<0.002], number of children [p<0.0001], and mother's educational level [p<0.014]. Tendency to abortion among pregnant women with unwanted pregnancy was 58.8%. 17% of mothers with previous pregnancy had unwanted pregnancy and 41% of them had abortion. There was a significant relation between going to Health Center during pregnancy [regular or irregular] and unwanted pregnancy [P<0.015]. In this study, 70.8% of unwanted pregnancies were as a result of contraceptive failures and 29.9% of them were due to non-use of contraceptives

Conclusion: the results of this study emphasize the necessity for more care on quality aspects of family planning services and specific attention on counseling

[Survey of placental weight and associated factors]

Introduction: placenta is essential for normal fetal development. Failure of the placenta can result in many fetal conditions. Placental development and function can be assessed by a number of methods, including measurement of placental weight

Objective: the aim of this study was to evaluate survey of placental weight and associated factors

Materials and Methods: in this study pregnant, women with singleton pregnancy and gestational age between 37-42 weeks delivered following complicated or no complicated pregnancies were included in a cross-sectional study. Also the patients were categorized into high placental weight [>750gr], normal placental weight [330-750gr] and low placental weight]<330gr]. The placental weight, birth weight, maternal age, gestational age, parity, preeclampsia, history of maternal diabetes, route of delivery, infants' gender and Apgar score were recorded and analyzed with chi2 test

Results: 1088 patients were included in this study. The mean maternal age was25.35+/-5.6 and gestational age at delivery was 274.51+/-9.56 days. The mean weight of birth and placental weight were 3214.28+/-529, 529.72+/-113 respectively. The prevalence rates of low and high placental weight were 2% and 2.8% respectively. There were statistically significant relationships between placental weight and birth weight, fetal distress, Apgar score, maternal diabetes, preeclampsia and kind of delivery. [P<0/05]

Conclusion: in this study, it was seen that placental weight can be related to some important variables that influence some maternal and neonatal outcomes. Therefore, attention to placenta and its growth during pregnancy, for example by sonography can guide us in providing neonatal health and even can be the base of preventive medicine. It appears that placental weight lower than 330gr can be a warning