BACKGROUND AND OBJECTIVE: Reflecting the wide variability of assisted reproduction technologies, the incidence of twin and higher order multiple gestation is increased which associated with COMPLICATIONs and prenatal and maternal morbidity and mortality. The purpose of this study was to compare FETAL and maternal COMPLICATION in twin and singleton pregnancies. METHODS: This prospective study was performed on 108 twin pregnant women (case group) and 201 singleton pregnant women who referred to Babol Yahyanejad hospital during 2001-2003. Data related to patients were recorded in a questionnaire and the COMPLICATION rate in both groups was compared. T-test and fishers exact test were used when appropriated. FINDINGS: Frequency of twin pregnancy was 1.4%. Preterm delivery was 60.2% in twin and 2.7% in singleton (p<0.05). Low birth weight and growth retardation was in 45.8% and 38.4% of twin and 7.5% and 10% of singleton, respectively. It was statistically significant (p<0.05). Frequency of placental abruption, previa, preeclampsia, FETAL anomaly and death were not statistically significant. CONCLUSION: Results show that FETAL COMPLICATIONs such as preterm delivery, growth retardation and low birth weight were seen with higher frequency in twin pregnancies compared to singleton pregnancies. Since, this may cause high prenatal morbidity and mortality, therefore more attention is required to reduce COMPLICATION.

Introduction: Gestational diabetes is a common COMPLICATION during pregnancy, affecting maternal and FETAL outcomes. Considering the increasing prevalence of gestational diabetes around the world, in the present study, we aimed to assess FETAL and maternal outcomes in pregnant diabetic women.Methodology: In this cross-sectional study, 85 women with gestational diabetes (gestational age>28 weeks), admitted to the maternity ward, were enrolled, along with 160 women with a normal pregnancy, who met the inclusion criteria (i.e., no history of diabetes, chronic diseases, endocrine disorders, or steroid use). By using a questionnaire, the required information, i.e., demographic data, medical information, gestational age, Apgar score, and adverse pregnancy outcomes such as preeclampsia, premature rupture of membranes, postpartum hemorrhage, macrosomia, stillbirth, and hypoglycemia, was recorded. The gathered data were analyzed using SPSS.Results: The mean age of diabetic and healthy mothers was reported to be 30.4±5.01 and 27.2±4.03 years, respectively; a statistically significant difference was found between the two groups (P<0.02). Also, the meansystolic and diastolic pressure, body mass index, and cesarean section were more prevalent in diabetic mothers (P=0.01); the two groups were significantly different in this regard. Furthermore, FETAL COMPLICATIONs such as macrosomia, stillbirth, and hypoglycemia were more common among diabetic subjects, compared to their healthy counterparts (P<0.01).Conclusion: Among maternal and FETAL COMPLICATIONs, gestational hypertension and cesarean section were more common in diabetic cases. Also, FETAL COMPLICATIONs such asmacrosomia, stillbirth, and hypoglycemia were more prevalent in newborns of diabetic women. Therefore, implementation of educational programs, screening of diabetic mothers, and attention to the associated COMPLICATIONs seem essential. Overall, all these COMPLICATIONs highlight the importance of gestational diabetes prevention.

Background: The preeclampsia / eclampsia is one of the most serious condition peculiar to pregnancy, which defined as occurrence of hypertension, proteinuria in pregnancy and convulsion in eclamptic women. There are major risk for eclamptic and pre eclamptic women due to maternal and FETAL COMPLICATIONs. Materials and Methods: In a prospective study, preeclamptic and eclamptic patients who were visited at Shariati hospital were divided into two groups due to having proper prenatal care or not. Maternal and FETAL COMPLICATION were studied in that two group. Maternal variables were included: incidence of preterm labor, eclampsia, mode of delivery, long term hospitalization, need for ICD, need to antihypertrnsive drugs over postportum, insistence of hypertension up to 6 weeks, postpartum trombocytosis, incidence of cesarean section due to abruptio placenta and IUGR , elevation of serum creatinine, incidence of HELLP syndrome and death of mother FETAL variables were included incidence of IUGR and IUFD, pre term delivery and for need NICD. Relationship of demographic characteristics such as maternal age, parity, educational level, mode of delivery, presence of underlying disease, and educational level of person who referred the patient were studied. Results: These variables except of educational level, and referral level were There was statistically significant difference between incidence of all of variables, in exception of mode of delivery. That means incidence of COMPLICATIONs is lower in group with adequate prenatal care. Conclusion: It seems that adequate prenatal care can reduce or obligate maternal and FETAL COMPLICATION in hypertensive disorders in pregnancy.

Background: Maternal and neonatal health indicators have the important role in evaluating community development.Objectives: In this study, we examined the effects of maternal and FETAL COMPLICATIONs leading to midwifery errors in referred cases to the Iranian Legal Medicine Organization and Medical Council of Forensic Medicine from 2006 - 2011 in Isfahan, Iran.Methods: In this cross - sectional study, we evaluated all midwifery cases that were referred to the Isfahan Legal Medicine organization and Medical Council of Forensic Medicine from 2006 - 2011 that had at least one warrant issued by the outcome of the Disciplinary Board. The data were collected by a checklist and analyzed by SPSS - 18. Research data were qualitative and quantitative (discrete and continuous variables).Results: A total of 206 cases were reviewed. In 66 cases, 32% of them the malpractice verdict in midwifery services was approved. According to our findings, the most maternal and FETAL errors led to the complaint include: FETAL or neonatal death (29.4%), maternal mortality (18.1%), and neurological disorders (15.3%). In addition, the highest rates of maternal medical malpractice were maternal mortality (56.8%) and in infant COMPLICATIONs, infant mortality with 28.8% frequency (P=0.03).Conclusions: It seems the maternal health program effort is impaired in our country. The maternal mortality is unacceptable, due to the fact that many of them are preventable. Taking strategies to prevent replication errors within the care of pregnant women is recommended.

Introduction: Exchange transfusion (ET) is an effective mode of therapy in the treatment of hyperbilirubinemia, but is associated with some COMPLICATIONs in 5-10% of the patients, especially in preterm newborns. The most important COMPLICATIONs following exchange transfusion are: Acidosis, thrombocytopenia, hypocalcemia, hyponatremia, hypoglycemia and transmitting infectious agents. This study aims to determine some COMPLICATIONs of exchange transfusion in neonatal hyperbilirueinemia in NICU of 22 Bahman 22nd Hospital in order to promote its safety and efficacy.Materials and Methods: In this study neonates with undergone exchange transfusion due to hyperbilirubinemia were evaluated over a period of 36 months in NICU of 22 Bahman 22nd Hospital from July 2005 to July 2008 in Mashhad. The questionnaires were completed according to the by patients’ data. The data were then and analyzed for statistical results.Results : Of the 28 neonates who entered the study, 3 required more than one ET. COMPLICATION of ET occurred in 24 neonates (85.7%).The most common COMPLICATIONs were being metabolic acidosis (67.9%) and thrombocytopenia (50%).Conclusion: In order to avoid COMPLICATIONs following exchange transfusion, it should be emphasized to have laboratory tests done. For instance, tests of platelet count and arterial blood gases are needed so that in cases of COMPLICATIONs, the available information can facilitate the treatment. They can be treated on time.

Background: Septoplasty is one of the most commonly performed operations with several COMPLICATIONs.Purpose: To categorize and demonstrate the probability of the occurrence of septoplasty COMPLICATIONs.Methods: Three hundred and twelve patients who underwent septoplasty in Loghman Hakim general hospital, Tehran, Iran, were followed up for 6 months and evaluated for probable post-operative COMPLICATIONs.Results: The most common COMPLICATION was remained deviation, which was observed in 26.2% of patients followed by synechiae and perforations. There was no case of serious and life threatening COMPLICATIONs.Conclusion: Septoplasty has both aesthetic and functional COMPLICATION. However, meticulous and careful surgery can prevent most of them.

Meconium-stained amniotic fluid (MSAF) occurs in approximately 5-20% of live births that meconium aspiration syndrome occurs in approximately 4-5% of these neonates after birth with breathing meconium goes to the small bronchial tree and clinical manifestation such as respiratory distress and tachypena, is present. Thease patients have high mortality and morbidity. For this reason, we studied two groups of infants with meconium stained fluid and compaired mortality and morbidity in two groups. One group was intubated and suction immediately after, and other group was not intubated. In this study, that was prospective and analytical cross-sectional, infants who were delivered with meconium-stained amniotic fluid (MSAF) throught a 3 years period (1996-1999) AkbarAbadi Hospital were studied. In this period 33037 infants were delivered and meconium-stained amniotic fluid (MSAF) occurred in 3254 (9.85%) of this live births. In 217 instance (6.67%) amniotic fluid was thick, in 188 (86.64%) of this infants the trachea was immediately. After birth intubated and suctioned. But unfortunately in 29 infants (13.36%). The trachea was not immediately after birth intubated and suctioned. In the intubated group COMPLICATIONs included: Sepsis 17.55% (25 patients), pneumothorax 13.82% (26 patients), respiratory distress syndrome (RDS) 15.42% (29 patients), peresistent FETAL circulation (PFC) 3.19% (6 patient). In 29 infants (13.36%) that we couldn’t intubated and suctioned, COMPLICATIONs included: sepsis 10.34% (3 infants), pneumothorax 37.93% (11 infants), RDS 17.24% (5 infants), PFC 6.9% (2 infants). In all in intubated group COMPLICATIONs were in 45.74% (86 infants) that 6.38% (12 infants) of this were died. In unintubated group, COMPLICATIONs were seen in 72.41% (21 infants), that 13.79% (4 infants) were died. In this study intubation and suction immediately after birth in thick meconium-stained amniotic fluid decreased meconium Aspiration syndrome but increased it’s morbidity.

Objectives: FETAL cardiac arrhythmia has good prognosis. However, some can lead to hydrops FETALis and perinatal mortality. There are not sufficient studies on the prevalence and COMPLICATIONs of FETAL arrhythmias in Iran, thus, making parents anxious. Therefore, we performed this study to determine its proper management and to prevent its COMPLICATIONs during pregnancy. Then we can help parents by giving them sufficient information about their FETAL problem.Materials and Methods: This descriptive-analytic study included 81 pregnant women with FETAL arrhythmia detected in routine monitoring. For cases, we performed FETAL echocardiography. Data was analyzed by SPSS 20 (P<0.05).Results: This study assessed the FETAL period until 28 days after labor. FETAL arrhythmia was confirmed in 37 cases through echocardiography. The most prevalent arrhythmia was extrasystole with 27 cases (72.97%). Two cases with congenital heart disease experienced heart failure and hydrops FETALis and died in neonatal period and 25 cases survived. Eight cases had bradycardia including 5 with sinus bradycardia and 3 with atrioventricular block. Seven cases had congenital heart problems and 4 of them led to heart failure. Perinatal mortality was seen in six cases. Tachycardia was seen in two cases (5.4%) with no heart failure or hydrops FETALis. One case died of preterm delivery.Conclusion: Congenital heart disease is considered as an important risk, affecting FETAL and neonatal outcome in fetuses with arrhythmias. As pregnancy advances, the frequency of arrhythmias decreased and converted to sinus rhythm.