Early identification of fetuses with chromosomal abnormalities enables health care providers to form an appropriate management plan for each patient. The main objective of this study was to determine the role of ultrasonography in screening and identifying fetuses at risk for chromosomal abnormalities. A retrospective review of 6480 patients from the Obstetrics and Gynecology ward of Firouzgar hospital in Tehran was undertaken. Computer databases of patients were correlated to compare the results of the fetal ultrasonographic examination with the cytogenetic results from amniocentesis. Univariate and multivariate analyses were used to determine the best correlations between ultrasonography findings and chromosomal abnormalities. Thirty-seven chromosomal abnormalities were found in 6480 fetuses (0.57%). Down syndrome was the most common finding with trisomy 18 and 13 being the next two most common abnormal findings. Multivariate analysis showed significant correlations between anomalies of the central nervous system, heart, face and neck, and extremities and increased nuchal fold, increased bowel echogenicity, abnormal biparietal diameter to femur ratio and the presence of chromosomal abnormalities (p value<0.001). Analysis of data indicated that the presence of any kind of ultrasonographic abnormality increases significantly the risk of fetal chromosomal abnormalities. It is also suggested that a normal ultrasonographic examination in an otherwise at-risk patient will significantly reduce the risk of fetal chromosomal abnormalities.

Background: The placenta is a soft organ with vital importance. Increased placental stiffness was reported in pathological conditions emerging during pregnancy, such as diabetes mellitus and hypertension. Nowadays, placental stiffness can be quantitatively measured using the shear wave elastography (SWE) technique. Objectives: We aimed to assess the factors affecting elasticity by finding the normal elastogram values of healthy pregnancy placentas using the SWE technique due to the importance of early diagnosis in risky pregnancies. Patients and Methods: In total, 288 healthy pregnant women in the second or third trimester were included in our prospective study. The pregnant women who had pathology in their fetus and its appendices or a posteriorly located placenta were excluded from the study. Obstetric ultrasonography and a placental elasticity assessment were performed in all the pregnant women. Speed values were obtained from five different locations of the placenta, including the central S1, S2, S3, S4 and peripheral P regions. The elasticity of the regions were compared, and the factors affecting elasticity were investigated. Results: There were significant differences among the velocity values obtained from five different areas of the placenta. The mean velocity values obtained from the central region were higher than those of the peripheral region (P < 0. 001). There was also a significant difference in the mean velocity measurements obtained from the central region (P < 0. 001). The hardest region of the placenta was the maternal surface, while the softest region was the peripheral surface. The elastographic velocity values of the placenta were found to correlate with maternal age, body mass index, placental localization, thickness, and grade, whereas it did not correlate with gravidity, parity, gestational week, and amniotic fluid index. Conclusion: The elasticity of the placenta varied according to the region and surface, whereas it did not change according to gestational week. It may be convenient to use the elasticity values obtained by SWE from specified regions in the follow-up of placentas in high-risk pregnancies. However, considering the affecting factors and contradictory study results, a large number of large-scale studies is required to strengthen the efficiency of SWE in the placental assessment.

Background: Spontaneous preterm labor is one of the common obstetrics problems causing several physical, psychological and economical outcomes. Although due to these outcomes and the efficacy of cares for decreasing them, preterm labor screening is cost-effective and it is still one of the challenging issues in obstetrics.Objective: In this study preterm labor screening by using cervical transvaginal sonography was evaluated.Materials and Methods: This observational cohort study was performed in Yazd, Iran. Samples were selected from pregnant women at gestational age of 21-24 weeks who had single live fetus and referred to the obstetrics clinics of two selected hospitals in Yazd. Gestational age was estimated based on the sonography of the first trimester and cervical length measured by transvaginal sonography. Data analysis was done by using t and x2 test as well as ANOVA. Statistical significant level was considered as p<0.05.Results: From 450 participants, 47 cases had preterm labor and 6 cases had positive funneling. Mean age of women with term labor was 26.09±4.13 years and that of women with preterm labor was 26.7±3.51 years (p=0.334). Duration of pregnancy and cervical length significantly differed between women with and without funneling (p=0.001). The sensitivity and specificity of screening based on cervical length of 25mm were 55.5% (50.9-60.1%) and 93.6% (91.2-96%) respectively.Conclusion: Based on the results of the present study, transvaginal ultrasound assessment of cervical length in low risk women has an acceptable reliability for screening of preterm labor.

Background & aim: Occupational exposures can cause problems such as reproductive system disorders; however, the effects of some exposures, such as psychological stress, have not been investigated yet. This study aims to investigate the effects of women’s psychological stress on obstetric disorders.Methods: This historical cohort study was conducted on 1400 working women in Mashhad, Iran. Data collection was conducted through completing a check list and a questionnaire on psychological stress and obstetric disorders as well as subsequent interviews with participants on health issues. After completing the questionnaire, the participants were divided into four groups according to their level of psychological stress. Frequencies of reproductive disorders were compared among the four groups. To analyze the data, t-test, ANOVA, Chi-squared and Fisher’s exact tests were carried out using SPSS. P-value less than 0.05 was considered significant.Results: The results showed that group four with the most severe psychological stress and the lowest age had the highest risk of reproductive disorders including spontaneous abortion and placental abruption.Conclusion: In this study, severe stress had a significant relationship with the risk of some obstetric complications. It is therefore recommended to use stress management techniques in order to reduce psychological stress, which in turn could prevent its adverse effects.

Objective: To study the association between social, demographic, cultural and maternal care practice variables and obstetric fistula status in Ethiopia. Materials and Methods: The most recent Ethiopia Demographic and Health Survey conducted in 2005 is used to study the association between social, demographic, cultural and maternal care practice and obstetric fistula. We use both univariate and bivariate analyses to describe the association between the selected variables on obstetric fistula status. Results: A number of social, demographic and maternal care practice variables are found to be significantly (p<0.05) associated with obstetric fistula status. These include level of education, age at first birth, place of residence, antenatal services and place of delivery. Conclusion: The study results emphasize the significance of both treatment and prevention activities in eradicating this highly preventable health condition of women in Ethiopia.

Introduction: The growing demand for high-quality obstetric care and treatment has led to the advent and development of a field known as obstetric triage. The present review study aimed to examine the development of tools and criteria for obstetric triage services. Methods: In this narrative review, two authors searched for related articles using the keywords of “ obstetric triage, gynecology triage, perinatal Triage, maternity triage, midwifery triage” AND “ tool, index, scale, questionnaire, system” . With Persian and English language limitation, searches were performed in Scopus, Google Scholar, Scientific Information Database, ProQuest, Medline, Embase and Web of Science databases for articles published from 2000 to 2018. Results: Out of the 289 articles reviewed in this study, 8 articles met the eligibility criteria. Out of these 8 articles, 6 were dedicated to introducing a tool designed and only 2 introduced an obstetric triage system. The obstetric triage tools and systems covered included Emergency Severity Index (ESI), Obstetric Triage Acuity Scale (OTAS), Birmingham symptom specific obstetric triage system (BSOTS), Maternal Fetal Triage Index (MFTI), Florida Hospital Obstetric Triage Acuity Tool, self-assessment questionnaire for gynecologic emergencies (SAQ-GE) and Perinatal Emergency Team Response Assessment (PETRA). Overall, the validity and reliability of the studied method were investigated and found to be acceptable in only 5 of the reviewed studies. Conclusion: The review showed the lack of consensus on how to devise a single standardized tool or system for obstetric triage. The comparison of different obstetric triage tools and systems demonstrated the need for a standardized and widely-approved system with high validity and reliability and standard definitions for obstetric triage to determine the right priority and waiting times of obstetric care services.

Introduction: In obstetric triage, women who referred with obstetric complaints and those with acute or emergency situation are first evaluated. Waiting time is one of the important factors that should be considered in the management and organization of the healthcare section. So far, the exact waiting time for emergency care and obstetric triage in Iran has not been estimated. Therefore, this study was performed with aim to determine mean waiting time for obstetrics triage in Tehran. Methods: This cross-sectional study was performed in 2018 on 9238 patients referred to obstetric triage of educational and medical hospitals in Tehran. Triage was actively performed using 5-level obstetric triage form (level 1: require immediate intervention, level 2: high risk requiring, levels 3: aassessment at the earliest opportunity, level 4: no acute problem, level 5: requires only one visit or consultation), In this research, a checklist containing personal, obstetrics, and also recording the time of triage and obstetric triage form was used. Data were analyzed by SPSS software (version 20) and descriptive statistical tests and ANOVA. P<0. 05 was considered statistically significant. Results: Mean total waiting time in morning, evening and night shifts were 22. 35 ± 3. 60, 18. 12 ± 3. 67 and 19. 15 ± 3. 67 min, respectively. ANOVA test showed no significant difference between mean waiting time based on working shifts per day (p = 0. 122) and month (p = 0. 473). Mean waiting time in level 2, 3, 4 and 5 of obstetric triage were 2. 73± 0. 40, 5. 3± 1. 13, 5. 76± 1. 69, 5. 96± 1. 20 min, respectively. Conclusion: Mean total waiting time for obstetric triage clients is somehow higher than the recommended rate. It is recommended to modify the process of service delivery to the clients of obstetrics triage in order to reduce the waiting time and achieve to the standard.