Background: Vaginal bleeding is a tragedy that causes a high mortality and morbidity rate. The aim of this study was to find the most frequent causes of vaginal bleeding in first half of pregnancy. Materials and methods: This study is a cross sectional study performed on 161 cases with vaginal bleeding during pregnancy who had been referred to Taleghani Hospital. Sampling was achieved using non random convenient technique.Results: The mean age of subjects was 27.1±6.1 years and the mean gestational age was 16.3±10.1 weeks. Mean of gravidity was 2.5±1.6. Thirty three percents of subjects were primigravid. The most common causes of bleeding were: abortion (72.7%), PLACENTa PREVIA (12.4%), ectopic pregnancy (8.1%), and PLACENTa abruptio (6.8%).Conclusion: Of 161 cases, 75 (46.5%) lead to abortion or curettage. Abortion was by far the most common cause of vaginal bleeding.

Introduction: Abnormal adhesion of PLACENTa is one of the complex problems of gynecology and obstetrics and is considered life-threatening for mother and fetus. The present study was performed aimed to compare the pregnancy outcomes in PLACENTa accreta with and without PREVIA. Methods: In this analytical-comparison study, the medical records of 50037 women who had referred to Imam Khomeini Hospital in Ahvaz for delivery in 2015-2019 were examined for the diagnosis and recording of abnormal PLACENTal adhesions. A total of 172 patients were confirmed with a definite diagnosis of abnormal PLACENTal adhesions that they were divided into two groups of accreta (n=95) and accreta with PREVIA (n=7) for evaluation and comparison. Data were analyzed by SPSS (version 24) and Chi-square, T–, test, and Man-Whitney test. P<0. 05 was considered statistically significant. Results: There was no significant difference between the two groups in terms of number of pregnancy (P=0. 884), number of cesarean (P=0. 771), history of abortion (P=0. 384), and gestational diabetes (P=0. 824). Antenatal bleeding in accreta–, privia group was 2. 43 times of accreta group (OR: 2. 34, 95% CI: 1. 22-45, p=0. 009) and there was significant difference between the two groups. No significant difference was observed between the two groups in the frequency of hysterectomy, percentage of blood transfusion, admission to ICU and the units of used blood, but cystostomy in PREVIA-accreta group was 2. 2 times to accreta group (P=0. 027). There was significant difference between the two groups in terms of gestational age at birth (p=0. 004), birth weight (p=0. 054), and percentage of preterm delivery (P=0. 015),so that gestational age and birth weight were significantly lower in the accreta-PREVIA group. Conclusion: In both groups, accreta and accreta with PREVIA were similar risk factors, but the needs for cystostomy and preterm delivery was significantly more in the accrete-PREVIA group.

Dear Editor, PLACENTa PREVIA (PP) probably inhibits the development of preeclampsia (PE) during pregnancy (1, 2) and the presence of PE decreases the incidence of PP (2, 3). It could be because of different etiologies and mechanisms of PP against PE (1, 3). PE is defined as a hypertensive disease during pregnancy that is related to a disorder in the PLACENTa and vascular endothelium (1, 4). PP is the obstruction of the internal os of the cervix by the abnormally implanted PLACENTa (2, 5)....

Background and Objective: PLACENTa PREVIA (PP) is a common cause of pri-partum bleeding leading to high mortality and morbidity in mothers and neonates. This study was conducted to determine risk factors and outcomes of PP in Golestan province of Iran.Materials and Methods: This case-control study was done on pregnant women admitted for delivery to the Dezyani hospital of Gorgan, Iran during 2002-07. All PP cases were recruited as case group and 251 non-PP ones were entered into the study as control group. Student t-test and Chi-Square test were used to assess the relationship between variables.Results: In this study out of 33473 pregnant cases, 82 women (0.24%) had PP. The mean (±SD) age of mothers with PP was 28.5 (±6.2) years. There was a significant correlation between PP and delivery method (P<0.05). History of cesarean section was significantly higher in cases than controls (P<0.05). The prevalence of hysterectomy due to PP was significantly higher in women with history of cesarean section (24%) than other ones (5%) (P<0.05).Conclusion: We found a significant relationship between history of cesarean section and hysterectomy due to PP. Therefore, PP should be considered in women with a history of cesarean section.

Background: We studied the possible advantages of feed-forward control nursing model in the treatment of PLACENTa PREVIA.Methods: We enrolled 60 pregnant women who were receiving treatment for expectant PLACENTa PREVIA between Jan-uary 2010 and January 2016 and randomly divided them into the control group and the observation group with 30 cases in each group. In the control group, we offered specialist nursing which included examination, body positioning, vaginal bleeding record, psychological consultation and medication observation. Feed-forward control nursing was applied in the observation group which included establishing feed-forward control nursing improvement team, con-ducting quality control of nursing defects and putting forward ideas for improvements and verifying improvement outcomes.Results: The observation group got significantly higher success rate and lower complication rate compared with con-trol group. Gestational age and fetal weights improved apparently in the observation group. When we compared the amount of postpartum bleeding and pregnancy bleeding in two groups we did not find any statistically significant dif-ference (P>0.05). Patients’ satisfaction rate toward our nursing services was much higher in the observation group and the rate of nursing errors was significantly lower in this group. All differences were statistically significant (P<0.05).Conclusion: Application of feed-forward control nursing model in the expectant treatment of PLACENTa PREVIA can improve treatment success rate, decrease complications and upgrade nursing quality.

PLACENTa PREVIA is one of the common causes of third trimester obstetrical hemorrhage and the latter is an important cause of maternal mortality specially in developing countries. The aim of this study was to determine the frequency of PLACENTa PREVIA and related factors in pregnant women attending emergency maternity centers of Kerman during 1998. 1560pregnants with gestational age of 28 weeks of more were studied. Data on maternal age, parity, gravidity, blood group, gestational age, clinical presentation, history of previous cesarean section and abortion and perinatal mortality within 24 hours of delivery were analysed due to PLACENTa PREVIA. Only 15 had PLACENTa PREVIA according to the sonographic reports. Maternal age, gravidity and parity had relationship with PLACENTa PREVIA and with increasing these factors the prevalence of PLACENTa PREVIA was increased. Gestational age had also significant relationship with PLACENTa PREVIA, which means more possibility of PLACENTa PREVIA in lower gestational age. 9 cases of placenat PREVIA attended with chief complaint of vaginal bleeding. Statistical analysis showed that blood group B is a significant risk factor for developing PLACENTa PREVIA (OR= 3.8). There was no relationship between history of abortion, cesarean section and PLACENTa PREVIA. The prevalence of PLACENTa PREVIA in Kerman is slightly more than other regions of the world and its relationship with above can bear a significant effect on forecoming studies.      

Background: Abnormal PLACENTal invasion has increased parallel with persistent rise in Caesarean delivery. Management relies on accurate diagnosis and delivery should be planned at an institution with appropriate expertise and resources for managing this condition.Case: We present a case of a PLACENTa invasion anomaly which is the major risk factors of peripartum deaths. In this case we try to explain our approach which reduces unnecessary hysterectomy rates.Conclusion: In order to avoid postpartum hemorrhage and hysterectomy protocols, our approach which consists bilateral hypogastric arterial ligation, Bakri balloon tamponade and If necessary methotrexate therapy can be applied succesfully.

Introduction: Vasa PREVIA is a very dangerous variation in which the vessels present inside the amniotic curtains are located on the cervical hole. These vessels may be located between the cervix and the fetus. As a result, the vessels are susceptible to compression, as well as tear or rupture, which results in rapid discharge of the blood fetus, and this state is associated with fetal mortality in 6% unidentified conditions. The present study is a case report of pregnancy with a velamentous variate cord that prevented the subsequent tragic events by early diagnosis and timely cesarean section. Patient Information: A 31-year-old pregnant woman with fetal developmental disorder was examined for Doppler ultrasonography and due to increased umbilical cord vessel resistance, at 37 weeks of pregnancy, became cesarean which was observed during operation velamentous variate cord. Conclusion: IUGR and fetal growth retardation can be associated with PLACENTal disorders. Therefore, in cases where we have fetal developmental disorder, closer examination of the PLACENTa can lead to early termination of labor and choice of delivery method to prevent neonatal mortality and morbidity.