Objective: This study was conducted in order to assess the prevalence of different cervicovaginal infections during PREGNANCY.Materials and methods: Totally 110 healthy pregnant women with complaints of vaginal symptoms in their third TRIMESTER of PREGNANCY were checked for vaginal candidiasis, bacterial vaginosis, vaginal trichomoniasis, streptococcus b hemoliticus, gonorrhea, syphilis, and infection by chlamydia trachomatis and HIV.Results: Among 110 studied women and mostly nullipara, the mean age was 25.2 years. All of them had at least one symptom including discharge, itching or burning of vagina. Among them 39 (35.5%) had vaginal and endocervical infection identified by laboratory tests including candidiasis 26.4%, bacterial vaginosis 8% and streptococcus b hemoliticus 5.3%. Gonorrhea and trichomoniasis were not seen. Three of the patients had positive IgG antibody for chlamydia trachomatis. None of them had serological positive test for syphilis and HIV.Conclusion: Symptomatic pregnant women need to be actively searched for infections. Besides speculum examination as an easy to carry out clinical test and if needed laboratory exams must be used to choose the best treatment.

Background: Vaginal bleeding during PREGNANCY is one of the important causes of maternal, fetal and neonatal death. Women who remaine pregnant after vaginal bleeding, are at risk of complications such intrauterine fetal death (IUFD), intra uterine growth retardation (IUGR), preterm labor, placental abruption, preterm pre-labor rupture of membrane (PROM), and low birth weight.Methods: This prospective case–control study was done on 120 pregnant women, 60 with first TRIMESTER bleeding and 60 control ones, in Shariati hospital in Isfahan, Iran. All women were evaluated for PREGNANCY outcomes including bleeding in second and third TRIMESTER, abortion, preterm pre labor rupture of membrane, preterm labor, low birth weight, intra uterine growth retardation, mode of labor, APGAR coefficient in 5 minute, and neonatal intensive care unit (NICU) admission. Data was analyzed by Student t and c2 tests.Findings: There were no significant differences between groups in number of previous pregnancies and labors, number of children, history of abortion, premature rupture of membrane (PROM), intrauterine fetal death (IUFD), mod of labor, APGAR coefficient, neonatal intensive care unit admission and intra uterine growth retardation (IUGR) (P≥0.05). But placenta accreta, second TRIMESTER bleeding and preterm labor were significantly more in pregnant women with first TRIMESTER bleeding (P≤0.05).Conclusion: According to our results and other studies from other countries, first TRIMESTER bleeding could predict maternal and fetal complications. We recommend training pregnant women about these complications and their prevention.

Introduction: Rudimentary horn PREGNANCY (RHP), an entity with a diagnostic dilemma is known to rupture most commonly in second TRIMESTER, sometimes in early third TRIMESTER. This case of ectopic rudimentary horn (RH) presented acutely in the first TRIMESTER.Case Presentation: A 30 years old G3P2L2 with previous two vaginal deliveries presented with acute abdominal pain and features of hemorrhagic shock at 8 weeks 5 days gestational age. With clinical diagnosis of ruptured ectopic PREGNANCY, the patient immediately underwent laparotomy, which revealed hemoperitoneum with a unicornuate uterus along with ruptured RHP. RH excision with ipsilateral salpingectomy and right tubal ligation was done and the maternal life salvaged.Conclusion: High index of suspicion based on clinical history and examination complemented with diagnostic radiological modalities can help in prenatal and pre-rupture diagnosis of RHP, hence its prompt treatment to alleviate scope of any emergency situation and the disastrous consequences leading to maternal morbidity and mortality.

Background: A significant number of pregnancies, particularly in women with previous histories of infertility, are associated with fetal abnormalities. Methods such as the nuchal translucency (NT) measurement enable us to identify more pregnancies with chromosomal abnormalities.Materials and Methods: This analytic cross-sectional study was performed in 446 pregnant women at 11-14 weeks gestation, from 2009 to 2010 in the Fetal Medicine Unit of Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences. All NT measurements were performed by a certified sonographer using the Fetal Medicine Foundation (FMF) recommended protocol. FMF first TRIMESTER software was used for primary and secondary (adjusted) risk calculation.Results: The average maternal age was 28.5 years and 15% of mothers were ³35 years of age. The average crown rump length (CRL), gestational age and NT thickness were 61.7, 12.4 weeks and 1.75 mm, respectively. There were 20 cases with increased adjusted risk (4.04%) and 4 cases of documented abnormal karyotype.Conclusion: In our study increased adjusted risk was 4.04%.Documented abnormal karyotype were 0.9% and 28% of total and high-risk groups who accepted amniocentesis, respectively. In this study, 50% of women with high-risk results and about half of those with abnormal karyotypes were seen in women under age 35. Knowing these risks is of utmost importance in PREGNANCY, particularly in patients with infertility histories.

Objectives: The purpose of this study was to determine the perinatal outcome and PREGNANCY complication (preterm delivery, preterm prelabour rupture of membrane [PPROM], preeclampsia, placental abruption and intrauterine growth restriction [IUGR]) of threatened miscarriage.Materials and Methods: A total of 963 patients attended the study. Of these, 493 women had threatened miscarriage. The control group included 470 pregnants without first TRIMESTER vaginal bleeding. We compared the two groups according to maternal age, gravida, parity, spontaneous or induced abortion history, PREGNANCY period, livebirth or PREGNANCY loss, newborn weight and Apgar values after 1 and 5 minutes, newborns’ gender for livebirth and preterm deliveries.Results: Incidence of preterm delivery, abortion, lower gestational fetal weight and preterm rupture of membrane was increased in threatened miscarriage group. Mean PREGNANCY period in threatened miscarriage group was 243 days; in control group was 263 days. There was adverse influence of maternal age and abortion history on outcomes in pregnancies with threatened miscarriage. However sex of the fetuses and Apgar values after 1 and 5 minutes were similar between two groups.Conclusion: Threatened miscarriage is an important situation to predict both the maternal and fetal outcomes in late PREGNANCY. Maternal obstetric history on previous pregnancies should be questioned. It is therefore essential to consider these pregnancies as high risk group and provide careful antenatal care.

Background: Medical induction abortion is an acceptable alternative to surgical abortion for PREGNANCY termination. Misoprostol is an inexpensive PGE1 analogue that can be used easily and safely as a single agent for first- and second-TRIMESTER PREGNANCY termination.The objective of this study was to evaluate the efficacy of two different doses of vaginal misoprostol for PREGNANCY termination with gestational age up to 16 weeks.Methods: This clinical trial included 100 pregnant women with gestational age up to 16 weeks requesting legal termination of PREGNANCY. The subjects were randomized in two equal groups, and received either 200 (group 1) or 400 mg (group 2) misoprostol vaginally every 6 hours with a maximum of four doses. Response to treatment was defined as complete or incomplete abortion within 48 hours after initial dose. Curettage was performed for patients with heavy bleeding or incomplete abortion. The abortion outcome and side-effects were assessed.Results: The groups were similar in maternal age, gestational age, parity and obstetrical history and indication for PREGNANCY termination. The side effects in group 2 were significantly higher than in group 1 (P<0.05). There were no statistically significant differences between the two groups regarding completeness of the abortion and mean time to abortion induction.Conclusions: In the termination of pregnancies up to 16 weeks, the 200 mg per dose regimen of misoprostol was as effective as the 400 mg regimen; however, side-effects were more common with the higher dose.

Introduction: Induced abortion is defined as medical or surgical termination of PREGNANCY before fetal viability is achieved either due to maternal or fetal causes. Considering the potential complications of surgery and anesthesia, hospitalization, costs and time spent, medical induced abortion has replaced surgical treatment in the past two decades. The aim of this study was to evaluate the efficacy of vaginal Misoprostol (Prostaglandin E1) in medical termination of first TRIMESTER PREGNANCY. Methods: This descriptive analytic study was done on 100 women in first TRIMESTER of PREGNANCY that referred for termination of their pregnancies to hospitals affiliated to Mashhad University of Medical Sciences in 2006. Vaginal Misoprostol (800  mg) was prescribed and in cases of failure of induced abortion, a second dose followed 24 hours later. Control sonography was performed in all patients to detect any residue of PREGNANCY one week later. In failed cases of induced abortion or the presence of residue, dilatation and curettage (D & C) was done. Data were analyzed by Chi square test and p value of <0.05 was considered significant. Results: In our study 83 women (83%) had successful complete abortion. Medical abortion was achieved by first dose of vaginal Misoprostol in 55 patients (62%) while in 28 enrolled women (34%) a second dose of vaginal Misoprostol was needed. D & C was done in 17 cases. No side effects were noted due to vaginal Misoprostol treatment in our study.Conclusion: Medical abortion in first TRIMESTER PREGNANCY with vaginal Misoprostol showed a safe and cost-effective treatment modality.

Background: This report is about a PREGNANCY with a triploid fetus and underscores the potential of first TRIMESTER combined screening to detect this devastating chromosomal aberration earlier in PREGNANCY. This report is about a PREGNANCY with a triploid fetus identified from the first TRIMESTER combined screening and confirmed by amniocentesis. Methods: A 28 year old, G5P2AB2 woman was referred to our clinic at 15 weeks of gestation due to a remarkable decrease of her first TRIMESTER double biochemical markers and therefore in the high-risk range for trisomy 13 and 18. The woman underwent amniocentesis which revealed a karyotype of 69, XXX. The parents opted for termination and in post mortem physical examination, a hydrocephalus fetus with marked Intra-Uterine Growth Retardation (IUGR) in addition to syndactyly of third and fourth digits, low set malformed ears, micrognathia and club foot, was seen. Results: Our results and previous reports highlight the need to consider a somewhat consistent pattern of the first TRIMESTER combined screening in a PREGNANCY with triploidy and underscore the potential of this screening strategy to detect this chromosomal aberration earlier in PREGNANCY. Conclusion: Early prenatal diagnosis of this syndrome would provide women an opportunity to terminate an affected PREGNANCY earlier. This is also important in preventing the risks of associated later induced abortion or obstetric complications.