OHSS with spontaneous ovulatory cycle is extremely rare. We report a case of severe OHSS associated with a spontaneous normal SINGLETON PREGNANCY in a 24 year-old woman suffering from severe abdominal pain and dyspnea. Pelvic sonography revealed a 7-week intra-uterine single viable fetus accompanied by ascites and polycystic enlarged ovaries. She was given indomethacin orally and underwent repeated paracenteses, and then discharged after 26 days and delivered a normal baby at 38 weeks of PREGNANCY.

Background: Remaining the placenta and membranes is one of the risk factors for postpartum bleeding and puerperal infection. It is valuable to get familiar with the anatomy of the placenta and identify its variants to manage postpartum bleeding and puerperal infections caused by the remaining placenta and membranes. The placenta comprises three main parts: a placental disc, a three-vessel umbilical cord, and two extraplacental membranes (amnion and chorion). An amnion is a thin membrane lacking blood vessels and nerves that includes the chorionic plate and, its vessels and the fetus. There is no report on a placenta with two attached amniotic membranes in SINGLETON PREGNANCY.Case Report: This paper reports a placenta related to a baby boy from a SINGLETON PREGNANCY with three fetal membranes (two attached amniotic layers and a chorionic layer).Conclusion: In the clinical examination of the placenta, it is important to be aware of the variant of the membranes so that we can prevent possible bleeding and infection after delivery due to the retention of PREGNANCY products. There is also no report on the variant of membranes, so possible consequences are unknown.

Background: SINGLETON PREGNANCY with a live birth beyond 37 weeks of gestation is the ultimate goal of any assisted reproductive technology. However, SINGLETONs conceived after ART are found to have a poor perinatal outcome in comparison to naturally conceived SINGLETONs. It was hypothesized that the outcome of SINGLETON conceived after transfer of two or more embryos may be dependent on the sharing of uterine space with other embryos.Methods: Patients who had single gestational sac visualized at 6 weeks after transfer of 4, 3 or 2 embryos were considered for the study.195 SINGLETON pregnancies were selected for final evaluation such that as per implantation rates of 25%, 33%, and 50%, they were divided into 3 groups of 50, 82 and 63 cases, respectively. The basic characteristics of PREGNANCY (gestational age, birth weight) were compared using analysis of variance (continuous variables), and categorical variables were evaluated with chi-squared test. The p<0.05 was considered statistically significant.Results: Among the various variables including maternal age, conception, type of infertility, type of abortion, total live birth, gestational age in live birth, birth weight, kind of embryo transfer and gestational age, there was not significant statistical differences between groups except gestational age that it was higher in group with 50% (p<0.04) implantation rate. Therefore, higher number of initial embryos may affect the perinatal outcome of SINGLETON conceived subsequently.Conclusion: There is higher chance of missed abortion in patients with SINGLETON pregnancies conceived after multiple embryo transfer. Gestational age at delivery and birth weight were correlated with number of embryo transfered.

Most cases of Ovarian Hyperstimulation Syndrome (OHSS) are associated with the use of exogenous gonadotropins for the induction of multiple oocytes. However, OHSS is rarely associated with a spontaneous ovulatory cycle in women with multiple gestations, hypothyroidism, polycystic ovary syndrome, or molar pregnancies. Herein, we report a case of OHSS in a woman with spontaneous PREGNANCY, without any underlying diseases or risk factors. The clinical findings showed abdominal pain, nausea, dyspnea, and amenorrhea. After imaging and laboratory tests, the final diagnosis was established. The patient was managed successfully without any complications. In conclusion, although spontaneous ovarian hyperstimulation is a rare condition, physicians should be able to diagnose this condition. In fact, early diagnosis and successful management can potentially prevent serious complications, which are likely to develop rapidly in patients.

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.