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.

Most fetal heart rate patterns can be interpreted accurately so that management decisions can be made correctly. How-ever, few fetal heart rate patterns are so ambiguous that the obstetricians cannot interpret them precisely. A 27-year-old woman at 38 weeks’ gestation in her first pregnancy was admitted with heavy vaginal bleeding and decrease in fetal movements. Fetal status was indeterminate according to an indefinite fetal heart rate tracing with regular decelerations. After emergent cesarean delivery, a ruptured Vasa Previa, traversing the fetal membrane, unsupported by either the umbilical cord or placental tissue, was clearly identified. Treatment decision-making is challenging in such patient with indefinite fetal heart rate pattern because limited data exist to guide management. Well-designed studies are needed to clarify the uncertainty about the effect of indefinite fetal heart rate pattern on clinical outcomes.

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.

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.

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: 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.