مجله زنان مامائی و نازائی ایران
سال پانزدهم شماره 7 (هفته اول تیر 1391)

Accurate prediction of chorioamnionitis remains a critical challenge in cases of preterm rupture of membranes and may influence obstetrical management. C-reactive protein (CRP) is a circulating indicator of inflammation whose role of measurement in clinical practice remains unclear. The aim of our study is to investigate the association of C-reactive protein with histological evidences of chorioamnionitis in preterm premature rupture of membranes. This cross sectional study was done on 50 women with gestational age 25 to 34 weeks and preterm premature rupture of membranes from June of 2009 to June of 2010. HS C-reactive protein was measured at the end of pregnancy. In order to detect histological chorioamnionitis, pathological examination was done on placenta after delivery. All the samples were investigated by a pathologist who was unaware of patient’s clinical status and his CRP level. The extent and location of acute inflammation was reported. Data were analyzed by students’ T-test, Mann Whitney, ROC curve, sensitivity indicators and SPSS software version 13. Mean concentration of C-reactive protein in pathologically detected chorioamnionitis was 7.26±5.07 mg/L and in the patients without chorioamnionitis was 5.21±2.98 mg/L. There is no significant correlation between concentrations of C-reactive protein and chorioamnionitis (p= 0.14). Three cut points was selected (8, 10 and 15) with sensitivity and specificity of 0.62, 0.76, 0.25; 0.85, 0.06 and 1, respectively. There is no clear evidence to support the use of C-reactive protein for the early diagnosis of chorioamnionitis.

Anxiety and depression are the two most common disorders which all the women experience during their life. Pregnancy and childbirth are stressing events in women’s life which are associated with some degree of anxiety. Concerning the infant’s abnormalities, birth pain, and feeling the maternal responsibilities are prenatal sources of anxiety. This research has been done in order to study the relationship between the mothers non-harmful anxiety with neonatal anthropometric indices during pregnancy periods. Samples of this longitudinal research have been chosen from the pregnant women referred to Public Hospitals, and health and social security center of Tehran from September of 2010 up to November of the same year.150 pregnant women with gestational age of less than 3 months were chosen based on the target. Because of the longitudinal study, cases that completely filled the Cattell Anxiety Inventory Form in three stages were reduced to 41 persons. Cattell Anxiety Questionnaire was completed in three quarters of pregnancy period by subjects and association of project colleagues. All the postnatal anthropometric indices of the infants (weight, height, head perimeter, and apgar score) were recorded based on the neonatal characteristic sheets. Data were analyzed by SPSS software, and (18th version) inferential and descriptive statistics. The Pearson correlation and regression methods were used to study the relationship among research variations. p=0.05 was considered statistically significant. Anxiety score didn’t show any significant relation between the two last quarters and apgar score (p=0.05) but a positive correlation between the first quarter and apgar score (p=0.05). The findings of this research can be a positive approval of effect of mother non-harmful anxiety on neonatal anthropometric indices. In other words, increasing of the anxiety in an acceptable level can be an ideal item for a fetus and improve the situation of neonatal anthropometric indices.

Regarding the importance of having healthy child, there are several tests for fetal status assessment. Non stress testing is the most widely used primary testing method for assessment of fetal well-being in many researches but the predictability of the test is variable in different studies. Present study was designed to determine diagnostic values of the non-stress test for predicting fetal outcomes in high risk pregnancies 37-41 weeks. This study was performed retrospectively and reviewed two hundred and fifty high-risk cases include (pregnancy- induced hypertension, diabetes mellitus, oligohydramnios, premature rupture of membranes, decreased fetal movement, intrauterine growth restriction) in Dezyani hospital that performed non-stress testing before delivery and after reanalysis of test. We followed this parameters: decrease fetal heart rate during delivery, one and five minute apgar scores, need to resuscitation, NICU admission, meconium passage and fetal death. With respect of reactive and non-reactive response divided into two groups and based on occurrence of fetal complications after delivery compared between them. In this way sensitivity, specificity, positive predictive value, negative predictive value, Yuden index and accuracy of the test were estimated. We found that sensitivity, specificity, positive predictive value, negative predictive value, Yuden index and accuracy of the non-stress test for predicting fetal outcomes in high-risk cases were 43.2%, 74.7%, 48.1%, 71%, 17.9% and 63.6%. The frequency of low apgar, need to resuscitation and NICU admission were more common in the group of pregnancies with a non reactive NST than in the group with reactive NST. The difference was statistically significant (p<0.05). Reactive non-stress test is a good predictor of the healthy fetus, but non-reactive non-stress test is not valid.

Fertility is considered as one of the most important family functions. Thus, infertility may cause important emotional disorders, and social and mental consequences including reduction of satisfaction and quality of life. Aim of this study is to compare the quality of life in fertile and infertile women referring to public clinics in Mashhad city. In this cross-sectional analytical study, one hundred fertile women attending Health Centers, and one hundred infertile women attending Montaserieh Infertility Center were randomly selected. Women aged 22 to 45 years, and were their husband’s only wives. All the participants used the same contraception method. The subjects completed the General Health Questionnaires (GHQ28) and World Health Organization’s quality of life questionnaire - BREF (WHOQOL-BREF). Data were analyzed via X2, Mann-Whitney test, and SPSS software version 14. Certainty coefficient was 95% and p< 0.05was considered significant. The two groups had no statistically significant differences in demographic features, other interfering variables, and general health. The infertile women expressed more marital satisfaction (p=0.014). The two groups had no statistically significant differences in none of quality of life fields such as physical (p= 0/46), mental (p= 0/86), social (p=0/53), circumstantial (p=0/18), and general (p=0/94). In present study, there were no significant differences in quality of life between two groups, and the scores acquired by both groups were in medium level. It seems that more research needs to be established on this issue to improve the quality of life particularly in women as the family and society foundation.