مجله زنان مامائی و نازائی ایران
سال هجدهم شماره 164 (هفته دوم مهر 1394)

Vitamin D deficiency in pregnancy is widespread in many parts of the world، and there is an association between vitamin D level and adverse outcomes of pregnancy. Considering the importance of maternal health progress، this study was performed with aim to determine the prevalence of vitamin D deficiency in first trimester of pregnancy and evaluation of related factors affecting this vitamin. This cross-sectional study was performed on 1581 pregnant women during their first prenatal visit in Masjed-Soleiman health centers in 2014. Maternal data was collected using a questionnaire. A blood sample was taken from each woman to measure serum 25-hydroxy vitamin D using ELISA method by Immunodiagnostic Systemdimided (IDS) kit. Was analyzed by SPSS software (version 18)، and descriptive and analytical tests (Spearman، variance analysis، independent t). P<0. 05 was consider significant. Mean serum level of 25 (OH) D was 13. 05 ng/ml (SD± 6. 36) and overall prevalence of vitamin D deficiency estimated as 84%. Mean serum level of was significantly associated with duration of sun exposure، use of sunscreens، type of Hejab and type of dwelling (P<0. 0001). But، there was no correlation between mean level of vitamin D and maternal age (P=0. 773)، gestational age (P=0. 174)، parity (P=0. 509)، and occupation (P=0. 786). Considering high prevalence of vitamin D deficiency among pregnant women in Masjed-Soleiman، it seems that screening and vitamin D supplementation be essential in this population.

The monthly cycle begins with hemorrhage phase and is followed by follicular phase and finally, terminates with luteal phase. These monthly cycles are associated with hormonal fluctuations and can affect the physiology of women''s body. Therefore, present study was performed with assumption that the monthly cycle affects women's physiological indices and compared the selected physiological indices in luteal and follicular phases of menstrual cycle in mature girls. This field method study was performed on 30 teenage girls with normal monthly period of 25-35 days in the past five months. Subjects were evaluated in two luteal and follicular phases of menstrual cycle in terms of physiological indices such as VO2max, systolic and diastolic blood pressure, resting heart rate, and body temperature. Data was analyzed by SPSS software (version 18) and using Kolmogrov-smirnov test and dependent t-test. P<0.05 was considered significant. In this study, there was a significant difference between the luteal and follicular phases of the menstrual cycle in terms of VO2max and body temperature (P≤0.05). VO2max was higher in follicular phase than luteal phase and body temperature was higher in luteal phase than follicular phase. However, resting heart rate, systolic blood pressure and diastolic blood pressure during were not significantly different between the luteal and follicular phases of the menstrual cycle (P≥0.05). Some physiological indices such as VO2max and body temperature are affected by menstrual cycles.

The adult patient's population with congenital heart disease (CHD) is rapidly growing due to progress in cardiologic and surgical interventions. Almost a million adult with CHD are living in western world. The present study was performed with aim to evaluate the newest studies to determine the cardiac assessment before pregnancy, best diagnostic methods, and determining the cases of pregnancy contraindication in congenital heart disease.

In this narrative review article, the most recent researches, reviews, guideline articles, gynecology and cardiovascular surgery reference books were selected and evaluated by the keywords of pregnancy, congenital disease and their equivalents; then, the most important and strongest diagnostic and therapeutic recommendations were provided. 20 articles were used in this study consisted of the related articles in the PubMed, Scopus, Google scholar databases during 1997 to 2014.

Cardiac contraindications to pregnancy in CHD included severe pulmonary hypertension, severe obstructive lesions, class III/IV congestive heart failure and Mar fan syndrome with aortic root >40 mm and sever PI and right ventricle failure. Echocardiography is the preferred imaging modality for guiding the treatment care of these patients.

Preconception evaluation is essential for genetic consultation, identifying/optimizing medical and surgical ideals before pregnancy in order to improve outcomes. A multidisciplinary approach with collaboration between gynecology, anesthesiology, cardiology and cardiac surgery at a specialized center is required for treatment management of these patients.