مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 218 (هفته اول آذر 1395)

Preterm labor (PTL) is a leading cause of infant's mortality and recent findings suggest that assisted reproductive technology (ART) may lead to preterm birth. This study was performed with aim to investigate the relationship between ART and PTL among singleton live-birth in Tehran province.
This retrospective cohort study was conducted on 4704 pregnant women with singleton live-birth referred to Tehran province from 6-21 July 2015. The association between ART and PTL was evaluated using crude odds ratio and adjusted odds ratio. Also, the association between the cause of infertility and PTL was evaluated among ART births. Data analysis was performed by SPSS software (version 16) and regression logistic method. P Among 4704 singleton women, there were 337 (7.2%) ART pregnancy and 4367 (92.8%) spontaneous pregnancy. The PTL rate was significantly higher in ART pregnancy than spontaneous pregnancy (10.1% vs. 4.9%, PAmong singleton live-birth, PTL and PTL/early term rates were two-fold and 1.4-fold higher in ART mothers than spontaneous pregnancy after controlling for confounding factors.

Different factors have been identified for bacterial vaginosis recurrence. But still the main cause of recurrent bacterial vaginosis remains a mystery. This study was performed with aim to determine the relationship between personal and medical factors with recurrent bacterial vaginosis in women referred to the gynecologic clinics of Mashhad.
This cross-sectional study was conducted on 61 women with recurrent bacterial vaginosis symptoms who had at least 3 times of bacterial vaginosis symptoms during last year and referred to gynecologic clinics of 17 Shahrivar and Bahar Tamin Ejtemaie hospitals of Mashhad in 2015. Data collection tools included demographic – medical questionnaire and Amsel clinical criteria (To diagnose vaginosis recurrence). Data analysis was performed by SPSS software (version 16) and binary logistic regression. P According to the results of binary logistic regression, there was significant relationship between husband's job (OR = 0.15, %95CI= 0.02-0.93, P= 0.005), family income (OR = 2.07, %95CI= 1.23-3.87, P= 0.024), the number of intercourse per week (OR = 2.15, %95CI= 1.03-3.70, P= 0.015), the time of changing the smell of the discharge in the menstrual cycle (OR = 1.76, %95CI= 0.23-2.71, P= 0.004) and vaginal douches (OR = 1.59, %95CI= 0.52-2.44, P= 0.041) with bacterial vaginosis recurrence. But, there was no significant association between other variables with vaginosis recurrence (P> 0.05).
Factors such as occupation, income, intercourse numbers and vaginal douche are effective in the recurrence of bacterial vaginosis, so it is recommended that these factors be considered in educational programs for couples.

Pulmonary edema is a dangerous complication of pregnancy. The prevalence of this emergency increases by some pregnancy complications like preeclampsia. Pulmonary edema can be categorized into two types of cardiogenic and noncardiogenic subtypes which each one has separate cause and treatment. This study was performed with aim to evaluate the pathophysiology of disease, factors involved in it, prevention and diagnosis and treatment of pulmonary edema in pregnancy.
In this review article, to find the relevant articles, we searched databases of PubMed, Cochrane, Embase, Goggle Scholar and Scopus using the keywords of pulmonary edema, pregnancy, obstetrics, preeclampsia, fluid overload, cardiac failure, tocolytic therapy and pregnancy complication without time limitation up to 2015. 57 articles was selected and reviewed.
Most important causes of pulmonary edema in pregnancy included tocolytic therapy, pre-existing cardiovascular disease, over hydration by intravenous fluid, preeclampsia and infections. Cardiogenic pulmonary edema is more prevalent than the noncardiogenic type in pregnant women and occurs more usually in the first days of postpartum period. The diagnostic tests for pulmonary edema are clinical symptoms, chest X ray and echocardiography. The treatment of this edema is ventilator support, blood pressure reduction by nitroglycerin and loop diuretics like furosemide. For non-cardiogenic pulmonary edema, the treatment consists of supportive measures and resolution of underlying disorder.
According to the mechanism of pulmonary edema, preventive measures are crucial in high risk patients. In cases of pulmonary edema, early prompt supportive cares and proper treatments can save the patient’s life.

Placental site trophoblastic tumor (PSTT) is a subgroup of gestational trophoblastic tumor and its incidence is very rare and 1 in 10000. The origin of this tumor is placental site and its symptoms are vaginal bleeding, metastatic symptoms, and …. Here, a rare presentation of PSTT is reported.
Case Report: A 24-years old woman, P1L1 with history of vaginal delivery one year ago and abnormal vaginal bleeding from 6 months ago had referred. Pelvic sonography reported a fibroma sized 29×45 mm as a myoma in the uterus. Due to abnormal vaginal bleeding which was refractory to medical therapy, myomectomy was done. The pathologic diagnosis was leiomyosarcoma. Then, the patient was referred to Ghaem Hospital Tumor Clinic. The diagnosis of the second pathology review of the same specimen was placental site trophoblastic tumor. Serum hCG level was 119 milliunit in milliliter. The patient had no desire to preserve fertility, so hysterectomy was done. One week after surgery, hCG level was normal and now after 8 months, the patient is disease free.
Placental site trophoblastic tumor is a rare tumor which should be suspected in a patient who presents with term pregnancy and abnormal vaginal bleeding and a myoma in sonography.