مجله زنان مامائی و نازائی ایران
سال پانزدهم شماره 27 (هفته اول آذر 1391)

Ovarian carcinoma is extremely rare in pregnancy. Prevalence of ovarian tumors in pregnancy is 1 case per 1000 pregnant women. This report is one case ofOvarian Adenocarcinoma in Pregnancy with Pulmonary Metastasis. Patient A 34-years-old pregnant woman with term pregnancy، fever، cough، and dyspnea was admitted at Qaem Hospital. The patient had severe distress respiratory so، endotracheal intubation was immediately performed. In her scenography، a huge abdominal mass was reported and on chest radiography، there were multiple pulmonary lesions. Cesarean section was carried out on the patient. During cesarean، unilateral salpingo-oophorectomy was implemented. On histological examination، ovarian adenocarcinoma was reported. The patient died after 10 days of admission. Investigating samples of pulmonary lesions، metastatic lesions were also reported. By immediate diagnosis of ovarian masses in pregnancy and proper treatment with surgery or chemotherapy، maternal death and perinatal mortality could be decreased.

Today، Cesarean section is the most common obstetric surgery. In the past 20 years، its rate has been increased from 5% to 20%. Unintended consequences in cesarean section are more than in vaginal delivery; especially for mother. The experiences have shown that the women who had consumed sisymbrium during their gestational had more successful vaginal delivery. The goal of this study is to determine the effect of sisymbrium seeds consumption at the end of pregnancy on the rate of cesarean delivery and Apgar score. This double-blind clinical trial was held on 68 eligible nulliparous women who referred to the Health Care Centers of the Rafsanjan city. Individuals were randomly located into case and control groups. 28 packets which contained 2mesghal (equal to about 5 grams) of sisymbrium – seeds were given to the case group from 37th week. Two-sectional questionnaire was used for data collection. Some parts were filled in seven Health Centers of Rafsanjan City and the rest was completed in the maternity by the trained midwives. Data were analyzed by SPSS statistical software version 16، independent T and chi-square tests. P value less than 0. 05 was considered statistically significant. According to the results، duration of first stage in labor (p=0. 022) and cesarean rate (p=0. 032) was significantly less in intervention group while spontaneous labor was more. But this difference was not statistically significant (p=0. 29). Apgar score in the first (p=0. 39) and the fifth minute (p=1) and intrauterine passage of meconium (p=0. 53) didn’t have any significant difference in two groups. Sisymbrium- seeds affect the parturition process by ripening cervix without increasing cesarean delivery or decrease of neonatal Apgar.

Different studies have emphasized the effects of the acupressure on labor and delivery، so its effects are as important as medical and midwifery factors. This study was aimed to evaluate the effects of the acupressure at Hugo point on the process and outcome of labor in nulliparous women. This quasi- experimental study was held on 100 nulliparous women who were admitted in Social Security Hospital of Ardabil city for delivery from October to March of 2010. 50 women were located in the case group (acupressure group) and 50 women in the control group (placebo group). The acupressure group received acupressure at Hugo point (between the thumb and index finger) but placebo group received acupressure at points other than Hugo point on two hands. This intervention was performed during contractions and in 4، 6، 8 and 10 cm cervical dilatation for 20 minutes. Then، duration of active phase، the second stage of labor، need for oxytocin during labor، labor pain intensity at the end of the first and second stage of delivery، Apgar score of neonates at first and fifth minutes، kind of delivery، mothers'' satisfaction of delivery experiences، and onset of breast feeding were recorded. The gathered data were analyzed by SPSS statistical software version 12، chi-Square، T، and Mann Whitney tests. P value less than 0. 05was considered statistically significant. The results of the study showed that acupressure at Hugo point reduced the length of delivery (p<0. 001)، need for augmentation with oxytocin (p<0. 001)، labor-pain intensity at the end of first and second stage (p<0. 001)، cesarean section (p=0. 026)، significantly increased mothers'' satisfaction of delivery experience (p=0. 006)، and early onset of breast feeding (p=0). Duration of second stage (p>0. 05)، Apgar score of first and fifth minutes were not significantly different in two groups (p>0. 05). Acupressure at Hugo point improves many outcomes of labor such as: length of delivery، need for augmentation with oxytocin، labor-pain intensity، cesarean section، mothers'' satisfaction of delivery experience، and breast feeding. Therefore، it can be used in normal deliveries without any complications.

Imperforate anus (IA) is a congenital abnormality in which the baby cannot excrete feces normally. The infant is born without a normal rectal opening. This disorder is the most common pediatric surgical problem. Since imperforate anus patients are operated in the first few days of infancy، diagnosis of other congenital anomalies is of vital importance. The present study was aimed to determine the prevalence of congenital heart disease in patients with imperforate anus. This retrospective-descriptive study was held on 97 patients with imperforate anus who were referred to Dr. Sheikh Pediatric hospital for surgery and were undergone echocardiography (2004-2009). Information about congenital heart anomalies and its type، infant''s gender، and age of mothers were recorded. Finally، overall prevalence of heart disease risk and affliction to its different types were measured and reported. Data were analyzed by SPSS statistical software version 14. In order to compare mothers'' age in cardiac and non-cardiac infants، T-test was used. And chi-square test was performed to compare the infants'' gender in two groups. No cardiac dysfunction was observed in 68 infants (70%) while 29 (30%) of them had congenital heart anomalies. 16 infants (55%) were male and 13 infants (45%) were female. The highest prevalence rate of congenital heart anomalies was in the Northern Khorasan. The most common congenital heart diseases were respectively: Atrial septal defect (45%)، ventricular septal defect (27. 5%)، ventricular septal defect with patent ductus arteriosus (10/3%)، and ventricular septal defect with atrial septal defect (7%)، and patent ductus arteriosus with atrial septal defect (3. 4%)، patent ductus arteriosus with ventricular septal defect and atrial septal defect (3. 4%) and tetralogy of fallot (3. 4%). This study confirms an increased risk of congenital heart disease among infants with imperforate anus.