مجله زنان مامائی و نازائی ایران
سال هفدهم شماره 119 (هفته اول آبان 1393)

Basic treatment of patients with cervical intraepithelial neoplasia is prevention of regress to invasive carcinoma. One of the treatment methods of these patients is conization. This study was performed with the aim to evaluate the related factors of remained dysplasia after treatment of cervical intraepithelial neoplasia (CIN) by cold knife conization. This Cohort study was performed on 25 patients with cervical dysplasia who were diagnosed in colposcopy and underwent cold knife conization with indication of conization in 2013. Based on the results of conization، hysterectomy was performed for the patients with high grade dysplasia، in-situ intraepithelial cancer، microscopic invasive cancer and positive margin specimens. Histology results of these patients were compared to pathologic result of the patients with dysplasia and negative margin conization who underwent conization for other reasons. Finally، the factors of remained dysplasia after treatment of CIN with cold knife conization were evaluated. Data was analyzed using statistical SPSS software (version 17) and T-test and Mann-Whitney test. P≤ 0. 05 was considered significant. Among 25 patients، only one case of conization specimen margin was positive for dysplasia that was appeared to be invasive Squamous cell carcinoma in performed hysterectomy. Other 11 patients who despite negative margin underwent hysterectomy، 4 patients (36. 3%) have high grade dysplasia (CIN III)، 1 patient (9%) have low grade dysplasia (CIN I) and 6 patients (54. 5%) were free of remained dysplasia in cervical pathology bioopsy after conization. The results showed that severity of cervical dysplasia with remained disease after conization is the factor of remained dysplasia after treatment of CIN. Severity of dysplasia is an effective prognostic factor patients in the possibility of remained dysplasia after conization in patients with cervical dysplasia، thus، close follow-up of these patients is recommended.

Relief of labor pain is one of midwifery the new cares. Nowadays، non-pharmacological pain relief methods such as acupressure are considered due to their low side effects. This study was performed with the aim to review the studies which evaluated the effect of acupressure on labor pain relief. All of the published articles up to 2013 in SID، Iranmedex، Irandoc، Magiran، Googlescholar، Pubmed، Medline، Embase، CINHAL، Cochran and IRCT which were performed on pregnant women with age 18-35 years، 37-41 gestational week، single-pregnancy، cephalic، and onset of active phase were assessed by Jadad scale. The articles with score ≥3 were selected. Finally، the results were reported as qualitative and quantitative. 18 clinical trials were assessed that 12 articles obtained score≥ 3 based on Jadad scale. Acupressure points used were SP6 in 7 articles، L14 in 2 articles، GB21 and SP6 in 1 article، L14 and BL67 in 1 article and L14 and SP6 in 1 article. Most of the studies showed the positive effect of acupressure on labor pain relief، but the side effects were not reported. Since many articles have been performed with high validity about the effect of acupressure، thus it can be suggested for labor pain relief. Since in the most of the high quality studies، SP6 and L14 were more used for labor pain relief compared to other points (GB21، L32، L67) thus this point can be suggested with more coefficient for labor pain relief.

Early diagnosis of congenital abnormalities at early of pregnancy and termination of these pregnancies can prevent from birth of defective newborns that are overload for family and society. This study was performed with the aim to diagnose aneuploidies by amniocentesis in high risk cases identified by first trimester screening test. This descriptive-analytic (cross-sectional) study was performed on 121 pregnant women that their result of Down syndrome and other Aneuploidy screening were high risk at first trimester of pregnancy (11 to 13 weeks and 6 days) and were referred to fetus medicine section of Tabriz Alzahra hospital to perform amniocentesis (15-20 weeks) in 2013. A questionnaire was used for data collection which includes demographic characteristics of the subjects، data obtained by the results of first trimester screening tests، and data obtained by amniocentesis (the results of fetus karyotype). Data was analyzed using SPSS software (version 13) and coefficient tests، T-Test، and ANOVA. P≤0. 05 was considered significant. Aneuploidy was detected in 11 newborns that 5 Down syndrome، 3 cases of trisomy 18، and 1 Klinefelter''s syndrome were identified. There were significant relationship between risk of Down syndrome and amniocentesis results (P= 0. 0001) and between increasing NT thickness and amniocentesis results (P= 0. 04). There was no significant relationship between demographic characteristics of the subjects and results of first trimester screening (P>0. 05). There were significant relationship between age (P= 0. 03)، number of delivery (P= 0. 047)، number of alive children (P= 0. 036) and history of anomaly in previous child (P= 0. 001) and amniocentesis results. In the present study، 10% of high risk cases identified by first trimester screening test were diagnosed as aneuploidy by amniocentesis.