مجله زنان مامائی و نازائی ایران
سال هجدهم شماره 139 (هفته اول فروردین 1394)

Determining of gestational age is of great importance in prenatal care. Nowadays، sonography is accepted as the best method of calculation of gestational age. But as pregnancy enters into the third trimester، the accuracy of parameters determining the gestational age by ultrasound decreases. Therefore، there is a need to new ultrasonic parameters. This study was performed with the aim to evaluate the correlation between gestational age and fetal colon diameter; and finally establishing a normal range of colon diameter in Iranian fetuses. This cross-sectional study was performed on 100 pregnant women who had referred to the hospitals of Islamic Azad University of Mashhad for routine ultrasound assessment at third trimester in 2013-14. The patients underwent sonography. The maximum diameter of fetal descending colon was measured in transverse section، then its correlation with gestational age was assessed by Pearson correlation test. Data was analyzed by SPSS software (Version 16). From 100 screened fetuses، 60 fetuses aged 38 weeks or more، and 40 fetuses aged less than 38 weeks. The minimum and maximum of measured colon diameter in preterm fetuses were 10. 9، 13. 4، respectively and in term fetuses were 13. 5، 17. 9 millimeter، respectively. Statistical analysis showed a significant relationship between gestational age and colon diameter (P=0/98). there is a good linear relationship between gestational age and fetal colon diameter; therefore، it can be used as an independent biometry for determining of gestational age. Also، colon diameter seems to be a good marker for identifying term fetuses.

Anxiety is one of the psychological problems in pregnant women that sometimes takes the pathological form and affects the mental health of mother. This study was performed with aim to determine the effects of fetal movement counting on general health of mother. This Quasi-Experimental study was performed on 208 nulliparous women who were randomly divided into two groups. At 28 weeks of gestation، they completed the GHQ-28، then the intervention group started to count fetal movements from 28 to 37 weeks of gestation and the control group received routine care. Again، both groups completed the questionnaire at 37 weeks of gestation and the results were compared. Means scores of GHQ in intervention group at 28th and 37th of pregnancy were 23. 52±10. 23 and 21. 09±10. 12، respectively that the difference was significant (P=0. 025). The means in control group were 23. 69±9. 43 and 23. 88±8. 60، respectively that the difference was not significant (P=0. 52). In comparing the mean scores in two groups، it was found that the difference was not significant at 28 weeks of gestation (P=0. 37)، but it was significant in 37 weeks of gestation (P=0. 002)، and counting of fetal movements could improve the mental health of mothers compared to control group. There was no significant difference between two groups in the mean frequency of maternal concern about decreased fetal movement (P=0. 36)، hospitalization due to it (P=0. 25) and the mean of gestational age at the time of decreased fetal movement (P=0. 19). Counting of fetal movements by mother at 28 to 37 weeks of gestation improves the general health of mother.

All women with prosthetic heart valve should undergo long-term treatment with anticoagulants drugs. Anticoagulants suitable for use in the treatment of pregnant women with prosthetic heart valves has met with controversy. Due to limited information on the strategies used in the treatment of pregnant women with prosthetic heart valve، this study was performed with aim to evaluate the advantages and disadvantages of the use of anticoagulants in pregnant women with prosthetic valve to achieve key points for medical use.

To access the performed studies about anticoagulant therapy in pregnant women with prosthetic valve، databases of PUBMED، MEDLINE، SCOPUS و EMBASE و DARE and also، related keywords were used. Last guidelines related to the coagulant therapy after surgery of prosthetic heart valve were studied.

best coagulation regimen in pregnant women with mechanical valve is using warfarin with dose <5 mg.