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ABSTRACT Introduction & Objective: Ovarian hyperstimulation syndrome has been described after treatment with exogenous gonadotropins, clomiphen citrate and GuRh,s, but spontaneous form of this syndrome is very rare. This is a case report of spontaneous ovarian hyperstimulation syndrome associated with a case of spontaneous pregnancy and ovarian torsion. Case: The patient was a 30-year –old woman who was admitted due to abdominal pain from 1 week ago at 11 weeks gestation .In physical examination her abdomen was severely distended and diffusely tender and both ovaries were enlarged about 15 cm each and were tender. Ultrasonography revealed a single alive intrauterine fetus, 10 weeks gestation, with bilateral multilocular ovarian cysts with smooth surfaces and clear contents. Laboratory results showed low albumin and elevated CA125 (295 U/ml). She received 100g albumin and due to dyspnea a paracentesis was done. After 2 weeks she was readmitted with a complaint of right lower quadrant pain and tenderness and underwent laparotomy with diagnosis of right ovarian torsion. The ovary untwisted and several large cysts were aspirated. She had a normal vaginal delivery of a normal healthy female infant weighing 3100g at 40 week's gestation. Conclusion: Ovarian torsion and rupture should be considered in these patients. If surgery needed , untwisting of ovarian even if it is chemic and contron of bleeding seems to be enough.

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ABSTRACT: Introduction & Objective: Heterotopic pregnancy refers to the simultaneous occurrence of pregnancy intrauterine and outside of uterine corpus. It is most often manifested in women who have undergone artificial reproductive technology (ART) but rarely occurs spontaneously. Heterotopic pregnancy still remains as a diagnostic and therapeutic challenge to practitioners. In this situation physicians should have high suspicion for diagnosis and intrauterine pregnancy protection. This study reported a case of ruptured spontaneous heterotopic pregnancy. Case: A 32 year-old woman with abdominal pain, nausea, vomiting and hypovolumic shock in 1386 referred to emergency department in Sanandaj hospital. She reported one previous cesarean section. On examination, the patient's abdomen was distended. She had generalized tenderness and rebound tenderness in abdomen. The ultrasonographic examination revealed large amount of fluid in pelvic and abdominal cavity with a large hematoma in right adnex but there was intrauterine pregnancy at 7 weeks with normal fetal heart activity. She underwent laparotomy for heterotopic pregnancy and ruptured tube with tubal pregnancy removed. Intrauterine pregnancy continued without problem and led to birth of a healthy female neonate. Conclusion: Physicians should be quite cautious of heterotopic pregnancy in woman at reproductive age. Any abnormality on physical examination or ultrasonography of a patient with intrauterine pregnancy and abdominal pain should heighten the clinician's suspicion for heterotopic pregnancy

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Introduction & objective: Unilateral Twin Ectopic Pregnancy is very rare and only 100 cases have been reported till now. Bilateral Twin Ectopic pregnancy is the rarest type of Dizigotic twin pregnancy. We have reported a case of Bilateral Twin ectopic pregnancy with live simultaneous IIntra Uterine Pregnancy that its prevalence is unclear. We didn’t find any similar cases in the literature. Case: The patient was a 34-year-old woman with intermittent crampic pain in both abdominal lower quadrants for 2 days. The patient had a history of abortion and also a secondary infertility and HMG Injection. The ultra-sonography showed a 12 week pregnancy uterus with bilateral ovarian cyst where one of them was ruptured and a large amount of fluid in pelvic cavity was seen. Therefore, a decision was made for surgery. During operation, two much dilated non ruptured area in left falopian tube and two ectopic pregnancies in the right fallopian tube were seen which one of them was ruptured. Conclusion: Considering the ectopic pregnancy, when encountering women in reproductive age, is necessary and any pregnant woman with abdominal pain must be considered for.

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Introduction & Objective: Health control beliefs account for one of the most important indicators of health beliefs for planning health educational programs. It's also known as a main structure in understanding and predicting health behaviors. In addition, health control beliefs are predictor of health behaviors. Thus, they play a basic role in the pregnancy period. This study was conducted to assess the relationship between health controls beliefs and life style in the pregnancy period. Materials & methods: This cross-sectional analytical study was conducted at Gonabad University of Medical Sciences in 2008. The samples were 115 pregnant women referring to therapeutic – health centers of Gonabad, Iran, that were selected by simple random sampling. Measurement tools were consisted of three questionnaires: personal information inventory, multi-dimensional scale of health control beliefs and life styles questionnaire in pregnancy period. The collected data were analyzed using One-way ANOVA by the SPSS software. Results: The mean age and pregnancy age of the samples were 20±.27 year’s and 23 ±.6 weeks respectively. 83.5 percent of the women were householders, 41.7 percent had diploma and 54.8 percent were experiencing their first pregnancy. The highest scores of health control belief scale were related to internal belief, effective person belief and chance belief dimensions respectively. In addition, statistical analysis showed significant relationship between dimension of internal belief of health control and dimensions of nutrition and safety from life style in pregnancy period. Conclusion: The present study showed that health internal control belief is higher, in comparison to other two criteria, in pregnant women of Gonabad. However, thinking based health control beliefs, especially internal health control beliefs, can be strengthened by using appropriate teaching methods in pregnant women, as part of high risk group.

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Introduction & Objective: Unwanted pregnancies and its complications are one of the most important global problems related to mothers. The aim of the present study was to determine the factors affecting unwanted pregnancies in urban areas of the Kohgiloyeh and Boyer Ahmad province. Materials & Methods: In this case – control study conducted at Yasuj University of Medical Sciences in 2008 ,350 women were chosen as the case group, and 700 women as the control group. During the study, data collection forms were completed by each group. Subsequently, the collected data was analyzed using SPSS version 16 by using the logistic regression, univariate, and multivariate analysis. Results: According to the results of univariate analysis, the variables husband’s education in primary school , age of the last child under one, uncertain prevention methods and receiving means of prevention from the private sector revealed that significant differences existed between the two groups (P Value<0/05). Finally, the multivariate analysis beetwen husband education variables, age of the last child , prevention methods, and receiving a contraceptive device, a significant correlation was observed with unwanted pregnancy(P Value<0/05). Conclusion: Results of this study determined that three variables (contraceptive method, the place of obtaining means, and level of her husband education) are the most important variables which affect the chance of increasing of unwanted pregnancy in users of contraceptive methods.

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Abstract Background & aim: Proper nutrition is essential in the prevention and improvement of maternal problems and fetal health during pregnancy. The aim of this study was to determine the effect of nutrition education package on knowledge and nutritional behavior of pregnant women coping with problems and taking supplements during pregnancy. Methods: In the present clinical trial, a number of 88 pregnant women referred to health centers in Karaj, Iran, were selected and randomly divided into two groups (Intervention and control group). Two sessions of approximately 60 minutes including classes on nutrition during pregnancy was held for the intervention group using presentation, booklets, and educational film sex education with similar method was held for the control group. Data were collected through a questionnaire. The collected data was analyzed by analysis of variance with repeated measures analysis of covariance and logistic regression analyzes. Results: In the intervention group, in the field of knowledge dealing with problems during pregnancy and after the intervention supplements in two stages were significantly higher than the control group (p˂001). Scores in the intervention group in the field of nutritional problems during pregnancy included constipation, heartburn, swollen hands and feet, anemia and urinary tract infections during both stages of the intervention were better than the control group (p˂005). Iron and multivitamin supplementation in the intervention group during two phases after the intervention phase was better than the control group (p˂005). Conclusion: The content of educational package was evaluated as an appropriate policy in promoting nutritional knowledge and behavior among pregnant women. Key words: Education, knowledge behavior, nutritional supplements, pregnancy

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Background & aim: Recurrent pregnancy loss (RPL) refers to the occurrence of two or more consecutive losses of clinically recognized pregnancies prior to the 20th week of gestation. The aim of this study was to investigate the hypothesis that recurrent pregnancy loss (RPL) is associated with a common insertion-deletion polymorphism in the angiotensin-converting enzyme gene.. Methods: The present paper intended to study the ACE deletion (D)/insertion (I) polymorphism in women with recurrent abortion. One hundred patients with recurrent abortions (at least two) as cases and one hundred healthy female with two or more normal term deliveries and without a history of abortion selected as controls. Genomic DNA was isolated from peripheral blood leukocytes and the ACE insertion/deletion (I/D) polymorphism in intron 16 was performed by polymerase chain reaction (PCR). For the statistical analysis, SPSS software version18 was used and Chi-square tests were calculated. Results: Seven patients, (7 %), and non from the control group, were homozygote (I/I) for ACE polymorphism (OR=22.82 95% CI=1.26-412.69 p=0.034), depicting no significant associations between ACE D allele or DD genotype and RPL. Conclusion: The present study showed no significant associations between ACE D allele or DD genotype and RPL.

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Background & aim: Unwanted pregnancy increases maternal and child mortality and increases health centers workload. The purpose of this study was to estimate the additional workload caused by unwanted pregnancies in the province's health system of Kohgilouyeh & Boyerahmad province, Iran. Methods: The present cross-sectional study was conducted in the second half of 2009 on the prenatal care for pregnant women referred to city health centers. Frequency of maternal and child care were assessed according to the latest Ministry of Health guidelines. Average time required to provide each patient was calculated based on the role results, then added workload was assessed. Data were analyzed using SPSS software. Results: An overall 350 unwanted pregnancy cases were identified. Assuming the same unwanted pregnancies in the first half and the second year of 2009 total of 21,140 times the equivalent of 3696 hours of extra work visit were added to the labor working primary health care centers in the city. Conclusion: Unwanted pregnancies resulting in increased staff workload of health centers, and if not provided with sufficient manpower, it may lead to the reduction of maternal and child health care qualities of these centers.

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Background & aim: The effect of stress on the nervous system activity may be due to alterations in the structure of the nervous system. In this study, the effects of maternal stress was examined on the seizure threshold and hippocampal structure of their offspring during pregnancy. Methods: In this study, thirty pregnant mice were divided into two groups. 1) No stress group and 2) Stress group that received one hour immobilization stress from 1 to 14 day of pregnancy. The seizure threshold test was performed in offspring by injection of Pantilen tetrazol (PTZ). To study of the hippocampus development, the mouse offspring were divided into three groups: The control group no received immobilization stress on pregnant rat and their offspring also no received PTZ. The Sham group no received immobilization stress on pregnant rat but their offspring received PTZ. and experimental group that pregnant rat received immobilization stress and their offspring received PTZ. At the end of the experiences, all offsprings were killed by chloroform and their hippocampus fixed in and processed and 5µm sections were prepared and stained by the H&E method. The pyramidal and granular layers thickness in the Hippocampus were measured using Motic software and the number of cells in these layers and the number of blood vessels in the molecular and polymorphic layers were counted. The data were analyzed using ANOVA and T test. Results: The results showed a significant increase in seizure threshold in offspring whose mothers were under stress, compared with offspring whose mothers were not under stress. Average thickness of hippocampal pyramidal and granular in the experimental group than in the control group showed a significant increase (p<0.001). in addition, mean thickness of pyramidal and granular layers of hippocampus significantly increased in the experimental group compared to control group. The number of cells in hippocampal and granular layers significantly decreased in the experimental group when compared with control and sham groups (p<0.001). Conclusion: Prenatal stress can cause an increase in seizure threshold and also impair offspring's development and their hippocampal structure.

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Background & aim: Gestational diabetes is defined as diagnosing impaired glucose tolerance for the first time during pregnancy. The purpose of the present study was to compare the effect of aerobic and resistance training on fasting blood sugar, insulin and insulin resistance in women with gestational diabetes.

Methods: A total of 34 women with gestational diabetes voluntarily participated in the present Semi- experimental interventional study, which were selected from the available sampling pool. The participants were randomly assigned into 3 groups. 12 participants (age 28/92 ± 3/60 years) participated in an aerobic training group (3 days/week, 30-45 min/day, 50-70%maximum heart rate), 11 participants (age 30/27 ± 4/14 years) participated in a resistance training group (3 days/week, 2-3 set of 15 repetition, 50-70%maximum heart rate and Rating of perceived exertion), and 11 participants (age 29/18 ± 4/23 years)  were in control group who did not participate in any exercise program during the study period. Blood samples were collected in the pre-test and post-test to assess the level of blood sugar and insulin. Statistical analysis of covariance was used to compare the groups. The data were analyzed by the SPSS software (ver.23. The significant level was considered p≤0.05.

Results: The results of the present study showed a significant difference in insulin plasma levels  (p = 0.031), insulin resistance index (p = 0.008) and insulin sensitivity among groups. T-test results indicated a significant reduction in fasting blood sugar of resistance group (p=0.12) but no increase was observed in the aerobic group. At the levels of insulin, insulin resistance and insulin sensitivity, no significant changes were observed in exercise group.

Conclusion: It was concluded that resistance training compared with aerobic training was more effective in reducing fasting glucose levels in women with gestational diabetes.

 fasting blood sugar, insulin, insulin resistance, insulin sensitivity, pregnancy

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Background & aim: Pregnancy is every woman's stage of life. During this period, women experience physical, mental and social changes. It is very sensitive, challenging and therefore a critical period for every woman particularly in HIV-positive women. During pregnancy, an HIV-positive mother is facing a psychological crisis which includes fear of transmission to children, death, leaving children to the family or a guardian, adverse effects during pregnancy and the effects of pregnancy on their health. Therefore, HIV-positive pregnant women are vulnerable and require supportive interventions.  Care for pregnant women with HIV negative women are unique and different. However, no more information about experience of pregnancy in HIV positive women exists. Therfore, the aim of the present study was to explore the lived experience of pregnancy in HIV-positive women.

Methods: The present qualitative study with hermeneutic phenomenological approach included 12 HIV-infected pregnant women who referred to the counseling center for behavioral diseases at Imam Khomeini Hospital of Tehran University of Medical Sciences who were recruited through purposive sampling. Data were collected through semi-structured interviews. Data saturation was achieved after 16 interviews, each 40 to 90 min of duration with participants and then was analyzed by the method proposed by Diekelmann (1989).

Results: The participants in the present study were of 22- 39 years of age. After data analysis, the main themes and 3 sub-themes emerged. These themes included: “return to life” with the three sub-themes of experience of motherhood, stability and protection, and gratification.

Conclusion: The results revealed that although the experience of pregnancy in HIV-positive women was associated with a deep sense of fear of transmission of the disease and having children was viewed as a way of hope. Motherhood gave their lives meaning and provided for them to return to life. Understanding and awareness of all those are necessary for health care providers.The findings of this study emphasize on the need to design and implement comprehensive prevention strategies and interventions tailored to have a good feeling of pregnancy in these women.

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Background and aim: Ovarian pregnancy is an uncommon form of ectopic pregnancy which usually diagnosed so late. The aim of this study is to report a case of ovarian ectopic pregnancy

Case presentation: A 19 years old woman, with a history of polycystic ovary, first pregnancy, gestation age 9 weeks and 4 days, visited the doctor. She was complaining of severe abdomen pain and vaginal spotting and she was bedridden because of threatened miscarriage. She had discharged from hospital with progesterone suppository prescription. Requesting a transvaginal ultrasound and heterogeneous echogenic mass (size18×8/5) was shown near the left ovary. It was shown as ectopic pregnancy. The patient was hospitalized by ectopic pregnancy in ovary diagnosis and she was treated by methotrexate.

Conclusion: In pregnant women that complain of bleeding and spotting in early pregnancy, in addition to threatened abortion, ectopic pregnancy should exist even in the absence of clinical symptoms, should be considered.

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Abstract
 
Aim & Objective: Twin ectopic pregnancy is very rare and in most cases occurs due to the use of assisted reproductive treatments. This study reports a case of twin ectopic pregnancy and spontaneous one-way deals.
 
Patient presentation: Investigated woman was 28 years old with third pregnancy and abortion recored have a healthy child of five years, with bleeding due to threatened abortion, despite treatment with progesterone. Following ultrasound, ectopic pregnancy twin confirmed eight weeks and finally due to signs of uterine rupture, the mother was undergone salpingectomy.
 
Conclusion: The study reports a case of ectopic pregnancy, spontaneous unilateral twins, who had been threatened abortion treats incorrectly,
Therefore, in pregnant women with bleeding in early pregnancy are the common complaints, it is necessary to treat threatened abortion, ectopic pregnancy diagnosis should be considered.
 

 

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Background & aim: The purpose of this study was to design a questionnaire for prenatal health care in order to step through the design of a standard tool for measuring and promoting prenatal care. Reducing maternal mortality rates requires extensive management of various aspects of care during different stages of pregnancy. Therefore, the aim of this study was to design a management questionnaire for prenatal care.

 

Methods: This descriptive-comparative study was carried out to accomplish a comparative study among the advanced countries; therefore, a simple random sampling method based on the population and availability of information available to the three countries (Iran, Japan, and the United Kingdom) was selected. Required data were collected through referrals to official sites, scientific journals, books and databases, and identified the dimensions and indicators that affect health care management and were ranked by experts. Subsequently, with the opinion of specialists and experts, the initial questionnaire was prepared and reassessed by experts. The final questionnaire was distributed to 420 network administrators, randomly assigned to health experts. The data from the field study were analyzed using statistical methods (confirmatory factor analysis).

 

Results: In the present study, the reliability of the reagents, the composite reliability of the conceptual model, the convergent validity of the model and the differential validity were confirmed, and the indicators of the designed questionnaire included the contents of the package of care that included 15 questions; human resources care 8 questions, equipment and logistics 5 questions, system of statistics and information 3 questions, financial resources 5 questions and management of health care delivery 17 questions, reliability of reagents was confirmed by factor load above 0.7.

 

Conclusion: Designing a questionnaire and its application for prenatal care can help managers of Kohgiloyeh and Boyer Ahmad provinces focus on structures that are effective in promoting health care during pregnancy and can improve the quality and quantity of prenatal health care.

 

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Background & aim: Pregnancy and childbirth in most developing countries are major causes of illness, death and disability of women in reproductive age. Reducing the mortality rate of pregnant mothers requires extensive management in different aspects of care. Therefore, the purpose of this study was to determine and evaluate the effects of management model structures on prenatal health care in Kohgiluyeh and Boyerahmad province.

Methods: This is a descriptive-analytical and cross-sectional study carried out in Kohgiluyeh and Boyer Ahmad province on health network managers of affiliated cities, family health experts, health workers and midwives working in comprehensive health services centers in quantitative and qualitative manner in 2018. To collecting data, questionnaires were distributed among 420 target groups using multistage sampling method.  Descriptive statistics were used to describe the quantitative variables of the central indicators such as mean and standard deviation, as well as qualitative variables. Then, PLS software was used for path analysis, structural equation modeling, path coefficients and T values.

 

Results: In this study, 400 targets were participated, 70% of whom were female and the rest were male. Most participants (51.5%) were between 25 and 35 years of age. In this study, the effect of facilities and equipment on care (p <0.01), procurement management, care delivery (p <0.001), ICT system (p <0.001) and care contents (p <0.01), and financial resources (p <0.05) had significant effect, while HRM was not significant and had the least effect on prenatal health care management.

 

Conclusion: The results showed that provincial managers should pay special attention to the improvement of ICT structures, facilities, equipments and human resources management.

 

 

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Background & aim: Maternal infections are the most important risk factors to fetal health in humans, most of which are caused by viral agents. Viruses are among the most contagious infectious agents that can cause many complex and irreversible complications, including; Stunted growth, intracranial calcification, microcephaly and fetal death. The aim of the present study was to report a case of stillbirth in the second trimester in a pregnant woman infected with the new coronavirus (SARS-CoV-2).
 
Case Report: A 23-year-old woman with a first gestation and a gestational age of 23 weeks based on the first day of her last menstrual period, with fever symptoms and complaints of pain in the abdomen and flanks, along with a referral for a gynecologist (UTI) and to check the possibility of kidney infection refer to the gynecology department of Vali-e-Asr Hospital in Kazerun. An ultrasound performed one hour after the mother was admitted indicated that the fetus was healthy, but the next morning during the examination, the mother showed signs of severe shortness of breath and the fetal heart rate was not heard. The mother's lungs were scanned immediately and her infection with the new coronavirus (SARS-CoV-2) was confirmed. The new coronavirus (SARS-CoV-2) may alter immune responses in the mother-fetus relationship and jeopardize the potential risks of a cytokine storm following maternal infection.
 
Conclusion: Following the physiological adaptation changes in pregnancy, respiratory problems increase in pregnant women, so given the current state of the new coronavirus epidemic, it is necessary to provide more care of pregnant women.
 
 

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Background & aim: One of the emergencies of pregnancy is preeclampsia and eclampsia, which due to its complications, rapid diagnosis and treatment of these diseases is recommended. Preeclampsia is the third leading cause of maternal mortality in the world. Timely identification of this disorders and its risk factors in different areas can be useful in diagnosing, treating, and preventing its complications. The aim of this study was to determine the prevalence of preeclampsia, eclampsia and related factors in pregnant women who referred to the maternity ward of Imam Sajjad Hospital in Yasuj.
 
Methods: This is a cross-sectional descriptive study. The study population is pregnant women who referred to the maternity ward of Imam Sajjad Hospital in Yasuj in 2016.All pregnant women who had been admitted to Imam Sajjad Hospital, Yasuj, from April 2016 to the end of March 2017 with pre-eclampsia, had entry criteria that included: visits by a gynecologist, routine maternity care and Laboratory diagnostic tests were performed and after registering their profile, parameters related to their condition including complications of preeclampsia, clinical condition, recovery, and other items needed to achieve the goals of the study were recorded from the records of doctors and observations of doctors and nurses. Collected data was analyzed using Chi-square, Accurate and Fisher tests.
 
Results: The prevalence of pre-eclampsia was estimated to be 4.9%. No significant relationship was seen between the prevalence of preeclampsia, previous history of preeclampsia and blood pressure (p=0.07). It was also revealed that the prevalence of preeclampsia was higher in women with the first pregnancy and it decreases with increasing number of pregnancies. The result of this study indicated that the prevalence of cesarean section with preeclampsia is higher than in normal delivery.
 
Conclusion: The prevalence of preeclampsia in Yasuj was 4.92. it was concluded that the preeclampsia prevalence in Yasuj in 2016 is similar to that of the studies conducted around the world and our country. Although, it seems that hospitalization of pregnant mothers due to preeclampsia is not concern among other problems. Due to prevalence of preeclampsia and its complications and since prevention of this disorder is not currently possible in pregnant women therefore, timely and appropriate care should be taken during pregnancy for diagnosis in time and prevent adverse effects.
 
 

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Background & aim: Pregnancy at cesarean section is rare and delays in diagnosis and treatment are associated with maternal complications, but diagnostic and treatment methods are being studied due to its rarity and there is no standard protocol for pregnancy management at cesarean section. . The purpose of the present report was to provide a method of early diagnosis and treatment of pregnancy at the site of cesarean section.
 
Case Report: A 34-year-old woman with a second pregnancy, gestational age of 8 weeks and 3 days, and a history of a cesarean section complained of spotting and severe abdominal pain. The amount of β human placental gonadotropin (β-hCG) was reported to be 5600 mmol/ml. In transvaginal ultrasound, the gestational sac containing internal echoes without a embryonic pole was seen at the site of the previous cesarean section and the blood flow around the gestational sac. The patient was followed up for 3 days for spontaneous abortion of ectopic pregnancy or reduction of gestational sac size in the hospital. Due to the increase in β-hCG, dilatation and suction curettage and hysteroscopic resection were performed. Twenty-four hours after treatment, the first β-hCG, 191 mmol/ml, was reported. The next study was performed in two stages at 48-hour intervals and had a downward trend. Then, a week later, the β-hCG level was increased to 30 mmHg. The millimeter had arrived. After 11 days of follow-up, follow-up was stopped due to a decrease in β-hCG.
 
Conclusion: In the present patient, pregnancy at the cesarean section was diagnosed with transvaginal ultrasound in the early stages and appropriate treatment was performed with dilatation and suction cortex and hysteroscopic resection. In pregnant women, with the complaint of vaginal spotting and a history of previous cesarean section, the possibility of miscarriage at the cesarean section should always be considered to prevent further possible complications and the possibility of uterine removal.

 
 

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Background & aim: Background and Aim: Among working women, health professionals are more exposed to environmental factors and unfavorable working conditions than working women. A large group of health professionals consists of nurses and operating room staff who provide services in hospitals. For this purpose, the present study was conducted to determine the effect of unfavorable working conditions on the incidence of spontaneous abortion in operating room staff and nurses of teaching hospitals in Isfahan.
 
Methods: This was a retrospective analytical study. The statistical population included 300 women working in the nursing wards and operating rooms of Isfahan teaching hospitals during the years 2016-2017, by census sampling method. The data collection tool was a researcher-made questionnaire. The questionnaire consisted of 3 main parts; Details of total pregnancies and demographic information were adjusted to examine the demographic structure of the study group, occupational factors, and pregnancy outcome during the last pregnancy. Data were analyzed using t-test, chi-square and Mann-Whitney tests.
 
Results: In the present study, 13(8.7%) of women working in the operating room and 12 (8.1%) of women working in nursing wards had a history of spontaneous abortion in the last pregnancy, which was statistically different(p=0.85). 111 operating room staff(74%) experienced more than 3 hours of standing, 42(28.1%) more than 44 hours per week, and 57(38%) experienced a turbulent environment with almost constant noise. The operating room group was exposed to anesthesia gases (98%), sterilizing agents(94%) and x-rays(97%) which were statistically significant(p <0.05). Despite the difference in most unfavorable work situations, no significant difference was observed between the incidence of spontaneous abortion in the two groups(p=0.85).
 
Conclusion: Based on the results of the present study, the incidence of spontaneous abortion in the operating room group was not significantly different from women working in nursing wards.
 

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Abstract:
Background & aim: Pancreatitis is an inflammation of the pancreas that occurs acutely or chronically. Symptoms of acute pancreatitis include: epigastric pain, nausea, vomiting and in severe cases shock and even death. Pancreatitis should as well be considered as a differential diagnosis in pregnant patients presenting with epigastric pain. Therefore, the aim of the present study was to determine and report a case of a pregnant patient with acute necrotizing pancreatitis in Imam Sajjad Hospital of Yasuj.
 
Case Report: The patient was a 24-year-old woman, having her first pregnancy with a gestational age of 28-29 weeks. The patient had a history of 3 years of primary infertility following polycystic and hypothyroid ovaries and had been referred to the hospital with symptoms of abdominal pain, nausea and vomiting. The patient was asked for amylase and lipase tests as well as imaging to confirm necrotic inflammation of the pancreas. According to the surgical advice, the patient underwent hydration treatment, lack of oral nutrition, broad-spectrum antibiotics, and finally surgery to remove necrotic tissue. The patient was discharged in good general condition.
 
Conclusion: Acute pancreatitis during pregnancy can lead to many maternal and fetal complications, including maternal-fetal mortality and preterm delivery, which can be prevented with timely diagnosis and appropriate treatment.