طاهره خلیلی بروجنی

Ectopic pregnancy is a relatively common problem in women of reproductive age. This study was conducted with the aim of investigating the relationship between each of the treatment methods performed among women with a history of EP with their future fertility.

This cross-sectional study was conducted in 2020. A total of 207 patients who were diagnosed with EP in Al-Zahra and Shahid Beheshti hospitals in Isfahan between 2016 and 2018 were included in the study. Demographic characteristics as well as the data about the type of treatment (pharmacological treatment, radical surgery and conservative surgery) that were performed for the patients with previous EP were extracted from their health files. Then, during a phone call with the patients, they were asked about their fertility status after the treatment, then the fertility results of these people in different treatment groups were investigated and compared.

This study showed that women with past history of EP who were treated with medication had significantly more successful pregnancies than the surgical group. While the comparison between two types of radical and conservative surgical methods did not show a significant difference in pregnancy success.

Successful pregnancy was seen more in patients with previous EP who were treated with medications compared to those who underwent surgery. According to this study, radical and conservative surgery methods had no effect on the success of the next pregnancy.

There is a controversial effect of Tamoxifen in reducing breast cancer recurrences, while it may increase the chance of uterine cancer occurrence. In this study, we report a rare case uterine neoplasm shortly after breast cancer treatment.

A 50-year-old woman, gravida 6 live 5 and abortion 1, with history of treated breast cancer referred with the complaint of prolonged abnormal uterine bleeding from one year before. Her breast cancer was treated by surgery and Tamoxifen therapy, which was exchanged to letrozole after her new complaint. Although, no further evaluation had been performed earlier, recently uterine myxoid leiomyosarcoma was defined.

Tamoxifen is one of the most effective drugs in the treatment of breast cancer, but it can increase the risk of uterine cancer. In our case, after taking tamoxifen, she developed uterine leiomyosarcoma. As a result, users of this drug, especially in cases with symptoms such as abnormal bleeding, should be carefully screened for uterine cancer.

Retroperitoneal hematomas, as a rare but significant quantity in patients with history of recent operation, should be suspected in all patients who demonstrate signs of hypovolemia without apparent blood loss. Here, we have presented a rare case of postpartum hematoma to aware about this diagnosis in similar cases.

Case Report:

A 24-year-old gravid 1 woman with term pregnancy had tachycardia and oliguria after delivery with large episiotomy extended up to right fornix. After volume resuscitation, a tense tender swelling in the upper part and posterior lateral of vagina in vaginal exam was suspicious to retroperitoneal hematoma, and emergent laparotomy confirmed the diagnosis.

Post-vaginal delivery laceration extending from posterior vaginal wall to uterosacral ligament and rarely to para-vesical space can be a life-threatening emergency and a cause of maternal mortality. Careful examination and repair of extended episiotomy or laceration is the key factor to prevent retroperitoneal hematoma.

Infected pregnant women with new coronavirus (COVID-19) has raised concerns about the increased risk of complications due to pregnancy, the presence of predisposing factors, multiple possible diagnoses, and treatment limitations.

Case Report:

In this study, the status of two pregnant patients infected with COVID-19, who were referred to Amin hospital in Isfahan, Iran, in 2020, and were evaluated for prognostic factors. In both pregnant women, the definitive diagnosis of COVID-19 was confirmed by reverse transcription polymerase chain reaction (RT-PCR) nucleic acid testing. One in her second trimester of pregnancy with no obvious comorbidity, and the other in third trimester with poor medical and obstetric history. Despite pregnancy termination, they had experienced different and unpredictable complication and prognosis.</div>

It seems that the initial and course of laboratory findings, probably the gestational age, and prescription of anticoagulants agent, even in prophylactic dose, have a major role in prognosis of pregnant women with COVID-19.

Bilirubin level measurement through BiliCheck device can be a useful method in diagnosing neonatal jaundice due to no need for frequent blood-taking. Thus، the present study aimed to compare serum and transcutaneous bilirubin levels in infants with neonatal jaundice hospitalized in Hajar Hospital in Shahrekord. In this descriptive-correlation study، 417 infants with neonatal jaundice were examined. A questionnaire including demographic information (age and weight of infant at the time of reception، weight at the time of birth، age of pregnancy، and infant sex) was completed. As the infants were hospitalized، the blood-taking were done to control serum bilirubin based on the routine stages of the unit and transcutaneous Bilirubin level was controlled by BiliCheck device and the data were recorded. Pearson coefficient and independent t-test statistical analysis were used through SPSS software. From the total of 417 infants under this study، 322 infants were term and 95 infants were preterm. 51. 3% were male and 48. 7% were female. Weight average of term infants was 3081467. 88 and in the preterm infants، it was 2335572. 44 gram. The results indicated the linear coefficient was direct and meaningful between the serum and transcutaneous bilirubin levels in term and preterm infants. ‍ The findings suggested that mean difference of bilirubin levels on these two methods of measurement in term infants in different days were meaningful while there is no significant mean difference in preterm infants indicating the efficacy of this device in measuring bilirubin levels in preterm infants.