فهرست مطالب نوشین حاتمی زاده

Acute kidney injury after childbirth is a rare disorder. However, it can have long-term consequences for the mother and the baby. Among the risk factors causing acute kidney injury are placental abruption and preeclampsia. The purpose of this article is to describe a case of postpartum acute renal failure that occurred in connection with placental abruption and preeclampsia.

Case report: 

The patient was referred at 33 weeks and five days of gestation based on ultrasound with complaints of labor pain and vaginal treatment. Our report is an interesting case for several reasons: a patient underwent a cesarean section with suspicion of placental abruption and was then treated for suspicion of preeclampsia and finally diagnosed with acute renal failure. Also, differential diagnosis was difficult due to the increase in liver function tests and the outflow of serous fluid.

Paying attention to the risk factors of Acute kidney failure plays a significant role in better management of midwifery services. Therefore, placental abruption and its risk factors should be carefully evaluated as an independent risk factor for perinatal mortality.

Preterm premature rupture of membranes (PPROM) is one of the important causes of perinatal mortality. This study aimed to compare the effects of azithromycin and erythromycin on pregnancy outcomes in mothers with PPROM.

In this clinical trial study, patients diagnosed with PPROM between 24 and 34 weeks were treated with two drug regimens. Group A (n = 30) received oral azithromycin one-gram single dose and Group B (n = 30) received oral erythromycin 400 mg every 6 hr for 7 days. In addition, both groups were treated with intravenous ampicillin 2 grams every 6 hours for 48 hours and then amoxicillin 250 mg orally every 8 hours for 5 days. Primary outcomes including latency period and clinical chorioamnionitis and secondary outcomes including the type of delivery, amniotic fluid stained with meconium, postpartum endometritis, neonatal sepsis, baby's birth weight, and live birth rate were compared between the two groups.

In the current study, the latency period was significantly higher, while postpartum endometritis and laboratory-confirmed neonatal sepsis were significantly lower in the azithromycin group than in the erythromycin group. Other outcomes did not show significant differences between the two groups.

Azithromycin is more effective than erythromycin in the increased latency periods and decreased postpartum endometritis and neonatal sepsis in women with PPROM. Therefore, azithromycin can be a suitable alternative to erythromycin in the treatment of PPROM.

Coronary artery diseases (CAD) are leading causes of death in developed countries. Also, 10-15% of elderly people of the United State of America have gallstone. These two diseases have similar risk factors, such as obesity, elderliness, diabetes, hyperlipidemia, and hyper tension. Determining the correlation of coronary artery disease and gallstone is the main Aim of this study. This analytical cross-sectional study was done on 130 patients whom were suspected to CAD and have been referred to Shohadaye Kargar Hospital of Yazd echocardiography department. They have been randomly selected and echo test and sonography have been done for all by expert specialists. Data were analyzed by chi-square, Exact Fisher and Mantel-Haenszel tests. Stress test were negative in 80 (61.53%) and were positive in 50 (38.47%) patients. Of 80 negative stress test subjects, negative gallbladder sonography was observed in 77 (96.25%) patients; while in 3 (3.75) patients gallbladder sonography was positive. Among 50 positive stress test patients, 42 (84%) and 8 (16%) patients had negative and positive gallbladder sonography, respectively. There not found statistically significant association between CAD and gallston (p= 0.022). Patients who had coronary artery disease, compared with healthy individuals, are at increased risk of gallstones. In men older than 50 years suffering from vague upper abdominal pain, Liver and gallbladder sonography ultrasound is recommended for detection of probable biliary stones.