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Background: Despite relatively easy access to contraceptive, the prevalence of unwanted pregnancy is high. The purpose of this study was to estimate the proportion of unwanted pregnancies and related factors among mothers delivering at 6 hospitals in Tabriz.
Materials and methods: In this cross-sectional study, 1576 women attended to 6 hospitals for delivery or abortion in September 2004 in Tabriz were interviewed. The questionnaire surveyed demographic characteristics, fertility history, contraceptive use, and willingness to pregnancy. The data were analyzed by multivariate logistic regression using SPSS and EPI software.
Results: Totally, 414(26.7%) women had unwanted pregnancy. Higher age (OR=1.06), higher number of live children (OR=1.37), and having history of unwanted pregnancy (OR=4.34) were associated with unwanted pregnancy.
Conclusion: Unwanted pregnancy is quite common in the region, thus, appropriate policies should be considered to eliminate this maternal health concern.

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Background: The present study was achieved to investigate the effect of Hypericum perforatum extract on abortion and any changes on embryonic development and oogenesis in pregnant mice.
 Materials and methods: A dose of 1.457g/kg body weight (approximate oral dose in human per day) of dried alchoholic extract of the plant dissolved in water were given orally to Balb/C mice strain, once a day for 7 days (after vaginal plug observation as day 0 of pregnancy up to day 7). Then experimental embryos were removed from uterus on day 15 of gestation and compared with 15 days control embryos. The external and internal morphological properties of all embryos and the survival rate were determined.
 Results: In all experiments, no conspicuous external or internal abnormalities in embryos were detected. The gross conditions of nervous system, liver, kidney and their development were normal as compared with sham and controls. There was no significant difference in the thickness of uterus wall and the number of endometrial glands among experimental, sham and control pregnant mice. However, in ovaries there were significant differences in some investigated parameters such as the number of corpus lutei cells and their diameters, and the number of degenerating follicles. Hormonal analysis of pregnant mice serum on day 15 of gestation showed a significant increase in the level of FSH and LH and a significant decrease in the level of progesteron as compared with those of controls.
Conclusion: Therefore, according to our results, it can be concluded that using Hypericum perforatum extract during pregnancy has no effect on embryos. It does not produce any abnormalities or change in development, and the significant decrease in the level of progesteron is not sufficient to produce abortion.

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Background: This study was designed to compare the benefits of intramuscular progesterone, 100 mg daily, and cyclogest suppository, 400 mg BID, to support luteal phase in IVF cycle.
Materials and methods: In this Clinical Trial study 162 patients, between 20-40 years, were selected for rapid Zift cycles. Seventy seven cases used 400 mg cyclogest suppository BID and 88 used 100 mg daily intramuscular progestron to support luteal phase. Age, duration of infertility, number of follicles and number of embryos were the variables which were assessed. Pregnancy rate and abortion rate were also compared between the two groups who underwent the treatment.
Results: Frequency of chemical pregnancy (positive β-HCG) was 27.3% in cyclogest and 30.6% in intramuscular progesterone group and there was no significant difference between two groups (NS). Clinical pregnancy, according to sonography findings on 5th week, was seen in 22.1% of cyclogest and 27.1% of intramuscular progesterone group (NS). Frequency of ongoing pregnancy was 15.6% in cyclogest and 18.8% in intramuscular progesterone group and there was no significant difference between two groups (NS).
Conclusion: In this study, the frequency of pregnancy, including chemical and clinical pregnancy, in intramuscular progesterone group was more than cyclogest group, whereas there was no significant statistical difference between two groups with regard to the number of cases. Therefore, we need to assess the study with more cases.

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Background: The relation between postpartum weight retention and pre-pregnancy BMI and parity is controversial. Pregnancy has been cited as a contributor to overweight in women. Retention of gestational weight can be a significant contributor to obesity related complications. This study was performed to identify the impact of pre-pregnancy BMI and parity on weight change and BMI at 6 months postpartum.
Materials and methods: In a prospective cohort study, 503 parous women, 15-45 years old who delivered full-term, without complication and exclusively breastfed till 6 months, were assessed at 6 months postpartum in Javaheri hospital and other related centers to Islamic Azad University in 1385. The participants filled out questionnaires. The survey measured woman's weight and height. The information was used to compute each woman's pregnancy BMI, pregnancy weight gain and postpartum weight loss. The samples were analyzed to assess the impact of pre-pregnancy BMI on weight change at 6 months postpartum in fixed parity and the impact of parity on weight change at 6 months postpartum in fixed pre-pregnancy BMI.
Results: There were no associations between parity, height, family income, contraception, mode of delivery, age and weight changes at 6 months postpartum. There were associations between pre-pregnancy BMI and weight changes at 6 months postpartum if parity fixed (p>2).
Conclusion: To our knowledge, overweight women before pregnancy have higher risk of postpartum weight retention if parity were 3 or more. These findings support the need of the guidelines for preventing major weight retention associated with pregnancy.

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Background: Preeclampsia is a main cause of morbidity and mortality of pregnant women worldwide. Recently oxidative stress was considered as a part of pathophysiolgy of preeclamsia and 8-iso-prostaglandin F2α (8-iso-PGF2α) is known as a marker of oxidative stress. The purpose of this study was to measure and compare plasma concentration of free 8-iso-PG F2α in women with normotensive and preeclamptic pregnancies.
Materials and methods: In this descriptive-analytic study, Plasma free 8-iso-PGF2α levels were measured in pregnant women with preeclamsia (n=42) and normotensive pregnant women (n=39) between 28-38 weeks of gestation. Women in two groups were matched in age, gestational age and socioeconomic statue and all women were nulligravid.
Results: Free 8-iso-PGF2α levels were not significantly different in women with preeclamsia and normotensive group (17808 vs. 24288 pg/dl, NS). Plasma free 8-iso-PGF2α levels were increased in severe compared to mild preeclampsia (NS). Neonates weight of preeclamptic mothers was significantly lower than neonates of normotensive women (p<0.0001).
Conclusion: Although free 8-iso-PGF2α is a marker of oxidative stress in vitro, but its measurement is not valuable in clinical medicine. However, further studies in normal pregnancy and preeclampsia will be needed.

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Background: Imatinib mesylate selectively inhibits bcr/abl and other non-specific tyrosine kinases and represents a model of targeted therapy for chronic myeloid leukaemia (CML) as well as gastrointestinal stromal tumors (GIST). This study was designed to evaluate effects of imatinib on pregnancy and development of fetus. Materials and methods: In this experimental study, imatinib was administrated orally at doses of 7, 12, 22, 50 and 100 mg/kg/day and control groups received sterile water. The pregnant rats were subdivided into 2 groups. In group one, the pregnant rats were sacrificed on day 18 of gestation and the number alive and dead of foetuses were checked. The brain of fetuses were fixed in formalin and embedded in paraffin for histological studies. Selected slides were stained with hematoxylin and eosin (H&E). In group two, the fetuses were allowed to become mature. The effect of drug on learning and memory were assessed by a passive avoidance method using shuttle box apparatus.
Results: Histological studies revealed no evidence of teratogenic effects of imatinib on development of frontal and parietal bones. Imatinib given in 100 mg/kg dose caused weight decrease (p<0.001) and increase mortality in fetuses (p<0.01). Administration of imatinib in 7, 12, 22 and 50 mg/kg doses showed statistically significant reduction in learning and memory of fetuses (p<0.05).
Conclusion: Imatinib can decrease development, learning and memory of fetuses. So, it is recommended that women treated with imatinib avoid becoming pregnant.

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Background: Prenatal care reduces the incidence of prenatal illness and death by health promotion, danger signs recognizing, and where to seek care for pregnancy complications. The purpose of this study was to determine the barriers of prenatal care and the relationship between the barriers of prenatal care and pregnancy outcome among women visited Tabriz hospitals.
Materials and methods: In this cross-sectional study, 140 mothers were selected by purposed sampling among women visited Tabriz hospitals. Data were gathered by questionnaires, mothers file and newborns identification card. Chi-square, T-test, Spearman correlation, Kolmogrov Smirnov and Kruskal Wallis were used to analyze data.
Results: There was a significant correlation between early married mothers (2%), low education of mothers (73%), low income for the family (73%), rented houses (46%), multi pregnancy (33%), many children in the family (25%), unwanted pregnancy (30%), usual complications in the pregnancy (67%), the lack of prenatal care in the previous pregnancies (27%), going to the centers at the time of problems (16%), the lack of encouraging factors (52%), inappropriate situation of clinics (30%), doctors office (17%), preterm labour (3%), fewer than 7 points of Apgar score (12%) in the first minute of birth, IUGR (3%), LBW (5%) and the adequacy of prenatal care (p<0.001).
Conclusion: The significance of prenatal contacts not only does the provision of quality and client-centered counseling and encourages pregnant women to obtain adequate prenatal care it also suggests safe motherhood programs should emphasize the education and communication content of prenatal care.

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Background: Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of azoospermic men. The aim of this study was to evaluate the factors interfering in the success of ICSI, including sperm collection method, testicular histology, age and hormonal assay of the couple, the number of retrieved oocytes, and the number of transferred embryos.
Materials and methods: In this retrospective cohort study, 246 azoospemic men (52 with obstructive azoosprmia (OA) and 194 with non obstructive azoospermia (NOA)) who were underwent sperm retrieval with PESA or TESE and ICSI protocol were studied. By long protocol of ovarian stimulation, oocytes were retrieved 36h after hCG administration. After 48h, cleaved embryos were replaced in the uterine cavity.
Results: Clinical pregnancy rates (21.1% in OA versus 10.8% in NOA) was significantly correlated with sperm origin (P<0.05). Female partner’s age and serum FSH significantly influenced pregnancy rates in both groups (p<0.001) and also pregnancy rates was significantly influenced by number of retrieved oocytes and transferred embryos in NOA groups (P<0.05).
Conclusion: ICSI can make a chance for fertility in azoospermic men. Higher success rates in OA patients can be related to better quality of sperm. The value of male hormonal assay and testicular biopsy was not remarkable.

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diagnosis is very difficult, confusing and challenging. Delay in diagnosis or misdiagnosis is potentially life threatening for mother. Case Report: In this report, a 27-year old woman complaining of abdominal pain and bleeding spotting with 3 weeks delay was referred to hospital. Diagnostic evaluations showed corneal heterotopic pregnancy. Corneal and oviduct was removed and the site was restored. Intrauterine pregnancy was aborted after a few days. Conclusion: Because cornual pregnancies are located at the most richly vascularized area, any rupture can cause heavy bleeding, acute shock and death. So, cornual pregnancies need accurate diagnosis and urgent treatment. Keywords: Pregnancy, Ectopic pregnancy, Heterotopic corneal pregnancy.

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Background: Prenatal Restraint stress (PRS) leads to cognitive-behavioral disorders and neuro-pathological deficits in children. The present study evaluated the effect of trichostatin A (TSA) on hippocampal level of pro- and anti-inflammatory cytokines in rat model of prenatal restraint stress.
Materials and methods: In this experimental study, 20 pregnant Wistar rats were randomly divided into 4 groups, including control, PRS+NS, PRS+TSA5, and PRS+TSA10. PRS was induced from 13 embryonic day, one hour per day during seven days. Two hours before PRS, administration of TSA was intraperitoneally performed. At the end of one month, the hippocampal levels of pro-inflammatory cytokines such as interleukine-1β (IL-1β), interleukine-6 (IL-6),tumor necrosis factor-α (TNF-α) and anti-inflammatory cytokine (interleukine-10; IL-10) were measured by ELISA technique. Statistical differences between groups were analyzed by ANOVA and Tukey post hoc test and p˂0.05 was considered statistically significant.
Results: A significant increase in pro-inflammatory cytokines content and decrease level of IL-10 in hippocampus were observed in PRS+NS group compared to the control (p˂0.05). However, TSA treatment was significantly decreased IL-1β, IL-6 and TNF-α and increased IL-10 compared to the PRS+NS group in dose manner (p˂0.05).
Conclusion: It seems that TSA with anti-inflammatory effects leads to the modification of hippocampal inflammatory cytokines and reduces inflammation in offspring’s hippocampus who exposed to stress in the prenatal period.

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Background: Due to the role of the markers of the first trimester of pregnancy in the adverse pregnancy outcomes and the inadequacy of studies conducted in Iran, in this study the frequency and relationship between adverse pregnancy outcomes in mothers with abnormal PAPP-A and free βHCG values were investigated.
Materials and methods: In this cross- sectional study, 501 pregnant women referred to Nasl-Omid Laboratory in Tehran between 2012 and 2016 were studied. Demographic data, medical history and serum values of PAPP-A and free ß-HCG of pregnant women were collected from their medical record or via telephone interview. Cut-off of the markers was considered as 0.4 MOM.
Results: A total of 501 pregnant women with a mean age of 29.14±24.4 years and a gestational age of 37.8±1.67 weeks were studied. 37.9% of pregnant women had abnormal levels of markers. In NT sonography report, subchorionic hematomas were reported in 17.2% of subjects. A significant relationship was found between maternal diabetes and hypertension and preterm delivery with PAPP-A (p<0.001 and p=0.02, respectively). There was also a significant relationship between subchorionic hematoma, preterm delivery and fetal death with free βHCG (p= 0.02, p=0.02 and p=0.009, respectively).
Conclusion: Diabetes, high blood pressure, and preterm labor are related to PAPP-A, and subchorionic hematoma, preterm labor, and fetal death are associated with free ß-HCG.

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Background: Fetal weight is a common index of health in neonates and determination of related factors would help to improve the conditions and outcomes. The aim of this study was to speculate the relationship between placental location and neonatal weight.
Materials and methods: We conducted an observational-prospective study on 87 pregnant women. Placental position was categorised by ultrasonography as anterior, posterior and lateral position. Demographic information, including age, early pregnancy weight, weight in the last week of pregnancy, height, gravid, parity, history of underweight in previous pregnancies and history of underweight in the husband family, was recorded in the checklist. Association of placental location with neonatal weight was noted in three groups.
Results: The highest birth weight was seen in cases with lateral placenta and the least weight was observed in anterior placenta cases and there was statistically significant association between placental location and neonatal weight.
Conclusion: Totally, according to the obtained results, it may be conducted that there is significant association between placental location and neonatal weight and the least weight was observed in anterior placenta.

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Background: Awareness of fetal gender at primary stages of pregnancy is very important. Fetal sex determination can reveal pressing information regarding fetal health. One of the methods of determining gender in the first trimester is according to the location of placenta. . This study investigated the accuracy and sensitivity of this method with trans-abdominal ultrasound in determining the sex of the fetus in the first trimester of pregnancy.
Materials and methods: In this analytic– cross sectional study, 192 pregnant women who were visited by obstetrical clinics in Rajaii hospital, Tonekabon, Iran in 2019 were chosen by convenient sampling method. Trans-abdominal ultrasound was performed among them. Inclusion criteria were pregnant women who were in their 7th-11th weeks of pregnancy and exclusion criteria were multiple pregnancies, abortion and reluctance to participate in the study.  The fetal gender was predicted based on the location of the placenta (right, left, anterior, posterior). The results were compared with the actual sex of the fetus after birth. SPSS- statistical software version 21 was used for statistical analysis. P-value<0.05 was considered as significant level.
Results: Out of 192 studied fetuses, 90 were female infants (46.9%) and 102 were male (53.1%). In 72% of the cases with placenta located on the right side, the fetus was male and in 70% of  the cases with placenta located on the left side, the fetus was female (P<0.05). The gender determination method accuracy in this study was 71.3% and the sensitivity for male and female sex determination was measured respectively 74.5% and 67.7%.
Conclusion: According to the results, right and left positions of the placenta had significant relation with fetal gender. More conducted research with larger sample size as well as more detailed investigations about placental location is strongly urged.

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Background: Nausea and vomiting of pregnancy (NVP) are one of the most common complications affects up to 80% of future mothers. A phase III randomized clinical trial demonstrated the efficacy of the doxylamine-pyridoxine combination [under the trade names of Diclectin® in Canada]. Doxylamine succinate-pyridoxine hydrochloride sustained release combination has been considered as a safe and well-tolerated formulation by pregnant women. Due to the high prevalence of NVP in Iranian pregnant women, we aimed in this study to formulate this combination.
Materials and methods: Direct compression method was used to prepare this formulation. First, tablets containing two active agents were prepared. Eudragit L100 and L10055 were used to coat the tablets. Then the coated tablets, were exposed to acidic conditions to ensure their stability in the stomach environment. All in-vitro evaluations were done. The analysis of the APIs was done using high-performance liquid chromatography coupled with ultraviolet detection, the HPLC method was developed and fully validated.
Results: Based on the dissolution test and release profile, the formulation containing 3.5% croscarmellose in the core and Eudragit L100-55 as coating polymer showed optimum similarity to the famous brand. In the optimized formulation, no significant release was detected in pH equal to stomach and total release happened in the intestine pH, similarity and difference factors for pyridoxine and doxylamine were 78% and 3% ,71% and 4%, respectively.
Conclusion: In this study, a comparable formulation of pyridoxine and doxylamine with famous brand was prepared for the management of NVP.