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Background and purpose: Since estimation of weight in study of intrautrine growth retardation (ÏÜGR) is important therefore this study was conducted due to importance of weight in premature fetus and macrosomia and estimation of weight in mothers with premature rupture of membranes (PRÔM). Ïn this propective study it was tried to find out the best and possible formula to estimale the fetal growth on the basis of parameters such as: BPD, FL and ÂÇ.
Materials and Methods: Hundred pregnant mothers, referred to Ësfahan educational hospital, who delivered about a week after sonography were selected. The fetal weight was estimated according to parameters of BPD, FL and ÂÇ by four formulas (Three hadlock and one shepart) then compared with the real birth weight to achive the results.
Results: The results showed that Ë4 formula (one of the Had lock formulas using all the three parameters) is the best with standard deviation 28 g/kg.
Çonclusions: Due to the development in sonography and determination of BPD, FL and ÂÇ, the estimation of fetal weight is possible with a minimal error.

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Background and purpose: Neonatal icter is one of the most prevalent diseases in neonatal period and may lead to serious important complications such as kern icterus. For appropriate therapeutic approach to these patients, there is need of blood sampling and in some cases, repeated blood sampling, in order to measure bilirubin which causes certain complications such as infection, anemia, pain etc. Therefore non invasive measurement of bilirubin is an interest of researchers. Purpose of this study is to compare between measures of transcutaneous bilirubinometry (TÇB) and serum bilirubin (SB) in neonate patients.
Materials and methods: This study was a clinical trial and done by simple sampling.was method. Neonates admitted in NÏÇÜ and neonatal ward with clinical indication of measuring bilirubin were studied. Âfter giving instruction to the patients and matching TÇB measuring conditions, rate of bilirubin was labelled on forehead of the patients and serum bilirubin was measared by conventional method.
Results : From 105 TÇB and SB measurements, 49.5% were males and 50.5% were females. Gestational age of mother was 31.53 + 3.68 weeks and birth weight 1905.80 ± 778.50 grams. 76.6% of them at the time of sampling were under phototherapy and 18.1% were transfused. General correlation index between SB & TÇB was 0.686 and for females 0.750, birth weight between 1500 to 2500 grams, gestational age between 32 and 36 weeks (0.821) and in patient without phototherapy it was 0.699.
Çonclusion: This study revealed that, there is a favorable correlation between transcutaneous bilirubinometry (TÇB) and serum bilirubin (SB) in neonate patients. Thus TÇB can be used as a screening method.

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Background and purpose : The role of glycoconjugate terminal sugars on development of fetal tissues as inducing factors has been distinguished. Lectinhistochemistry tracing of α-L- fucose terminal sugar, defining its effective time and elucidating its specific role in development of the mouse kidney were among the main objectives of this study.
Materials and methods : Fetuses of Balb/c pregnant mice on 9th – 20th gestational days were fixed by formalin. Specimens were histologically parffinized after dehydration. Serial sections were done for preparation of 10 micrometer sections. Lotus tetragonolobus (LTÂ) lectin as specific tracer of α-L-fucose terminal sugar was diluted as standard solution (10 micrograms lectin in 1 ml PBS as defined by Sigma Çompany). Üsable sections which had been matched by alcian blue were posed to lectin. Then alcian blue was used as counterstain. Prepared sections were observed using light microscope and the range of reactions determined.
Results : The first reaction with LTÂ was observed on 15th fetal days. Range and intensity of reaction to LTÂ increased in higher gestational day. This phenomenon reached to maximum on 19-20th fetal days. Ôutstanding point was selective reaction of urinary tubes to lectin and other tissues were stained merely by alcian blue.
Çonclusion : Previous researches have confirmed that terminal sugars reveal in some stages of organogenesis and do their key roles on development. Ïn this study we observed that α-L-fucose reveals in 15th fetal day on urinary tubes and increases in higher days. Ït reaches to maximum in terminal fetal days. So we suggest that this terminal sugar has key role in development of urinary tubes.

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Background and purpose: Ultra sonography is the method of choice in pre-natal diagnosis of fetal anomalies however, sonography has limitations in oligohydramnios, maternal obesity and complex fetal anomalies. MRI, is a method with high contrast resolution, large FOV for fetus, placenta and uterine, along with multiplanar images. The aim of our study is to compare the sonographic and MRI findings in fetal anomalies by two radiologists who perform MRI test to show additional data relative to sonograpgy.
Materials and methods: This research was a case series study and performed in Imam Khomeini Hospital in Sari in year 84-86. All pregnant women with gestational age of more than 20 years were evaluated with sono-graphically for fetal anomalies by one radiologist. Additionally, patients with abnormal fetuses were evaluated with MRI testing and the MRI films were examined again after birth. The sonographic and MRI findings were matched together.
Results: The fetal anomalies in this study include: CNS abnormalities 47%, urinary tract abnormalities 39% and gastrointestinal abnormalities 14%.
Conclusion: The sonography and MRI findings were similar in 60.8% of cases studied sonographic findings were more than MRI in 8.6% of cases. MRI findings showed more than sonography in 30.4% of cases presented. Thus, MRI has a complimentary role in pre-natal diagnosis of fetal anomalies.

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Background and purpose: Premature rupture of membrane (PRÔM) is a common and challenging issue in obstetrics. Ëarly diagnosis of PRÔM and the consequent infection has a pivotal role in proper management of patients. The detection of PRÔM is easier in a case with visible vaginal fluid, but is difficult when trivial amount of vaginal fluid presents. Ïn this study, we aimed to assess the diagnostic value of LDH and creatinine in vaginal fluid for detecting PRÔM.
Materials and methods: Pregnant women were recruited in the third trimester (28-42 weeks) when attending prenatal care unit at Kowsar Ëducational hospital, Ghazvin, Ïran during 2008. Ünder sterile condition, vaginal fluid was collected using speculum. Fern test was performed and adequate vaginal fluid was aspirated from posterior fornix to measure LDH and creatinine.
Results: 223 pregnant women with mean age of 25.4±5.5 (16-43) years were recruited into this study. The mean of gestational age was 37.6±3.2 weeks. Visible vaginal fluid was detected in 72 (32.3%) while Fern test was positive in 56 (25.1%). Visible vaginal fluid detected by a specialist is considered as a gold standard test. Üsing RÔÇ curve analysis from SPSS, we have found that a cutoff point of >180 Ü/L for vaginal fluid LDH level is a reasonabl diagnostic value for PRÔM at sensitivity of 85%, specificity of 80%, PPV of 66.3%, NPV of 91.6% and an accuracy of 81%. The same analysis on vaginal creatinine using a cutoff point of >0.9 mg/dl showed diagnostic value with sensitivity of 72%, specificity of 35%, PPV of 34.7%, NPV of 72.6% and accuracy of 47%.
Çonclusion: Vaginal fluid LDH at a cutoff point of >180 Ü/L is clinically a useful diagnostic test for detection of PRÔM.

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Abstract Background and purpose: The most common serum used in culture media is fetal bovine serum (FBS). Given that FBS is costly, this study aimed at evaluating the hydatid cyst fluid (HCF) as a substitute for FBS in culture medium of fibroblast cells isolated from rat. Materials and methods: In this experimental study, skin dermal area from inguinal and abdomen of rat were used for fibroblast preparation. Fibroblasts cells were isolated using trypsin enzyme and then were cultured in RPMI medium (including 20% FBS). After sufficient cell growth, they were isolated and cultured in 24-well microtiter plate in three successive concentrations as follows: pure RPMI and RPMI medium supplemented with 10% and 20% FBS as control groups, and RPMI medium supplemented with 10% and 20% HCF. Then survival rate and proliferation level were checked in three successive days using invert microscope (morphology evaluation) and trypan blue 0.4% as vital dye (quantitative evaluation), respectively. Results: Proliferation and growth of fibroblast cells in RPMI medium supplemented with 10% and 20% FBS concentrations were normal during the three days with 95% survival rate. In contrast, fibroblast cells in RPMI medium supplemented with 10% and 20% HCF concentrations were converted from normal to spherical form over the three days and 80 % of them were alive. Conclusion: The results indicated that we can apply HCF as an alternative for FBS up to 72h in RPMI medium. It can also be used as transport or short maintenance media for fibroblast cells.

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Abstract Background and purpose: Paternal-fetal attachment behaviors areexpectantfather’s feelingtowards his unborn baby. These behaviors play very important roles in paternal identity, pregnancy outcome, and future growth and development of the baby. The severities of these behaviors are different between fathers and depend on many factors. The aim of this study was to assess paternal-fetal attachment behavior and some related factors. Material and methods: This cross-sectional study was carried out in 12 health centers affiliated to Tehran University of Medical Sciences. Four hundred expectant fathers who had wives in their 20-40thweeks of pregnancy were selected. Data was collected through aself-structured questionnaire and the paternal fetal attachment scale. Pearsoncorrelation, ANOVA, and t-test were applied to analyze the data. Results: Findings showed that factors such as ethnic groups, higher education, gestational age, planned pregnancy, baby’sgender, and attendingultrasound scans hadsignificant effects on paternal-fetal attachment. Previous marriage, fetal anomaly, tobacco use, multiparty and high risk pregnancy resulted in lower paternal attachment to the fetus.Norelationship was found between paternal-fetal attachment and being married to a relative, infertilityhistory, previous intrauterine fetal death or abortion, type of ultrasound, and attending prenatal classes. Conclusion: According to the factors influencing paternal-fetal attachments, enhancing the level of prenatal care by providing training and consultationswill help expectant fathers to accept their roles more easily and act more supportive towards their wives.

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Background and purpose: Around three million fetuses lose their life before birth each year. Recognizing the risk factors of these deaths could help in controlling and preventing at least a number of them. This study was conducted to determine the risk factors for uterine deaths. Materials and methods: This cross-sectional study was conducted in 225 cases of fetus uterine deaths aged >20 week that occurred in Mashhad Ghaem Hospital during 2011-2014. Data was collected using a researcher-made questionnaire in three parts (maternal, fetal and placenta characteristics). We investigated the epidemiologic information, diagnostic and therapeutic measures, and the process of disease before death including fetal, maternal, membrane and placental characteristics. Then influencing factors and causes of deaths were examined in a specialized committee. Results: The main risk factors for fetal death included idiopathic (86 cases, 38.2%), fetal (83, 36.9%), placental and umbilical cord (29, 12%), and maternal (27, 12%). The most prevalent maternal disease during pregnancy was hypertension (21.3%). Unclassified abnormalities (15 cases, 7.4%) and neural tube defects (14, 6.9%) were found more in dead fetuses. Placenta was reported unusual in 84 cases (37.3%). Conclusion: Controlling and appropriate treatment of maternal diseases in pregnancy, early detection and proper treatment of congenital anomalies, placenta and membranes problems could be of great benefit in reducing the rate of fetal death. Also, consulting and training programs for mothers who are more at risk during pregnancy, applying therapeutic interventions and proper management of delivery can be helpful.

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Fetus papyraceus is a rare condition that describes a mummified fetus during multiple pregnancies. In this condition one fetus dies in early pregnancy, while the other fetus/es continue to live. The cause is unknown, but it does not seem to be a coincidental event. It is believed to be the result of abnormal growth and development in early pregnancy. This study describes a case of fetus papyraceus that was diagnosed during labor.

In ultrasound examination of a pregnant woman (19 weeks and 4 days gestational age) she was found to be pregnant with twins. It reported one live fetus and one dead fetus. Delivery was performed in natural course at 38 weeks and 4 days gestational age in which a boy was born alive and apparently healthy (Apgar scores 9 and weighing 3000 grams), while the other was a dead fetus that seemed mummy weighing 800 grams.

Fetus papyraceus is rare and its early diagnosis is of great benefit in preventing severe complications. Full investigation of the fetus and placenta will help to determine effective factors in formation of fetus papyraceus.

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     Background and purpose: Maternal mental health has a major role in promoting the health of a mother and her family. Father’s involvement in pregnancy is one of the influential factors that promotes mental health in pregnant women. Therefore, this study aimed to determine the effect of paternal-fetal attachment on mothers’ mental health.
Materials and methods: A clinical trial was conducted in 60 primipara mothers and eligible spouses attending two health centers affiliated with Mashhad University of Medical Sciences. Convenient sampling and random assignment was performed. Goldberg's General Health Questionnaire was administered. The fathers in intervention group attended three 120-minute sessions of Attachment training (group discussion) once a week. Then, the effect of these trainings on the mental health of their wives was assessed at three stages: before, immediately after, and three weeks later. Data was analyzed in SPSS V22 applying descriptive and inferential statistics.
Results: Higher scores in mental health represents severity of the symptoms. In this study, the average mental health scores in intervention group at post-test (p=0.038) and follow-up (p=0.001) was significantly lower than those of the control group.
Conclusion: Paternal-fetal attachment therapy was found to be effective in increasing the mother's mental health and committed fathers were observed to have a major role in follow-up assessments.
 

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Background and purpose: Nausea and vomiting occur in 50-90% of pregnancies. Maternal-fetal attachment plays an important role in accepting maternal identity, the desired outcome of pregnancy, and the growth of child. This research was done to determine the relationship between pregnancy nausea and vomiting with maternal-fetal attachment.
Materials and methods: This Cross sectional study was carried out in 432 pregnant women at 13-20 weeks gestational age attending health care centers in Ahwaz, Iran 2016. Data was collected using the Rhodes Index of Nausea, Vomiting and Retching and the Cranley's Maternal-Fetal Attachment Scale. Data analysis was done applying independent t-test and Chi-square test in SPSS 20.
Results: In this study, the mean score for maternal-fetal attachment in women with nausea and vomiting was higher (91.38±12.122) than those without nausea (89.70±11.56) which showed no significant difference between the two groups (P= 0.141). But, there was a significant difference between the two groups in the scores for attributing characteristics to fetus 19.96±4.17 (P=0.17) and mother's self-sacrifice 20.33±2.75 (P= 0.38).
Conclusion: Nausea and vomiting during pregnancy did not show any significant association with the overall score for maternal-fetal attachment, but the aspects of maternal-fetal attachment indicated a significant association with pregnancy nausea and vomiting. Women who had more pregnancy nausea and vomiting had lower self-sacrifice and higher rate of attributing characteristics to fetus.
 

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 Background and purpose: There are many studies on the health effects of dietary advice and physical activity in pregnancy while only a few reported the effects of simultaneous administration of motivational interviewing, dietary advice, and physical activity on neonatal outcome in pregnant women with metabolic syndrome (MetS). This study was designed to examine the effects of these interventions on fetal-neonatal outcome in pregnant women with MetS.
Materials and methods: A randomized, single‑blind, controlled clinical trial was performed in 120 pregnant women with metabolic syndrome at 15- 20 weeks of gestation in two hospitals in Babol, north of Iran, 2018. The participants were allocated into two groups (n= 60 per group) using blocking randomization and were followed up until the end of pregnancy. Fetal-neonatal outcomes were compared between the two groups from week 32 of pregnancy. The interventional program included one motivational interview, two nutrition consultation sessions, and three sessions of physical activity (per week).  The control group received routine care. Demographic and fertility characteristics, anthropometric measurements, and biochemical and pregnancy outcomes were recorded. Data analysis was done applying independent t test, ANOVA, and logistic regression.
Results: The incidence of respiratory distress syndrome was found to be significantly lower in intervention group (3.7%) compared with the control group (14.5%) at the end of the pregnancy (P=0.01).
Conclusion: Dietary recommendations, motivational interviewing, and physical activity in pregnant women with MetS during prenatal care can be used as safe and practical interventions to prevent respiratory distress syndrome.

(Clinical Trials Registry Number: IRCT2017042333070N1)
 

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Background and purpose: Menstrual blood-derived mesenchymal stem cells (MB-MSCs) expressing CD44, CD90, and CD105 markers were recently introduced. These cells are a good source of stem cells for research and use in regenerative medicine due to uncomplicated collection without invasive surgical intervention or ethical issues. Cell culture is one of the most essential techniques in molecular cell biology, and the culture medium is the most critical component. Serum is one of the crucial components of the culture medium and a protective solution. One of the most common serums used in cell culture is fetal bovine serum (FBS). This serum is an unknown mixture and can contain unfavorable factors such as endotoxin, mycoplasma, viral contaminants, or prion proteins. Therefore, there is a need for a human substitute for FBS that can be utilized for clinical applications. In this study, a humanized protocol utilizing autologous serum (AS) instead of FBS is tested to investigate the expansion of MB-MSCs and exosomes released from these cells.
Materials and methods: A menstrual blood sample was collected from the donor on the second day of menstruation. Autologous serum samples were also collected to prepare the culture medium. First, mesenchymal stem cells were extracted from menstrual blood and then cultured in an environment enriched with autologous serum at different concentrations of 10%, 15%, and 20%. The investigation was done on the cells obtained in the third passage. Cultured cells in autologous serum were analyzed regarding expansion and expression of mesenchymal surface markers (CD73 and CD105). An inverted microscope was used to study the expansion, and flow cytometry was used to investigate the expression of mesenchymal markers. Also, in the next step, the culture medium of cultured cells in autologous serum was collected for exosome isolation. Exosome isolation was done by a three-step combination method of sedimentation, size exclusion chromatography with CL-2B sepharose resin, and making it concentrated. Finally, the purified exosomes were analyzed regarding morphology, size, and expression of CD9, CD63, and CD81 markers. Transmission electron microscope (TEM), dynamic light scattering (DLS), and flow cytometry analysis were operated, respectively.
Results: According to the observations, cell expansion was observed in all three concentrations of autologous serum, and the most favorable results were marked in the concentration of 15%. In addition, flow cytometry results indicated the expression of mesenchymal markers CD73 and CD105 in cells cultured with 15% autologous serum. Exosomes were isolated from the culture medium of mesenchymal stem cells cultured with autologous serum, and their characteristics were investigated using dynamic light scattering, transmission electron microscope, and flow cytometry techniques. The size of the exosomes ranged from 30-150 nm, and their morphology was cup-shaped. The expression of exosome markers such as CD9, CD63, and CD81 was also confirmed.
Conclusion: As a result, with the increase of using mesenchymal stem cells in regenerative medicine, it is imperative to ensure the safety of the process and materials used in this field. Therefore, autologous serum can be a suitable option for the culture of mesenchymal stem cells derived from menstrual blood.
 

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Background and purpose: The rising rates of cesarean sections represent a significant global health challenge due to their associated high costs and adverse maternal and neonatal health outcomes. In Iran, including the city of Ramsar, the rate of cesarean sections exceeds the national standards set by the Ministry of Health. This study aims to investigate this issue among primiparous women at Imam Sajjad Hospital in Ramsar, addressing concerns raised by the Ministry of Health.
Materials and methods: This descriptive-analytical study analyzed demographic data and the underlying reasons for cesarean sections among 123 primiparous women at Imam Sajjad Hospital during the years 2021 and 2022. Data were collected using a standardized checklist and analyzed using SPSS software, employing Chi-square and Fisher’s exact tests.
Results: The average age of the mothers was 29.24 ± 5.19 years, with an average height of 163.27 ± 5.15 cm. Female infants accounted for 52.8% of the total, and the mean Apgar score was 8.89 ± 0.59. The primary indications for cesarean sections were non-progression of labor (26.8%) and meconium-stained amniotic fluid (26.0%), both considered unpredictable factors. A significant relationship was found between the indication for cesarean section and the mothers’ educational level and place of residence (P≤ 0.05). However, no significant association was observed with the infant’s gender, maternal age, or gestational age.
Conclusion: Based on the findings, the causes of labor non-progression and fetal distress warrant further investigation. Additionally, educational interventions during pregnancy are recommended to enhance parental awareness.