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Introduction: Nausea and vomiting are among the prevalent complaints in pregnancy, but there is a controversy about their treatments. At present, because of the problems caused by these complaints for mothers and incompatibility with drug treatments physicians prefer to use non-drug interventions such as acupressure. In this study, we evaluated the effectiveness of acuptessure in treatment of nausea and vomiting in pregnancy.
Materials and Methods: This was a randomised clinical trial study. 120 pregnant women with nausea and vomiting complaints that submitted in prenatal clinics and referred to Alavi pain clinic in Arak were investingated.
After filling out of questionnaires, the participants were alternatively divided into case and control groups. In case and groups, wrist band (for 90 minutes) was fastened in appropriate and non-appropriate sites, respectively. The subjects were followed up at 24 hours in 3 times visit and their responses to treatment were evaluated.
Results: The incidence of nausea and vomiting in the case group was significantly lower than control group. The rate of improvement of patient symptoms in the case group was six times higher than control group. No serious side-effect was observed in studied population.
Conclusion: Our findings indicated that acupressure is a safe and appropriate method used for treatment of nausea and vomiting in pregnancy.

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Introduction: An association between depression and altered immunity has been suggested by a number of studies but has not been consistently demonstrated .The effect of maternal depression response on fetal immune system have not been investigated. Thus in this study we evaluated the effects of depression on some parameters of innate and humoral immune system of pregnant women and their infants. Materials and Methods: 62 pregnant women (including 32 depressed and 30 healthy) and their infants in Taleghani hospital of Arak in 2004 were included in this study. All depressed mothers had a diagnosis of depression by Beck Depression Inventory (BDI) and clinical interview based on DSM-IV system. The level of immunoglobulins and components were evaluated by single radial immunosdiffusion (SRID) method of Mancini. Leukocyte and lymphocyte counts were determined by Hycel (an automated cell counter) and for more accurancy were also evaluated by manual method. Statistical analysis was performed using K-S, Mann-Withney, One way ANOVA, Kruskal-Wallis and Pearson tests. P<0/05 was considered significant. Results: Serum IgM level and serum C4 level of infants of mothers with depression were significantly lower than infants of healthy mothers. Lymphocyte number and percentage in infants of depressed mothers was also significantly higher than infants of healthy mothers. The mean cord/maternal blood ratio of IgG in infants of depressed mothers was also significantly lower than infants of healthy mothers. Serum IgG level of depressed mother was significantly higher than other mothers. Conclusion: Fetal impact of stress and depression during pregnancy is just beginning to be understood and research in this area is developing. Our results indicated that maternal depression adversely affects the development and function of fetal immune system. These results are in agreement with the immunological findings of preterm and LBW infants.

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Introduction: About 21 millions low birth weight infants are born throughout the world and have less surviving chance compared to death rate of infants due to other causes. The aim of this study is to determine the relation of mothers' nutrient intake in the last trimester with the delivery of low birth weight infants. Materials and Methods: This Cohort study with a 3-months follow up was carried out on all the pregnant mothers visiting health care centers in Shahrood during their third trimester. Simple sampling was done and samples included 424 subjects. One-week food record of subjects was documented biochemical and hematological tests and also anthropometric examinations were done, and demographic data were gathered. The infants’ birth weight was measured after delivery. Data was gathered by a questionnaire and analyzed using Chi square, Mann-Whitney and Leven tests and logistic regression. Results: Total number of 424 pregnant mothers was studied in accordance with their amount of energy and protein intakes, and was classified in two groups of adequate and inadequate status. It was disclosed that 75% of mothers received low energy (less than 2500 k cal) and 20% were low in protein intake (less than 60gr). Low birth weight prevalence was detected to be 13%. Among low birth weight infants 14%, 25% and 43% were attributed to mothers with low energy, low protein, and non-iron tablets intake respectively. There was a significant relationship between birth weight and iron supplementation (P=0.015), as well as multi-vitamins (P=0.048) during the last trimester of pregnancy. It was also disclosed that the probability of low birth weight infants among low weight mothers was 86%. Conclusion: According to the results there is a significant relationship between mother's nutritional status in the last trimester of pregnancy and infant's birth weight, so it is recommended that mother's weight gain especially in the third trimester and using adequate supplementations be considered.

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Introduction: Abdominal pregnancy is 1 in 10000 live births and advanced abdominal pregnancy is rare. Abdominal pregnancy is associated with high morbidity and mortality with the risk for death 7 to 8 times greater than tubal ectopic pregnancy and 90 times greater than intrauterine pregnancy. In this article a case of advanced abdominal pregnancy is reported. Case: The patient was a 35 year’s old (G4P3) woman presented with undelivered pregnancy after two years. After diagnostic procedures laparatomy was done. During the operation, fetus adhesion to the omentum was released. A 9 kg calcified fetus was delivered. Then the placenta and left adnex was removed completely. Conclusion: Regarding the high mortality rate of abdominal pregnancy, in every pregnancy specially in the precence of it’s risk factors (such as PID, history of ectopic pregnancy, history of infertilitry and using drugs to induce ovulation, IVF, prior tubal surgery and …) and also suspicious symptoms, this probability and early intervention must be considered.

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Background: Backache is a common problem in pregnancy period . Scientists believe that some simple exercise can help to prevent the occurrence of backache during their pregnancy period. Thus, this research carried out in order to investigate the effect of some simple exercises and correct daily activity in prevention of backache in pregnancy period. Methods and Materials: This is a clinical trial study that was carried out on 138 of pregnant women .The first group including 66 women which considered as control group and treatment group including 72 women. The research had four stages: 1) stage of taking history. 2) Arrange a teaching program. 3) stage of performance( In case group samples were done 60 minutes aerobic exercises for 3 days a week for the 30 weeks undersupervision a physiotherapist). 4) Assessment the results. Data were analyzed by SPSS for statistical analysis. Results: According to the result 18.2% of woman that were under treatment and 36.6% of control group, suffered from backache. Chi-square test showed significant differences between two groups. In addition Odd ratio of treatment population was 2(CI%95 = 4/04-1/91 & p<0/05). Conclusion: The result showed simple exercises during pregnancy period can not eliminate backache, but it can decrease delay backach.

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Background: Brucellosis is a zoonotic disease which is endemic in Iran. Infection with brucella species during pregnancy can have negative impacts on the outcome of pregnancy however, there is no consensus on its leading to abortion or other severe complications. The aim of the present study is to determine the role of brucellosis in pregnancy and to characterize the risk factors, clinical presentations, and immunology of brucellosis based on the existing reports. Materials and Methods: In this review article, we studied papers on Pubmed, Elsevier, Cohrane, SID, Ovid, ISC, and IranMedex through such keywords as brucellosis, abortion, intra-uterine fatal diseases, and preterm labor. Results: Among the original research papers, 51 were found to be related to the title of this study and dealt with the outcome of brucellosis on pregnant women and had discussed the complications of pregnant patients suffering from brucellosis. Conclusion: According to the investigations made in this study, brucellosis in pregnancy can manifest as normal delivery, increased incidence of spontaneous abortion, intra-uterine fatal diseases, and premature delivery. Therefore, in endemic areas, especially those with inhabitants of low socioeconomic class, educating girls and women of childbearing age about brucellosis and its dangers and risk factors and isolating pregnant women may help prevent the disease and its complications in pregnancy. Moreover, further immunological investigation on the role of immunological reactions following brucellosis infection in pregnant women is required.

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Background: Measurement of mean arterial blood pressure is better predictive factor for pregnancy-induced hypertension than measurement of the systolic and diastolic blood pressure or systolic blood pressure. According to the theory of “protective effect of fish oil supplementation on pregnancy-induced hypertension “and the importance of blood pressure control in pregnancy, the present study was conducted to investigate the effect of fish oil supplementation in pregnancy on mean arterial blood pressure. Materials and Methods: In this clinical trial study, 120 healthy pregnant women were randomly divided into two groups of 60 persons. Same prenatal care was performed for both groups and the intervention group was received Salmon fish oil capsule 1000 mg/day, from 16th week to the end of the pregnancy. Systolic and diastolic blood pressure were measured in both groups once every four weeks up to 28th week, every 2 weeks from 28th till 36th week and once every week up to the end of pregnancy. Mean arterial blood pressure was calculated and all gathering data was analyzed with T test and Mann-Whitney test. Results: Mean arterial blood pressure in the intervention and control group was 80.76±5.50 and 78.46±4.50 mmHg which was not significantly different (p>0.05). Conclusion: The results showed that adding fish oil supplements to the diet of pregnant mothers had no significant effect on mean arterial blood pressure.

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Background: Multiple sclerosis, an immune-mediated demyelinating disorder, is one of the most common diseases of the central nervous system. Two-thirds of patients with multiple sclerosis are women in their child bearing age, 20s and 30s. Multiple sclerosis is followed by neurological disability in young people. The purpose of this study was to determine pregnancy outcomes in patients with multiple sclerosis and compare them with healthy pregnant women. Materials and Methods: In this cohort study,37 pregnant women with multiple sclerosis and 73 healthy pregnant women were compared in terms of pregnancy, child birth, and infant variables. Patient information was collected through questionnaires and evaluated using independent t-test, Chi-square, and Mann-Whitney test. Results: The results showed that pregnancy complications like preeclampsia and gestational symptoms in women with multiple sclerosis were higher than the control group (p=0.001). Instrumental delivery was more in women with multiple sclerosis (p=0.05) and there was not a significant difference between the two groups in terms of neonatal outcomes. Conclusion: The resultsof this study show that some of the complications of pregnancy are higher in women with multiple sclerosis. Also, normal delivery and instrumental vaginal delivery were more in women with multiple sclerosis that couldbe due to fatigue in this population. Hence, these findings should be taken into consideration in planning andmanaging pregnant patients.

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Background: Considering the lack of a standardized and validated questionnaire on oral health care for pregnant women based on a specific behavioral pattern, the aim ofthis study was development and psychometric assessment of an oral health instrument based on Health Belief Model in pregnant women. Materials and Methods: This cross-sectional study was carried out on 340 pregnant women in Arak city. After reviewing the related literature, the instrument was designed and its content validity ratio, content validity index, face validity, and exploratory factor analysis were measured. For measuring the reliability of the scales, three methods, including test-retest, internal consistency, and agreement, were used. Data analysis was done using SPSS software. Results: The reliability of the 61 items was evaluated with impact score of 1.5 and the content validity index of 0.79 and based on exploratory factor analysis were classified into seven categories. The overall reliability measured through Cronbach alpha was 0.84. The reliability of the questionnaire was 0.88, perceived susceptibility was 0.73, severity was 0.70, perceived benefits was 0.75, perceived barriers was 0.71, the cues to action was 0.72, and self-efficacy was 0.76. Kappa coefficients were determined with a high performance for checklists. Conclusion: This study provided good evidence of the strength factor structure and reliability of Health Belief Model structures about oral health behaviors in the vulnerable group of pregnant women, according to the study of psychometrics process.

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Background: Today, ultrasonography has become the main tool used for the evaluation of fetal anomalies. The aim of this study was to evaluate fetal heart rate changes immediately after combined two- and 4-dimensional ultrasound.

Materials and Methods: This study was performed on 191 pregnant women aged 15 to 45 years old who were referred for 4-dimensional ultrasonography in summer 2013. Before the onset of 2-dimensional ultrasonography, baseline fetal heart rate was measured by ultrasound. At the same time, the maternal heart rate was recorded during one minute. Then, combined ultrasonography was performed and same parameters were recorded at the end.

Results: Maternal heart rate significantly decreased after combined ultrasonography (p=0.0001). Fetal heart rate did not differ before and after ultrasonography (p=0.693).

Conclusion: Four-dimensional ultrasonography has no effect on fetal heart as an indicator for evaluating the fetus temperature.

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Background: The pathogenesis of recurrent pregnancy loss includes complex interaction of several genetic and environmental factors. Changes in blood coagulation factors during pregnancy may play an important role in the occurrence of recurrent abortions (RA). Recently, inherited thrombophilia has been considered as a possible cause. Therefore, in this study we have investigated association of factor V (G1691A) and factor II (G20210A) polymorphisms in Iranian patients with recurrent abortions.

Materials and Methods: A total of 203 women participated in this study: 105 women with two or more consecutive unexplained miscarriage as cases and 98 women with at least two healthy children as control group. Total genomic DNA was isolated from Peripheral blood leukocytes. The presence or absence of mutation in the FV (G1691A) and FII (G20210A) polymorphisms were assessed by PCR-RFLP, using Mnl1 and HindIII digestion enzymes, respectively. Finally, the data were  analyzed using Chi-Square test.

Results: The results showed no statistical significant differences in the prevalence of FV (G1691A) and FII (G20210A) polymorphisms between patients and control group.

Conclusion: considering the results of this study, these polymorphisms Seem to have no role in etiology of recurrent pregnancy loss in the studied population.

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Background:  Recurrent pregnancy loss (RPL) is defined as the occurrence of two or more consecutive pregnancy losses prior to 20^th week of gestation. There are several leading causes of RPL including uterine anatomical defects, infections, genetic, immunological, and environmental factors. However, despite in a large number of cases no causes have been identified, therefore, it is introduced as idiopathic.

Recent studies have implicated the role of miRNAs in endometriosis, preeclampsia, infertility and RPL. Therefore, the aim of the present study was to investigate the association of miR-196a2C>T (rs11614913) with RPL in Iranian women.

Materials and Methods: In this case-control study, 183 Iranian women including 83 patients with at least two unexplained consecutive pregnancy losses and 100 healthy controls with at least one live birth and no history of pregnancy loss were investigated. Patients with recurrent pregnancy losses due to anatomic, hormonal, chromosomal, infectious, autoimmune, or thrombotic causes were excluded from the study group. Genotyping was performed using Tetra- ARMS PCR method.

Results:  Significant difference in distribution of miR-196a2 rs11614913 genotypes was found in RPL patients in comparison to controls, with p value of 0.04 and odds ratio equal to 2.96 (95% CI: 1.03-7.03).

Conclusion: The results of the present study provide evidence for association between genetic variation in miR-196a2 and recurrent pregnancy loss. Further studies will be required to validate the significance of the studied genetic variation in diverse populations and its regulatory role on target genes.

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Background: Listeria monocytogenes is one of the most important causes of abortion and postpartum infection in newborns. Because of the importance of L . monocytogenes in the health of pregnant women and newborn babies, the aim of this study was to determine the prevalence of these bacteria in pregnant women and to compare the level of prevalence between women with a history of abortion and with no a history of abortion.

Materials and Methods: In this study, 540 samples of pregnant women were provided from Arak Taleghani hospital. The samples were cultured in enrichment media, then L .monocytogenesis was isolated in specific media.

Results: Of clinical samples, 14 cases had Listeria monocytogenes. Of these samples, 8 cases in women had a history of abortion, while women with no history of abortion were 6 Most cases of positive culture were related to the age of 25 to 34 years, including 7 cases, the lowest cases were 35 to 44 years old including 3 women and 4 women were between 17 and 24 years old.

Conclusion: The study showed that Listeria monocytogenes can cause infection in pregnant women. The use of Phenotypic methods and specific media can apparently isolate listeria monocytogenes from healthy pregnant women.

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Background: Recurrent pregnancy loss (RPL) is a heterogeneous condition with the prevalence of more than 1% among women of reproductive age, which is defined as the occurrence of more than two miscarriages. Immune-mediators, cytokines, determine the role of immune cells in response to tissue incompatibility conditions. Colony stimulating factor 3 (CSF3) is a cytokine affecting the expression of other cytokines such as IL-4, and suppressing the immune response against semi-allograft embryo. This study was done for the first time on the association of the rs1042658 polymorphism at 3’UTR of the CSF3 gene with the susceptibility to recurrent pregnancy loss, supposing the effect of it on the expression level and stability of the CSF3 gene transcript.

Materials and Methods: 122 RPL women and 140 healthy fertile women as a control group were enrolled in this case-control study. Genotype distribution of the selected polymorphism was evaluated by T-ARMS PCR method and the results were analyzed by logistic regression test.

Results: comparison of the genotypic frequencies in the 3'UTR of the CSF3 gene in patients and controls resulted in the statistically significant difference in the incidence of pregnancy loss in order to the protection effect of the genotypes carrying T allele was observed between two groups (p<0.05). History of the abortion among the relatives of RPL women versus the relatives of controls showed significant differences (p=0.05).

Conclusion: Findings showed significant relationship between rs1042658 polymorphism and the risk of recurrent pregnancy loss, which can affect the susceptibility of the condition.

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Background: The aim of this study was to determine the effect of preconception endurance exercise training with voluntary exercise activity during pregnancy in mother mice on lipid profile in adult offsprings.

Materials and Methods: Twenty four C57BL/6 female mice were randomly divided into four subgroups: trained in preconception period and exercised during pregnancy (TE)(20.3±1.02g); trained in preconception periods but unexercised during pregnancy (TC)(21.58±0.4g); untrained in preconception periods but exercised during pregnancy (CE)(21.02±0.23g); untrained and unexercised (CC)(19.23±0.45g). Trained mice were subjected to a protocol of moderate endurance exercise training over a period of 4 weeks for 5 days before pregnancy. The fasting blood samples were collected from adult mice(8 weeks old) and serum levels of glucose and lipid profile were measured. Data were analyzed using two way ANOVA and Tukey’s post hoc test.

Results: The Glucose test results in offspring showed that there was a significant interaction between group and sex and group main effect (p<0.001) Glucose levels of male offspring were significantly lower in TC and TE groups. Results on LDL also showed that the sex main effect was significant (p<0.001), and LDL levels of male born to TE and TC dams lower than in female offspring.

Conclusion: Improving the mother's physical fitness by providing regular endurance training in the preconception period and maintaining it by exercise activty throughout pregnancy may have potential for eliciting positive changes in lipid profile of offspring, specially males.

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Background and Aim: Reducing the fertility rates in Iran and use of multiple contraceptive methods in recent decades have been affected by many social, economic and demographic factors. Therefore, this study was conducted to study the fertility pattern and common preventive fertility methods at Arak city in 2017 year. Materials and Methods: This cross-sectional study was conducted on 384 married women referred to Arak remedial centers in 2017 year. The participants were randomly selected from Vali Asr, Taleghani and Amir Kabir hospitals. The participants information was collected using questionnaire and  subsequently analyzed using Stata software version 12. Ethical Considerations: This study with research ethics code IR.ARAKMU.REC.1396.4 has been approved by research ethics committee at Arak University of Medical Sciences. Findings: Our results showed that the mean age and average duration of marriage of women were 40.03 ± 11.19 and 21.08 ± 12.73 respectively, as well, 281 (73.2%) of women used the natural fertility prevention methods. Most of the participated women were post-graduate diploma with lacked income and housekeeping. Other contraceptive methods such as pills, condoms, IUDs, one-month menses and three-month injections were 8.9, 3.28, 6.38, 1.7 and 2.6, respectively. Conclusion: The most common method for preventing fertility is natural method. Condoms and pills are used more than the other contraceptive methods. There is a lack of awareness of modern contraceptive methods. Therefore, it is recommended that married women be educated about educational materials and counseling for familiarizing them with contraceptives.

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