fa بررسی پیامد حاملگی در زنان حامله با سابقه خونریزی واژینال در نیمه اول بارداری آناتومی آناتومی پژوهشي(توصیفی- تحلیلی) Research <p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="AR-SA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt">هدف: </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">ارزیابی پیامد حاملگی در زنان حامله مبتلا به تهدید به سقط.<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">مواد و روش کار: </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">یک مطالعه کوهورت آینده نگر بر روی 1000 زن حامله انجام شد. 500 زن (گروه مورد)</span><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">،</font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> سابقه خونریزی واژینال در نیمه اول حاملگی را می‌دادند و 500 زن دیگر (گروه کنترل) بدون این سابقه بودند. هردو گروه از هفته 20 حاملگی تا زایمان دنبال شدند. <p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">یافته‌ها: </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">زنان دو گروه تفاوت معنی‌داری از نظر سن</span><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">،</font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> پاریتی و شاخص توده بدنی نداشتند. <p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">زایمان زودرس خودبه‌خود 126 مورد (2/25%) در مقابل 47 مورد (4/9%)</span><b><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">، </font></span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">001/ 0</span><font face="Times New Roman"><font size="2"><span dir="ltr">P= </span><span dir="rtl"></span></font><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><span dir="rtl"></span>، [</span><font size="2"><span dir="ltr">ADJ RR= 1.4, CI 95% = 1.2-1.5 </span><span dir="rtl"></span></font><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><span dir="rtl"></span>، </span></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">پارگی زودرس کیسه آب] 51 مورد (2/10%) در مقابل 24 مورد (8/4%)</span><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">،</font></span><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">02/0</span><font face="Times New Roman"><font size="2"><span dir="ltr">P=<b> </b></span><span dir="rtl"></span><b><span style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><span dir="rtl"></span><span style="mso-spacerun: yes"> </span></span></b></font><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'">[</span><font size="2"><span dir="ltr">ADJ RR= 2.1, CI 95% = 1.2-2.3</span><span dir="rtl"></span></font></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"><span dir="rtl"></span> </span><b><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">،</font></span></b><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">کندگی زودرس جفت] 20 مورد (4%) در مقابل 7 مورد (4/1%) </span><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">،</font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> 1. /0</span><span dir="ltr"></span><span dir="ltr"><span dir="ltr"></span><font face="Times New Roman" size="2"> P= </font></span><span dir="rtl"></span><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><span dir="rtl"></span><font face="Times New Roman">،</font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> </span><font face="Times New Roman"><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'">[</span><font size="2"><span dir="ltr">ADJ RR= 1.1, CI 95% = 1.01-1.2</span><span dir="rtl"></span></font></font><span style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"><span dir="rtl"></span> </span><b><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">،</font></span></b><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">در گروه مورد بیشتر بودند.] <p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">تفاوت معنی‌داری بین دو گروه از نظر پره اکلامپسی</span><span lang="FA" style="FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA mso-bidi-font-family: 'Times New Roman'"><font face="Times New Roman">،</font></span><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"> کم بودن رشد جنین و میزان سزارین نبود. وزن نوزاد در موارد حاملگی ترم در گروه مورد کمتر از گروه کنترل بود. (8/560 ±4/3046 گرم در مقابل 432 ±6/3317 گرم<b>، </b>001/0= </span><font size="2"><font face="Times New Roman"><span dir="ltr">p</span><span dir="rtl"></span></font></font><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"><span dir="rtl"></span>.)<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">رابطه معنی‌دار مهمی بین تعداد دفعات خونریزی با زایمان زودرس خودبه‌خودی و کندگی زودرس جفت وجود داشت و همچنین رابطه معنی‌دار مهمی بین مقدار خونریزی با کندگی زودرس جفت وجود داشت.<p></p></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">بحث و نتیجه گیری: </span></b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA">تهدید به سقط میزان زایمان زودرس خودبه‌خودی و پارگی زودرس کیسه آب و کندگی زودرس جفت را زیاد می‌کند و وزن نوزاد را کاهش می‌دهد. بنابراین تهدید به سقط حاملگی را پر خطر کرده و مراقبت پره ناتال جدی‌تری را ایجاب می‌کند.<b><p></p></b></span></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><b><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"></span></b></p><p class="Chekide" style="TEXT-JUSTIFY: kashida TEXT-ALIGN: justify TEXT-KASHIDA: 0% MARGIN: 0in 0in 0pt unicode-bidi: embed DIRECTION: rtl" dir="rtl"><span lang="FA" style="FONT-FAMILY: Nazanin FONT-SIZE: 9.5pt mso-ansi-font-size: 8.5pt mso-bidi-language: FA"><p> </p></span></p> <p class="Abstract" style="MARGIN: 0cm 0cm 0pt"><p><strong><font face="Times New Roman" size="3"> </font></strong></p></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0cm 0cm 0pt"><font size="3"><font face="Times New Roman"><i><strong>Background & Aims</strong></i>: This study aimed to evaluate the pregnancy outcomes in pregnancies with threatened abortion (miscarriage).</font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0cm 0cm 0pt"><font size="3"><font face="Times New Roman"><b><i>Materials & Methods</i>: </b>A prospective cohort study was performed on 1000 pregnant women. 500 women (case group), had a history of vaginal bleeding during the first half of pregnancy and the other 500 women (control group), did not have this history.<span dir="rtl"></span><span style="mso-bidi-language: FA" dir="rtl"><span dir="rtl"></span> </span><span dir="ltr"></span><span dir="ltr"></span><span style="mso-spacerun: yes"> </span>Both groups of women were followed from 20 weeks of pregnancy up to delivery. </font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0cm 0cm 0pt"><font size="3"><font face="Times New Roman"><b><i>Results</i></b>: The women both groups did not have any significant differences according to age, parity, or body mass index (BMI). Spontaneous preterm delivery was in 126 cases (25.2%) vs.<span style="mso-spacerun: yes">  </span>47 cases (9.4%), P=0.001, [ADJ RR=1.4, CI 95%=1.2-1.5], premature rupture of membrane<span style="mso-spacerun: yes">  </span>were 51 cases (10.2%) vs.<span style="mso-spacerun: yes">  </span>24 cases (4.8%), P=0.02, [ADJ RR=2.1, CI95%= 1.2- 2.3], placental abruption were 20 cases (4%) vs. 7 cases (1.4%) P=0.01, [ADJ RR= 1.1, CI 95%= 1.01-1.2], were more in the case group.<span style="mso-spacerun: yes">  </span>There were no differences between the two groups regarding preeclampsia, small for gestational age (SGA), and cesarean deliveries. Neonatal weight (in term pregnancies) in the case group was lower than the control group (3046.4± 560.8 gram vs. 3317.6± 432 gram, P=0.001). There was a significant relationship between the number of bleeding episodes, spontaneous preterm delivery, and placental abruption and there was also a significant relationship between the amount of bleeding and placental abruption</font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0cm 0cm 0pt"><font size="3"><font face="Times New Roman"><b><i>Conclusion</i></b>: Threatened abortion increases the rate of spontaneous preterm delivery, premature rupture of membrane and placental abruption, and decreases the neonatal weight. Therefore threatened abortion makes a pregnancy as high risk and demands more serious prenatal care.</font></font><font size="3"><font face="Times New Roman"><b><span style="mso-spacerun: yes">    </span></b></font></font></p><p class="Amatnmagale" style="TEXT-ALIGN: justify MARGIN: 0cm 0cm 0pt"><span style="mso-bidi-language: FA"><p><font face="Times New Roman" size="3"></font></p></span></p><p align="center" class="Amatnmagale" style="TEXT-ALIGN: center MARGIN: 0cm 0cm 0pt"><font size="3"><font face="Times New Roman"><b>SOURCE</b>: URMIA MED J 2012: 23(3): 349 ISSN: 1027-3727</font></font></p> تهدید به سقط، زایمان زودرس، پارگی زودرس کیسه آب، پره اکلامپسی، زایمان سزارین، پیامد حاملگی، وزن نوزاد، خونریزی واژینال Threatened miscarriage, Preterm delivery, Premature rupture of membrane, Preeclampsia, Cesarean delivery, Pregnancy outcome, Neonatal weight, Vaginal bleeding 254 259 http://umj.umsu.ac.ir/browse.php?a_code=A-10-582-253&slc_lang=fa&sid=1 Farideh Dadkhah فریده دادخواه 370031947532846005454 370031947532846005454 No Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran دانشگاه علوم پزشکی تهران، بیمارستان فیروزگر Maryam Kashanian مریم کاشانیان maryamkashanian@yahoo.com 370031947532846005455 370031947532846005455 Yes Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran دانشگاه علوم پزشکی تهران، بیمارستان شهید اکبرآبادی Giti Eliasi گیتی الیاسی 370031947532846005456 370031947532846005456 No Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran دانشگاه علوم پزشکی تهران، بیمارستان شهید اکبرآبادی