Aim The present study was conducted with the aim of comparing the coping strategies and levels of psychological adjustment in depressed and non-depressed women experiencing intrauterine fetal death (IUFD). Methods This was a causal-comparative study. The research population includes all the depressed and non-depressed women experiencing intra-uterine fetal death who had active case file in specialized infertility clinics of district 5 of Tehran in 2017. Thirty depressed women experiencing intra-uterine fetal death and 30 non-depressed women experiencing intra-uterine fetal death (total 60 subjects) were selected through available sampling. For gathering the data, coping inventory for stressful situations (CISS), Veit and Ware’ s mental health inventory, and Beck’ s depression inventory were used. The data were analysed by statistical methods of multivariate analysis of variance. Findings Results suggested that there is a significant difference in problem-focused coping strategies and emotionally-focused coping strategies in depressed and non-depressed women (P<0. 01), but no significant difference was observed in avoidance coping strategies among depressed and non-depressed women (P=0. 79). Also, results indicated that psychological helplessness is significantly lower in non-depressed women compared to depressed women and non-depressed women enjoy higher psychological well-being (P<0. 001). Conclusion The present study showed that coping strategies and psychological adjustment are variables that can affect the depression of women experiencing intrauterine fetal death. Therefore, these variables should be considered in order to treat the depression of these individuals.

Intra uterine fetal death (IUFD) is a traumatic event for the family which occurs in for about 1% of all pregnancies. In comparison with other countries this rate is ncreasing in Iran. Statistical reports from health centers of Firoozabad estimated the rate of 2.2% per year. Although obstetrical management has improved significantly, more than 50% of these cases are still unexplained. This research was a case-control study to determine risk factors for intra uterine fetal death. A standard questionnaire was designed consisting of four major parts: Maternal, fetal, placenta and umbilical cord factors. The questionnaire was filed by using medical records, between 1998-2003. Samples included 450 records, including 150 cases (those who had IUFD) and 300 controls (those who had live newborn). Generally, mother’s education (P=0.000), and gestational age (P=0.001) were found as major risk factors. Moreover, season of delivery had a statistically significant association with IUFD (P=0.000). Maternal risk factors included ), receiving prenatal care (P=0.001), and consanguinity (P=0.004), pregnancy complications (P=0.06), the history of IUFD (P=0.000), ruptured amniotic fluid (P=0.007). Structural abnormality (P=0.000) such as impaired neural tube (P=0.000), fetal sex (P=0.000) and fetal weight (P=0.000) were major fetal risk factors. Intra uterine growth retardation (IUGR) (p=0.000) and third trimester bleeding (P=0.000) were the risk factor related to placenta and cord prolapse (P=0.01) was the only umbilical risk factor for IUFD. Logistic regression analysis was further clarified the role of confounding variables. Risk factors related to mother, fetus, placenta and cord were investigated for IUFD. It is difficult to identify preventable factors of IUFD, however consultation, proper prenatal care, early diagnosis of complications and careful evaluation may reduce the incidence of IUFD. This study suggests that certain measures has to be taken by Iran’s health Ministry to make the women aware of the risk factors related to IUFD. Also during teaching sessions to medical students and staff, preventive medicine should be taken into consideration with emphasis on the local studies.

Adrenal hemorrhage during neonatal phase is more prevalent than was thought before and most of the cases are diagnosed after the autopsy. However massive hemorrhage is rare. The mozst important cause of adrenal hemorrhage is perinatal injuries, but large fetal size, maternal diabetes, congenital syphilis, anoxia, hemorrhagic diseases and immaturity are predisposing factors. Incidence rate of adrenal hemorrhage is 0.2% to 0.5% during perinatal phase. The diagnosis of the adrenal hemorrhage in this phase is rare. Our case was a four-day-old full term neonate who was born via normal vaginal delivery, with Apgar score 3. The baby was intubated immediately which was followed by seizure attacks and unfortunately death on the fourth day of life. The neonate was female with 3100 g weight. At autopsy the left kidney appeared larger than normal and the adrenal subcapsular hematoma which amounts to about 50 mL, was seen. According to previous studies delivery per vaginam, macrosomia and acidemia are some important risk factors for adrenal hemorrhage. Risk factors of the present case were normal vaginal delivery and acidemia. The neonate may present no symptom or sign during fetal or neonatal phase. So serial sonography is considered one of diagnostic methods.

Background: Antiphospholipid syndrome (APS) is a non-inflammatory autoimmune disease primarily characterized by thrombosis. Previous studies have indicated that disorders in proteins S and C, Factor V Leiden, and homocysteine levels can contribute to the occurrence of miscarriage in patients with APS. Objectives: This study aims to determine the prevalence of protein S, protein C, Factor V Leiden, and homocysteine disorders in patients with APS. Methods: This research was conducted as a retrospective study, utilizing the clinical information of patients who were referred to Golestan Ahvaz Hospital and whose records were available. A pre-prepared checklist was used to extract and record patients' clinical information, including demographic data, prevalence of miscarriage, vascular disorders (arterial and venous), pulmonary and venous thrombosis, preterm labor, intrauterine fetal demise (IUFD), intrauterine growth restriction (IUGR), and disorders or deficiencies of proteins C and S, as well as homocysteine levels. Results: In the present study, the results showed that a reduction in proteins C and S was observed in 18 (15. 1%) and 20 (16. 8%) patients, respectively. Thrombosis was present in 103 (86. 6%) patients, and 27 (22. 7%) patients had Aps Ab. The results indicated a statistically significant relationship between protein C deficiency, thrombosis, vascular events, and the presence of Abs in patients (P < 0. 05) Additionally, a significant relationship was found between protein C deficiency and IUFD (P < 0. 05). However, no significant relationship was observed between Aps Ab and IUFD or IUGR (P > 0. 05). Conclusions: The results indicated that protein C can be used as a diagnostic factor in AP patients. Additionally, protein C was associated with IUFD in these patients.

Background: Although the association between first-trimester increased nuchal translucency (NT) and chromosomal defects is well-defined, there is little knowledge about the importance of increased NT in fetuses with normal karyotypes. Hence, this study was designed to evaluate outcomes of normal karyotype fetuses with increased NT. Methods: This observational retrospective study was conducted on 720 pregnancies with increased NT (>3mm) at 11 to 13 weeks of gestational age in Yas Hospital, Tehran, Iran, from 2016 to 2020. Study outcomes were incidence of preeclampsia, intrauterine growth restriction) IUGR (, preterm labor, fetal anomaly, cardiac malformations, hydrops fetalis, abortion, and intrauterine fetal death (IUFD) in pregnancies without evident chromosomal karyotype abnormalities. Results: Out of 720 participants who underwent karyotyping in the study center, 523 fetuses had normal karyotype results. In the pregnancies assessed for outcome, 357 (68. 3%) reached live birth, 104 (19. 9%) aborted, and 62 (11. 9%) resulted in IUFD. Study outcomes including preeclampsia (<0. 001), IUGR (<0. 001), preterm labor (<0. 001), fetal anomaly (<0. 001), cardiac malformations (<0. 001), hydrops fetalis (0. 017), abortion (<0. 001), and IUFD (<0. 001) resulted in a statistically significant difference in the distribution of cases across NT intervals. Conclusion: This study demonstrated adverse pregnancy outcomes increased with increasing NT despite normal karyotyping. Hence, tight observation of mothers and fetuses should be done in normal karyotype fetuses with increased NT.