Introduction: Heterotopic PREGNANCY (HP), defined as the simultaneous occurrence of intrauterine and ectopic pregnancies, is extremely rare in natural conception. However, its incidence has been increasing with the widespread use of ovulation induction agents and assisted reproductive technologies (ART). HP poses a significant diagnostic challenge, as the confirmation of an intrauterine PREGNANCY may lead clinicians to overlook the possibility of a concurrent ectopic PREGNANCY. Failure to establish an early diagnosis can result in tubal rupture, intra-abdominal hemorrhage, maternal morbidity or mortality, and loss of the intrauterine PREGNANCY. Case Presentation: We report the case of a 29-year-old primigravida with a history of clomiphene citrate use, who presented on September 24, 2021, to the emergency department of Sarem Subspecialty Hospital with acute severe abdominal pain, nausea, and two episodes of syncope. A twin intrauterine PREGNANCY at 12 weeks’ gestation had been documented on ultrasound one day earlier. On admission, she was hemodynamically unstable, with a blood pressure of 60/80 mmHg, cold sweating, and tachycardia. Emergency ultrasonography revealed a large amount of free intraperitoneal fluid. The patient was immediately taken for laparotomy, during which approximately 500 mL of blood and clots were evacuated. The uterus and right adnexa appeared normal; however, a fetus with its placenta was identified adjacent to the left ovary with active bleeding. Following removal of the ectopic gestation and hemostasis, a left salpingectomy was performed. The patient was transferred to the ICU and discharged three days later in good general condition, with a viable intrauterine singleton PREGNANCY confirmed by ultrasound. The PREGNANCY progressed uneventfully, and at 37 weeks, she underwent cesarean section due to marginal placenta, resulting in the delivery of a healthy male infant weighing 3200 g with Apgar scores of 9 and 10. Conclusion: This case highlights the importance of maintaining a high index of suspicion for heterotopic PREGNANCY, even in the presence of a confirmed intrauterine PREGNANCY. Prompt diagnosis and timely surgical intervention are crucial for maternal survival and preservation of the intrauterine gestation. Reporting such cases contributes to greater clinical awareness, facilitates earlier recognition, and supports optimal management strategies in similar scenarios.

Objective: To Evaluate PREGNANCY rate in synchronized dairy herd by Selectsynch procedure and PG.Design: Experimental study.Animals: Three hundred and seventy four dairy cows were randomly allocated to three groups: selectsynch, synchronized with PG and spontaneous heat.Procedure: All cows were cleaned at day 30 after parturition and allocated to the following groups: synchronization by select synch-insemination (n=139), synchronization by PG-insemination (n=125) and natural heat-insemination (n=110). PREGNANCY was diagnosed at days 42-50 after insemination.Statistical analysis: Chi-square test.Results: For these methods PREGNANCY rate were54 percent, 44.8 percent and 46.4 percent, respectively. Moreover there were not any significant difference among them.Clinical implications: Since selectsynch made an acceptable PREGNANCY, it can be recommended for dairy herds.

Introduction: The majority of embryo transfers (ETs) to date have been performed on day 3 to reduce the potential risk of fetal growth arrest. Transfer on day 5 provides higher clinical PREGNANCY outcomes with reduced risks of multiple pregnancies. This study aimed to evaluate the PREGNANCY outcome between day 5 embryo transfer and day 4 fresh embryo transfer in patients undergoing intracytoplasmic sperm injection (ICSI). Materials and Methods: This study was conducted at the Infertility Research Center of Sarem Hospital, Tehran, in 1402 on 921 infertile women who had been referred for ICSI. These patients were assigned to receive fresh embryo transfer (n=163) and blastocyst stage transfer (n=758). Statistical analyses were performed using SPSS software. Conclusion: There was no significant difference between the two groups in terms of mean age and PREGNANCY rate. The PREGNANCY rate on the fourth day (31.29%) was similar to that on the fifth day (28.50%) (PV <50.0). However, there was a significant difference between the two groups in terms of embryo quality (PV<0.05).

Spontaneous quadruplet is rarely seen. Quadruplet PREGNANCY is accompanied with severe complications such as; abortion, premature Our patient was a 29- year old lady with history of first PREGNANCY twin that was aborted. In the second PREGNANCY at three months of gestation sonography showed quadruplet PREGNANCY so cerclage was performed for the patient. At 26 weeks gestation she was admitted to Alzahra hospital with diagnosed premature labor at 29 weeks plus 2 days of gestation the PREGNANCY was terminated by cesarean section, 4 newborns 2 healthy girls and one boy and the second boy expired after 24 hours due to RDS.

Background: PREGNANCY luteoma is a rare non neoplastic condition of the ovary. It is usually asymptomatic and found incidentally during imaging in PREGNANCY or during cesarean section. PREGNANCY luteoma can also occur after ectopic PREGNANCY.Case Presentation: A 30 year old female presented to G.B. Pant Hospital, Andaman and Nicobar Islands institute of Medical Sciences, Port Blair in October 2015 with abdominal pain. After initial investigations, exploratory laporotomy was done for ruptured ectopic PREGNANCY. Enlarged ovary was removed along with the ruptured portion of fallopian tube. Histopathological examination revealed solid aggregates of large cells with abundant eosinophilic cytoplasm; diagnosis of PREGNANCY luteoma was given.Conclusion: It must be considered in the differential diagnosis of ovarian masses in pregnant females that early diagnosis of this entity may avoid unnecessary radical surgery.

Introduction: Satisfying psychological needs during PREGNANCY is defined as a feeling of satisfaction, increased independence, improved interaction between others and the environment, and spontaneous increase of mental energy to achieve successful PREGNANCY and delivery. The present study was conducted with aim to create and validate the PREGNANCY psychological needs questionnaire. Methods: In terms of applied purpose, the current research is qualitative and quantitative combined data (mixed) and in terms of study method is foundational data. The statistical population included women referred to specialized women's clinics and midwifery centers in Kermanshah city in 2022-2023, and 40 people were selected through purposeful sampling with the inclusion criteria up to theoretical saturation and were subjected to in-depth interviews. After the analysis of the interviews, a tool suitable for the Iranian context was prepared to measure the psychological needs of PREGNANCY. In order to analyze the data in the qualitative part of content analysis and in the quantitative part of exploratory factor analysis, first and second order factor analysis were used and Cronbach's alpha was used to measure its reliability. Results: Based on the results of exploratory factor analysis, six factors were extracted and the fit of the six-dimensional model of psychological needs of PREGNANCY was confirmed based on the results of confirmatory factor analysis. Considering the theoretical foundations and the content of the questions, these factors were named (supportiveness, affection, motivation and hope, emotional understanding, empathy and sexual need). Also, the reliability of the questionnaire was reported as 0. 89. Conclusion: The results of the present study showed that the PREGNANCY psychological needs questionnaire has the necessary validity and reliability, and it is possible to measure the psychological needs of pregnant women through this tool.