Introduction: Pregnancy after assisted reproduction technology is the one of risk factors that can result in anxiety. Many studies showed that for up to 20% of infertile women, the emotional burden of infertility persist even after successful treatment. This study aims to determine anxiety levels and its related factors in ARTs Pregnant women undergoing sample infertility centers in Tehran.Materials and Methods: In this cross sectional study, 100 ARTs Pregnant women were participated. Data was collected by Beck Anxiety Inventory (BAI) and personality/demographic questionnaires. Data analysis was performed with SPSS.V.14.Results: Mean age was 33.7±6.81 and mean of married duration, gestational age, infertility duration and number of treatment failures was 8.70±5.18, 20.18±10.8, 7.37±6.81 and 1.9±1.6 respectively. Of 45 Pregnant women in the first trimester, 28.9% (n=13) have moderate and sever anxiety. Of 20 Pregnant women in the second trimester, 35% (n=7) have moderate and sever anxiety and finally, of 20 Pregnant women in the third trimester, 40% (n=14) have moderate and sever anxiety. There is a significant relation between anxiety levels with duration of infertility and history of treatment failure (p=0.03) (p=0.02).Conclusion: Careful consideration and psychological consultation for ARTs Pregnant women is necessary to detect high-risk Pregnant and reduce the anxiety and poor pregnancy outcomes.

Dear Editor I read the fascinating letter entitled: 'All That Glitters is Not Gold: A Pregnant woman with a Rare Inherited Bleeding Disorder" published in the latest issue Iranian Journal of Blood and Cancer with great attention. . .

The perioperative imaging of a Pregnant woman presents a unique challenge to orthopaedics surgeon as concern about the radiation risk to the embryo or fetus. This article highlights effect of radiation exposure on foetus.I would like to discuss about the amount of radiation exposure in a Pregnant woman during fluoroscopic guided closed femoral Interlock nailing as radiation has significant cancerous and non cancerous effect on fetus.

Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever of the Nairovirus group. Although primarily a zoonosis, sporadic cases and outbreaks of CCHF affecting human do occur. The disease is endemic in many countries in Africa, Europe and Asia. Onset of symptoms is sudden, with fever, myalgia, dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia. There may be nausea, vomiting and sore throat early on, which may be accompanied by diarrhea and generalized abdominal pain. IgG and IgM antibodies may be detected in serum by ELISA.Case Report: A Pregnant woman was admitted in a hospital with severe vaginal bleeding. Fever, myalgia, headache, nausea, abdominal pain, gingival bleeding, jaundice, petechia, and ecchymoses were present. ELISA IgM for CCHf was negative in the first day of admission but in the sixth day of illness, this test became positive.Conclusion: Treatment with oral Ribavirin in was started and continued for ten days. After ten days, the patient was discharged from hospital. No problems were detected in follow up visits.

Patient Information: Pregnancy is rare in most women with Cushing’ s syndrome (CS) due to the lack of ovulation. A 36-year-old woman, who had experienced cesarean section in her first pregnancy and her second pregnancy had occurred despite the Intrauterine Device (IUD), was referred to the hospital. The results of routine pregnancy tests and screening tests indicated normal general conditions. At the 12th week of pregnancy, the first manifestation of blood pressure was observed. During the pregnancy, the patient was constantly monitored and, finally, at the 34th week, she underwent cesarean section due to the severity of symptoms, cesarean section history, and delayed fetal infarction. A boy was born, weighing 1700 grams and was hospitalized in the NICU ward. Regarding the lack of control of blood pressure after pregnancy, an abdominal MRI was asked for the patient to examine the renal artery; a 3cm mass was reported in her right adrenal, and a diagnosis of Cushing’ s syndrome was presented to her. The right laparoscopic adrenalectomy was conducted for the patient and gradually the Corton intake was stopped. After the recent procedures, all of the patient’ s symptoms, including hypertension, edema, proteinuria, hyperglycemia, and hyperlipidemia were resolved. Proximal muscles pain and weakness remained about 1 year after her laparoscopic adrenalectomy, and they were improved by physiotherapy. Conclusion: Secondary hypertension can occur due to Renovascular hypertension, pheochromocytoma, and Cushing’ s syndrome. Although Cushing’ s syndrome is rare in pregnancy, these cases can be accompanied by hypertension, preeclampsia, preterm labor, and fetal loss. Therefore, a more complete assessment and attention to important symptoms such as blood pressure is necessary to prevent the complications.

The causes of periorbital ecchymosis are traumatic and non-traumatic head and neck insults. This report deals with a non-traumatic bilateral spontaneous periorbital ecchymosis in pregnancy.The case studied was a 24-year-old woman in her eighth month of pregnancy who realized her spontaneous ecchymosis around both eyes which was more prominent in the right eye 12 hours after vomiting. She did not have any history of head and neck trauma or surgery. Her visual acuity, ophthalmic examination, blood pressure, and urine analysis were normal. Twenty days after the first evaluation, the ecchymosis completely recovered and the patient was well completely after six months. Although, there are systemic and local causes in the etiology of periorbital ecchymosis, spontaneous occurrence of the condition in a Pregnant woman not having preeclampsia is unknown.

Introduction: The black widow spider is known in the Mediterranean region as L. tredecimguttatus species that in Khorasan is known with its local name as “ Dalmak” . The venom of this spider contains excitatory neurotoxins called alpha-latroteins. Black widow spider bite cases are rare during pregnancy, and few studies have been performed in this regard, the symptoms of a bite during pregnancy are not different from those of non-Pregnant women, and causing acute fetal complications are unlikely. In this study, a case of a black widow spider bite was reported in a Pregnant woman. Case presentation: The reported case is a 29-year-old woman (Gravid 2(with 6-week gestational age who was unaware of her pregnancy and complained of abdominal pain and right lower extremity burning from the night before referring to Ghaem Hospital Emergency Department, Mashhad. The patient was examined, and after rule out of the possibility of ectopic pregnancy and other differential diagnoses, the patient was treated with maintenance therapy with the diagnosis of black widow spider bites, and after two days of hospitalization, she was discharged with good general condition, good vital signs and complete relief of abdominal pain. Conclusion: Black widow spider bites can mimic symptoms similar to acute abdominal surgery, ectopic pregnancy, or other diagnoses, In the early months of pregnancy, it can be very difficult to diagnose the cause of the symptoms. In addition, black widow spider bites during pregnancy can mimic the symptoms of cholecystitis or appendicitis, which can be diagnosed by careful examination of the patient and obtaining a proper history.

A Pregnant woman (Gravida 2, Abortion 1, twin pregnancy with microinjection, Gestational Age: 23 weeks and 3 days) was referred to a tertiary referral hospital with complaints of fever, dry cough and dyspnea. She was admitted with a diagnosis of COVID-19. During her hospitalization, O2 saturation progressively declined, which required acute respiratory care and support leading to intubation and mechanical ventilation. Gradual recovery occurred through treatment processes and finally the patient was extubated. However, there was another episode of respiratory failure leading to reintubation after 5 days. Meanwhile, serum liver enzymes increased significantly and leaded to intrauterine death of both fetus followed by a critical decline in cardiac output to less than 10% and cardiac arrest followed by unsuccessful resuscitation within hours.