Introduction: Preeclampsia is the most common medical complication in PREGNANCY. Regarding the pathophysiology and complex etiology of preeclampsia, a wide range of markers have been investigated. In addition to predictive value, identification of these factors may provide a clear mechanism for the pathogenesis of preeclampsia. This review study was performed with aim to evaluate the role of four serum markers and uterine artery Doppler ultrasonography in predicting preeclampsia at second TRIMESTER of PREGNANCY.Methods: In this review study, the databases of SID, Weily online library, Elsevier, Scopus, Pubmed, and the Google Scholar search engine were used during 2000 to 2017 in order to find the relevant studies. To access all articles in English and Persian, the key words of BHCG, Inhibin A, Activin A, alpha-fetoprotein, serum markers, uterine artery Doppler sonography, second TRIMESTER, and preeclampsia prediction were used with all possible combinations of these words.Results: The results of various studies indicate that none of the studied markers, including AFP, b-HCG, INH-A and Activin A alone, do not provide predictive power for preeclampsia with high sensitivity and specificity. However, uterine artery Doppler ultrasonography at second TRIMESTER of PREGNANCY can be used as a screening test to predict preeclampsia in high risk women.Conclusion: The most important strategies for prediction of preeclampsia include individual characteristics, uterine artery ultrasonography, and biomarkers. None of these markers alone can' t predict preeclampsia with high sensitivity and specificity.

Introduction: The purpose of this study was to compare the efficacy and side effects of two different misoprostol regimens for SECOND-TRIMESTER PREGNANCY termination.Methods: 60 consenting women who were at 14 to 28 weeks of gestation with indications for PREGNANCY termination were randomly assigned to two equal groups to receive either vaginal or oral misoprostol. The dosing regimen was 400μg as the initial dose followed by 400μg and up to 3 doses (1200 mg) if needed in each group. Efficacy and side effects were compared.Results: 30 patients randomly assigned to vaginal and 30 to oral misoprostol group. Demographic characteristics were similar in both the groups. The percentage of women who delivered was significantly higher in vaginal group than the oral group (86.7 vs.43.3, P=0.0006).The average induction to delivery interval was shorter in vaginal group, but this difference was not significant (9.7±4.2 vs. 12.7±7.3 P=0.083). No significant differences in complication rates or side effects were noted between the two groups.Conclusion: Vaginal administration of misoprostol resulted in a higher success rate for second TRIMESTER PREGNANCY termination, whereas, no significant differences in induction to delivery time and complication rates were noted between vaginal and oral groups.

Background and aim: Many researches have shown a relationship between levels of bHCG in PREGNANCY and preeclampsia, which can be used as a method for early diagnosis. The aim of this study was to determine relationship between levels of HCG in second TRIMESTER of PREGNANCY and preeclampsia.Methods: This study was conducted as a Nested case control study. Blood samples were taken from 1200 pregnant women who were in their second TRIMESTER of PREGNANCY and were admitted for prenatal care in Arak prenatal clinics. After isolation of serums, blood samples were stored in -20°C until delivery time. Finally serum HCG levels, blood pressure, proteinurea, edema, seizure and neonate statue were analyzed in 50 preeclamptic women (case group) and were compared with 50 normotensive women (control group).Results: All women were complicated with mild preeclampsia. The mean of the bHCG in preeclamptic women was 43.08±32.56 Iu/ml and means of HCG in normotensive women was 27.48±25.97 mu/ml (P<0.05), the mean of systolic blood pressure in case and control groups were 144.09±11.30 mmHg and 110.26±8.13 mmHg, respectively (P<0.001). The mean of diastolic blood pressure in preeclamptic women was higher than normotensive women (90.45±4.34 mm/hg and 70±9.80 mm/hg) (P<0.001).Conclusion: Our data showed a significant relationship between mean levels of HCG preeclampsia in second TRIMESTER. Therefore, screening of high risk group with HCG hormone and careful prenatal care should be considered during PREGNANCY.

Background and Objective: Preeclampsia is potentially life-threatening and as a dangerous complication of PREGNANCY. This study was performed to assess the relationship between serum zinc level and preeclampsia.Materials and Methods: This analytical and prospective study was conducted on 1033 pregnant women who referred to prenatal clinics of Tehran city. Demographic questionnaire and reproductive history was completed and also a venous blood sample was taken from all the pregnant women upon entry. Preeclampsia was defined as blood pressure equal or more than 140/90 mmHg along with proteinuria after 20th week of PREGNANCY. Data was analyzed using SPSS16 software and independent samples t-test.Results: The incidence of preeclampsia was 1.9 %. Mean serum zinc level was 116.6±95.7 mg/dl. In 27.4% of samples, the zinc serum level was lower than 51 mg/dl and the zinc serum level of 72.6% of samples was at normal range. The independent samples t-test showed that there was a significant relationship between maternal serum zinc level and preeclampsia as the mean serum zinc level in pregnant women with preeclampsia was lower than normal pregnant women.Conclusion: The results showed that serum zinc level is associated with preeclampsia.

Introduction: PREGNANCY toxemia causes many pregnant mothers at risk for adverse midwifery complications and sometimes the risk of death. If this complication occurs early in the second TRIMESTER of PREGNANCY, the mother will be deprived of having a child as a result of this complicated PREGNANCY. Here we present a woman who has had premature PREGNANCY toxsemia. The known risk factors in this woman were not positive.

The second TRIMESTER scan is the most important sonographic evaluation during PREGNANCY. The second TRIMESTER ultrasound examination is not only for confirming gestational age but also it provides an ideal opportunity for assessing fetal anatomy and therefore structural normality. In addition, assessment of placental position and morphology, amniotic fluid volume, number of fetuses, evaluation of soft markers for chromosomal defects and the comparative interpretation of various measurements are all important pointers to potential problems. This examination is commonly referred to as a „routine second TRIMESTER anomaly scan‟. The optimal time at which to offer the routine anomaly scan is the earliest gestation at which the necessary measurements and a full fetal anatomy survey can be performed and the latest gestation at which an acceptable range of options can be offered to the parents if an abnormality is detected. Although the measurements required to date the PREGNANCY accurately can be taken after 15 weeks of gestation, and most of the fetal anatomy can be evaluated at 18–20 weeks, the optimal time for examination of fetal heart can be provided at 23-28 weeks. It is recommend that the routine anomaly scan is performed between 20 and 24 weeks but we recommend anomaly scan to be done before 20 weeks (18-20 weeks) in Iran as we have limitation for legal termination if needed. Although it is necessary to examine the entire fetus and other uterine contents in detail, it is not always feasible to do this in the order suggested. It is suggested that the measurements are always carried out early in the examination so that they are not forgotten. It is not reasonable to expect all structural fetal abnormalities amenable to ultrasound detection to be diagnosed at a routine second TRIMESTER anomaly scan. Though if the approach is systematic then no major structural abnormality should be missed. However there are several examples from anomalies such as microcephaly which might be missed in second TRIMESTER scan if there is no serial examination. In the majority of normal pregnancies, measurement of the biparietal diameter (BPD) and femur length (FL) provide the most accurate assessment of gestational age in the second TRIMESTER. It is recommended that measurements of the head circumference (HC), transcerebellar diameter (TCD) and abdominal circumference (AC) are also undertaken. They provide further confirmation of gestational age and aid in the exclusion of growth related abnormalities and spina bifida. In addition, their inclusion encourages a systematic examination of the whole fetus. An ultrasound examination is in the unique position of being both a screening test and a diagnostic test for fetal anomalies. Its clinical value is directly dependent on the skills of the sonographer, first, in obtaining the correct images for evaluation and measurement and, second, in the correct interpretation in each specific and unique clinical situation. Such examinations must only be performed by individuals who have undergone a supervised period of training that enables them to identify and distinguish between the range of normal findings, findings of uncertain significance and abnormalities at varying stages of gestation.