Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry.

BACKGROUND: Psychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum. METHODS: A cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions. RESULTS: The prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (ß = 1.776, P < 0.001), as well as its three subscales: somatization (ß = 1.355, P = 0.019), anxiety symptoms (ß = 2.249, P < 0.001), and depressive symptoms (ß = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (ß = 1.344, P = 0.038) and the somatization subscale (ß = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (ß = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (ß = 1.998, P = 0.012) and depressive symptoms (ß = 1.949, P = 0.020). CONCLUSION: The high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.

Prevalence and risk factors of prenatal anxiety disorders: A cross-sectional study.

Background and Aims: Studies regarding the risk factors of prenatal anxiety disorders are inconclusive and sometimes contradictory. The current study aimed to define the prevalence and risk factors for anxiety disorders in women during pregnancy. Methods: This is a cross-sectional and hospital-based survey of two public hospitals (Ayatollah Rohani and Yahyanejad) of inpatients/outpatients, obstetric wards/clinics, and four private outpatient obstetric clinics in the city of Babol. Convenience sampling was utilized to recruit 432 pregnant women. A trained clinical psychologist conducted the Structured Clinical Interview for DSM-5 (SCID-5) to diagnose anxiety disorders. In addition, the Brief Symptom Inventory 18 (BSI-18) was completed by the participants to assess the severity of psychological distress. Results: Of 432 pregnant women, 132 (30.5%) were diagnosed with anxiety disorders. Anxiety disorders included 61 cases of pregnancy adjustment disorder (47.7%), 52 cases of generalized anxiety disorder (40.6%), and 15 cases of specific phobia (to delivery) (11.7%). The logistic regression results showed that the age, pregnancy, education, parity, and high-risk pregnancy variables predicted 28% of the variance of anxiety disorders. Furthermore, as the age (ß = 0.94, p = 0.003) and gestational age (ß = 0.9, p < 0.001) increased, the probability of anxiety disorders in pregnancy decreased. Moreover, university education (ß = 1.65, p = 0.049) and high-risk pregnancy (ß = 1.72, p = 0.02) were recognized as risk factors for developing anxiety disorders during pregnancy. Conclusion: The high incidence of anxiety disorders in pregnant women suggests that obstetricians should pay more attention to identifying and treating anxiety disorders in all pregnant women, especially in high-risk pregnancies.

Women's worries about prenatal screening tests suspected of fetal anomalies: a qualitative study.

BACKGROUND: Pregnant women with suspected fetal anomalies experience a great deal of stress following prenatal screening tests. The present study aimed to investigate women's worries about prenatal screening tests suspected of fetal anomalies. METHODS: Through the use of qualitative content analysis, the reports of women whose prenatal screening tests were suspected of fetal anomalies were analyzed and the results were interpreted. The participants were selected from four public and private maternity care clinics of Babol, Iran, from December 2021 to January 2022, using targeted convenience sampling. Data were collected from 20 women aged 24 to 41 years old, who underwent prenatal screening tests and were suspected of fetal anomalies, using semi-structured face-to-face interviews. RESULTS: The four main themes included the "causes of worries" (with sub-themes of challenge with spouse and relatives, medical diagnosis processes, previous unpleasant experiences, physical and mental problems, financial worries, and misinformation), "anxiety-coping styles" (with cognitive emotion-oriented, behavioral emotion-oriented, and problem-oriented sub-themes), "reactions to a possible diagnosis of anomaly" (with three sub-themes, namely concealment, extreme fear and worry, and denial), and "attribution of the cause of the anomaly" (with sub-themes of consanguine marriage, evil eyes, tendency to have a baby of a particular gender, a history of anomalies in the previous child, the spouse's medical illness, unplanned pregnancy, and high maternal anxiety). CONCLUSION: Women with suspected fetal anomalies experience a great deal of stress, the most important reason for which is the "physician's uncertainty". "Sharing worries with relatives" was the most common style of coping with worries. Establishing emotional support and empathetic communication between midwives and physicians with pregnant women suspected of fetal anomalies were important ways to reduce their worries.

The role of psychological self-care on worry of vaccination against COVID-19 in Iranian pregnant women: A cross-sectional study.

Background and Aims: Although previous studies have reported some psychological factors to prevent the worry of vaccination against COVID-19 in pregnant women, the role of psychological self-care is unclear. The present study aimed to investigate the role of psychological self-care in pregnant women on the depressive symptoms, psychological distress, and worry of vaccination against COVID-19. Methods: The present cross-sectional study was conducted during the peak of the Delta variant of COVID-19 in Babol city (North, Iran) from August to November 2021. Two hundred pregnant women referring to three prenatal clinics completed five questionnaires including; demographic characteristics, Edinburgh postnatal depression scale, psychological self-care, brief symptom inventory 18, corona disease anxiety scale, and acceptance of vaccination-3 inventory. Results: Pregnant women were in relatively good condition based on psychological self-care but were not significantly associated with demographic characteristics, such as age, gestational age, educational background, pregnancy, and risk of parity. It was psychological self-care of pregnant women which negatively predicted the depressive symptoms (ß = -0.311, p < 0.001), anxiety symptoms (ß = -0.269, p < 0.001), psychological distress (ß = -0.269, p < 0.001), and worry of vaccination against COVID-19 (ß = -0.214, p < 0.001). Conclusion: Women's psychological self-care plays a protective role against the depressive symptoms, anxiety symptoms, psychological distress, and worry of vaccination against COVID-19 during pregnancy. Clinicians need to pay more attention to the role of psychological self-care as an important factor in preventing the symptoms of anxiety and depression during regular pregnancy visits.

Screening of psychiatric disorders in women with high-risk pregnancy: Accuracy of three psychological tools.

PURPOSE: This study investigated the optimal cutoff points of three psychological tools for screening psychiatric disorders in women with high-risk pregnancy. DESIGN AND METHODS: In this cross-sectional study (N = 155), sensitivity/specificity of the Edinburgh Postnatal Depression Scale (EPDS), the Brief Symptom Inventory 53-items (BSI-53), and the BSI-18 were computed with respect to having a psychiatric diagnosis based on the clinical interview. RESULTS: The usual cutoffs (≥13 for EPDS, T-score of 63 for BSI-53) demonstrated poor diagnostic accuracy. The optimal thresholds were computed for EPDS cutoff of 6.5, GSI = 0.47 for BSI-53, and GSI = 0.5 for BSI-18. PRACTICE IMPLICATIONS: The use of psychological tools among pregnant women with high-risk pregnancy may need to be modified in order to accurately identify psychiatric disorders.

Depressive symptoms and psychological distress from antenatal to postnatal period in women with high-risk pregnancy: A prospective study during the COVID-19 pandemic.

BACKGROUND: The impact of the coronavirus disease 2019 (COVID-19) pandemic on mental disorders in postnatal period remains unknown. AIM: The study aimed to determine the extent to which the COVID-19 pandemic may aggravate depressive symptoms and psychological distress of women with high-risk pregnancy in postnatal period. METHODS: This prospective cross-sectional study was conducted on women with complicated pregnancies from antenatal to postnatal period. In the first phase, from December 2019 to January 2020 (before the beginning of the COVID-19 pandemic), 122 pregnant women filled in the Edinburgh Postnatal Depression Scale (EPDS) and Brief Symptom Inventory 53-items (BSI-53). In the second phase, with the start of the COVID-19 pandemic from February to June, 30% of the participants (41/122) completed three questionnaires: EPDS, BSI-53, and the posttraumatic stress disorder (PTSD) scale in postpartum period. RESULTS: During the COVID-19 pandemic, from antenatal to postnatal period, the depression score of EPDS, total scores, all the subscales of BSI-53, and global severity index-53 increased in women with high-risk pregnancy. Furthermore, the persistence of antenatal depression occurred in 85.7% of the participants, and the onset of postnatal depression occurred in 80% of them. About 12% of the women also experienced PTSD symptoms during the postnatal period. CONCLUSION: The COVID-19 pandemic may aggravate the prevalence and persistence of postnatal depression in women with high-risk pregnancy. The study calls for clinical implementation to identify and help women with mental disorders in postnatal period, especially women experiencing complicated pregnancies.

Prevalence and factors related to psychiatric symptoms in low risk pregnancy.

BACKGROUND: Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City. METHODS: This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data. RESULTS: The prevalence of depressive disorders was 15.4%% for Edinburg scores ≥13. The overall rate of maternal psychiatric symptoms (global severity index or GSI scores ≥ 1.75) was 48.5%. The prevalence of psychiatric symptoms was high; for 25% somatization, 258% anxiety, obsession-compulsion disorders or OCD 6.4%, 8.8% interpersonal sensitivity, 5.3% phobia, 7.6% paranoid ideation, and 1.2% psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (ß=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17). CONCLUSION: The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women.

The Effect of Brief Supportive Psychotherapy on Prevention of Psychiatric Morbidity in Women with Miscarriage: A Randomized Controlled Trial about the First 24-hours of Hospitalization.

OBJECTIVES: Miscarriage is a common pregnancy complication causing substantial psychiatric complications. This study was designed to investigate whether the administration of brief supportive psychotherapy (BSP) is effective on the management of women with miscarriage when conducted in the first 24 hours of hospitalization in order to prevent symptoms of anxiety, depression, and grief at four-months post-miscarriage. METHODS: We conducted a randomized clinical trial on 79 women with miscarriage hospitalized in Ayatollah Rohani teaching hospital. The women were randomly assigned into two groups (39 in the experimental group and 40 in the control group). All interventions were implemented for two study groups during the first 24 hours of hospitalization in a private room in the hospital. The experimental group received a two-hour BSP. The objective outcomes were assessed using Hospital Anxiety and Depression Scale and Perinatal Grief Scale (PGS), which has three subscales (active grief, difficulty coping, and despair) and were measured before the intervention and at four-months post-miscarriage. RESULTS: The results of pre-tests in the follow-up of the trial suggested that the participants who received BSP reported significant reductions in the mean scores of active grief (-34.2±9.7 vs. 28.1±-6.9), difficulty coping (27.1±6.4 vs. 23.3±4.3), despair (28.0±8.4 vs. 22.8±5.2), and total PGS (89.6±23.1 vs. 74.4±15.3), in contrast to participants in the control group who did not report such results. Further, the results of generalized estimating equations models revealed that brief supportive psychotherapy caused a significant decrease in the level of factors including active grief, difficulty coping, despair, total perinatal grief, anxiety symptoms, and depressive symptoms in subjects in the experimental group compared to those in the control group after miscarriage. Also, the frequency of anxiety symptoms (13.5% vs. 60.5%), depressive symptoms (32.4% vs. 71.1%), and grief symptoms (10.8% vs. 65.8%) was found to be significantly lower in the group receiving psychotherapy than in the control group at four-months follow-up. CONCLUSIONS: Administration of BSP session during the first 24 hours of hospitalization for women with miscarriage can be considered a reliable method to prevent anxiety symptoms, depression symptoms, and perinatal grief at four-months follow-up.

Triglyceride to HDL cholesterol ratio and risk for gestational diabetes and birth of a large-for-gestational-age newborn.

BACKGROUND: Using oral glucose for glucose challenge test (GCT) and glucose tolerance test (GTT) is problematic, especially in early pregnancy when the pregnant woman is experiencing gastrointestinal complications. This research seeks to investigate the relationship between the ratio of Triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) and the risk of gestational diabetes and large for gestational age (LGA) fetus for suggesting a more appropriate index for diagnosis of gestational diabetes. METHODS: The present cross-sectional study investigated pregnant women visiting the Perinatal Clinic of Ayatollah Rouhani Hospital in Babol for prenatal care from September 2015-2016. The GCT was performed on these pregnant women at 24-28 weeks as a screening test and their lipid profile, including HDL-C and TG, was simultaneously assessed after eight to 14 hours of fasting. RESULTS: Significant differences were observed between women with and without gestational diabetes in terms of mean triglyceride, HDL, LDL/HDL ratio, triglyceride/LDL ratio and triglyceride/HDL ratio. The cut-off point of TG/HDL in the GTT was 4.254 with a sensitivity of 79.07% and specificity of 78%. CONCLUSIONS: According to the results obtained, lipid profile can help predict the risk of gestational diabetes, especially TG/HDL ratio that has a high sensitivity to diagnose gestational diabetes, while, lipid indices could not predict birth of a LGA neonate.

Vaginal discharge concentrations of ß-human chorionic gonadotropin, creatinine, and urea for the diagnosis of premature rupture of membranes.

OBJECTIVE: To determine the diagnostic value of vaginal discharge concentrations of ß human chorionic gonadotropin (ß-hCG), creatinine, and urea to identify premature rupture of membranes (PROM). METHODS: An observational cross-sectional study was conducted between 12 June, 2014, and 11 June, 2015, among 120 women who were admitted to an Iranian hospital at 28-41 weeks of pregnancy. Women with positive pooling and nitrazine test results were assigned to the PROM group (n=60), whereas those with negative test results were assigned to the control group (n=60). Samples of vaginal discharge were obtained. RESULTS: Mean concentrations of ß-hCG, urea, and creatinine were all higher in the PROM group than in the control group (all P=0.001). The diagnostic accuracies as defined by area under the curve for creatinine, urea, and ß-hCG were 0.891, 0.895, and 0.908, respectively. The corresponding optimal cutoff values were 20.33 µmol/L, 0.94 mmol/L, and 39.5 IU/L, respectively. CONCLUSION: The vaginal discharge concentrations of all three markers exhibited favorable predictive value for the diagnosis of PROM; however, ß-hCG showed greater diagnostic accuracy than either urea or creatinine.

A RCT of psychotherapy in women with nausea and vomiting of pregnancy.

STUDY QUESTION: Does adding psychological intervention to medical therapy improve nausea/vomiting, psychological symptoms, and pregnancy distress in women with moderate nausea and vomiting of pregnancy (NVP)? SUMMARY ANSWER: Three weeks of medical therapy plus psychotherapy yielded statistically and clinically significant improvements in NVP-specific symptoms, anxiety/depression symptoms, and pregnancy distress, compared with medical therapy alone. WHAT IS KNOWN ALREADY: Pregnancy with nausea/vomiting is associated with psychiatric morbidity. Evidence supports the exploration of psychosocial reactions in addition to biochemical markers related to NVP. STUDY DESIGN, SIZE, DURATION: This prospective, open-label, randomized, controlled, parallel-group study was performed at two obstetrics clinics in Iran. A total of 86 women, aged 18-40 years, between 6 and 12 weeks pregnant with moderate NVP, more than 5 years of education, and not currently practicing any relaxation techniques or undergoing any psychotherapy, were enrolled from June 2013 to November 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS: A total of 86 moderate NVP women were randomly allocated to either a control (medical therapy alone) or experimental (medical therapy plus psychotherapy) group. Block randomization was achieved using a paper list prepared by an investigator with no clinical involvement in the trial. The experimental group was given pyridoxine hydrochloride (40 mg daily) for 3 weeks, and also received intensive mindfulness-based cognitive therapy (MBCT) in eight individual sessions (50 min each) over 3 weeks. The control group was given pyridoxine hydrochloride (40 mg daily tablet) for 3 weeks alone. All participants completed the Rhodes index of nausea, vomiting and retching (RINVR), the hospital anxiety and depression scale (HADS), and the prenatal distress questionnaire (PDQ) at baseline, 3 weeks after baseline at the end of the study, and at a 1 month post-treatment follow-up. Linear mixed-effects models were used, in an intention-to-treat analysis. MAIN RESULTS AND ROLE OF CHANCE: In the psychotherapy plus medical therapy group, the mean relative difference between baseline and post-treatment decreased for RINVR; nausea 8.2 (95% confidence interval (CI) 4.1, 10.2), vomiting 3.5 (95% CI 1.5, 5.8), and total RINVR 11.7 (95% CI 6.5, 16.5), for HADS; anxiety 5.1 (95% CI 3.2, 9.2), depression 3.5 (95% CI 2.4, 7.3), total HADS 7.2 (95% CI 4.4, 12.1), for PDQ; birth concerns 3.3 (95% CI 1.3, 9.1), body concerns 1.5 (95% CI 0.9, 5.1), relationship concerns 2.1 (95% CI 1.2, 5.9), and total PDQ 5.9 (95% CI 3.5, 10.6). At 1 month after treatment, the statistically significant improvement in RINVR, HADS and PDQ, as well as clinical improvement in severity of symptoms, persisted. Medical therapy plus psychotherapy also improved nausea/vomiting symptoms, psychological symptoms, and reduced pregnancy distress more than medical therapy alone, with an effect size of 0.42-0.72 over the trial period. LIMITATIONS, REASONS FOR CAUTION: The conclusions were limited to a small number of women with moderate NVP. It is unclear whether the difference between the outcomes in the different groups was related to MBCT alone, or to the extra time and attention paid to patients in the medical therapy plus psychotherapy. The participants in the study did not remain blind to the treatment and the outcome may only be representative of women with moderate NVP who have been referred to obstetrics clinics. WIDER IMPLICATIONS OF THE FINDINGS: These findings show that adding 3 weeks of psychological intervention to medical therapy may appear to produce positive therapeutic outcomes upon conclusion of treatment, and 1 month after treatment. This suggests that psychotherapy should be considered as an adjunctive treatment option for women with moderate NVP. In future studies, however, a group of patients who are receiving placebo psychotherapy along with medical treatment should be included. Furthermore, an economic evaluation of the addition of psychological intervention to standard medical therapy would be useful.

Women's satisfaction in early versus delayed postcaesarean feeding: A one-blind randomized controlled trial study.

BACKGROUND: The early postoperative feeding after caesarean section (C- section) has remained controversial. This study was designed to evaluate the safety and efficacy of early versus delayed postcaesarean section oral feeding regarding gastrointestinal complications and patients postoperative satisfaction after C- section. METHODS: This clinical trial study was conducted on 200 pregnant women undergoing planned C-section under spinal anesthesia (Registration Number: IRCT: 138712211760N1). Women were randomly divided in two groups; group A (early feeding group) comprised of 101 patients who were encouraged to take oral fluid. If they tolerated, they continue semi-solid and solid foods starting 2 h after caesarean section. Group B (delayed feeding group) comprised of 99 patients who were given oral fluid 8 h after surgery. After beginning of feeding the patients' tolerance, first flatus, first defecation, beginning of regular diet, the length of hospital stay and also patient satisfaction level were evaluated in each group by visual scale analog (VAS). RESULTS: The mean time of the first passage of flatus was 10.2±1.7 hours for the early oral feeding group versus 10.7±1.6 hours for the delayed feeding group and the difference was significant (P=0.03). Duration to first defecation and length of hospital stay as well as patient satisfaction level did not differ significantly between the two groups. CONCLUSION: The results of this study suggest early postcaesarean feeding. It is well tolerated and helps return normal feeding habits.

Daily versus intermittent iron supplementation in pregnant women.

BACKGROUND: The purpose of this study was compare of daily iron supplementation in three time frames- daily, weekly and three time weekly supplementation in preventing anemia in healthy pregnant women. METHOD: The present study was a prospective simply randomized clinical trial. During January 2006- January 2008, 150 healthy pregnant women without anemia, in their 16th week of pregnancy were randomly allocated into three equal groups. The first group (n = 50) received a 50 mg-ferrous sulfate tablet daily, second group (n = 50) received a 50 mg-ferrous sulfate tablet three times a week, and the third group (n = 50) received two 50 mg-ferrous sulfate tablets (100 mg) weekly, respectively for 12 consecutive weeks. Serum hemoglobin, ferritin, and iron were measured before and after the supplementation. Paired t and ANOVA tests were used as appropriated. RESULTS: There were no significant differences between the pre- and post-treatment hemoglobin levels with iron supplementation in the three group (P = 0.518, P = 0.276, respectively). The mean serum iron level before and after treatment with iron supplementation in the three groups was not statistically significant (P = 0.962, P = 0.970, respectively). Although the mean serum ferritin level before and after treatment with iron supplementation was statistically significant in the three groups, no significant differences were found comparing the three groups (P = 0.827, P = 0.635 respectively). CONCLUSIONS: This results suggested, three times a week or weekly iron supplementation is as effective as daily supplementation for healthy pregnant women without anemia. TRIAL REGISTRATION: ISRCTN: IRCT201101093820N1.

Comparison of three malignancy risk indices and CA-125 in the preoperative evaluation of patients with pelvic masses.

BACKGROUND: Patients with pelvic mass are the most referred patients to gynecologist. The aim of this study was to evaluate the ability of three malignancy risk indices (RMI 1, RMI 2 and RMI 3) and CA-125 to discriminate a benign from a malignant pelvic mass in our region (North of Iran). METHODS: This retrospective study was performed on 182 women with pelvic masses referred to Yahyanejad Hospital from 2007 to 2009. Ultrasound scans were scored as one point for each of the following characteristics: multilocular cyst, solid areas, intra-abdominal metastases, ascites, and bilateral lesions. For each patient a total ultrasound score (U) was calculated. The difference of the three RMI was based on the allocation of the U and M scores. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of level of serum CA-125, the RMI 1, 2 and 3 were compared. RESULTS: Mean age of the patients was 39.9 ± 9.3 years. Most of them were premenopausal (161 women or 88.4%). A significant linear trend for malignancy was found by increasing age, ultrasound score, and serum CA-125. The best performance of CA125 was at a cut-off 88 U/ml, with a sensitivity of 88%, a specificity of 97%, a positive predictive value of 84%, and a negative predictive value of 99%. RMI 1 and 3 at the optimal cut off point of 265 and RMI2 at the optimal cut off point of 355, had a sensitivity of 91%, specificity of 96%, a positive predictive value of 78%, and a negative predictive value of 99%. CONCLUSION: In our population we found that there is no statistically significant difference in the performance of three malignancy risk indices (RMI 1, RMI 2, and RMI 3) and CA125 in differentiating between benign and malignant pelvic masses.

Angiomyofibroblastoma of the vulva.

Angiomyofibroblastoma is a benign well-circumscribed tumor characterized by alternating hypocellular and hypercellular areas with abundant thin-walled blood vessels. The tumor cells are bland and spindle-shaped or epitheloid and tend to concentrate around the vessels or cluster in small nests. Herein, we report a case of angiomyofibroblastoma of the left labia major in a 50-year-old female. The tumor measured 18 x 16 x 11 cm and appeared as an ulcerated rubbery vulvar mass with rapid enlargement during one month. Ultrasonography demonstrated a soft tissue tumor with homogeneous echo and normal vascularity. Histologically, cells were positive for vimentine, desmin, and estrogen and progesterone receptors but negative for cytokeratin; all in favor of the diagnosis of angiomyofibroblastoma.

Serum beta human chorionic gonadotropin levels and preeclampsia.

OBJECTIVE: Preeclampsia is one of the most common complications of pregnancy. It is a trophoblastic disorder. Since human chorionic gonadotropin (hCG) is secreted by trophoblast, the purpose of the study was to determine the levels of beta (hCG) in preeclampsia and normal cases. METHODS: This study was conducted on 40 term pregnant women with preeclampsia (case group) and 40 normal pregnant cases (control group) in the Department of Obstetrics and Gynecology, Medical University, Babol, Iran, from 2004 to 2005. Serum beta-hCG in all cases were measured by radioimmunoassay. The mean beta-hCG level in preeclampsia (mild and severe) was compared with normal cases. RESULTS: The maternal serum, beta-hCG level in patients with preeclampsia (39840 +/- 24630 IU/L) was higher than in the control group (27460 +/- 25862 IU/L) (p=0.031). In mild preeclampsia (34 cases), the mean serum beta-hCG level was 31991 +/- 16758 IU/L while in severe preeclampsia (6 cases) 84312 +/- 9257 IU/L (p<0.0001). The mean serum beta-hCG level in mild and severe preeclampsia was higher compared to the normal cases. CONCLUSION: The results of this study show that the levels of beta-hCG in severe form of preeclampsia is higher compared to the milder ones.