Terminal Pregnancy Complicated by Measles and Premature Labor:a Case Report

Measles infection in pregnant women is a very dangerous clinical condition.Patients usually had complicated pneumonia,and virus could pass through the placenta to the fetus and lead to premature delivery,stillbirth,miscarriage and neonatal measles.In this report,one such case,which was diagnosed by clinical signs and symptoms,clinical and laboratory examination was described.After proper therapeutic treatment,the infection was well-controlled and a baby was born by nature labor.

Effects of aromatherapy with Rosa damascena on nulliparous women's pain and anxiety of labor during first stage of labor

Background： Reducing labor pain and anxiety is one of the most important goals of maternity care. Objective： This study aimed to assess the effects of aromatherapy with Rosa damascena on pain and anxiety in the first stage of labor among nulliparous women. Design, setting, participants and interventions： This was a randomized clinical trial of 110 nulliparous women. The eligible participants were randomly assigned to two groups of aromatherapy and control in an Iranian maternity hospital. The participants received 0.08 mL of Rosa damascena essence in the aro- matherapy group and 0.08 mL of normal saline in the control group, every 30 min. Pain was measured 3 times, once each at three stages of cervical dilation （4-5, 6-7, and 8-10 cm）. Anxiety was measured twice, once each at two stages of cervical dilation （4-7 and 8-10 cm）. The tools for data collection were the Spielberger anxiety questionnaire, numerical pain rating scale, demographic and obstetric questionnaire, and an observational checklist. Data analyses included the t-test, Mann-Whitney U test and Chi-square test. Main outcome measures： Severity of labor pain and severity of anxiety were used as primary outcome measures. Labor and delivery characteristics （including number of contractions, duration of contractions in second stage, Bishop score, augmentation by oxytocin, Apgar score, and mode of delivery）, demographic characteristics, and fertility information were used as secondary outcome measures. Results： Pain severity in the group receiving aromatherapy with R. damoscena was significantly lower than in the control group after treatment at each pain assessment （cervical dilation of 4-5, 6-7, and 8-10 cm; P 〈 0.05）. Anxiety levels were also significantly lower in the treatment group than in the control group after treatment at each time of measurement （cervical dilation of 4-7 and 8-10 cm; P 〈 0.05）. Conclusion： Aromatherapy with R. damascena reduced the severity of pain and anxiety in the first stage of labor. Aromatherapy with R. damascena is a convenient and effective method for pain and anxiety reduc- tion during the first stage of labor.

Preterm Labor,a Syndrome Attributed to the Combination of External and Internal Factors

Preterm labor(before 37 weeks’gestation)is the leading cause of neonatal mortality and morbidity,which can be divided into iatrogenic preterm labor,infectious preterm labor,and spontaneous preterm labor(sPTL).Up to now,there continue to be great difficulties in prediction and prevention of sPTL,owing to multiple risk factors,pathogenesis,and pathologic processes contributing to the event,which have not been fully clarified.Pregnancy maintenance and parturition is a complicated process with continuous maternal-fetal dialogue,in which both maternal and fetal factors participate and affect the outcome of pregnancy,including sPTL.Besides,external factors can also participate in sPTL,individually or through the interaction with internal factors.In this article,we summarize recent studies regarding sPTL from our and other groups,and discuss the risk factors and pathogenesis of preterm birth from both external and internal(maternal and fetal)aspects,so as to provide theoretical evidences for the diagnosis,prevention,and treatment of sPTL in the future.

Pregnancy Outcomes Associated with Ovarian Hyperstimulation Syndrome:A Retrospective Cohort Study of Infertile Women

Objective To assess the relationship between ovarian hyperstimulation syndrome(OHSS)and adverse outcomes using population-based data in the United States.The hypothesis is that patients with OHSS were more likely to deliver preterm and more likely to have hypertensive disorders.Methods This retrospective cohort study identified 94 patients with OHSS and 183 matched referents in eight counties in Minnesota.Data were collected regarding pregnancy history,infertility treatment,and pregnancy outcomes.Using the Rochester Epidemiology Project,study subjects were identified from female patients,aged 18 to 49 years,who were diagnosed with infertility from January 2,1995 to December 1,2017,and had a pregnancy greater than 20 weeks'gestation.The primary outcome was preterm delivery or hypertensive disorder of pregnancy incidence in the OHSS group when compared with control patients.Chi-squared test,t test,and multivariate logistic models were used where appropriate.Results Patients with OHSS were more likely to deliver preterm(odds ratio,2.14;95%confidence interval,1.26–3.65;P<0.01),and their neonates were more likely to be small for gestational age(odds ratio,4.78;95%confidence interval,1.61–14.19;P<0.01).No significant differences between the groups were observed in any other outcome.Patients with OHSS are more likely to deliver preterm if they undergo fresh transfer compared with a freeze all and subsequent frozen transfer(odds ratio,3.03,95%confidence interval,1.20–7.66,P=0.02).Conclusion OHSS may lead to preterm birth and small-for-gestational-age neonates,which changes patient counseling and leads to arranging specialized obstetrical care for these patients with OHSS.