Back ground

Anemia in pregnancy is associated with increased rates of maternal and perinatal mortality, premature delivery, low birth weight, and other adverse outcomes

Materials and Methods

A prospective study was conducted on 1405 Iranian pregnant women who delivered during 2015. Blood was collected from all the subjects to measure the hemoglobin (Hb) during 16-19 weeks, 22-24 weeks, and 34-36 weeks of gestation. According to the level of hemoglobin, it is divided into 4 groups. Group 1 Hb > 10.1 gm/100ml (control group), Group 2 Hb= 8.1-10 gm/100ml (mild anemia) Group 3 Hb= 6.5-8 gm/100ml (moderate anemia) Group 4 Hb <6.5 gm/100ml (severe anemia). After delivery, the neonates were weighted within 24 hours after birth. Maternal hemoglobin and birth weights were compared.

Results

The anemia prevalence was 20.2%

(Hb<10g/dl). Out of them, 16.2 % hadmoderate anemia (Hb=6.5-8 g/dl) and 83.8% had mild anemia (Hb=8.1-10 g/dl). Severe anemia did not detect in pregnant women. The hemoglobin levels in non anemic group showed a drop in the second trimester. Pregnant women with hemoglobin less than 10 g/dl, considered as anemic gave birth to neonates with birth weight of 2.6kg, while pregnant women with higher hemoglobin level (>10 g/dl), considered  as normal gave birth to heavier and normal babies (3.3 kg). The severity of anemia during three trimesters was closely associated with birth weight of newborns.

Conclusion

The low hemoglobin values during three trimesters of pregnancy were associated with low birth weight in Iran. The anemia can lead to intra uterine growth retardation.

Fibroadenoma is the most common benign mass of breast in females 20-50 years of age. Juvenile fibroadenoma accounts for only 4% of total fibroadenomas. Moreover, the incidence of giant juvenile fibroadenoma is found to be only 0.5% of all fibroadenomas. A 15-year-old woman at the 12th week of gestation was referred to the Shahid Sadoughi Hospital, Yazd, Iran because of a mass in the right breast from one year ago. On Physical examination and imaging, a large mass was found in her right breast. Fine needle aspiration biopsy reported fibroadenoma. Mass enucleation and breast reconstruction were performed. Pathologic examination confirmed a giant fibroadenoma. No serious complications were reported during one-month follow up. The most highlighted point of this presentation was giant size of juvenile fibroadenoma in a pregnant woman. This case report shows that large breast tumors in the adolescent age group can be benign and breast-conserving surgery should be considered in such cases.