Beigi A, Zarrin Koob F,
Volume 58, Issue 4 (8 2000)
Abstract
Estimating fetal weight in utero, for better management of pregnancy and appropriate timing of delivery especially in high-risk pregnancies is necessary. Our purpose to evaluate a simple method in estimating fetal weight in Iranian pregnant patients and also to compare was with a previous western study. This study was carried out in Arash hospital, Tehran university of medical sciences in 1996-99. In a descriptive-analytic study that was done prospectively on 464 pregnant patients, ultrasonic measurement of biparietal diameter (BPD), mean abdominal diameter (MAD), and femur length (FL) performed close to delivery was conducted. Birth weight also was identified. Statistical analysis was done using multiple linear regression on the data and also student's T-test for comparison. Mean birth weight was 2320 gr. The outcome of linear regression analysis was the following model: Weight (gr)=95.8×FL (cm)+25×MAD (cm)-15.6×BPD (cm)-4632.1. The effect of all parameters were statistically significant (P<0.02). A fetal weight estimating table was also developed. T-test analysis showed a significant difference (P<0.05) in some final ranks of table (Weight estimations>4000 gr) in comparison with the Rose and Mc callum study. Our study showed that ultrasound using the sum of BPD, MAD and FL is a precise method in fetal weight estimation. Application of other biometric measurements may be needed for better elucidation especially in small and large for gestational age fetuses.
Zarrinkoub F, Beigi A,
Volume 65, Issue 6 (3 2007)
Abstract
Background: Jaundice is one of the most frequent problems observed in newborns. Our purpose was to investigate the incidence and the risk factors on jaundice noted in the first 24 hours after birth.
Methods: All newborns observed to have jaundice within the first 24 hours after birth were enrolled prospectively in this study. Laboratory evaluations included blood group typing of mother and newborn, hemoglobin and hematocrit, complete blood count, peripheral blood smear, reticulocyte count, G6PD activity, maternal indirect and neonatal direct Coombs test, and serum total, conjugated, and unconjugated bilirubin. In all cases, gender, birth weight, Apgar scores, gestational age, mode of delivery, birth trauma, cephalhematoma, maternal age, parity, or any siblings with neonatal jaundice were recorded. Data were analyzed using one-way ANOVA, Student's t-, and chi-square tests.
Results: Of a total of 2096 newborns delivered in one year, 122 (5.8%) developed jaundice within the first 24 hours after birth. Risk factors for hyperbilirubinemia were ABO incompatibility, prematurity, infection, G6PD deficiency, cephalhematoma, asphyxia, and Rh disease. There were no statistically significant relationships between jaundice and maternal age, parity, mode of delivery, neonatal gender or previous siblings with jaundice (p>0.05).
Conclusions: Jaundice observed in the initial 24 hours after birth was infrequent, but clinically significant. All newborns should be followed by repeated exams within the first 24 hours after birth and before discharge, especially if the maternal blood group is O.
Beigi A, Behdani R, Zarrinkoub F,
Volume 65, Issue 7 (4 2007)
Abstract
Background: Infectious complications of hysterectomy remain common despite the use of antibiotic. The usual existing methods of preoperative antisepsis do not control the vaginal bacteria that are the primary cause of contamination at the surgical site. Our goal was to assess whether febrile morbidity after total abdominal hysterectomy is decreased by the addition of povidone-iodine gel at the vaginal apex after the routine vaginal preparation with povidone-iodine solution.
Methods: We carried out a prospective randomized trial on women admitted for elective abdominal hysterectomy. Inclusion criteria included planned abdominal hysterectomy for benign or malignant gynecologic conditions. Exclusion criteria consisted of emergency surgery, current treatment for pelvic infection, and known povidone-iodine allergy. A total of 168 patients were randomized to either the control group or the intervention group, who received 20 cc povidone-iodine gel placed at the vaginal apex immediately before the operation. Both groups received the routine preoperative preparation of antimicrobial prophylaxis, abdominal and vaginal scrubbing with povidone-iodine solution prior to the operation. The primary outcome was post-operative febrile morbidity. Other outcomes included abdominal wound infection, vaginal cuff cellulitis or pelvic abscess. Data was analyzed using Fisher's exact test. p<0.05 was considered statistically significant.
Results: The overall rate of febrile morbidity was 20.5%. Febrile morbidity occurred in ten of 80 (12.5%) women receiving the povidone-iodine gel preparation and 24 of 86 (27.9%) women not receiving the gel (p<0.05). The rate of abdominal wound infection was 18.6% (16) in the control group, and 5% (4) in the gel group (p<0.05). Vaginal cuff cellulitis was seen in three patients from the control group versus one woman from the gel group (p>0.05). Pelvic abscess was diagnosed in one patient from the control group and in no patients from the gel group (p>0.05).
Conclusion: Preoperative vaginal povidone-iodine gel is an effective technique for reducing febrile morbidity and the risk of abdominal wound infection after hysterectomy.
Beigi A, Saeedi L, Samiei H, Zarrinkoub F, Zarrinkoub H,
Volume 66, Issue 1 (30 2008)
Abstract
Background: Whatever its etiology, the inflammatory reactions of preeclampsia lead to the activation of endothelium and result in vascular damage. CRP is considered a sensitive index of systemic inflammation, so it is used as predictive factor for disease. This study was carried out to test the screening and predictive abilities of the CRP test in order to detect and diagnose pregnant women prone to preeclampsia prior to the onset of symptoms.
Methods: In this prospective cohort study, conducted in Arash Hospital between 2005 and 2006, we determined the CRP levels of 201 pregnant women at 10-16 weeks of pregnancy. Based on exclusion criteria and illness, 31 patients were excluded and 170 patients were followed until the end of their pregnancies.
Results: In this study, the mean serum CRP values of those who had preeclamptic and those who had normal pregnancies were compared and the statistical differences were significant: 6.18 mg/L for preeclamptic patients compared with 4.12 mg/L for normal patients (p=0.003). Using a chi-square test, we found that patients whose CRP level was ≥4 were six times more likely to have preeclampsia than those with CRP levels <4 (k=9.4 p=0.002 OR=6.15 95% CI=0.69-22.28).
Conclusion: This study confirms the results of previous reports indicating a significant relationship between rising serum CRP in the first trimester of pregnancy and preeclampsia at third trimester. More studies consisting of other inflammation factors are necessary to find an acceptable and reasonable screening test to diagnose pregnant women who are prone to preeclampsia.
Behdani R, Beigi A, Mobaraki N,
Volume 66, Issue 2 (1 2008)
Abstract
Background: Approximately 10 percent of all pregnancies continue to 42 weeks'gestation. The true prevalence of pregnancies lasting longer than 41 or 42 weeks'gestation has been difficult to establish because many such diagnoses occur as a result of an inability to accurately establish time of conception. Several studies indicate that menstrual dating is often inaccurate and can lead to induction of labor for a presumed but inaccurate diagnosis of postterm pregnancy. It is now widely accepted that a more precise method of determining gestational age is the first trimester measurement of crown-rump length of the fetus.
Methods: We carried out a cross- sectional study on patients who were referred for a prenatal care to Arash hospital, Medical Sciences/University of Tehran. Women in the first trimester of pregnancy who presented to the center during the study period with precise date of last menstrual period were eligible to enroll. They underwent an ultrasound dating scan between 8 and 12 weeks, measuring crown-rump length. The estimated date of delivery (EDD) was changed if there was a discrepancy of more than 5 days from the gestation, calculated from the last menstrual period (LMP). For the remaining women (no-scan group), gestation was determined using the LMP. Data were analyzed using SPSS, 11. Statistical significance was assessed with Chi-square, student t-test and Anova, using a significance threshold of < 0.05.
Results: Of 217 women who were enrolled, 10.6% of the patients who underwent an ultrasound dating scan were postdate versus 3.7% of the patients whose gestational age calculated from LMP (p=0.005).
Conclusions: The application of first trimester sonographic measurement of crown-rump length of the fetus results in a significant reduction of the diagnosis of postterm pregnancies.
