Tehran University Medical Journal

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In a descriptive study on 791 cases of normal vaginal deliveries within the period of 6 months (20th Sept 1994-20th March 1995) in Shariatti hospital, the duration of active phase of labor was evaluated. In 140 pregnant women (69 primigravida and 71 multipara) which had the inclusion criteria (single fetus, cephalic presentation, 37 to 42 weeks of pregnancy, admission before cervical dilatation of 3-4 cm, no need for augmentation of labor, forceps-vaccum or cesarean section) the mean duration for 1st stage was 2.31 hrs in primigravid and 1.56 hrs in multipara, for 2nd stage was 35 minutes in primigravid and 17.5 minutes in multipara. Maternal age, parity and fetal birth weight had influence on the duration of labor. Maternal age and parity each had independent and also additive effects on the duration of labor. Fetal birth weight of >3500 gr in multipara and >4000 gr in primipara caused lengthening of the duration of labor.

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259 consecutive colposcopic examinations were done at colposcopic unit in Shariati Hospital during 1995-97. 58 cases were omitted due to lack of biopsy report. There were 167 cases of concordance and 34 cases of discordance between results of pap test colposcopic directed biopsy in these cases. We evaluated the value of pap test as a screening test versus colposcopic directed biopsy and found sensitivity of 42.4%, specificity of 94%, PPV (Positive predictive value) of 60.8%, and NPV (Negative predictive value) of 89.3%, false nagative and false positive rates were 57.8% and 5.3%, respectively. If pap test and HPV DNA screening were done simultaneously, almost all invasive cancer and HiSIL would be detected

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Betamethason Causes adrenal suppression in woman at risk of pre‌term delivery.
Materials and Methods: An interventional study was done on 25 women at risk of pre-term delivery, Betamethason course (12-mg-im q 24 hr for 2 doses) was prescribed for 2 consecutive weeks. ACTH Stimulation test was done one week after each Betamethason injection. (1st between 30-31 w and the 2nd one week later. Serum Cortisol levels were measured before betamethason administration and then before and 30 minutes after ACTH Stimulation test.
Results: All Subjects had normal baseline Cortisol level. Mean baseline serum Cortisol levels decreased with each ACTH stimulation test from 24.32±0.77 ug/dl ( before Betamethason) to 7.33±1.73 ug/dl ( one week after the second course of Betamethasone) (p < 0.0001). The mean stimulated Cortisol levels also decreased from 23.93±1.44, ug/dl (befor Betamathason) to 19.53=+2.69 (one week after the second course of Betamethasone) (P<0.007), compared with initial ACTH stimulation test. Laboratory evidence of adrenal suppression (Cortisol < 6 ug/dl) observed in three patients one week after the first course of betamathasone injection and in 15 patienst after the second course. No sign or symptom of Addisonian Crisis occurred antepartum or intrapartum.
Conclusion: Antenatal administration of Betamethasone caused measurable adrenal suppression in women at risk of preterm delivery. The number of women with adrenal suppression increased each week that antenatal betamethason was repeated.

 

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Background: There is dearth of reports from Iran regarding the prevalence of postterm pregnancy and its complications. The present study was conducted to evaluate the prevalence, management and outcome of prolonged pregnancies.

Methods: This cross-sectional study included data from the hospital records of all women referred to Shariati Hospital, Tehran, from 2001 to 2002 with pregnancies of more than 40 weeks in duration. Pregnancies ≥40-42 weeks were considered postdate and those more than 42 weeks postterm pregnancy. The data compiled from the hospital records were subjected to t, χ² and Mann-Whitney U tests.

Results: Of the 1500 deliveries in this hospital, 98 patients were included in this study, 66.3% of whom were nullipara and 33.7% multipara. The prevalence of postterm pregnancy was estimated to be 3.3%. Cervix dilation of 2 cm or less on admission occurred in 65 women (73.3%). The mean Bishop score was 4.31. Of the 62 fetuses that underwent assessment tests, 54 (87.1%) were normal. The median time between the last test and induction of labor was 2.1 days, and 2.6 days for cesarean deliveries, which was not a significant difference (P=0.6). Cervical ripening with misoprostrol was performed in 36 cases (36.7%) and was successful in 18 cases. In this group, the median time for cervical ripening in multiparas was significantly less than nulliparas (4 vs. 7 hrs, P=0.004). Women not subjected to cervical ripening had a higher cesarean rate than those who did undergo cervical ripening (74.7% vs. 66.1%), although this difference was not significant (P=0.9). Vaginal and cesarean delivery rates showed no significant difference between cases that underwent induction with oxytocin and those subjected to cervical ripening with misoprostol (P=0.9). The mean Apgar score was 9.5, with all scores above 6. There were no cases of neonatal hypoglycemia, hypocalcemia, NICU admission or prenatal death. The mean nursery stay was 1.84 days with a range of 1-8 days.

Conclusions: The prevalence of postterm pregnancies was 3.3% in this study, due in part to erroneous estimation of gestational age. Sonography exam in the first half of pregnancy can provide a better estimation of gestational age and thereby reduce the rate of postterm pregnancy. Cervical ripening and induction of labor shorten the duration of pregnancy however, whether it has any beneficial effect on neonatal outcome remains controversial.

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Background: Osteoporosis threatens the aged population especially the menopausal women and can lead to life long disability and death. Appropriate knowledge and behavior have an important role in prevention of osteoporosis. In this study the knowledge, attitude and behavior of women regarding osteoporosis is assessed and compared in different age groups.
Methods: This cross sectional study includes 390 women in reproductive, premenopausal and menopausal age groups who had come to Shariati hospital clinics and each had answered the designed questionnaire. The questionnaires were scored and analyzed. Women’s knowledge, attitude and behavior were assessed and compared by X2 test in the three age groups and P<0.05 was considered significant.
Results: 15–30% of women didn’t know what osteoporosis is and in 380 of them attitude or behavior was not good. Education had a significant effect on knowledge of women in reproductive and premenopausal ages (P=0.002, 0.04 respectively), but had no effect on their attitude or behavior. Age had a significant effect on knowledge and attitude (P=0.001) but had no effect on behavior. Age had significant effect on the knowledge that exercise can prevent osteoporosis (P=0.014) but not on attitude or behavior. Age had no effect on knowledge, attitude or behavior of daily calcium intake to prevent osteoporosis. (P=0.123, 0.12, 0.153 respectively) 93% to 95% of women thought the risks of osteoporosis are less than cardiovascular disease or breast cancer.
Conclusions: 15–30% of women didn’t know what osteoporosis is. The total knowledge about osteoporosis was low. Although 22-75% of women younger than 54 years old had knowledge about the predisposing factors but their attitude or behavior was not good.