Search published articles


Showing 92 results for Pregnancy
Treatment of cervical pregnancy with preserving fertility: report of two cases
Sima Kadkhodayan , Golrokh Sherafati ,
Volume 72, Issue 10 (1-2015)
Abstract
Background: Cervix is a rare and dangerous site for ectopic pregnancy. When the placenta is implanted lower than internal cervical os, it is called “cervical pregnancy”. Known risk factors for cervical pregnancy are previous cesarean section, cigarette smoking, premature transfer of fertilized ovum before having suitable endometrium and pelvic inflammatory disease. In the past, hysterectomy was the usual treatment. Nowadays, with the newer diagnostic and therapeutic managements, cases of cervical pregnancy treated by fertility sparing methods have been reported. Conservative treatments include using methotrexate and KCl, hyperosmolar glucose, and prostaglandins. Also, surgical methods with fertility sparing have been reported. The purpose of this study is introducing two cases of cervical pregnancies treated by fertility sparing. Case presentation: The first patient had six weeks pregnancy with live fetus and detectable fetal heart beat. There was six weeks menstrual retard and βhCG titer was 10.000 UI/ml. Two doses of methotrexate were prescribed and pregnancy terminated successfully. The other patient had eight weeks pregnancy with fetal heart beat. There was eight weeks retardation and βhCG titer was 70379 UI/ml with no gestational sac in sonography in both patients. After prescribing two doses of methotrexate and doing curettage three days after the last dose of methotrexate, pregnancy terminated. The known risk factors for our patients were history of endometrial curettage in one and history of cesarean section in both of them. Conclusion: Conservative method may be considered for the treatment of cervical pregnancy in patients who desire to preserve their fertility. The treatment is associated with high success rates. Methotrexate (MTX) is the most common medicine for resolving ectopic cervical pregnancy, other medications such as KCl, hyperosmolar glucose, RU486 and prostaglandins have also been used with different success rate. Methotrexate may be administered systemic (intramuscular or intravenous) or local (intra-amniotic transfusion or intrauterine).
Relationship between body mass index of third trimester of pregnancy and type of delivery
Soroosh Aminolsharieh Najafi Aminolsharieh Najafi, Mahin Nomali , Zahra Goudarzi , Azita Maslahati , Elham Mobasheri ,
Volume 72, Issue 12 (3-2015)
Abstract
Background: Maternal Body Mass Index (BMI) is considered as one of most effective determinant of delivery rout, by increase in this index, risk factor of cesarean section enhanced. Based on high prevalence of obesity in women, this study designed to assess the relationship between admission BMI and type of delivery. Methods: Five hundred and forty pregnant women in third trimester of pregnancy (≥37weeks) were studied within 1 year (from June 2012 to June 2013), at Sayad Shirazi Referral Hospital, Gorgan, Iran, through a analytic cross-sectional study. BMI was calculated for each mother at the time of labor admission. Height and weight were measured, and were categorized into 3 groups according to their BMI which included of underweight and normal (BMI<25), overweight (BMI=25-29.9) and obese (BMI≥30). And in each group route of delivery (cesarean or natural delivery) were assessed. Pregnant women with the previous cesarean delivery, history of diabetes type 1, 2 or gestational diabetes, hypertension, twin pregnancy and unwilling to participate in study were excluded from study. Results: Mean of age and mean of gestational age were 25.8±5.4 years and 38.2±2.6 week, respectively. 50.6% of mothers were undergone cesarean delivery and there was a significant relationship between BMI and type of delivery (P<0.0001). For each unit increase in BMI, risk of cesarean section rose 1.08 times (CI95%=1.04-1.13, P<0.0001) and the risk of cesarean delivery in obese pregnant women was 2.8 (CI95%=1.7-4.4, P<0.0001) times higher than those with underweight and normal weight. Conclusion: There is a significant relationship between maternal BMI at the time of labor admission and type of delivery and increasing of BMI is associated with increasing of cesarean section rate. Thus, keeping the BMI in normal range during pregnancy is suggested to pregnant women to reduce the pregnancy complications.
Clinical results of microinjection with long protocol and prednisolone addition
Fariba Nanbakhsh , Behrooz Ilkhanizadeh , Nava Moghadasian Niaki , Sima Oshnouei, Pooya Mazloomi ,
Volume 73, Issue 1 (4-2015)
Abstract
Background: Last decades, we have observed major improvements in treating infertility by using microinjection. However, reduction in abortion or increase in fertility has not been significant. It seems use of corticosteroids improves clinical outcomes during assisted reproductive technology (ART) techniques. Therefore, this study tried to show how corticosteroids therapy improves the results of intracytoplasmic sperm injection (ICSI). Methods: This semi clinical trial study without control group was included infertile women with more than one year’s infertility and were candidate to ICSI which were referred to Kosar Infertility Center, Urmia University of Medical Sciences from April 2011 to September 2013. Patients received prednisolone which was started 20 mg/day from one day before embryo transfer to 7 days, then for 2 days more 1 tablet and stopped. Pregnancy outcomes were chemical and clinical pregnancy, ectopic pregnancy, multiple pregnancy and rate of abortion before 20 weeks. Beta human chorionic gonadotropin (HCG) test was performed. Patients with positive pregnancy test were followed by sonography in 6, 12 weeks and 20 weeks of pregnancy. Results: One hundred and eighty one patients entered to the study. The mean± SD of age and fertility duration were 30.42± 6.07 and 7.69± 5.54 years. The mean± SD of transferred embryo was 4.60± 1.10 and embryo grading was 138 (44.7%) grade A, 124 (40.1%) grade B, 47 (15.2%) grade C, respectively. There were no significant difference between fresh/frozen embryo transfer in pregnancy outcomes (P> 0.05 in all of outcomes comparison). The incidence rate of biochemical pregnancy was 48.1% (87), clinical pregnancy rate with appearance of fetal heart was 44.2% (80), incidence rate of abortion before appearance of fetal heart (6 weeks) in women with intra-uterine pregnancy was 5.9% (5), incidence rate of abortion before 20 weeks was 12.9% (11). Incidence rate of ectopic pregnancy was 2.3% (2) and rate of multiple pregnancies was 32.5% (26). Conclusion: Our study suggests that the infertile patients who receive prednisolone in ICSI cycle, had improved pregnancy outcomes. Additional confirmatory studies are needed.
Evaluation of side effects of ondansetron in pregnancy: a descriptive case-series study
Masoomeh Mirzamoradi , Zahra Heidar , Parichehr Kimiaee , Masoomeh Saleh , Sepideh Ashrafivand ,
Volume 73, Issue 1 (4-2015)
Abstract
Background: Ondansetron is a 5-hydroxytryptamine receptor antagonist which is a highly effective antiemetic for postoperative and chemotherapy induced nausea and vomiting. It is an off-label drug to treat nausea and vomiting of pregnancy but availa-ble data about its safety is limited. In this study our purpose was to evaluate neonatal outcomes in women who received this treatment. Methods: This study is a descriptive retrospective case series study, included 22 preg-nant women who treated with ondansetron due to repeated nausea and vomiting unre-sponsive to our center's protocol, at Mahdiyeh Hospital, Tehran, Iran from May 2006 to September 2014. We investigated neonatal factors including: gestational age at birth, stillbirth, neonatal birth weight, apgar score, need to NICU admission and major birth defects. Results: The outcomes of 22 pregnancies and 22 newborns are presented here. We had two twin pregnancies and two abortions. Ondansetron was initiated in 18 cases (72%) on average gestational age of 9 weeks, during organogenesis. In 8 cases (32%) on-dansetron continued till third trimester of pregnancy. In primary evaluation, all the pa-tients had ketonuria, 15 cases (60%) had hypokalmia (K< 3.5), 3 cases (12%) had ab-normal TSH that all of them were hyperthyroidism and 5 cases (20%) had abnormal liver function test (LFT) Three patients (12%) had positive urine culture, one patient had hypercalcemia and one patient who was known a case of hypocalcemia had low serum calcium. The mean time of admission due to hyperemesis gravidarum (HG) was 5 days (2-10 sd=1.92). In this study we had only one preterm birth and the mean neo-natal birth weight was 3110 gram, one newborn was low birth weight due to preterm birth. Finally none of newborns had low apgar score, no one needed to NICU admis-sion and no congenital anomaly was seen in neonates. Conclusion: Ondansetron taken during pregnancy was not associated with increased risk of adverse fetal outcomes.
Rupture of an unscarred uterus in a nullipar pregnant women with a history of curettage: case report
Mahboobeh Shirazi, Fatemeh Rahimi Shaar-Baf, Seyed Akbar Moosavi ,
Volume 73, Issue 2 (5-2015)
Abstract
Background: Rupture of uterus is a catastrophic complication associated with significant maternal and fetal morbidity and mortality. The prevalence of an unscarred uterine rupture is very rare. Although the most important complication of dilatation and curettage is perforation of uterus, dilatation and curettage is not introduced as an important cause of uterine rupture. Case presentation: Here we present a case of uterine rupture in a pregnant woman that was admitted in Tehran General Women Hospital, in December 2014, with reducing fetal movement in her 41th weeks of pregnancy. She did not have any risk factors for rupture of uterus including cephalo-pelvic disproportion and polyhydramnios, also there was no history of uterine surgery such as myomectomy and uterine abnormality repair. A term dead male neonate was delivered by cesarean section due to arrest of descending in stage 2 of labor. The baby weighed 3400 gr and had anomaly in ears, larynx, uvula and soft palate. Its chromosomal study depicted both trisomy and monosomy for chromosome 13 and 21. Mother had a history of illegal curettage and trauma to the uterus in her first pregnancy two years ago. She did not say to us this history and abortion during admission. After cesarean section we saw that in the left side of the posterior wall of uterus was ruptured and baby was died. At surgical exploration, moderate hemoperitoneum was evident. Fetus was already dead at the time of extraction. Total estimated blood loss was 100 ml, the patient was transfused with two units of packed cell. The woman was discharged on the fifth postoperative day in good condition. Conclusion: Effective contraception and safe curettage can reduce maternal mortality and morbidity. Also special attention to a history of curettage to predict uterine rupture is critical.
The relationship between Helicobacter pylori infection and hyperemesis gravidarum in pregnant woman
Leila Ghasempour Shirazi, Shirin Rafie Tari,
Volume 73, Issue 3 (6-2015)
Abstract
Background: Hyperemesis gravidarum (HG) starts between four and seven weeks after the first day of the last period, and ends at twenty weeks of pregnancy. The etiology of HG, is unknown. Recent studies worldwide show the Helicobacter pylori (H. pylori) infection as a possible cause of the severe nausea and vomiting in pregnancy, recent studies showed H. pylori to have a role in occurrence of it during pregnancy. The current study assessed the immunoglobulin G (IgG) and immunoglobulin M (IgM) titer to H. pylori in pregnant women with HG. Methods: This is a case-control study of the pregnant patients of a gynecologist's office in the Marvdasht city from April to September 2013. One hundred and twenty three patients were randomly chosen based on their conditions and were divided into two groups (case n1= sixty three and control n0= sixty). The IgG and IgM titers against H. pylori were measured by ELISA method. Data analysis was performed using Chi-square test, Mann-Whitney U-test, and T-test in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). The significant level of the test was considered (P= 0.05). Results: Totally, 123 pregnant women were evaluated 63 women with hypermesis gravidarum and 60 without HG. Forty nine women out of 63 in HG group and 48 women in the control group were IgG positive for H. pylori. Also, mean serum level of IgG was 51.6 in the HG group (P= 0.685). Twelve women out of 63 in HG group and 20 women in the control group were IgM positive for HP. Also, mean serum level of IgM was 27.7 in the HG group (P= 0.675) Except for the mother's blood type, there were no other statistically significant differences found between the two types of antibodies against H. pylori. Conclusion: There is no relationship between helicobacter pylori and hyperemesis gravidarum in pregnant woman. Considering the high prevalence of H. pylori infection in our country, there is a need for studies with more samples and more diagnostic methods.
Designing an artificial neural network for prediction of pregnancy outcomes in women with systemic lupus erythematosus in Iran
Mahmoud Akbarian , Khadijeh Paydar, Sharareh R Ostam Niakan Kalhori , Abbas Sheikhtaheri ,
Volume 73, Issue 4 (7-2015)
Abstract
Background: Pregnancy in women with systemic lupus erythematosus (SLE) is still introduced as a major challenge. Consulting before pregnancy in these patients is essential in order to estimating the risk of undesirable maternal and fetal outcomes by using appropriate information. The purpose of this study was to develop an artificial neural network for prediction of pregnancy outcomes including spontaneous abortion and live birth in SLE. Methods: In a retrospective study, forty-five variables were identified as effective factors for prediction of pregnancy outcomes in systemic lupus erythematosus. Data of 104 pregnancies in women with systemic lupus erythematosus in Shariati Hospital and 45 pregnancies in a private specialized center in Tehran from 1982 to 2014 in August and September, 2014 were collected and analyzed. For feature selection, information of the 149 pregnancies was analyzed with a binary logistic regression model in SPSS software, version 20 (SPSS, Inc., Chicago, IL, USA). These selected variables were used for inputs of neural networks in MATLAB software, version R2013b (MathWorks Inc., Natick, MA, USA). A Multi-Layer Perceptron (MLP) network with scaled conjugate gradient (trainscg) back propagation learning algorithm has been designed and evaluated for this purpose. We used confusion matrix for evaluation. The accuracy, sensitivity and specificity were calculated from the confusion matrix. Results: Twelve features with P<0.05 and four features with P<0.1 were identified by using binary logistic regression as effective features. These sixteen features were used as input variables in artificial neural networks. The accuracy, sensitivity and specificity of the test data for the MLP network were 90.9%, 80.0%, and 94.1% respectively and for the total data were 97.3%, 93.5%, and 99.0% respectively. Conclusion: According to the results, we concluded that feed-forward Multi-Layer Perceptron (MLP) neural network with scaled conjugate gradient (trainscg) back propagation learning algorithm can help physicians to predict the pregnancy outcomes (spontaneous abortion and live birth) among pregnant women with lupus by using identified effective variables.
Vitamin D deficiency and mode of delivery: a study in Tehran Women General Hospital
Mojgan Asadi , Farzane Saeidifard , Mostafa Qorbani , Khadijeh Adabi ,
Volume 73, Issue 6 (9-2015)
Abstract
Background: Vitamin D deficiency is a widespread problem especially in the developing countries like Iran. The prevalence of vitamin D deficiency differs from moderate to severe among Iranian women, particularly among pregnant women, and it can cause some problems such as preeclampsia, gestational diabetes mellitus (GDM), premature labor and primary cesarean section. The aim of this study was to evaluate whether the mode of delivery is related to serum vitamin D levels or not and if there is any difference in the percentage of cesarean section between vitamin D-deficient and vitamin D-insufficient women. Methods: This cross-sectional study was carried out between the April 2012 and April 2014 in a woman university hospital, Tehran, Iran. One hundred and eighty-six women aged between 17 and 52 years old (Mean age 28.46 and SD5.97) were surveyed in this study. The study group comprised of (N=186) consecutive cases attending Tehran Women General Hospital Clinic for normal vaginal delivery or cesarean section. Women who underwent cesarean section due to previous cesarean delivery were not recruited for the study. The participants were divided into two groups: women with vaginal delivery and women with cesarean section. Serum vitamin D concentration (25(OH) Vitamin D) was measured for each patient. Concentration of serum vitamin D was compared between these 2 groups. Results: One hundred and twenty-eight (68.8%) women had cesarean section and 58 (32.2%) had vaginal delivery. Median and inter-quartile range (IQR) of serum 25(OH) D were 13.64 and 12.47 ng/ml respectively, among women with cesarean section, compared to 11.68 and 12.59 ng/ml in those with vaginal delivery. No statistically significant difference was detected in serum vitamin D between these 2 groups (P=0.72). In addition, no statistically significant difference was detected between women with vitamin D deficiency and women who were vitamin D insufficient (P=0.8). Conclusion: In this study, there was no association between serum vitamin D levels and delivery mode.
Adverse pregnancy and neonatal outcomes in polycystic ovary syndrome women
Roshan Nikbakht , Mahvash Zargar , Zeinab Barekati , Razieh Mohammad Jafari , Nahid Shahbazian , Mojgan Barati ,
Volume 73, Issue 11 (2-2016)
Abstract

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorders in reproductive age women. These women confer with complications of pregnancy such as gestational diabetes, pregnancy-induced hypertension, preeclampsia and neonatal complications such as small for gestational diabetes (SGA) are more prevalence in women with PCOS. The aim of this study was to evaluate the incidence of complications associated with PCOS in pregnant women.

Methods: This was an observational and prospective study which recruited 205 pregnant women with PCOS from Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences (AJUMS) between 2013 and 2014. Inclusion criteria were women with PCOS and gestational age over 20 weeks. The demographic and clinical variables including mother's age, body mass index (BMI) and conditions of pregnancy including pregnancy-induced hypertension, preeclampsia, gestational diabetes and overt diabetes and neonatal complications such as preterm labor (PTL), SGA and intrauterine fetal death (IUFD) were recorded.

Results: The prevalence of hypertension disorders, preeclampsia, gestational diabetes and overt diabetes were observed in 44 (21.5%), 18 (8.8%), 29 (14%) and 22 (11%) patients, respectively. The history of familial diabetes was shown in 28 patients (13.6%). In addition, the history of pregnancy induced hypertension was reported in 25 patients (12.1%). Only 6 patients (2.9%) had history of gestational diabetes. Among neonatal complications due to PCOS, SGA with 15.3% and then PTL with 12.6% had highest prevalence. IUFD was shown only in 2 patients.

Conclusion: Pregnant women with PCOS are at the higher risk for pregnancy and neonatal complications. Specifically, these women should be evaluated for pregnancy induced hypertension during pregnancy than others.


Herpes encephalitis during pregnancy: a case report of maternal death
Leila Pourali , Azadeh Khazaee , Sedigheh Ayati , Parvaneh Layegh , Salmeh Dadgar , Fatemeh Mirza Marjani , Ehsan Esmaeelpour ,
Volume 74, Issue 1 (4-2016)
Abstract

Background: Herpes encephalitis is the most common cause of fatal encephalitis in the world which often presents with sudden fever, headache, seizure, focal neurologic symptoms, and consciousness loss. The aim of this study was to report a case of maternal death caused by herpes encephalitis which appropriate antibiotic therapy delayed because of early diagnosis of eclampsia.

Case Presentation: A 16-year-old pregnant woman at 36th weeks of gestation was referred to gynecology emergency department of Ghaem Hospital, Mashhad University of Medical Sciences in 2016. She was admitted due to 4 times of generalized tonic-clonic seizures and blood pressure of 140/90 mmHg with diagnosis of eclampsia. Cesarean section was performed for fetal distress and eclampsia remote from delivery. 6 hours after cesarean section because of higher than 39 °C and reduction in consciousness status, she was transferred to intensive care unit (ICU). The first brain magnetic resonance imaging (MRI) was normal. Lumbar puncture (LP) was performed and brain MRI was repeated that increased signal was observed in two sides of basal ganglia. Intravenous acyclovir was administered by possible diagnosis of viral meningoencephalitis. Cerebrospinal fluid (CSF) was positive in terms of herpes simplex virus type 1 (HSV-1). Unfortunately, the patient died 35 days after hospitalization by diagnosis of HSV-1 encephalitis and bilateral infarction with frequent seizures and clinical manifestation of septic shock refractory to treatment.

Conclusion: Although the first diagnosis for generalized convulsion during pregnancy is eclampsia, but in case of recurrent and specially atypical seizures and low consciousness level, other diagnosis like meningoencephalitis, brain lesions and cavernous sinus thrombosis (CVT) must be considered and ruled out.


Evaluation of salivary catalase activity in blighted ovum gestation
Maryam Ahmadizadeh , Hamidreza Vaziri , Reyhaneh Sariri , Hoorieh Shaigan ,
Volume 74, Issue 2 (5-2016)
Abstract

Background: Anembryonic gestation (blighted ovum) is the most common identifiable pathology in the first trimester of pregnancy, always leads to miscarriage. Early pregnancy failures from blighted ovum are often due to chromosomal abnormalities and a poor quality of sperm or egg. Oxidative stresses as a factor of disturbance balance between the production of free radicals and antioxidant defenses is involved in the pathogenesis of many diseases, including mouth and throat cancer and cardiovascular disease. Catalase is one of the defensive systems against damages caused by oxidative stress in human. The aim of this study was to compare the activity of salivary catalase in women with blighted ovum and women with history of normal pregnancy.

Methods: This case-control study was performed on 34 patient women with blighted ovum and 34 healthy women as a control group. The study was performed in biochemistry laboratory at the University of Guilan from October 2015 to July 2015. The age range was 20-44 years and 18-45 years in patient and control groups, respectively. Unstimulated saliva samples were collected using spitting method. Catalase activity was measured by evaluating the constant rate of hydrogen peroxide decomposition in patient and control groups.

Results: The patient group matched with healthy subjects in average age and having no other diseases history. The biochemical enzymatic assays indicate that the average catalase activities of saliva in patient and control groups were 14.47±3.8 and 16.42±3.48, respectively. Therefore, the catalase activity was significantly reduced in patient group as compared to the control group (P=0.03).

Conclusion: The obtained results suggested that oxidative stress plays an important role in the pathogenesis of blighted ovum. Therefore, determination the activity of other antioxidant enzymes, in addition to catalse, may be used as a marker for diagnosis of blighted ovum. More studies with larger studied-population is recommended to confidently comment on the results of this study.


Urinary incontinence and pelvic girdle pain during pregnancy: a clinical trial
Reihaneh Pirjani , Zinat Ghanbari , Mahsa Rezaee , Mahboobeh Shirazi , Parichehr Pooransari ,
Volume 74, Issue 4 (7-2016)
Abstract

Background: To examine the association among pelvic girdle pain (PGP), urinary incontinence (UI) and pelvic floor muscle (PFM) function in pregnant women in second and third trimester.

Methods: 300 pregnant women who admitted for standard pregnancy care were enrolled in the study. Urinary incontinency was measured via the international consultation on incontinence questionnaire short form. Pelvic girdle pain was diagnosed according to existing guidelines. Vaginal examination assessed pelvic muscles contract- relax patterns and muscle strength. The software stata version 13 (Stata Corp., TX, USA) was used for data analysis.

Results: Overall 300 women (150 with PGP and 150 without PGP) were included in final analyses. There was not significant differences between the demographic data including, body mass index before pregnancy, maternal age, mode of delivery. Prevalence of urinary incontinence in women with pelvic girdle pain was 41.5 percent (CI 95%: 32.01- 51.48) while the prevalence of urinary incontinence in women without pain was 21.9 percent (CI 95%: 14.99-30.03). Using logistic regression, the relationship between urinary incontinence and pelvic girdle pain was significant. (CI 95%: 1.07-3.31, P=0.02). Multivariate logistic regression analysis was used to evaluate the relationship between PGP and pelvic floor muscle function and results showed that pelvic floor muscle strength in women with PGP was significantly lower than women without PGP. (CI 95%: 0.24-0.68, OR= 0.4, P<0.001). The duration of the contraction of the pelvic floor muscles in patients with PGP was significantly shorter than women without PGP. (CI 95%: 0.21-0.60, OR =0.35, P<0.001).

Conclusion: There was a significant association between pelvic girdle pain and urinary incontinence during the second and third trimesters of pregnancy and also the pelvic floor muscle strength and duration of the contraction of the pelvic floor muscles in women with pelvic girdle pain was significantly lower than those without PGP.


Pregnancy outcome in amniocentesis and chorionic villous sampling: ten- year report
Shirin Niromanesh, Nima Mousavi Darzikolaei, Fatemeh Rahimi-Shaarbaf, Mahboobeh Shirazi,
Volume 74, Issue 6 (9-2016)
Abstract

Background: Chorionic villus sampling refers to a procedure in which small samples of placenta are obtained for prenatal genetic diagnosis, generally in the first trimester of pregnancy in 11 weeks till 13 weeks+6 days. This procedure provides prenatal diagnosis in pregnancy. Amniocentesis is a technique for windrowing amniotic fluid from the uterine cavity using a needle via a trans abdominal approach. Amniocentesis and chorionic villus sampling are invasive prenatal procedure. Their complications are fetal loss vaginal bleeding, rupture of membrane chorioamnionitis and limb reduction. There are some probable predictors of fetal loss after chorionic villus sampling and amniocentesis including maternal age, gestational age, number of needle insertion, previous miscarriage, and placental location. The aim of this study was to compare procedure related complications of amniocentesis and chorionic villus sampling in a tertiary referral hospital in Iran.

Methods: This retrospective cohort study was done in pregnant women who were high risk in genetic screening tests. The pregnancy outcome of women who underwent amniocenthesis and chorionic villus sampling was assessed in Yas Women General Hospital (Mirza Kuchak Khan), Tehran, Iran, from 2001 to 2011. Group one, pregnant women who underwent amniocentesis, was compared with group two, pregnant women that underwent chorionic villus sampling. The statistical analyses were performed with SPSSv.20 using a significant level of α<0.05.

Results: There were no significant differences between the two groups in procedure related fetal loss before 24th weeks of pregnancy (1.1% in chorionic villus sampling group versus 0.6% in amniocentesis group, P=0.318). A significant relationship between the number of needle insertion in the chorionic villus sampling group and fetal loss before 24th weeks of pregnancy was seen P<0.028. There were no significant differences between the two groups in the occurrence of vaginal bleeding, rupture of membrane, pre-term birth, placenta location, low birth weight and very low birth weight. The risk of chorioamnionitis was higher in chorionic villus sampling group (P=0.019). No significant difference was observed between the liquid and bloody amniotic fluid and pregnancy complications.

Conclusion: There was no significant difference between the procedure related complications of amniocentesis and chorionic villus sampling.


Effectiveness of stress management training on stress reduction in pregnant women
Mahboobeh Shirazi , Fatemah Azadi , Mamak Shariat , Shirin Niromanesh , Mahmoud Shirazi,
Volume 74, Issue 7 (10-2016)
Abstract

Background: There are evidences that suggest the impact of stress on pregnancy outcome. Prolong antenatal depression and anxiety may cause lots of adverse pregnancy outcomes such as abortion, still birth, low birth weight and preterm labor. The aim of this pre-posttest randomized control trial study was to determine the role of stress management training in the first trimester on stress reduction in pregnant women referring to General Yas Women Hospital related to Tehran University of Medical Sciences in Tehran, Iran, from May 2014 to January 2016.

Methods: Anxiety status of 75 pregnant women in the first trimester was assessed by standard anxiety questioner using Hamilton anxiety rating score. Scores 18-25, 25-35 and >35 were considered for mild, moderate and severe anxiety, respectively. According to the level of anxiety, women with moderate and severe anxiety as the interventional group were arranged for participation in stress management workshops, applying mindfulness technique including: body scan, setting meditation and passing thought technique in 5 an hour sessions. For this experimental group were made available CD training for practicing lessons during the week. All groups didn’t need to medical treatment according to the psychiatrist interview. In the ending of therapy, clinical groups were assessed by anxiety scale again. Women with mild anxiety as the control group received only regular prenatal care without any psychological interventions. The validity and reliability of questioner were approved by experts in this field. This research was supported by Tehran University of Medical Sciences and Health Services grant and also the study approved by ethics committee of Tehran University of Medical Sciences. Data were analyzed using the statistical software SPSS version 18, and Student’s t-test analyses were performed.

Results: The level of anxiety and stress was decreased significantly between women in clinical groups, 27.5 to 14.1 for moderated level stress (P= 0.001) and 40.1 to 16.6 for high level of stress (P= 0.0001) respectively.

Conclusion: First trimester of pregnancy is a crucial stage of fetal growth and development. Based on our findings, stress management training in this period has beneficial effects on stress reduction and enhances maternal health status.


Effect of the time in administration of clomiphene on follicular growth, endometrium and pregnancy rates in PCOS patients
Mahtab Zeinalzadeh , Yousefreza Yousefnia Pasha , Zinatossadat Bouzari , Mohadese Mahdavi , Mojgan Naeimi Rad,
Volume 74, Issue 12 (3-2017)
Abstract

Background: Clomiphene citrate is very successful in inducing ovulation; there is usually a discrepancy between ovulation and pregnancy rate. If treatment is started early in the cycle this negative effect is reduced. The aim of this study was to investigate the effect of the time of administration of clomiphene citrate on follicular growth, endometrial thickness and ovulation and pregnancy rates in PCOS (Polycystic ovary syndrome) patients.

Methods: This randomized controlled trial study was performed on 115 PCOS (Polycystic ovary syndrome) women in Fateme Zahra Fertility and Infertility Research Health Center in April 2012. Patients randomly divided into two groups. Patients in the early group (No. 55) received 100 milligrams of clomiphene citrate tablet daily starting the next day after finishing medroxyprogesterone acetate tablet for 5 day, whereas the patient in the late group (No. 60) received 100 milligrams of clomiphene citrate tablet daily for 5 day starting on day 3 of the menstrual cycle. Then on follicular growth, endometrial thickness and ovulation and pregnancy rates by SPSS software, version 16 (Armonk, NY, USA) were compared in two groups.

Results: 36.4% of patients of early administration of clomiphene and 60% of patients in the later administration of Clomiphene were able to build dominant follicle. This difference was statistically significant (P<0.011). There was no statistically significant difference between the two groups on age, body mass index, duration of infertility. Findings showed that in the early group 14 (63.6%) and in the late groups 8 (36.4%) women who made dominant follicle, were pregnant. There was significant difference between these two groups (P<0.001). But, in the number of follicles, endometrial thickness and pregnancy rate, there were no significant difference. In the early administration of clomiphene, the pregnancy rate was 25.5%. However in the later administration of clomiphene it was 13.3% (P=0.882).

Conclusion: According to the results of this study, if the dominant follicle was made, with administration of clomiphene citrate in luteal phase the incidence of successful pregnancy is higher.

The relation between Y chromosome microdeletions and recurrent pregnancy loss
Hoda Ahmadi , Reza Mirfakhraie , Shiva Irani ,
Volume 75, Issue 10 (1-2018)
Abstract
Background: Recurrent pregnancy loss is a form of infertility with at least three consecutive pregnancy losses or more. Y chromosome microdeletions are a class of most likely genetic factors that occur in a special zone of Y chromosome which is named azoospermia factor region. The purpose of this study was to analyze the presence of Y chromosome complete microdeletions in male partner of couples suffering from idiopathic recurrent pregnancy loss among Iranian population.
Methods: In the present study, Y chromosome microdeletions were evaluated in ninety-two male partners of couples with the experience of recurrent pregnancy loss as the patient group and also a group containing fifty fertile males as the control group. The research has done in Medical Genetic laboratory of Tehran and Islamic Azad University Science and Research Branch, Tehran, Iran within June 2013 to September 2014. The selected sequence tagged site markers (primers) including sY84, sY86, for azoospermia factor a; sY127, sY134, sY129, for azoospermia factor b and sY254, sY255, for azoospermia factor c were used to screen complete microdeletions in Y chromosome. At the first step DNA samples were extracted from all men’s peripheral blood in both patient and control groups and then multiplex polymerase chain reaction and also agarose gel electrophoresis were performed on this DNA samples so as to detect deletions.
Results: With due attention to the data resulted from multiplex polymerase chain reaction and agarose gel electrophoresis in order to recognize Y chromosome micro deletions in azoospermia factor region, in this work, all the bands related to the mentioned primers which were formed during the polymerase chain reaction, were detected on the gel obviously. It means that none of the samples neither the fifty fertile men nor the ninety-two patient men had complete micro deletions in their Y chromosome.
Conclusion: This study suggests that there is no correlation between Y chromosome micro deletions and occurrence of recurrent pregnancy loss in Iranian population.

Identification of Candida species by molecular and mycological methods in pregnant women with vulvovaginal candidiasis
Nahid Arefi Lisar , Parivash Kordbacheh , Sasan Rezaie , Mahin Safara , Roshanak Daie Ghazvini , Heidar Bakhshi , Zahra Omidvar Jalali ,
Volume 75, Issue 12 (3-2018)
Abstract
Background: Vaginal candidiasis is common in during pregnancy. It may lead to complications like abortions, premature birth, low birth weight, chorioamnionitis and fungal systemic neonatal infection. The aim of present study was identification of Candida species by mycological and molecular methods in pregnant women with vaginal candidiasis.
Methods: This cross-sectional study was performed on 80 pregnant women with or without clinical symptoms of vulvovaginal candidiasis referred to Shahid Noorani Talesh Hospital, Gilan University of Medical Sciences, Iran, from April to December 2015 (8 months). All specimens were examined by direct microscopy and culture on CHROMagar Candida medium for isolation and differentiation of major clinical-significant Candida species (spp.). Cultured media were incubated at 35 °C for 48 hours and evaluated based on color and number of grown colonies. If no growth was observed, the media were incubated for several additional days. Subcultures were done on Sabouraud dextrose agar (Merck, Germany) and Corn meal agar with Tween 80 media (Micromedia, Hungary) for further study. Identification of Candida spp. carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.
Results: In this study, vulvovaginal candidiasis was observed in 20 (25%) patients. Twenty-two isolates were obtained from culture of specimens on CHROMagar Candida medium (Paris, France). The most common isolated species was Candida albicans 16 (72.8%) and followed by Candida glabrata 5 (22.7%), Candida tropicalis 3 (13.6%) and Candida krusei 1 (4.5%) cases. Two patients had mixed infection with 2 different Candida species (C. albicans and C. glabrata) While using PCR-RFLP method, the Candida species were identified as 13 (59.1%) Candida albicans, 5 (22.7%) Candida glabra, 3 (13.6%) Candida tropicalis and 1 (4.5%) Candida krusei cases, respectively. In direct examination were seen yeast budding cells and pseudohyphae in 8 culture positive specimens. In the present study, results of conventional mycological method in differentiation of Candida spp. were consistent with molecular results in 80% of cases. There was also significant correlation between vulvovaginal candidiasis with clinical symptoms (P<0.0001), including diabetes mellitus (P<0.014), and taking antibacterial drugs (P<0.003) in pregnant women.
Conclusion: PCR-RFLP was able to identify correctly the Candida spp. as a complementary method.

High-risk pregnancy due to thyroid storm: case report
Malihe Hasanzadeh , Mina Baradaran Khalkhale , Akram Behroznea, Leila Musavi ,
Volume 75, Issue 12 (3-2018)
Abstract
Background: Graves' disease is the most common cause (85% of all cases) of thyrotoxicosis in women in childbearing age. Many of the symptoms are similar to hyper-metabolic status during pregnancy. The cause of the disease is autoantibodies that stimulate the thyroid-stimulating hormone (TSH) receptor. Hyperthyroidism is uncommon in pregnancy and its prevalence is 0.1-%0.4. In this paper we introduce a patient who was admitted with a primary diagnosis of pulmonary embolism and treatment with final diagnosis of thyroid storm and was discharged with good condition.
Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 weeks of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition.
Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient.

Molar twin pregnancy with a live coexisting triple X fetus: case report
Leila Pourali , Atiyeh Vatanchi, Sedigheh Ayati , Anahita Hamidi , Akram Zarei Abolkheir ,
Volume 76, Issue 1 (4-2018)
Abstract
Background: Complete molar twin pregnancy with coexisting fetus is a rare and important diagnosis in obstetrics. Preeclampsia, preterm labor and life-threatening vaginal bleeding are the serious complications of this type of pregnancy. Gestational trophoblastic neoplasia should be ruled out after termination of pregnancy. In this study we reviewed a molar twin pregnancy with a live coexisting triple x fetus which has not been reported till now.
Case Presentation: Our case was a 22-year-old primigravida woman and 17-18th week of pregnancy, who referred to an University Hospital in Mashhad, Iran with complaint of vaginal bleeding On October 2016. Her first trimester ultrasonography in 13th week of gestational age, reported a live single fetus with an anterior great placenta and cystic formation regarding molar pregnancy. According to above-report, Amniocentesis was done in 15th weeks of pregnancy and its result was triple X. After severe and life-threatening vaginal bleeding, she underwent an emergent hysterotomy. A fetus with no obvious anomaly and a great hydropic and vesicular placenta delivered. Episodic crisis of her blood pressure was best controlled with anti-hypertensive drugs. In our case, chemotherapy with methotrexate was started after poor decline of βHCG titration and definite diagnosis of gestational trophoblastic neoplasia. Remission was completely achieved after four courses of chemotherapy.
Conclusion: Differentiation between complete molar pregnancy with live fetus and partial mole is always challenging in obstetrics. Serious complications as preeclampsia and severe vaginal bleeding may become life-threatening. Coexisting molar pregnancy should be ruled out in a pregnancy associated with frequent and unexpectant vaginal bleeding. Amniocentesis and an expert radiologist can help to differentiate them. Following these patients is very important to reveal any trophoblastic neoplasia.

A uterine perforation during laparoscopic cholecystectomy: case report
Atiyeh Vatanchi , Leila Pourali , Mona Jafari ,
Volume 76, Issue 2 (5-2018)
Abstract
Background: Laparoscopy is an acceptable procedure for cholecystitis in pregnancy. Laparoscopic complications during pregnancy can be unique. Uterine perforation is a rare complication during laparoscopy of pregnant women. Acquaintance with this complication can help surgeons and gynecologist to manage these patients properly. We will report a case of uterine perforation during laparoscopy.
Case presentation: Our patient was a 24-year pregnant woman with gestational age of 28 weeks. She had nausea and vomiting and right upper quadrant tenderness, she was admitted in surgery ward on January 2017 in an academic hospital in Mashhad and candidate for laparoscopic cholecystectomy with diagnosis of cholecystitis. Her fundal height was 28 centimeters. Laparoscopy was done with Hasson technique and three punctures. During abdominal trocar insertion uterine perforation occurred. Amniotic fluid leaked in the abdomen. Perforation repaired immediately and then cholecystectomy was done. Fetal heart rate was normal. After surgery according to stable vital signs and absence of bleeding and contraction, the patient was transferred to the midwifery department. The patient received one course of betamethasone for fetal lung maturation. Antibiotic therapy initiated. During the hospitalization, the patient was monitored daily for vital signs (fever and tachycardia), uterine contraction, vaginal bleeding and vaginal bleeding. Daily fetal heart monitoring was performed. After close prenatal care cesarean section was done in 38 weeks of pregnancy and a healthy baby was born with appropriate Apgar score.
Conclusion: Laparoscopy in pregnant women is usually safe. Pregnancy-specific complications such as uterine injury are not common, but with a series of precautions before and during surgery. These complications can be reduced. Uterine perforation during laparoscopy if properly managed is usually not associated with significant risk.

Page 3 from 5     

© 2026 , Tehran University of Medical Sciences, CC BY-NC 4.0

Designed & Developed by : Yektaweb