Showing 83 results for Pregnancy
Sh Niroomanesh , M Amirhosseini , M Lameian ,
Volume 56, Issue 6 (7-1998)
Abstract
The present research is a quasi-experimental prospective study to determine usefulness of stripping the fetal memberanes at term for preventing of postterm pregnancy. 212 pregnant women with firm gestational dates entered the study, 112 underwent stripping of the membranes and 100 controls did not. The difference between the number of patients who advanced beyond term (>290 days) was statistically significant between groups (P<0.01). The mode of delivery and neonatal APGAR score were similar in both groups.
M Ghfarnegad, M Hjazi, F Abrahimi,
Volume 57, Issue 3 (6-1999)
Abstract
In a historical cohort study we evaluated the effects of spontaneous abortion on subsequent pregnancy outcome. 1693 pregnant women were classifield in three groups: 1100: without any prior pregnancy, group 1 550: with history of one spontaneous abortion (G2A1), group 2 43: with two or more prior spontaneous abortions and no other prior pregnancies, group 3. We collected data through interview, patient's records and physical examination. We matched the patients according to their age subgroups, history of chronic disease, drug administration and radiation during current pregnancy and familial marriage. Then we compared adverse outcome of present pregnancy in group 1 and 2 with the women without prior pregnancy. We analysed the data with Chi-square and Fisher's exact methods. In this study we concluded that history of one spontaneous abortion had no effect on subsequent pregnancy except on prolonged ROM (P<0.000), but history of two or more abortions significantly affects occurrence of stillbirth (RR=29, P=0.003) and placenta previa (RR=8.5, P=0.03). These findings suggest that pregnant women with history of two or more spontaneous abortion need special prenatal care.
B Oladi ,
Volume 58, Issue 1 (4-2000)
Abstract
A 28 years old woman, gravida 2 and para 0 was admitted in labor with 39 week gestation. She had primary infertility for 8 years and she had an abortion in 1st trimester. The 2nd pregnancy occurred after 3 months use of bromocripin because of hyperprolactinemia. At admission, FHR was not detected. She delivered a full term dead newborn. Placenta was not separated and retained. Because of poor obstetric history conservative management with methotrexate was planned for the adhered placenta. After 10 days the retained placenta expelled out. She had her next pregnancy 15 months later. At last she delivered healthy full term male infant and the placenta was separated completely.
Niroomanesh Sh, Heidari A,
Volume 58, Issue 2 (5-2000)
Abstract
There are now several tests available that can assess fetal status. A series of 164 cases of high risk pregnancies were studied in order to assess predictive value of a nonstress test. The majority (36%) of patients complained about postdate pregnancy. A nonreactive test was identified in 24 of the patients (14.6%). Fetal distress, low Apgar score in 1 and 10 minutes after birth and mean of Apgar score in 5 minutes, cesarean section due to fetal distress, congenital anomalies, need of neonatal care, IUGR, abnormal presentation and perinatal death were much more common in the group of pregnancies with a nonreactive NST than in the group with reactive test. The difference was statistically significant. A reactive test was found to be a good predictor of the healthy fetus. Negative predictive value and specifity of the test were found 80% and 91.9%, respectively. The nonreactive test could identify a population at risk but it was not helpful as a stand alone modality in decision making, because of the low sensitivity and positive predictive value rates (33.3% and 58%).
Borna S, Darvish Tavangar E,
Volume 58, Issue 4 (7-2000)
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.
Jahanfar Sh, Ramazani Tehrani F, Sadat Hashemi M ,
Volume 60, Issue 4 (7-2002)
Abstract
Introduction: Unwanted pregnancy is one of the most important problems in family planning programs especially in developing countries. This cross-sectional study was conducted to determine the prevalence of unwanted pregnancy and factors that contributes to it's existence in ten cities in Islamic Republic of Iran.
Methods and Materials: From cases, 1548 subjects referring to the antenatal clinics of university hospitals in the following cities were included in the study: Fars, Systan and Balochestan, Hamedan, Kerman, West-Azarbayjan, Gillan, Khorasan, Khozestan, Isfahan. A face to face interview was conducted to fill out a questionnaire.
Results: The result suggests that the rate of unwanted pregnancy was reported around 34.96 percent. Familiarity with contraceptive methods was quite poor in some cities. Usage of contraceptive pills and condoms were also not correct and led to failure of the method by the rate of 12.5 percent and 8.8 percent respectively.
Conclusion: It is concluded that there is a need to plan a suitable educational plan in order to reduce the rate of the unwanted pregnancy.
Moghaddamy Tabrizi N, Mirzaei M, Eazadi Mood N,
Volume 63, Issue 4 (7-2005)
Abstract
Background: In 2-4% of couples in fertile ages, recurrent pregnancy loss (RPL) occurs which consisted one out of 300 pregnancies. The aim of this study was to comparison insulin resistance (IR) in patients with RPL to normal individuals.
Materials and Methods: In a case-controlled, prospective study, 49 non-pregnant, non-diabetic women with early RPL as the case group and 49 non-pregnant, non-diabetic women without RPL who had at least one live infant as the control group, and were matched by age, weight, and height, were enrolled. In both groups fasting insulin and glucose levels were measured and insulin resistance, which was defined as a fasting insulin (FI) level ≥20 microU/mL or a fasting glucose to insulin ratio (FGI ratio) of <4.5, was calculated.
Results: The RPL and control groups were similar with respect to age, BMI, fasting glucose levels and glucose to insulin ratios. FI was significantly higher in RPL group than control group (15.20±5.82 vs. 12.23±5.64 microU/mL). Also the frequency of patients with high FI (FI≥20µU/ml) in RPL group was significantly higher than in control group (22.45% vs. 6.12%, Odds Ratio=4.44, Confidence Interval 95%=1.15-17.07). Among the RPL group, 24.49% demonstrated insulin resistance, whereas only 8.16% of the matched controls were insulin resistant (Odds Ratio=3.65, Confidence Interval 95%=1.08-12.26). The RPL and control groups had similar in frequency of low FGI ratio. Also there was no significant difference between mean of FGI ratio in patients with fewer than 12 weeks miscarriage compared to over 12 weeks in RPL group.
Conclusion: Women with RPL have a significantly increased prevalence of insulin resistance when compared with matched fertile controls. It's recommended that in all women with RPL the glucose and insulin measurement should be carried.
Heydari M, Kiani Asiabar A, Faghih Zade S,
Volume 64, Issue 9 (9-2006)
Abstract
Background: Alteration in pattern of sexuality is known to be impressed by couples’ believes about women’s physical and psychological changes during pregnancy. The objective of this study is to evaluate the knowledge and attitudes of couples about sexual relations during pregnancy.
Methods: In a descriptive study from February to April 2005, two hundred sixty six consecutive pregnant women referring to a university hospital were asked to answer a questionnaire containing questions their sexual status and some demographic data. In 122 cases the answers of the spouses was collected also. The answers were compared in divided groups according to age range, duration of marriage, parity and educational status.
Results: Fifty five percent of men and fifty eight percent of women had a negative attitude about sexual relations during pregnancy, and 60% of men and 75% of women presented incorrect knowledge about sexuality during pregnancy. Main reasons for decreased sexual relations in pregnancy were mentioned to be dysparaunia, and the fear of trauma to the baby, abortion, membrane rapture, preterm labor and infection.
Conclusion: As couples’ knowledge and attitudes about sexuality affect their general sexual behavior during pregnancy it is crucial to provide proper consultation regarding sexual relations in prenatal care services.
Behnamfar F, Yazdani Sh, Sakhaee M,
Volume 65, Issue 8 (11-2007)
Abstract
Background: The use of serial quantitative beta-human chorionic gonadotropin (β-HCG) with transvaginal ultrasound to enhance early diagnosis of ectopic pregnancy (EP) improves options for conservative treatment with methotrexate (MTX). The aim of this study was to evaluate the outcome of unruptured EP treated with a single dose of intramuscular MTX injection.
Methods: This clinical trial included 41 EP patients with specific inclusion criteria for medical treatment. For each patient, MTX (50 mg/ml) was administered intramuscularly and a repeat dose was given if the weekly decrease in the level of β-HCG was less than 15%. The therapy was considered successful if the level of β-HCG fell below 10 mIU/cc without surgical intervention.
Results: Overall, 78% of the patients were successfully treated, among whom 18.7% received second doses of MTX. Of the patients who were successfully treated, 60% presented with vaginal bleeding without pelvic pain however, of those patients in whom the treatment failed, 88% presented with pelvic pain together with vaginal bleeding. Furthermore, the presence of free peritoneal fluid on vaginal ultrasound was a significant predictor of treatment failure (p<0.005). There was no relation between the women's age, gravidity or parity, the size of the conceptus, gestational age, pretreatment serum β-HCG titer, endometrial thickness on vaginal ultrasound and the efficacy of treatment.
Conclusions: With a reasonably high success rate, we found systemic single-dose MTX treatment to be a safe, conservative therapy for EP. However, when free peritoneal fluid is noted upon transvaginal ultrasound or when the patient presents with pain, the threshold for surgical intervention may be lower.
Ramezanzadeh F, Noorbala Aa, Malak Afzali H, Abedinia N, Rahimi A, Shariet M, Rashidi B, Tehraninajad A, Sohravand F, Bagheri M,
Volume 65, Issue 8 (11-2007)
Abstract
Background: Considering the psycho-social model of diseases, the aim of this study was to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.
Methods: In a randomized clinical trial, 638 infertile patients referred to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were included in this substudy. These couples were divided randomly into two groups. The patients in the case group received 6-8 sessions of psychotherapy before starting infertility treatment and were given fluoxetine 20-60 mg per day during the same period. The control group did not receive any intervention. Three questionnaires including the Beck Depression Inventory (BDI), Holmes-Rahe stress scale and a socio-demographic questionnaire were applied for all patients. The clinical pregnancy rates of the two groups, based on sonographic detection of the gestational sac six weeks after LMP, were compared. The data were analyzed by paired-T test, T-test, χ2 and the logistic regression method.
Results: The pregnancy rate was 47.1% in the case group and 7.1% in the control group. The pregnancy rate was significantly related to the duration and cause of infertility and the level of stress in both groups (p< 0.001). The pregnancy rate was shown to be higher in couples in which the male has a secondary level of education (p< 0.001).
Conclusions: Psychiatric interventions greatly improve pregnancy rates, and it is therefore crucial to mandate psychiatric counseling in all fertility centers in order to diagnose and treat infertile patients with psychiatric disorders and help couples deal with stress.
Eslamian L, Shahsavari H,
Volume 65, Issue 12 (3-2008)
Abstract
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.
Khazardoost S, Moezzi-Madani M, ,
Volume 66, Issue 2 (5-2008)
Abstract
Background: Medical induction abortion is an acceptable alternative to surgical abortion for pregnancy termination. Misoprostol is an inexpensive PGE1 analogue that can be used easily and safely as a single agent for first- and second-trimester pregnancy termination. The objective of this study was to evaluate the efficacy of two different doses of vaginal misoprostol for pregnancy termination with gestational age up to 16 weeks.
Methods: This clinical trial included 100 pregnant women with gestational age up to 16 weeks requesting legal termination of pregnancy. The subjects were randomized in two equal groups, and received either 200 (group 1) or 400 µg (group 2) misoprostol vaginally every 6 hours with a maximum of four doses. Response to treatment was defined as complete or incomplete abortion within 48 hours after initial dose. Curettage was performed for patients with heavy bleeding or incomplete abortion. The abortion outcome and side-effects were assessed.
Results: The groups were similar in maternal age, gestational age, parity and obstetrical history and indication for pregnancy termination. The side effects in group 2 were significantly higher than in group 1 (P<0.05). There were no statistically significant differences between the two groups regarding completeness of the abortion and mean time to abortion induction.
Conclusions: In the termination of pregnancies up to 16 weeks, the 200 µg per dose regimen of misoprostol was as effective as the 400 µg regimen however, side-effects were more common with the higher dose.
, , , ,
Volume 66, Issue 4 (7-2008)
Abstract
Background: The induction of catalytic antibodies (abzymes) was first postulated by Pauling in 1948. Various catalytic antibodies have been detected recently in the sera of patients with several autoimmune pathologies such as systemic lupus erythematosus and rheumatoid arthritis. In addition, antibodies with DNase and RNase activity have been discovered in the milk and sera of healthy human mothers, which shows the physiologic role of these antibodies. In this study, we examined the proteolytic activity of antibodies in the sera of pregnant women.
Methods: IgG antibody fractions were isolated from the sera of 30 healthy pregnant women in the first trimester of pregnancy and 10 control samples (men and nonpregnant women) by subsequent steps of chromatographic purification on Protein G sepharose and sephacryl S-300. All patients were in their first pregnancy and aged 25-35 years. The conditions for proteolytic activity, such as type of buffer, pH and temperature, were optimized. The proteolytic activity of these antibodies was demonstrated by in-gel assay with gelatin as the substrate.
Results: Antibody treatments at the optimum temperature showed that some samples from pregnant women contain proteolytic abzymes, as demonstrated by in-gel assays. Western blot results confirmed that the proteolytic activity is an intrinsic property of the antibodies.
Conclusions: During pregnancy and immediately after delivery women very often experience autoimmune processes similar to those in patients with autoimmune disease. Because of their specific immune status, pregnant women can produce various catalytic antibodies with different enzymatic activity. These proteolytic abzymes might be involved in the direct clearance of antigens from blood.
Rahimi Sharbaf F, Mirzaei F, Kaveh M,
Volume 66, Issue 6 (9-2008)
Abstract
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Background: The
prevalence of Rh alloimmunization has decreased following the use of anti-D
immunoglobulin. With serial amniocentesis, Doppler sonography of the middle
cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal
mortality has declined. However, Rh alloimmunization in twin pregnancies poses
a diagnostic and therapeutic challenge.
Case report: We are reporting,
for the first time in Iran, the successful treatment of severe Rh
alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the
live births of both neonates. Before treatment, the fetal hemoglobin levels
were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were
treated with several IUTs.
Results: After treatment, the neonates were
delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational
age of 34 weeks.
Conclusion: 10%
of population in Iran is Rh-negative, although Prophylaxis for Rh
alloimmunization is universal, as other part of the world it cannot irrigated.
For the best management of these cases, we need a well-equipped referral
center.
Sohrabvand F, Shariat M, Fotoohi Ghiam N, Hashemi M,
Volume 67, Issue 2 (5-2009)
Abstract
Background: The
transfer of multiple embryos during ART procedures (IVF/ICSI) in order to
maximize the chance of pregnancy, has resulted in increasing rates of multiple
pregnancies with a 20- fold increased risk of twins and 400- fold increased
risk of higher order pregnancies with significantly high maternal and perinatal
morbidity and mortality in comparison with singleton. Since at present there is
no limitation in number of embryos being transferred in ART cycles in
infertility centers in Iran, in order to evaluate the relationship between
number of embryos transferred, pregnancy rates and multiple pregnancy, this
study was performed in a referral university center.
Methods: In a cross
sectional descriptive analytical study a total of 536 ART cycles in infertile
patients treated at the Infertility Department of Vali-e-Asr Hospital &
Vali-e-Asr Reproductive Health Research Center from October 1999- March 2003 were
evaluated using a questionnaire dealing with the parameters affecting ART
outcome.
Results: There was a
total pregnancy rate of 21% with a multiple pregnancy rate of 12%. Increased
age had a negative effect on pregnancy rate with a significant difference over 40
years (p<0.05). Pregnancy rate was higher with increased number of
transferred embryos but it was only statistically significant when three versus
two embryos were transferred (p<0.008). When more than three embryos
transferred, although there was an increase in pregnancy rate, the difference
was not statistically significant, but there was a significant increase in
multiple pregnancy rate.
Conclusions: The maximum number of transferred embryos in ART cycles should not precede three
embryos especially in age groups less than 40 and also when good quality
embryos are available.
Garshasbi A, Faghihzadeh S, Falah N, Khosniat M, Torkestani F, Ghavam M, Abasian M,
Volume 67, Issue 4 (7-2009)
Abstract
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Background: Gestational diabetes mellitus is diagnosed as carbohydrate in tolerance demonstrated
for the first time in the course of pregnancy. The aim of this study was to evaluate
the selective screening method for gestational diabetes mellitus (GDM)
based on: 1- recommendation of
the fourth workshop- conference on GDM 2-
evaluation of risk factors
Methods: A case-
control study was performed on 370 pregnancies inflicted
by GDM in Hazrat
Zaynab
Hospital,
Shahed
University.
The maternal and perinatal outcomes and prevalence of risk factors based on recommendation
of the fourth workshop- conference on GDM
in these women with GDM were compared with the
same data and risk factors of randomly selected 600
pregnant women at the same time and in the same hospital, they all underwent
universal testing for GDM, and their OGTT
were normal.
Results: The prevalence of all risk factors was significantly higher in the group with GDM,
but 45 of these women (12%)
had no risk factors. 107 women (29%)
with GDM were at low risk and would remain undiagnosed
if selective screening method was used. The
main neonatal complications in the low- risk group did not differ from the
complications in other women with GDM.
Conclusions: The
universal screening of all pregnant women seems to justified whereas the
recommendations for not screening low- risk group are doubtful and require further
examination.
Borna S, Haghollahi F, Golestan B, Norouzi M, Hanachi P, Shariat M, Sarafnejad A, Niroomanesh Sh,
Volume 67, Issue 5 (8-2009)
Abstract
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Background: Zinc
is one of the elements necessary for growth and health in human. Some evidences
indicate that zinc deficiency is one of real difficulties for the public health
in both developed and developing countries. Since the pregnant women are more at
risk of zinc deficiency, the objective of this study was to determine the rate
of zinc deficiency in pregnant women in the 3 trimesters and to compare these data
with that of the healthy controls.
Methods: This research was an analytic- descriptive study which
was done on 677 pregnant women in 3 Trimesters and 140 non pregnant groups who referred to clinic of Tehran
University. Blood sample were taken And serum zinc was assessed By Enzymatic
technique.
Results: The prevalence of zinc deficiency is 16% in pregnancy
and 0%
in non pregnant women with a significant difference between two groups (p<0.001). Zinc
deficiency had no relation to mother's age, gestational age, Iron
supplementation, Parity and mothers BMI. Hemoglobin level showed a direct relation to zinc
deficiency and was grossly found to be more prevalent in Hb levels less than 12 (CI: 1/36-4/26, OR=2/4).
Conclusion: Acording to the finding of
presented study, zinc deficiency is more prevalent in Hb<12 inspite of iron
supplementation. Iron and zinc supplements in pregnancy period seem to be more
effective for Hb repair in each case.
Marzieh Ghafarnegad , Neda Arjmand , Zahra Khazaeipour ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Polycystic ovary syndrome (PCOS) is a common cause of ovulation insufficiency and then infertility. Therapeutic options to induce ovulation in anovulatory PCOS patients are clomiphene citrate, metformin, tamoxifen, dopamine agonists (bromocriptin), Gonadotrophin and laparoscopic ovarian electrocautery (LOE). Gonadotrophin and LOE are important options in anovulatory clomiphene citrate-resistant patients with PCOS. Literature data regarding compare of the efficacy of these two treatments are few. Therefore we aimed to study the pregnancy rates of these treatments in infertile clomiphene citrate-resistant patients with PCOS. Methods: A randomized clinical trial study was carried out in infertile clomiphene citrate-resistant patients with PCOS, referred to infertility clinic of Mirza Koochackhan Hospital of Tehran University of Medical Science in Tehran, Iran, between 2003 and 2008. Results: A total of 100 patients women were randomly allocated in two groups. There were no differences in age and pimary and secondary infertility duration. In LOE treatment group, eight cases (16%) were pregnant and all delivered at term. in gonadotrophin treatment 14 cases (28%) were pregnant, 10 cases (20%) delivered at term but four cases aborted. The cost in gonadotrophin treatment was significantly more than laparoscopic ovarian diathermy (p<0.001). In logistic regression analysis, age, BMI, cost and kind of treatment had no significant effect on pregnancy rate. Conclusions: Pregnancy and abortion rate in gonadotrophin treatment was more than LOE but the difference was not significant. More studies are needed.
Firoozeh Akbari Asbagh, Mahak Papan, Zahra Khazaeipour,
Volume 67, Issue 12 (3-2010)
Abstract
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Background: Insulin resistance is common in women with Polycystic
Ovary Syndrome
(PCOS) and can cause poor outcome of infertility
treatment. The aim of our study
was to assess the effect of treatment with metformin on outcome of Intra
Cytoplasmic Sperm
Injection (ICSI)
in infertile PCOS women.
Methods: A randomized clinical trial study was carried
out in infertile women with PCOS, before ICSI,
referred to infertility clinic of Mirza
Koochackhan Hospital
of Tehran University
of Medical Science
Tehran, Iran,
between 2006 and 2008.
The patients were randomized in two groups of
metformin 500 mg Po,
three times daily, six weeks before the ICSI
cycle and placebo patients in each group were divided into BMI
<28 kg/m2 and BMI
&ge28 kg/m2.
Results: Of 52
study women 26(50%) were in metformin
group. mean age were 29.8±4.9 year in
metformin group versus 29.4±5.9 year and
placebo groups. Treatment with
metformin, in subgroup of BMI <28 kg/m2,
significantly increased number of mature follicle (p=0.01),
embryo (p=0.04),
oocytes (p=0.007)
and mature oocytes (p=0.03)
but in subgroup of BMI&ge28 kg/m2,
there was no significant difference in the metformin and placebo groups (p>0.05).
Metformin treatment caused more chemical and
clinical pregnancy rates, and less abortion rate in overweight and normal patients,
but the differences were not significant (p>0.05).
Logestic regression analysis showed, adjusting
number of mature follicle, number of embryos, quality of embryos, oocytes and BMI
and treatment showed no significant effect on clinical pregnancy
rates (p>0.05).
Conclusions: Among normal weight PCOS
women, effect of treatment with metformin is better than overweight PCOS
women. However further
studies are needed.
Beigi A, Kazemipour Sm, Tabarestani H,
Volume 68, Issue 3 (6-2010)
Abstract
Background: Induction of labor implies stimulation of contractions before the spontaneous onset of labor and is indicated when have benefits to eighter mother or fetus. Uterine contractions and an appropriate cervix are two important factors in labor and are contributed to good outcomes. Nowadays, there are many therapeutic modalities for it such as misoprostol. Both vaginal and oral misoprostol may be used for eighter cervical ripening or labor induction. The tablets are stable at room temperature. Regarding the issue importance and lack of similar studies in Iran, this study was conducted to compare the efficacy of sublingual and vaginal misoprostol for labor induction.
Methods: This study was conducted as a randomized double-blind clinical trial. In this
survey, 250 women were randomly assigned to receive 25 g vaginal misoprostol plus sublingual placebo or 25 g sublingual misoprostol plus vaginal placebo in Arash hospital Tehran, Iran from 2008 to 2010. The maternal and fetal complications, Bishop Score, and time of pain onset and it’s interval with labor were monitored in two groups analyzed.
Results: Mean Bishop Score, and time of pain onset and its interval with labor were similar in two groups (p>0.05). 43 patients (34.4%) in sublingual and 54 (43.2%) in vaginal group had normal vaginal delivery (p>0.05). The frequencies of maternal and
fetal complications were similar between two groups (p>0.05).
Conclusion: It may be concluded that there is no difference between efficacy of sublingual and vaginal misoprostol in pregnancy outcomes, maternal and fetal complications and so each one may be used according to pregnant woman’s condition and physician attitude.
