Zahra Rezaei; Zahra Shahraki; Mahboobeh Shirazi
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: Utero-cutaneousfistulaisarareconditionfollowinguterinesurgeriesespeciallycesareansection. Thiskindof fistula has various etiologies including drain use, iatrogenic trauma, endometriosis, multiple abdominal surgeries, incomplete closure of uterine wound during cesarean delivery, inflammatory ...
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Introduction: Utero-cutaneousfistulaisarareconditionfollowinguterinesurgeriesespeciallycesareansection. Thiskindof fistula has various etiologies including drain use, iatrogenic trauma, endometriosis, multiple abdominal surgeries, incomplete closure of uterine wound during cesarean delivery, inflammatory processes related to intra-abdominal sepsis or infectious, and dislocation of intrauterine devices.
Case Presentation: This report deals with two unusual cases of utero-cutaneous fistula. The patients referred with discharge from abdominal wall. The first one had vesico-cutaneous fistula simultaneously. Both of them had a second cesarean section. After four months of cesarean section, in fistulography report of the first case, it was found irregular fistula tract associated with vagina following cannulation and contrast injection. In the second case, ultrasonography revealed the attachment of uterus to abdominal wall as well as accumulation and communication of the small amounts of fluid from uterine cavity to abdomen wall. After confirming the diagnosis, the repairing surgery was successfully planned.
Conclusions: Cesarean has some rare morbidity such as uterocutaneous fistula that needs awareness of physician and patient. The early diagnosis and repairing of this abnormality is essential.
Zahra Shahraki; Khadije Rezaie Keikhaie; Nooshin Amjadi; Zohrehsadat Hashemi Bonjar; Hosseinali Jahantigh; Fatemeh Doosti; Mahboobeh Shirazi
Volume 2, Issue 2 , May and June 2017
Abstract
Background: Preeclampsia is one of the causes of maternal and prenatal mortality and morbidity. The 24-hour urine sample is considered as a gold standard for preeclampsia diagnosis and shortening the time of urine collection will result in the patients’ convenience and shorter hospitalization. ...
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Background: Preeclampsia is one of the causes of maternal and prenatal mortality and morbidity. The 24-hour urine sample is considered as a gold standard for preeclampsia diagnosis and shortening the time of urine collection will result in the patients’ convenience and shorter hospitalization. The goal of this study was to determine thee diagnostic accuracy of 4 hour urine protein in comparison with 24 hour urine protein in pregnant women.
Methods: One hundred pregnant women, with a gestational age of more than 20 weeks, and were suspicious to preeclampsia were enrolled. The 24-hour as well as the 4-hour urine sample were collected. All data were analyzed using the SPSS software, version 20 (SPSS Inc., Chicago, IL, USA). The correlation coefficient was used to determine relationship between the 4 and 24-hour urine proteins. receiver operating characteristic (ROC) curve was used to determine optimal cut-off values of 4 hour proteinuria.
Results: The mean age and mean gestational age of participants was 26.8 & 6.1 years and 34.1 & 3.4 weeks. The mean 4-hour urine protein was 165.6 & 170.2 mg and the mean 24 hour urine protein was 926 & 1013 mg. The mean age, 4-hour urine protein, and 4 as well as 24 hour urine volumes were significantly different between cases with no, mild, or severe proteinuria. Pearson correlation coefficient between 4 and 24 hour proteinuria was strong (r = 0.97 and p < 0.001). The best cut off point for 4-hour proteinuria to determine proteinuria was 69.5 mg with a sensitivity of 93% and specificity of 100%. (Area under the curve = 0.99, p < 0.001).
Conclusions: Women that are suspicious to have preeclampsia, the total 4-hour urine protein values positively correlated with values of 24-hour samples.
Mahboobeh Shirazi; Fatemeh Shahbazi; Setareh Akhavan; Mohadeseh Sharifi Taskooh; Fatemah Azadi
Volume 1, Issue 3 , November and December 2016
Abstract
Backgroung: Given the importance of natural childbirth and emphasis on the normal vaginal delivery, and since important causes of having a C-section are lack of response to induction of labor with Syntocinon® injection and the fact that the cervix is unfavorable for labor.
Objective: The present ...
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Backgroung: Given the importance of natural childbirth and emphasis on the normal vaginal delivery, and since important causes of having a C-section are lack of response to induction of labor with Syntocinon® injection and the fact that the cervix is unfavorable for labor.
Objective: The present study aims at achieving the best method of cervical ripening for pregnancy termination to reduce the C-section rate, labor duration, economic burden, and labor pain.
Methods: In this regard, the current study examined the effect of hyoscine-N-butylbromide (HBB) on the progression of cervical ripening in normal vaginal delivery. In the current prospective double-blind controlled clinical trial, 60 pregnant females referred to Valiasr hospital (with the mean age of 27.2 years) were randomly divided into 2 groups of experimental and control; HBB and normal saline (placebo) were intravenously administered in the active phase of labor.
Results: The pain reduction in the patients, the duration of drug action until the cervical dilatation, the number of drug use for the full cervical dilatation, the time of the onset of the first, second, and third stages of labor, the length of hospitalization until the delivery, the drug effect on the fetus and mother, and the delivery method were evaluated in both groups. HBB significantly reduced the duration of the first stage of labor; however, it did not affect the second and third stages. Moreover, no negative effects were observed on the mother and fetus health.
Conclusion: According to the obtained results, it can be concluded that the intravenous injection of HBB can be applied as an effective drug for labor progress; however, further clinical studies with larger sample sizes are required to confirm these findings.
Mahboobeh Shirazi; Shirin Niroomanesh; Fatemeh Rahimi Shaarbaf; Maryam Rabiei; Mitra Eftekhariyazdi
Volume 1, Issue 1 , May and June 2016
Abstract
Introduction: The incidence of very echogenic amniotic fluid on ultrasonographic examination at term pregnancy is very low and its causes and significance in outcome of pregnancy are not well- understood. In previous studies, meconium was considered to be an important cause of very echogenic amniotic ...
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Introduction: The incidence of very echogenic amniotic fluid on ultrasonographic examination at term pregnancy is very low and its causes and significance in outcome of pregnancy are not well- understood. In previous studies, meconium was considered to be an important cause of very echogenic amniotic fluid and follow-up with amniocentesis and fetal well-being tests were recommended; however, in recent studies vernix caseosa has been identified to be an important cause. As a result, termination of pregnancy should not be performed due to discovery of ultrasonographic echogenic amniotic fluid because it is not associated with adverse pregnancy outcomes.
Case Presentation: We report a single term pregnancy with very echogenic amniotic fluid diagnosed by ultrasonography that was terminated by cesarean section.
Conclusions: There were no adverse outcomes for the mother or neonate and the amniotic fluid was clear at the time of delivery.
