Maternal Fetal Medicine
Mahboobeh Shirazi; Mohammadreza Zarkesh; Maliheh Fakehi; Marjan Ghaemi
Volume 7, Issue 4 , March and April 2022, , Pages 329-334
Abstract
Background & Objective: This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.Materials & Methods: This retrospective cohort study was recruited in an academic hospital affiliated ...
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Background & Objective: This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.Materials & Methods: This retrospective cohort study was recruited in an academic hospital affiliated with Tehran University of Medical Sciences between June 2018 and June 2020. The subjects of the study were the women who were scheduled for elective CS and divided into 3 groups according to the gestational age (38 0/7 to 38 6/7 as group A, 39 0/7 to 39 6/7 as group B, and 40 0/7 to 40 6/7 as group C). The neonatal outcomes and the growth and development status were evaluated by ages and stages questionnaires® (ASQ) after 12 months and compared between groups.Results: Totally, 952 neonates were eligible for this study. In groups A, B, and C, CS was performed in 314, 409, and 229 neonates, respectively. The first minute Apgar was significantly lower in the neonates with lesser gestational age at delivery (P < /em>=0.026). Indeed, neonatal hospitalization, hypoglycemia, and jaundice in group A were significantly higher than in other groups (P < /em><0.001). Regarding psychomotor development, the scores related to gross motor and problem-solving abilities in group A were significantly lower than those in other groups (P < /em><0.05).Conclusion: It is suggested to plan elective CS beyond 39 weeks of gestation to decrease prenatal morbidities and improve psychomotor development one year after birth.
Obstetrics and Gynecology
Mahboobeh Shirazi; Mehnoosh Torkzaban; Samira Fallah; Marjan Ghaemi
Volume 7, Issue 1 , September and October 2021, , Pages 20-24
Abstract
Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management ...
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Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion. Materials and Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was either simultaneously with the first dose of misoprostol or after beginning of the pain. Pain severity, induction-to-abortion time interval, total misoprostol dosage, Hemoglobin concentration, length of hospitalization, and size of retained pregnancy products by ultrasound, and the cumulative dose of opioid usage were compared between the groups.Results: The severity of pain which was measured by a visual analog scale (VAS), residual of conceived products, hospitalization days, and the total misoprostol dosage were significantly lower (P < /em><0.05) in the prophylaxis compared to the treatment group.Conclusion: Simultaneous administration of diclofenac with misoprostol as prophylactic method of pain management may be an optimal method in induced medical abortion in the second trimester.
Obstetrics and Gynecology
Fatemeh Golshahi; Mahboobeh Shirazi; Shirin Torabi; Fatemeh Rahimi Sharbaf; Farzaneh Nazari
Volume 6, Issue 3 , June 2021, , Pages 147-151
Abstract
Currently, ultrasound is a well-known clinical modality for pregnancy management and has a prominent role in clinical decision-making. Accordingly, developing guidelines to outline the minimum performance standards of using ultrasound is necessary for different areas of obstetric ultrasound. The fetal ...
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Currently, ultrasound is a well-known clinical modality for pregnancy management and has a prominent role in clinical decision-making. Accordingly, developing guidelines to outline the minimum performance standards of using ultrasound is necessary for different areas of obstetric ultrasound. The fetal brain is one of the most important assessments in anomaly scan. For a basic brain assessment, 3 axial planes are routinely defined. According to most guidelines, the fetal skull’s integrity, shape, and bone density should be assessed while measuring the head size. In this paper, we present 2 cases of skull bony defect with normal routine 3 axial planes. For better detection of CNS anomalies, it is necessary to add other views such as sagittal view to three routine planes. It leads to early detection of anomalies especially in first and early second trimester. Consequently, it helps in deciding for termination, planning interventions and further management.
Obstetrics and Gynecology
Fatemeh Golshahi; Mahboobeh Shirazi; Fatemeh Rahimi Sharbaf; Mohammad Reza Zarkesh; Narges Nahavandi
Volume 6, Issue 3 , June 2021, , Pages 152-156
Abstract
The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80% mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with ...
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The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80% mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with preterm birth at this age due to preterm uterine contractions. No etiology was found for hydrops and all signs resolved thoroughly after birth without treatment. After birth, the newborn was admitted to neonatal intensive care unit and discharged after 47 days in good condition. The infant was completely healthy within three months after delivery.
Maternal Fetal Medicine
Seddighe Borna; Marjan Ghaemi; Fatemeh Golshahi; Mamak Shariat; Mahboobeh Shirazi; Behrokh Sahebdel
Volume 5, Issue 4 , December 2020, , Pages 159-166
Abstract
Background & objective: Premature preterm rupture of membrane (PPROM) is a cause of preterm birth. This study investigated the effectiveness of Doppler ultrasound in predicting fetal complications and neonatal outcomes of pregnant women with PPROM.Materials & Methods: In this cross-sectional ...
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Background & objective: Premature preterm rupture of membrane (PPROM) is a cause of preterm birth. This study investigated the effectiveness of Doppler ultrasound in predicting fetal complications and neonatal outcomes of pregnant women with PPROM.Materials & Methods: In this cross-sectional study, a total of 23 pregnant women with PPROM were chosen in their 24 to 34 weeks of gestational age. The fetuses’ blood flow indices were evaluated by Doppler ultrasound pulsatility index (PI) in the middle cerebral, main pulmonary, right kidney, and fetal umbilical arteries and descending aorta at admission (because of PPROM) and 24 hours before delivery. Neonatal outcomes were assessed within the first week of birth.Results: The kidney artery PI increased (P < /em>=0.047) and pulmonary artery PI decreased (P < /em>=0.024) at pregnancy termination time. There was a negative correlation between the 5-minute Apgar score and fetal umbilical artery PI at admission (P < /em>=0.003) and pregnancy termination times (P < /em>=0.031). The fetal umbilical artery PI of neonates with abnormal brain ultrasound imaging results significantly decreased at admission (P < /em>=0.002) and pregnancy termination times (P < /em>=0.004).Conclusion: Fetal artery Doppler ultrasound PI may be a valid tool for predicting neonatal outcomes of women with PPROM.
Obstetrics and Gynecology
Arash Moshiri; Maryam Ahmadian; Seyedeh Nafiseh Naseri; Shima Sheibani; Mahboobeh Shirazi; Baratoallah Akbari; Atefeh Hoseinzadeh
Volume 5, Issue 2 , October 2020, , Pages 49-53
Abstract
Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint ...
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Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint was a history of fever and chills in the recent past two days. Since there were no suspicious findings in favor of infections, related to obstetrics and gynecology, the patient was referred to Mostafa Khomeini Hospital in Tabas (June 2020). The initial clinical examination revealed no fever, chills, cough, respiratory distress, body aches, gastrointestinal problems or anything else. The patient’s oxygen saturation level was 98%. Routine laboratorytests were requested for the patient. WBC count was 14000, lymphocyte count was 875 (6.25%), and platelet count was 117000. According to the recent history of clinical symptoms and positive paraclinical results, COVID-19 was suspected. In the chest CT findings, bilateral ground glass opacities (GGO) and consolidations were observed, which were compatible with COVID-19 pattern. Based on the positive clinical and lab tests, COVID-19 was detected and positive RT-PCR COVID-19 test confirmed our diagnosis.Conclusion: The patient was asymptomatic at the time of admission to our ward; however, she reported fever and chills in the last two days, which raised our suspicion about COVID-19. Due to significant lymphopenia and the increase in granulocytes counts, and thrombocytopenia accompanied with complementary lab tests, severe COVID-19 was diagnosed and confirmed with positive RT-PCR test.
Maternal Fetal Medicine
Parichehr Pooransari; Mahboobeh Shirazi
Volume 5, Issue 2 , October 2020, , Pages 68-71
Abstract
Background & Objective: Screening tests for common aneuploidy, especially trisomies 21, 18, and 13, should be offered to pregnant people of all ages at first and second trimesters. Theses include combined tests (nuchal translucency (NT)+biochemical pregnancy-associated plasma protein-A (PAPP-A), ...
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Background & Objective: Screening tests for common aneuploidy, especially trisomies 21, 18, and 13, should be offered to pregnant people of all ages at first and second trimesters. Theses include combined tests (nuchal translucency (NT)+biochemical pregnancy-associated plasma protein-A (PAPP-A), free beta-human chorionic gonadotropin (β-hCG)) and quad test. If the tests are positive based on cut-off value of 1:250, diagnostic tests such as amniocentesis and chorionic villus sampling (CVS) are suggested. The current study aimed to comparatively evaluate the results of these screening tests and amniocentesis.
Materials & Methods: This practical-basic study was designed to evaluate the accuracy of first and second trimester screening tests with amniocentesis results. A total of 45 subjects were selected from the patients referred for abnormal screening tests toShohadaya-ye-Tajrish hospital in Tehran, Iran, during 2014-2015. The results of tests (combined or quad) were positive based on cut-off value of 1:250. Data was collected through a questionnaire containing such information as age, gravidity, previous aneuploidy births, placenta location, blood group, amniotic fluid color, type of sampling needle, and mode of needle entrance.Results: The mean age of patients was 33.16 years. There was significant p-value between positive results of amniocentesis and age of the patients. Out of 45 amniocentesis tests, four had abnormal results (two in the first trimester (2/17) and two in the second trimester (2/24)). Also, three items were T21 and the forth was translocation between chromosome 11-22. We had one fetal loss due to amniocentesis procedure.Conclusion: Diagnostic tests are suggested for better evaluation of abnormal results. These screening tests have false positive and negative results. We attempted to evaluate the real results with invasive tests. Further research is needed to investigate the accuracy of screening aneuploidy tests.
Radiology
Mehnoosh Torkzaban; Nesa Rajabpoor Nikoo; Ateeh Kalateh; Mahboobeh Shirazi
Volume 5, Issue 1 , August 2020, , Pages 27-30
Abstract
Background and Objective: Conjoined twins (CTs) are rare complications of monozygotic twinning. Cephalothoracopagus is the rarest subtype of CTs and occurs once in every 58 sets of conjoined twins or once in every three million births. Here we present such a case and analyze the possible reasons for ...
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Background and Objective: Conjoined twins (CTs) are rare complications of monozygotic twinning. Cephalothoracopagus is the rarest subtype of CTs and occurs once in every 58 sets of conjoined twins or once in every three million births. Here we present such a case and analyze the possible reasons for ultrasonographic misdiagnosis and recommend solutions to avoid it.Case Report: In this article, we have reported a case of Cephalothoracopagus Janiceps twining. The ultrasonographic diagnosis was missed at 7 and 12 weeks scans. Increased thickness of nuchal translucency and absent nasal bone was observed alongside with suspected gastroschisis. The patient was referred for further evaluation at 13-14 weeks of pregnancy. Unexpectedly, two alive fetuses were reported fused in the head, thorax, and abdomen. Because of the poor prognosis, counseling was provided for parents and elective medical pregnancy termination was carried out. We have analyzed the possible reasons for ultrasonographic misdiagnosis.Conclusion: Without applying a standardized scanning of the entire uterus both in a longitudinal and transverse approach in early pregnancy, cephalothoracopagus twining may be misdiagnosed with a singleton pregnancy. A high level of concerns may raise for conjoined cephalothoracopagus twinning in case of finding a single fetal pole with an irregular body outline and a disproportionally large head in the presence of two separate fetal hearts in early pregnancy. Two fused heads with two brains and two sets of lower and upper extremities do confirm the diagnosis.
Mahboobeh Shirazi; Soheila Sarmadi; Shirin Niromanesh; Fatemeh Rahimi Sharbaf; Behrokh Sahebdel; Fatemeh Golshahi; Leila Asadi; Maedeh Rahmanzadeh
Volume 4, Issue 1 , March and April 2019, , Pages 12-15
Abstract
Background & Objective: Diagnosing fetal disorders and abnormalities in the early stages of pregnancy can prevent future adverse conditions for the infant and his/her family. This study aimed to evaluate the sensitivity and specificity of the first- and second-trimester screening tests for identifying ...
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Background & Objective: Diagnosing fetal disorders and abnormalities in the early stages of pregnancy can prevent future adverse conditions for the infant and his/her family. This study aimed to evaluate the sensitivity and specificity of the first- and second-trimester screening tests for identifying fetal chromosomal disorders in pregnant women.
Materials & Methods: A total of 960 pregnant women participated in this retrospective cohort study that was performed at Yas Hospital. The participants’ mean age was 31.07±0.17 years. In the present study, all pregnant women, who referred to Yas Hospital for their first- and second-trimester screening tests, were studied from 2015 to 2017.
Results: Most of the participants (43.4%) were primigravida. The sensitivity of the first-trimester screening test was 70%, and its specificity was 80.3%. The sensitivity and specificity of the second-trimester screening test were 45% and 94.5%, respectively.
Conclusion: Despite recent advances in the prenatal field, the accuracy of screening tests may still vary depending on maternal age and other existing characteristics. Consequently, in parents consulting, the possibility of false positives and negatives should be considered in the tests.
