Maternal Fetal Medicine
Maryam Kashanian; Nooshin Eshraghi; Majid Kalani; Arash Bordbar; Nasim Eshraghi; Mahnaz Kalati; Sara Norouzi; Amir Hossein Kashanian
Volume 9, Issue 2 , March and April 2024, , Pages 125-130
Abstract
Background & Objective: Preterm birth is the most important cause of neonatal mortality and morbidity. Finding the best treatment regimen, of antenatal corticosteroids, has been under serious concern. To compare the efficacy of intravascular versus intramuscular betamethasone phosphate ...
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Background & Objective: Preterm birth is the most important cause of neonatal mortality and morbidity. Finding the best treatment regimen, of antenatal corticosteroids, has been under serious concern. To compare the efficacy of intravascular versus intramuscular betamethasone phosphate on neonatal outcomes in the cases of imminent preterm birth.
Materials & Methods: A double-blind randomized clinical trial was performed on 136 eligible pregnant women with gestational age of 26- 34 weeks and imminent preterm birth (delivery within 24 hours). They were randomly assigned into two groups. Group A received intramuscular betamethasone phosphate, and group B received a similar dose of betamethasone phosphate intravenously. Women were followed up to delivery, and their neonatal outcomes were compared.
Results: Women of the two groups (68 women in each group), did not show a significant difference in maternal age, BMI, gravidity and parity, gestational age at the time of admission and delivery, history of miscarriage and assisted reproductive techniques, delivery route, sex and weight of newborns, and Apgar score in minutes 1 and 5. The need for NICU admission, duration of hospitalization, neonatal respiratory distress syndrome, surfactant requirement, and intubation were lower in the IV betamethasone group. There were no significant differences between the two groups according to necrotizing enterocolitis, intraventricular hemorrhage, and neonatal death.
Conclusion: Using IV betamethasone, in cases where there is no enough time to complete the 24-hour betamethasone course due to the possibility of impending delivery, may reduce neonatal complications due to quicker onset of action.
Obstetrics and Gynecology
Robabeh MohammadBeigi; Ayda Fathollahpour; Asadolah Fathollahpour; Maryam Kashanian; Narges Sheikhansari
Volume 6, Issue 3 , June 2021, , Pages 116-121
Abstract
Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials ...
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Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials & Methods: The study was performed as a descriptive cross-sectional study on pregnant women who were admitted to the labor ward for delivery. Serum level of 25-hydroxyvitamin D [25(OH) D], was measured and compared in women and the umbilical cord blood. The relationship between 25(OH) D levels and anthropometric neonatal factors including birth weight, birth length and head circumference was evaluated.Results: A total of 106 pregnant women (53 Iranians and 53 Afghan refugees’ women) were evaluated. There was a significant correlation between maternal serum level of 25(OH) D and that of their neonates, both in Iranians and Afghans considering gestational age as a confounding factor (R=0.62, P < /em>=0.000). Maternal and neonatal 25(OH) D levels were significantly higher in Iranians than Afghans (27.2±11.5 ng/mL VS 21.9±12.7 ng/mL, P < /em>=0.026 and 26.5±11.2 VS 17.3±11.4, P < /em>=0.000) respectively. However, neonatal weight and head circumference (HC), were not different in Iranians and Afghans except for neonatal height which was higher in Afghans (P < /em>=0.015) irrespective of lower amount of neonatal 25(OH) D levels.The mean cord levels of vitamin D in boys and girls did not show a significant difference. There was no significant correlation between 25(OH) D serum level and pregnant women’s level of education, pre-labor rupture of membranes (PROM), past medical history (PMH), taking supplements and smoking.Conclusion: Maternal and neonatal 25(OH) D levels did not influence neonatal anthropometry.
Maternal Fetal Medicine
Maryam Kashanian; Arezoo HoseiniMoghaddam; Seyyed Ali Javad Moosavi; Narges Sheikhansari; Hoda Abdollahi
Volume 6, Issue 2 , March 2021, , Pages 65-71
Abstract
Background and Objective: Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.Methods: The study was designed as a historical ...
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Background and Objective: Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.Methods: The study was designed as a historical cohort among pregnant women with and without asthma. A total number of 583 asthmatic patients were allocated to the case group and 753 women without asthmatic history were placed in the control group. Pregnancy, labor and neonatal outcomes were compared between the two groups.Results: The baseline characteristics of the women in both groups did not show significant differences. Gestational hypertension was more in the asthmatic group [43 (7.37%) VS 26 (3.45%), P < /em>=0.001]. Also the rate of preterm delivery was higher in asthmatic women [72 (12.34%) VS 77 (10.22%) in the control group, P < /em>=0.04]. However, the rate of preeclampsia was less in the asthmatic group [29 (4.97%) VS 71 (9.42%), P < /em>=0.008]. Apgar score at minutes 1 and 5 was less in asthmatic group. Intra Uterine Fetal Demise (IUFD) [24 (4.1%) VS 13(1.7%), P value=0.009], and neonatal death [31 (5.31%) VS 10 (1.32%), P < /em>=0.001] were more in the asthmatic group. The maternal and neonatal complications did not show significant differences in various severities of asthma. Multivariate regression model showed more risks for neonatal death [adjusted odds ratio (AOR)=4.18; CI95% 2.03-8.60], IUFD (AOR=2.43; CI95% 1.22-4.82), gestational hypertension (AOR= 1.43; CI 95% 1.40-1.45), and lower risk for preeclampsia (AOR 0.37; CI95%0.17-0.79) in asthmatic women.Conclusion: Regardless of the fact that asthmatic mothers had higher frequencies of gestational hypertension, IUFD and neonatal death, the effect of asthma on perinatal outcome is minimal, probably because of efficient medical control.
Forough Javanmanesh; Maryam Kashanian; Vajihe Zamani; Narges Sheikhansari
Volume 3, Issue 3 , September and October 2018, , Pages 99-103
Abstract
Aims: Pain is the main concern after surgery. Gabapentin was recently suggested as a pain killer to be used after various surgeries. The purpose of the present study was to evaluate the effects of gabapentin on pain relief and need for opiates after total abdominal hysterectomy.
Materials & Methods: This ...
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Aims: Pain is the main concern after surgery. Gabapentin was recently suggested as a pain killer to be used after various surgeries. The purpose of the present study was to evaluate the effects of gabapentin on pain relief and need for opiates after total abdominal hysterectomy.
Materials & Methods: This randomized double-blind placebo-controlled clinical trial was performed on 85 women who underwent total abdominal hysterectomy from March 2014 to March 2016 in Akbarabadi teaching hospital and Firoozgar teaching hospital in Tehran, Iran. Samples were selected using consecutive sampling method and were randomly assigned into the 2 groups. In case group (n=44) gabapentin (800mg) was orally administered one hour before surgery and in the placebo group (n=41) placebo which was similar to gabapentin administered. The pain score was assessed in 2, 6, 12 and 24 hours after surgery. Nausea and vomiting were also compared between the 2 groups. Data were analyzed by SPSS 19 software using statistical tests.
Findings: The two groups did not have significant differences according to pain score in the recovery room (point 0). Mean score of pain was lower in the case group in 2, 6, 12 and 24 hours after surgery (p=0.005). Meperidine (pethidine) use was less in the case group (p=0.003). There was no difference between the 2 groups for nausea and vomiting.
Conclusion: Using gabapentin before surgery can lower the pain after surgery and reduces the need for opiates. However, it doesn’t have an effect on nausea and vomiting.
Forough Javanmanesh; Maryam Kashanian; Sara Mirpang
Volume 3, Issue 2 , May and June 2018, , Pages 49-52
Abstract
Aims: The rate of induced abortion is growing worldwide. In this study, we aimed at comparing using misoprostol with or without Letrozole in abortion.
Materials and Methods: In this placebo-controlled trial, 46 women with a gestational age of fewer than 20 weeks, who were candidates of legal abortion, ...
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Aims: The rate of induced abortion is growing worldwide. In this study, we aimed at comparing using misoprostol with or without Letrozole in abortion.
Materials and Methods: In this placebo-controlled trial, 46 women with a gestational age of fewer than 20 weeks, who were candidates of legal abortion, were selected by simple randomization sampling method and randomly assigned into two groups. Drug group received 10mg daily Letrozole (4 tablets of 2.5mg) for 3 days prior to taking Misoprostol and the placebo group received daily placebo (4 tablets with the exact appearance of Letrozole) with the same instructions. After 3 days, Misoprostol was given to all the participants based on their gestational ages. The data were analyzed by SPSS 16 software, using independent sample t-test and Chi-square test.
Findings: 21 women (45.7%) had a successful complete abortion, and curettage was needed for 25 women (54.3%). Successful abortion rate was significantly higher in the group receiving Letrozole (78.3%) than the group receiving placebo (13.0%; p=0.0001). Mean induction-abortion interval was 22.61±7.721 hours in the drug group and 24.09±8.251 hours in the placebo group, which was not significantly different (p>0.05). There was no significant difference between the two groups in terms of vaginal bleeding and adverse effects.
Conclusion: Using 10mg daily Letrozole for 3 days followed by oral Misoprostol results in a significantly higher rate of complete abortion compared with placebo in women with a gestational age of less than 20 weeks.
Maryam Kashanian; Sara Norouzi; Nooshin Eshraghi; Mohammadreza Babai; Soheila Aminimoghaddam
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented ...
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Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented with late PPH. Bilateral uterine artery ligation was done to conserve the uterus, however, the hemorrhage did not cease. In order to control the bleeding, embolization was suggested. During angiography, a pseudoaneurysm of the feeding femoral artery was noticed and embolization was performed to save the patient.
Discussion: Uterine artery pseudoaneurysm is one of the uncommon causes of secondary postpartum hemorrhage and could lead to a life-threatening situation. Management should be multidisciplinary and the gold standard for treatment and diagnosis is through interventional radiology.
