Razieh Akbari; Ezat-Sadat Haj-seyed Javadi; Zahra Panahi
Articles in Press, Accepted Manuscript, Available Online from 15 May 2023
Abstract
Background and Objective: The aim of labor induction is to stimulate uterine contractions before the spontaneous onset of labor, resulting in vaginal delivery. Misoprostol is used off-label for a variety of indications in the practice of obstetrics and gynecology. Regarding the importance and lack of ...
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Background and Objective: The aim of labor induction is to stimulate uterine contractions before the spontaneous onset of labor, resulting in vaginal delivery. Misoprostol is used off-label for a variety of indications in the practice of obstetrics and gynecology. Regarding the importance and lack of similar research in Iran in Buccal, this research was done to compare the efficacy of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy.Materials & Methods: This study was conducted as a randomized clinical trial from 2017 to 2018. In this study, 300 women were randomly assigned to receive 50 µg Buccal misoprostol, 25 µg Vaginal, and 50 µg Sublingual in Kosar Hospital, Qazvin. The maternal and fetal complications, and Bishop score hour 1, and hour 6 were monitored in three groups and the findings were analyzed.Results: The results showed that there were no differences between fetal complications (p>0.05) and maternal complications (p>0.05) among the three groups. Bishop score hour 1 (P = 0.146), Bishop Score hour 6 (P = 0.704), and total dose (P = 0.15) also were no differences among there groups. The results of the study showed that there was a significant difference between the three groups (P = 0.015) in achieving normal vaginal delivery within 24 hours, as Buccal, Sublingual and Vaginal groups were achieved respectively. Conclusion: This study found that there is no difference in terms of fetal complications and maternal complications in the three groups, but there was a significant difference in Oxytocin use and vaginal delivery within 24 h from the start of induction.
Maternal Fetal Medicine
Zahra Panahi; Sedigheh Hantoushzadeh; Soudabeh Kazemi Aski,; Saeede Eslami Khotbesara; Mamak Shariat; Fahimeh Ghotbizadeh; Razieh Akbari
Articles in Press, Accepted Manuscript, Available Online from 17 May 2023
Abstract
Introduction: Despite the high efficacy of the Apgar score to find respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one the best indicator of fetal hypoxia. Therefore it’s so beneficial to consider these criteria and ...
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Introduction: Despite the high efficacy of the Apgar score to find respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one the best indicator of fetal hypoxia. Therefore it’s so beneficial to consider these criteria and its relationship with Apgar score for accurate diagnosis of prenatal respiratory distress retrospectively and by which reduces the unnecessary cesarean section(CS) rate.
Methods: 162 full-term (≥259 days) neonates delivered by CS with a diagnosis of decreased fetal heart rate (FHR) were evaluated. 1-min and 5-min Apgar scores and UApH were measured. The correlation between Apgar scores with UApH and the association between UapH and Apgar with the NICU admission were evaluated. The effect of other variables including mother’s age, gravidity, gestational age, birth weight, newborn gender, and causes of decreased FHR on Apgar scores and UApH were studied as well.
Results: The most common cause of decreased FHR was fetal distress, boys had higher weight (p=0.033) and lower UApH (p=0.049) than girls. Other parameters were not different significantly between males and females. There was a positive correlation between UApH and 1-min and 5-min Apgar scores (r=0.464 and r=0.370 respectively) when controlled for birth weight (p<0.0001). The RR for NICU admission in male acidemic neonates with abnormal 1-min Apgar was 14.05(CI95%: 5.7-34.6) in comparison to females (RR=1.06, CI95%:1-1.26).
Conclusion: Mild acidemia (UApH<7.2) at least in male fetuses would be a good predictor for postnatal complications and the need for NICU admission. Future studies with more samples are suggested.
Obstetrics and Gynecology
Fahimeh Ghotbizadeh; Zahra Panahi; Azam Tarafdari Manshadi; Saeed Soltani; Razieh Akbari; Mahdieh Parsapur
Volume 8, Issue 1 , January and February 2023, , Pages 68-75
Abstract
Background & Objective: Social factors which are integrated with health status are considered crucial in pregnancy morbidity. Mothers with a developed level of health literacy (HL) experience a lower risk of preterm delivery. This study aimed to evaluate the relationship between maternal HL ...
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Background & Objective: Social factors which are integrated with health status are considered crucial in pregnancy morbidity. Mothers with a developed level of health literacy (HL) experience a lower risk of preterm delivery. This study aimed to evaluate the relationship between maternal HL and prenatal care and pregnancy outcome.Materials & Methods: The research was a cohort study. A total of 323 participants were selected from prenatal clinics. The women were followed until delivery. Women who had gestational diabetes or preeclampsia or gestational hypertension during pregnancy were omitted. Data were collected with a survey.Results: The result found 34.1%, 33.1%, 23.8%, and 9% were categorized as having inadequate, problematic, sufficient, and excellent maternal HL. Women with sufficient and excellent literacy were meaningfully better in having earlier and more frequent antenatal care, earlier folic acid consumption, and exercise before and during pregnancy, pregnancy alarm sign awareness, neonatal birth weight, and breastfeeding.Conclusion: The results proposed that sufficient and excellent HL among women is related to good pregnancy outcomes and poor HL causes a poor chance to gain a positive pregnancy outcome. A cooperative work to grow maternal HL by considering HL levels, revision of educational materials into plain language, and provision of pregnant women with verbal and video instruction in addition to written materials are highly recommended.
Maternal Fetal Medicine
Zahra Panahi; Seyedeh Noushin Ghalandarpoor-Attar; Azade Shabani; Mamak Shariat; Fahimeh Ghotbizadeh; Sedigheh Hantoushzadeh; Elham Feizabad; Seyedeh Mojgan Ghalandarpoor-Attar
Volume 7, Issue 6 , September and October 2022, , Pages 536-542
Abstract
Background & Objective: The thymus gland significantly affects fetal immune system maturation. Additionally, there is a linear association between thymus gland size and its performance. Given the high prevalence of vitamin D deficiency in Iran and scarce studies with conflicting results, subjecting ...
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Background & Objective: The thymus gland significantly affects fetal immune system maturation. Additionally, there is a linear association between thymus gland size and its performance. Given the high prevalence of vitamin D deficiency in Iran and scarce studies with conflicting results, subjecting maternal vitamin D concentration effect on fetal thymus, we decided to investigate maternal vitamin D concentration and its relation to fetal thymus size in mid-gestation. This study also aimed to generate a race-specific reference range.Materials & Methods: We performed a cross-sectional study of ultrasound measurements of the fetal thymus at 18-22 weeks of gestational age in 94 pregnant women and its correlation with maternal serum vitamin D levels from May to July 2021 at the tertiary center of Imam Khomeini Hospital in Tehran, Iran.Results: The mean values of thymus perimeter, thymus-thoracic ratio, thymus transverse diameter, and thymus area in all participants were 4.18±0.56 cm, 0.37±0.04, 1.56±0.21 cm, and 1.11±0.76 cm2, respectively. There was a trend toward decreased thymus perimeter and transverse thymus diameter with decreasing level of maternal vitamin D. There was also a significant correlation between thymus perimeter and transverse thymus diameter with fetal biometric indices and gestational age. Furthermore, a significant correlation was observed between the thymus perimeter and transverse thymus diameter. Conclusion: We generated a race-specific nomogram for fetal thymus size in Iranian pregnant women. Moreover, the observed trend toward decreased fetal thymus size with decreasing maternal vitamin D levels requires further prospective investigations. A high prevalence of vitamin D deficiency and low compliance with daily vitamin D intake during pregnancy was also shown, which requires a solution.
Fahimeh Ghotbizadeh Vahdani; Sedigheh Hantoushzadeh; Maryam Deldar Pasikhani; Azin Ghamari; Maryam Hajatpour; Zahra Panahi
Volume 4, Issue 2 , May and June 2019, , Pages 51-56
Abstract
Background & Objective: Due to increased rate of risk factors, the incidence of placenta accreta (PA) is increasing worldwide. This study aimed to investigate the important factors regarding the occurrence of PA, as well as outcomes and complications of Trans Abdominal Hysterectomy (TAH) in the patients ...
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Background & Objective: Due to increased rate of risk factors, the incidence of placenta accreta (PA) is increasing worldwide. This study aimed to investigate the important factors regarding the occurrence of PA, as well as outcomes and complications of Trans Abdominal Hysterectomy (TAH) in the patients with PA.
Materials & Methods: The study was performed as an observational cross-sectional study. Between March 2011 and March 2017, 177 patients, known cases of PA that undergone TAH, were enrolled in our study. Extracted data include demographic characteristics, patient’s medical history, surgical approach and complications, such as blood loss and urologic problems.
Results: The average of maternal age and gestational age were 33.6±4.70 (range= 22-43) years and 34.6±3.16 weeks, respectively. Neither maternal age (P < /em>=0.652) nor BMI (P < /em>=0.659) had significant association with abnormal placentation. Previous history of dilation & curettage (D&C) was found in 34 patients that was not related to the occurrence of the PA (P < /em>=0.508).Twenty-one (11.9%) of the patients needed urological intervention that did not associated with placental position, skin and uterine incision (P < /em>=0.258, 0.410 and 0.219). There is no relation between amount of blood loss with gestational age (P < /em>=0.7) and number of C/S (P < /em>=0.4), gestational age (P < /em>=0.7), anesthesia (P < /em>=0.2), and curettage history (P < /em>=0.3).
Conclusion: Our mortality and morbidity rate is much lower than reported ones, indicating the high-level ability, skill and knowledge of the surgeons.
