Farnoush Farzi; Sodabeh Kazemi; Ziba Zahiri Sorouri; Samaneh Ghazanfar; Mahin Tayefeh Ashrafiyeh; Mandana Javanak; Mohammad Shahbazi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Having body mass index more than 29 is described as obesity in pregnancy. Anesthesia management in these patients has always been challenging. A 41-year-old woman, at 37weeks’ gestation with the weight of 200kg and body mass index of 66/05 was admitted with complaint of pain to Al-Zahra Hospital ...
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Having body mass index more than 29 is described as obesity in pregnancy. Anesthesia management in these patients has always been challenging. A 41-year-old woman, at 37weeks’ gestation with the weight of 200kg and body mass index of 66/05 was admitted with complaint of pain to Al-Zahra Hospital in Rasht. She reported a history of two previous caesarean sections and high blood sugar and hypothyroidism which were under control by drugs. The Anesthesiology team decided to choose Continuous Spinal Anesthesia method for her. After performing anesthesia, cesarean delivery was done and a female neonate was born with Apgar score of 5-9. They were discharged from the hospital in good condition after two days. Based on the results of this study, CSA approach is a suitable method for anesthesia management in cesarean section of obese patients. Also it is necessary to recommend these patients to refer to anesthesia counseling clinics before giving birth.
Maternal Fetal Medicine
Zahra Panahi; Fahimeh Ghotbizadeh Vahdani; Saeede Eslami Khotbesara; Razieh Akbari; Sedigheh Hantoushzadeh; Soudabeh Kazemi Aski; Mamak Shariat
Volume 9, Issue 2 , March and April 2024, , Pages 4-4
Abstract
Background and Materials: Despite the high efficacy of the Apgar score in finding respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one of the best indicators of fetal hypoxia. Therefore, it’s so beneficial to consider ...
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Background and Materials: Despite the high efficacy of the Apgar score in finding respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one of the best indicators of fetal hypoxia. Therefore, it’s so beneficial to consider these criteria and their relationship with the Apgar score for accurate diagnosis of prenatal respiratory distress retrospectively which reduces the unnecessary cesarean section (CS) rate.
Methods: 162 full-term (≥259 days) neonates delivered by CS with the 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 sex, 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 both sexes. 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 a male fetus would be a good predictor for postnatal complications and need for NICU admission. Future studies with more samples are suggested.
Obstetrics and Gynecology
Soudabeh Kazemi Aski; Seyedeh Hajar Sharami; Azadeh Tavangar; Ehsan Kazemnezhad; Seyedeh Fatemeh Dalil Heirati; Atoosa Etezadi
Volume 9, Issue 1 , January and February 2024, , Pages 14-21
Abstract
Background and objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus normal growth. The objective of this study was to compare the level ...
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Background and objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus normal growth. The objective of this study was to compare the level of PAPP-A in pregnancy weeks 11-14 in women with and without intrauterine growth restriction and to assess the ability of this marker to predict adverse outcomes in pregnancy. Methods: In this Comparative Cross-sectional study, 227 pregnant women were studied during 2017. Mothers were divided into two main groups with and without intrauterine growth restriction. The relevant data, including birth weight, preeclampsia, gestational diabetes, Apgar score, and PAPP-A, were recorded on special forms. Data analysis was done using SPSS-21 software. Results: The mean age of participating women in this study was 28.8 ± 5.6 years. The median (IOR) number of gravidity and Gestational weight gain was 1 (1) and 12 (7) kg respectively. The difference in median (IOR) PAPP-A in patients with and without IUGR was statistically significant 0.64(0.57) and 1 (0.57), respectively, P= 0.001.The cut-off point for PAPP-A was 0.73 with a sensitivity=72.2% (95% CI: 64.32-79.16%) and a specify =60.5% (95% CI: 48.65 -71.56%). Conclusion: The results of this study confirm the relationship between low levels of PAPP-A and adverse outcomes of pregnancy. In the present study, the optimal cut-off point (0.73) is higher than other studies, which can be due to racial and epidemiological differences.
Obstetrics and Gynecology
Roya Kaboodmehri; Seyedeh Hajar Sharami; Sodabeh Kazemi; Mandana Mansour Ghanaei; Seyedeh Fatemeh Dalil Heirati; Zahra Pourhabibi; Sina Montazeri
Volume 8, Issue 4 , July and August 2023, , Pages 350-356
Abstract
Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this ...
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Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this cross-sectional study, conducted in Al-Zahra hospital Rasht in the north of Iran, 234 patients, 18-45 years old, were enrolled. The demographic parameters (e.g. age, education, habitat and etc.) and AMH levels were recorded for each patient. The patients were divided into two groups based on their AMH levels [group 1: less than 1.1 (ng/ml) vs. group 2: more than (1.1 ng/ml)]. The data was analyzed by SPSS-21 software.Results: The mean AMH level was 2.66 ng/ml. Age, education status and habitat showed significant differences among subjects with AMH levels, so that with aging the AMH levels decreased. Patients living in villages or the ones with low educational degrees and those with higher parities also revealed lower levels of AMH (p<0.05).Conclusion: There was a significant relationship between age, educational status and habitat with AMH values. Similar to other studies, we believe that with aging the AMH levels decrease. Furthermore, the other two aforementioned demographic features could affect a woman’s ovarian reserve and fertility status, too.
Obstetrics and Gynecology
Soudabeh Kazemi Aski; Seyedeh Hajar Sharami; Morvarid Ghasab Shirazi; Ezat Hesni; Seyedeh Fatemeh Dalil Heirati; Misa Naghdipour; Alireza Forozan; Maryam Ghalandari; Forozan Milani
Volume 8, Issue 3 , May and June 2023, , Pages 268-276
Abstract
Background & Objective: The Covid-19 pandemic can cause complications for pregnant women and more serious maternal, fetal and neonatal care related to this disease should be considered in health systems. The aim of the present study was to investigate the maternal, fetal, and neonatal outcomes ...
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Background & Objective: The Covid-19 pandemic can cause complications for pregnant women and more serious maternal, fetal and neonatal care related to this disease should be considered in health systems. The aim of the present study was to investigate the maternal, fetal, and neonatal outcomes of pregnant women with COVID-19 disease.Materials & Methods: We performed a prospective study with a longitudinal design of all pregnant women hospitalized due to moderate and severe COVID-19 referred to Al-Zahra hospital, Rasht, Iran. After patient discharge, patients were followed until delivery, maternal, fetal, and neonatal outcomes were assessed by a 4-part researcher-made questionnaire.Results: In total, 166 pregnant women with Covid-19 were included in the study. The median gestational age in patients was 35.5 weeks and the median delivery age was 38 weeks. Delivery in 137 (82.5%) women were cesarean section and 29 (17.5%) had a vaginal delivery. The most common clinical symptoms among patients were fever, cough, and dyspnea with 50.9%, 38.5%, and 31.5% frequency, respectively, 9.6% had poor prenatal outcomes, 15 patients (9%) were admitted to ICU and 4 patients died (2.4%). Poor maternal outcomes were reported in 61.5% of patients with severe clinical symptoms, (p <0.001). There was no significant relationship between the severity of the disease and the type of delivery (p = 0.41).Conclusion: In our study we observed an increase in poor maternal, fetal and neonatal outcomes particularly in pregnant women with severe symptoms, although careful care is still recommended for affected pregnant women to reduce fetal, neonatal, and maternal complications. Further research will be needed to devise plan for pregnancy care and future health care crises.
Obstetrics and Gynecology
Soudabeh Kazemi Aski; Shiva Alizadeh; Saghi Ghafourian Abadi; Fereshteh Yaseri Gilvaei; Seyedeh Marzieh Kiai
Volume 7, Issue 3 , January and February 2022, , Pages 235-242
Abstract
Background and Objective: With the outbreak of the new coronavirus, some sections of society are more vulnerable, including pregnant women. Today, with the pandemic of COVID-19, anxiety, and worries about pregnancy and fetal health have increased and will be associated with adverse consequences ...
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Background and Objective: With the outbreak of the new coronavirus, some sections of society are more vulnerable, including pregnant women. Today, with the pandemic of COVID-19, anxiety, and worries about pregnancy and fetal health have increased and will be associated with adverse consequences for the health of mothers and infants. There is also insufficient information on the effects of coronary heart disease and COVID-19 on the fetus and pregnancy. Therefore, this study aimed to examine the level of awareness of pregnant women about coronavirus disease (COVID-19) and its correlation with observed stress in pregnant women.Methods: This cross-sectional analytical research was conducted on 384 pregnant women who were referred To Al-Zahra Medical Center at Rasht, Iran in 2020 and were selected through simple random sampling. Data collection tools were a demographic questionnaire, standard perceived stress questionnaire, and a researcher-made questionnaire on COVID-19 disease. Using statistical tests, the collected information was analyzed using SPSS 23 at an importance level of less than 0.05.Results: The average scores of pregnant women's knowledge about the signs, symptoms, and ways of transmitting coronavirus are lower than the scores of mothers' awareness about the cause of the disease and how to prevent it. However, in general, the average score of pregnant women' knowledge about COVID-19 is high. Also, the mean scores of concern about COVID-19 and perceived stress of pregnant women about this disease in this reading are high. The present study's findings showed that the amount of knowledge of pregnant women about COVID-19 has a statistically significant relationship with anxiety and perceived stress about this disease and has a positive correlation.Conclusion: This study's results showed that the more pregnant women are aware of COVID-19, the more anxious and stressed they are. As a result, to provide psychological support to pregnant women during pregnancy, medical staff training, the help of social media, and psychiatric experts can minimize harm to them and their fetuses.
Radiology
Maryam Rahmani; Behnaz Moradi; Masoumeh Gity; Mohammadreza Chavoshi; Sedigheh Hantoushzadeh; Soudabeh Kazemi Aski; Seyedeh Fatemeh Mahdipour Keivani; Narges Badraghe; Mohammad Ali Kazemi
Volume 6, Issue 2 , March 2021, , Pages 72-80
Abstract
Background and Objective: To evaluate the clinical course and CT findings of pregnant womenMethods: Fourthy (25 pregnant and 15 non-pregnant) patients were entered to the study. Chest CT features and clinical findings were evaluated between two groups. Data related to pregnancy and fetal status evaluated ...
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Background and Objective: To evaluate the clinical course and CT findings of pregnant womenMethods: Fourthy (25 pregnant and 15 non-pregnant) patients were entered to the study. Chest CT features and clinical findings were evaluated between two groups. Data related to pregnancy and fetal status evaluated in the pregnant group.Result: The average age of pregnant patients was 33.1±5.75 years and the non-pregnant group was 35.4±6.88 years. The gestational age ranged from 7 weeks to 39weeks+2days (mean =31weeks+5days). No significant difference was seen between the two groups about clinical findings except the duration of symptoms before CT which was more in pregnant patients (6.71 ± 5.5 days vs 3.53 ± 1.92 days). Two mortalities in pregnant and one in non-pregnant patients , 2(8%) cases of premature rupture of membranes (PROM), 3 (12%) cases of intra-uterine fetal death (IUFD), 3 (12%) cases of fetal distress and 2 (8%) cases of IUGR in pregnant group. Fifteen pregnant patients gave birth .No positive PCR result was detected in newborns. Unlike the control group, the common CT findings were ground-glass pattern.Conclusion: In summary, although we found the clinical findings in pregnant and control group were similar but pattern of CT involvement was different in pregnant patients and rate of ICU admission and mortality rate were more than control group. This viral pneumonia was associated with some important complications such as IUFD in severely involved mothers. CT could be an efficient tool for the early detection and severity assessment in the pregnant patients with COVID-19 pneumonia.