Obstetrics and Gynecology
maryam dehghan; tajosadat alameh; Zahra Allameh; zahra Seyed-Hoseini
Volume 8, Issue 2 , March and April 2023, , Pages 113-119
Abstract
Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly ...
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Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter or misoprostol modes. Cervical ripening in Foley catheter group was done with transcervical Foley catheter 18, and in misoprostol group with 25 μg single dose vaginal misoprostol (The maximum allowed dose for patients was 6 doses.). Bishop score, Apgar score, active phase duration, stage 2 duration and insertion to delivery interval were the main outcomes.Results: The mean time of ripening and the active phase in vaginal misoprostol group was significantly shorter than in Foley catheter group (2.32 versus 5.11 hours respectively, P-value = 0.0001). After intervention, Bishop score in vaginal misoprostol group was significantly more than Foley catheter group (8.70 versus 6.68 respectively, P-value = 0.0001). Insertion to delivery interval in vaginal misoprostol group was 9.54 hours and in Foley catheter group was 12.88 hours (P-value = 0.0001). The hospitalization time in Foley catheter group was significantly more than vaginal misoprostol group (P-value = 0.0001). The other outcomes were similar between groups.Conclusion: By the decreasing in the total time from insertion to birth, vaginal misoprostol was more effective than Foley catheter, as a cervical ripening method in our study.
Maternal Fetal Medicine
Tajossadat Allameh; Zahra Allameh; Zahra Javanmardi; Elham Moazam; Maryam Dehghan
Volume 8, Issue 2 , March and April 2023, , Pages 131-136
Abstract
Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean ...
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Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean section in Isfahan province.Materials & Methods: In this one-year descriptive cross-sectional study, 49889 pregnant women who had the natural childbirth (29631 deliveries), elective repeat Cesarean section (20148 deliveries) and VBAC delivery (110 deliveries) were enrolled, then maternal and neonatal complications were compared in three groups.Results: There was a significant difference between the three groups based on the maternal and neonatal outcome, Apgar scores in the first and fifth minutes after delivery and the need for resuscitation at birth (P <0.05). Neonatal outcome was better in natural delivery and then VBAC compared to repeat C-section, respectively. Maternal outcome was better in VBAC and then repeat C-section than the natural childbirth. Apgar scores in the first and fifth minute were better in VBAC, and later natural delivery than repeat C-section. Resuscitation at birth demonstrated better results for natural delivery and then VBAC than repeat C-section.Conclusion: Utilizing VBAC and natural delivery have better maternal and fetal outcomes compared to C-section, along with being more satisfactory and safer.
Obstetrics and Gynecology
Tajossadat Allameh; Maryam Dehghan
Volume 6, Issue 4 , August 2021, , Pages 202-208
Abstract
Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical ...
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Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical glandular cells (AGCs) referred to gynecology clinics in Isfahan, Iran, and seventy women were selected to undergo Pap smear test, colposcopic examination and ECC. EMC was performed in women older than 35. Pap smear test results were classified as normal, inflammation, AGCs and necrosis. Colposcopy, ECC and EMC findings were classified as normal, benign and malignant pathologic lesions.Results: Repetitive Pap smears findings were as follows: 15.7% were normal, 77.2% had inflammation, 4% had AGC and 3.1% had necrosis. Based on colposcopy findings, 61.2%, 7.5%, and 31.3% of the samples were classified as normal, benign and malignant, respectively. ECC findings in 95.5% of women was indicative of benign lesions and malignant lesions in 4.5%. EMC findings showed that 79.7% were normal, 8.5% had benign lesions and 11.9% had malignant lesions. Pap smears with several AGCs were associated with benign lesions in 24.2% of the cases and premalignant and malignant lesions in 14.2% of the cases.Conclusion: According to our study, due to the significant association between AGC cytology and pathologic cervical and endometrial lesions, intensive assessment is necessary in women with AGC Pap smears, especially in older and post-menopausal women, in order to reduce mortality.
Maternal Fetal Medicine
Maryam Dehghan; Neda Ebrahimian; Leila Mousavi Seresht
Volume 6, Issue 4 , August 2021, , Pages 228-232
Abstract
Background & Objective: Since the first reported respiratory distress syndrome due to the new version of the coronaviruses family, COVID-19, there is a concern about the possible maternal and perinatal outcome of new infection in a short and even long time, our information about the prognosis ...
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Background & Objective: Since the first reported respiratory distress syndrome due to the new version of the coronaviruses family, COVID-19, there is a concern about the possible maternal and perinatal outcome of new infection in a short and even long time, our information about the prognosis of pregnancy in sync with COVID-19 is limited. What is our task as scientists in eliminating the unknown facts?Materials & Methods: Here we try to present a couple of pregnant cases in their third trimesters of pregnancy that complicated with two contrary complication of COVID-19 infection, intending to illuminate the best management strategy in COVID-19 infected pregnant.Results: The first case had experienced thromboembolism, and also bleeding accident, who fortunately survived unlike the other case, who expired due to multi-organ failure and impossibility of anticoagulant agent administration for the suspected pulmonary thromboembolic accident.Conclusion: The prior report revealed the thrombo-inflammatory and hypoxic effect of COVID-19 that could lead to microvascular thrombosis and progression, which enforce health care providers, introducing the anticoagulant agents to decline COVID-19 mortality, especially in a critically ill patient. Pregnancy is associated with coagulation abnormality which could intensify the COVID-19-induced coagulopathy. But, one should balance the harm and benefit of such a hazard approach, is there any concern about vascular damage of COVID-19 and subsequent bleeding, that could be exacerbated with high dose anticoagulant agent administration? The other question that we want to discuss in the present report is about comparing the cost and benefit of anticoagulant therapy?
