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 & 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 in normal growth. The objective of this study was to compare the level ...
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Background & 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 in 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.Materials & 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 one (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 one (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 specificity =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.
Gynecology Oncology
Forozan Milani; Seyedeh Hajar Sharami; Negar Gholamalipour; Ehsan Kazemnezhad Leyli; Seyedeh Fatemeh Dalil Heirati; Yalda Donyaei-Mobarrez
Volume 9, Issue 1 , January and February 2024, , Pages 53-62
Abstract
Background & Objective: Evaluation of the alpha-fetoprotein is one of the screening tests during pregnancy. The purpose of this study was to determine the relationship between the level of alpha-fetoprotein in amniotic fluid (AF-AFP) and adverse pregnancy outcomes.Materials & Methods: This ...
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Background & Objective: Evaluation of the alpha-fetoprotein is one of the screening tests during pregnancy. The purpose of this study was to determine the relationship between the level of alpha-fetoprotein in amniotic fluid (AF-AFP) and adverse pregnancy outcomes.Materials & Methods: This comparative analytical study was performed on 244 pregnant women who referred to a private prenatal clinic in Rasht (Iran). Amniocentesis was performed on pregnant women with maternal serum alpha-fetoprotein (MS-AFP) was higher than 2.5MoM in the second trimester and based on this finding, participants were divided into four groups of 61 patients. The first group (control group) included pregnant women with normal MS-AFP, the second group included pregnant women with high MS-AFP and normal AF-AFP, the third group included pregnant women with high MS-AFP and low AF-AFP and the fourth group included pregnant women with high MS-AFP and high AF-AFP.Results: Adverse outcomes include abortion (6.6%), stillbirth (6.6%), IUGR (18%), LBW (29.5%), PTL (21.3%), fetal abnormalities (4.9%), preeclampsia (14.8%), gestational diabetes (8.2%), in the fourth group (high AF-AFP) was higher than other groups. The incidence of adverse pregnancy outcomes in the fourth group was 1.2 times higher than the control group, and this relationship was borderline statistically significant (P=0.056).Conclusion: Considering that adverse pregnancy outcomes are important causes of mortality and morbidity, early diagnosis of high-risk pregnancies and efforts for preventive interventions can be associated with reducing mortality and morbidity. Therefore, evaluation of the level AF-AFP can be helpful in determining adverse pregnancy outcomes.
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.
