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.
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.
Maternal Fetal Medicine
Sedigheh Borna; Vida Radi; Maasoumeh Saleh; Mina Ataee; Hanieh Feizmahdavi; Zohreh Salari; Mamak Shariat
Volume 7, Issue 3 , January and February 2022, , Pages 144-150
Abstract
Background & Objective: This study assessed the relationship between the ratio of fetal lung volume to head circumference and amniotic fluid index (AFI) in the third trimester of pregnancy.Materials & Methods: This prospective study was performed on low-risk pregnant women in their third trimester ...
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Background & Objective: This study assessed the relationship between the ratio of fetal lung volume to head circumference and amniotic fluid index (AFI) in the third trimester of pregnancy.Materials & Methods: This prospective study was performed on low-risk pregnant women in their third trimester of pregnancy. Fetal lung volume was determined separately using the lung-to-head ratio (LHR) for the right and left lungs. Moreover, the AFI was evaluated, and the Pearson correlation coefficient between LHR for both lungs and AFI was investigated.Results: Overall, 112 pregnant women were included in the study. The mean ± standard deviation (SD) of fetal Observed/Expected Right LHR (O/E RLHR) and O/E Left LHR (O/E LLHR) were 113.9±0.36 and 97.13±27.87, respectively. The mean ± SD of AFI was 12.5±4.96 cm. Pearson correlation coefficient did not show a significant relationship between AFI and the left and right LHR (P < /em>>0.05). However, O/E RLHR was significantly correlated with abdominal circumference (P < /em>=0.02, r=0.2), gestational age (P < /em>=0.21, r=0.27), and fetal weight (P < /em><0.001, r=0.27). There was a positive correlation between the number of days the infant was admitted to the neonatal intensive care unit and the volume of the right lung of the fetus (P < /em>=0.03, r=-0.2). No correlation was observed between fetal parameters and the volume of the left lung of the fetus.Conclusion: The results of this study showed that AFI in the third trimester of pregnancy was not significantly correlated with LHR.
Gynecology Oncology
Azam-Sadat Mousavi; Setareh Akhavan; Fareideh Sabzi shahrbabaki; Narges Izadi-mood; Fariba Yarandi; Mehran Ghazimoghadam; Mohammad Pouryasin; Saina Nassiri; Mamak Shariat; Ali Pouryasin
Volume 7, Issue 3 , January and February 2022, , Pages 151-157
Abstract
Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with ...
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Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with abnormal cytological results regarding the histopathological cut-off.Materials & Methods: In this cross-sectional study, 360 non-pregnant women (≥ 21 years) who had faced abnormal cytological findings (ASC-US and LSIL) were enrolled and referred for further diagnostic tests. The INNO-LiPA® HPV Genotyping Extra-II and Aptima HPV assay kits were used in DNA- and E6/E7 mRNA-based methods for detection of HR-HPV. Regarding the CIN-2+ histopathological cut-off, the diagnostic value of each molecular-based assay was calculated.Results: Among the study participants, 260 cases had ASC-US, and 100 had LSIL. The overall positivity rate for DNA- and mRNA-based methods was 74.4% (268/360) and 64.2% (231/360), respectively. Fifty-nine (16.4%) individuals showed CIN-2+. The DNA-based test showed higher sensitivity (100%) than the mRNA-based method (93.2%), while the mRNA-based method revealed greater clinical specificity (41.5%) compared to the DNA-based test (30.6%).Conclusion: Our results revealed appropriate clinical sensitivity of the molecular-based methods for triage of Iranian women with abnormal cytological results; however, the mRNA-based method showed greater specificity for detection of CIN-2+.
