Maternal Fetal Medicine
Maryam Nurzadeh; Maryam Moshfeghi; Mamak Shariat; Ashraf Sadat Jamal; Vajiheh Marsoosi; Laleh Eslamian; Mahsa Naemi; Maria Nezam Nia; Fedyeh Haghollahi; Seyede Houra Mousavi Vahed
Volume 8, Issue 4 , July and August 2023, , Pages 335-341
Abstract
Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational ...
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Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational historical cohort study was conducted on multiple pregnancies that underwent fetal reduction in Shariati Hospital and Omid Clinic between January 2018 and September 2021. The study population was divided into two groups according to gestational age at fetal reduction: 11–14 weeks' gestation (early reduction group) and 15–19 weeks’ gestation (late reduction group). The main outcome measures were the rates of pregnancy complications, pregnancy loss, preterm delivery, and adverse neonatal outcomes.Results: The study group included 107 patients with twin and multiple pregnancies that underwent abdominal MPR at 11-19 weeks’ gestation (79 in the early reduction group and 28 in the late group). The incidence of pregnancy complications (hypertension, diabetes, intrauterine growth disorder, preterm delivery, and pregnancy loss) was not significantly different between the two groups (P >0.05). The percentage of NICU admission was higher in the early reduction group compared to the late group (49% vs 18.5%, P=0.004). The weight of the first newborn was significantly heavier in the late versus early reduction group (2680.55±777.52 vs 2264.4±796.82, P=0.005).Conclusion: According to the present study, fetal reduction in twin or multiple pregnancies is a safe procedure with good obstetric outcomes if done by an expert specialist, especially when it is performed in the second trimester.
Maternal Fetal Medicine
Laleh Eslamian; Ashraf Jamal; Vajiheh Marsosi; Marjan Ahmadi; Alireza Golbabaei; Paria Boustani
Volume 7, Issue 3 , January and February 2022, , Pages 165-170
Abstract
Background & Objective: IUGR (intrauterine growth restriction) fetuses have been known as a significant concern in clinical practice. It is associated with fetal mortality and morbidity and prenatal adverse cardiac remodeling. The aim of this study is the evaluation of the relation between MPI (myocardial ...
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Background & Objective: IUGR (intrauterine growth restriction) fetuses have been known as a significant concern in clinical practice. It is associated with fetal mortality and morbidity and prenatal adverse cardiac remodeling. The aim of this study is the evaluation of the relation between MPI (myocardial performance index) abnormalities and doppler findings in both normal and IUGR fetuses.Materials & Methods: In this cross-sectional study, 400 consecutive pregnant women in Shariati Hospital, Tehran, Iran, in 2019 and 2020 underwent ultrasound assessment at 28-40 weeks, in which among the 400 performed ultrasounds, 47 fetuses with IUGR were selected as a case group, and 47 fetuses with normal weight were selected based on AGA (appropriate gestational age). Cardiac function was evaluated by measuring MPI in diastolic and systolic function in two groups. The results were compared to the IUGR (case group) and control group by SPSS software version 20.Results: In receiver operating characteristic (ROC) analysis, the AUC (area under the curve) for left ventricular MPI (LV MPI) was 0.929 (CI95%: 0.868-0.991; P < /em>=0.001), and the sensitivity and specificity values were 87% and 69.4% with a cut-off point of 0.2850. In ROC analysis, the area under the curve for RV MPI was 0.842 (CI95%: 0.741-0.942; P < /em>=0.001), and the sensitivity and specificity values were 78.3% and 63.9%, with a cut-off point 0.2850. Left and right ventricular MPI showed a significant difference statistically between the case and the control groups.Conclusion: The study showed a significant rise of MPI in IUGR fetuses. MPI can be considered as a useful parameter for evaluating the severity of growth restriction in IUGR fetuses.
