Maternal Fetal Medicine
Maryam Kashanian; Nooshin Eshraghi; Majid Kalani; Arash Bordbar; Nasim Eshraghi; Mahnaz Kalati; Sara Norouzi; Amir Hossein Kashanian
Volume 9, Issue 2 , March and April 2024, , Pages 125-130
Abstract
Background & Objective: Preterm birth is the most important cause of neonatal mortality and morbidity. Finding the best treatment regimen, of antenatal corticosteroids, has been under serious concern. To compare the efficacy of intravascular versus intramuscular betamethasone phosphate ...
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Background & Objective: Preterm birth is the most important cause of neonatal mortality and morbidity. Finding the best treatment regimen, of antenatal corticosteroids, has been under serious concern. To compare the efficacy of intravascular versus intramuscular betamethasone phosphate on neonatal outcomes in the cases of imminent preterm birth.
Materials & Methods: A double-blind randomized clinical trial was performed on 136 eligible pregnant women with gestational age of 26- 34 weeks and imminent preterm birth (delivery within 24 hours). They were randomly assigned into two groups. Group A received intramuscular betamethasone phosphate, and group B received a similar dose of betamethasone phosphate intravenously. Women were followed up to delivery, and their neonatal outcomes were compared.
Results: Women of the two groups (68 women in each group), did not show a significant difference in maternal age, BMI, gravidity and parity, gestational age at the time of admission and delivery, history of miscarriage and assisted reproductive techniques, delivery route, sex and weight of newborns, and Apgar score in minutes 1 and 5. The need for NICU admission, duration of hospitalization, neonatal respiratory distress syndrome, surfactant requirement, and intubation were lower in the IV betamethasone group. There were no significant differences between the two groups according to necrotizing enterocolitis, intraventricular hemorrhage, and neonatal death.
Conclusion: Using IV betamethasone, in cases where there is no enough time to complete the 24-hour betamethasone course due to the possibility of impending delivery, may reduce neonatal complications due to quicker onset of action.
Obstetrics and Gynecology
Farzaneh Abedini; Mahdis Mohammadian Amiri; Mahsa Danaei; Nooshin Eshraghi
Volume 7, Issue 6 , September and October 2022, , Pages 489-496
Abstract
Background & Objective: Premature rupture of membranes (PROM) and preterm delivery are the most important problems observed in pregnancies that can cause many consequences. The present study investigated the relationship between amniotic fluid index (AFI) and uterocervical angle in patients with ...
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Background & Objective: Premature rupture of membranes (PROM) and preterm delivery are the most important problems observed in pregnancies that can cause many consequences. The present study investigated the relationship between amniotic fluid index (AFI) and uterocervical angle in patients with PROM between 24 and 34 weeks of gestation.Materials & Methods: This study was a cohort study carried out on 50 pregnant women with PROM. Inclusion criteria were 24 to 34 weeks of gestation and singleton deliveries. Demographic characteristics and pregnancy history of the subjects were determined through interviews and examinations. Moreover, AFI and uterocervical angle were determined based on ultrasound results. Subjects were followed up until delivery.Results: Mean age of the patients was 25.14±5.32 years; 23 patients (46%) had delivery latency less than 7 days. The mean uterocervical angle in the delivery latency group ≤7 was significantly higher than that in the group more than 7 days (P < /i> <0.001). Moreover, the mean AFI in the delivery latency group ≤7 was significantly higher (P < /i> <0.001). The uterocervical angle above 107.7 with a sensitivity of 87% and a specificity of 88.9% had a predictive power and its area under curve (AUC) was 0.912 (P < /i> <0.001). The mean AFI below 5.4 with a sensitivity of 81.5% and a specificity of 65.5% had a predictive power (AUC: 0.866, P < /i> <0.001). Conclusion: Uteroservical angle and AFI can be good predictors for assessing delivery latency in women with PROM. Furthermore, the mean uterocervical angle in the delivery latency group ≤7 days is significantly higher than that in the group more than 7 days, but conversely AFI is less.
Maryam Kashanian; Sara Norouzi; Nooshin Eshraghi; Mohammadreza Babai; Soheila Aminimoghaddam
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented ...
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Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented with late PPH. Bilateral uterine artery ligation was done to conserve the uterus, however, the hemorrhage did not cease. In order to control the bleeding, embolization was suggested. During angiography, a pseudoaneurysm of the feeding femoral artery was noticed and embolization was performed to save the patient.
Discussion: Uterine artery pseudoaneurysm is one of the uncommon causes of secondary postpartum hemorrhage and could lead to a life-threatening situation. Management should be multidisciplinary and the gold standard for treatment and diagnosis is through interventional radiology.
