Behjat Khorsandi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and Objective: Understanding the reproductive and sexual needs of pregnant women seems to be crucial in increasing the effectiveness of services and addressing their needs and expectations. Therefore, the aim of this study was to explain the needs and concerns of reproductive and sexual health ...
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Background and Objective: Understanding the reproductive and sexual needs of pregnant women seems to be crucial in increasing the effectiveness of services and addressing their needs and expectations. Therefore, the aim of this study was to explain the needs and concerns of reproductive and sexual health of pregnant women during the COVID-19 pandemic.Method: This is a qualitative study with a content analysis approach. In this probe, 16 interviews were accomplished with 15 pregnant women who had referred to public and private pregnancy care centers. Data analysis was performed predicated on the content analysis approach using MAXQDA software version 12. Results: Based on 16 interviews conducted with pregnant women during COVID-19 pandemic, 19 women were found to be suffering from mental disorders, fears, Disrupting prenatal care and sexual problems.Conclusion: According to the results of this study and other studies in the area of reproductive and sexual health, due to its importance in the quality of individual and married life, it should be considered in health planning activities and scores of studies and interventions in these areas are thus suggested
Mahin Najafian; Mahtab Shariati; Sara Masihi; Roshan Nikbakht
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension. Methods: This randomized controlled ...
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Introduction: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension. Methods: This randomized controlled clinical trial study was conducted on 60 pregnant women with a diagnosis of gestational hypertension and chronic hypertension. Women were randomly divided into the control (n=30) and the DASH diet (n=30) groups for 2 months and were followed until delivery. The outcomes of maternal pregnancy including the incidence of preeclampsia, placental abruption and preterm delivery (<37 weeks) were assessed during follow-up examinations. Birth weight and minute 1 and minute 5 Apgar score of the infant were also assessed. Results: After 1 and 2 months of intervention, systolic and diastolic blood pressure in the DASH diet group was significantly lower than the control group (P<0.05). The incidence of preeclampsia (P=0.035), preterm delivery (P=0.020) and placental abruption (P=0.007) in the DASH diet group was significantly lower than the control group. The mean gestational age at the time of termination of pregnancy was not significantly different between the two groups (P = 0.467). There was no significant difference between minute 1 and minute 5 Apgar scores of the infants and the mean birth weight of the infants was not significantly different between the DASH and control groups (P = 0.756, P = 0.115 and P = 0.101, respectively). Conclusion: The DASH diet could be used as an effective strategy to improve the clinical outcomes of pregnant women with gestational and chronic hypertension.
ahmed elkhyat; amal elsokary; shereef elshwaikh
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Study design: A prospective observational study.Patients: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced ...
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Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Study design: A prospective observational study.Patients: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by dietary modifications. Patients were classified later into respondent and non-respondent. All patients were stimulated with letrozole 2.5 mg twice daily for 5 days for 6 cycles. Ovulation and pregnancy rates were assessed. Results: From 84 patients who were enrolled in our study, 33 patients were allocated into non responder group and 28 patients were allocated in responder group and It was found that despite there was statistical difference between both group as regard weight gain , weight after 6 months and BMI after 6 months , there was no significant difference between both groups as regard the ovulation rate , pregnancy rate and complications to ovulation induction (OHSS).Conclusion: weight gain in lean PCOS patients - although non-significant- but it may improve the reproductive outcomes (ovulation rate and pregnancy rate) and the need of further study with larger number and longer duration of follow up for confirmation of this results.
Obstetrics and Gynecology
Zinah hammad; Ban J. Edan
Volume 8, Issue 2 , January and February 2023, , Pages 167-172
Abstract
Background: One of the worldwide healthcare problems is Diabetes mellitus (DM), and the prevalence of this disease increases steadily, particularly in pregnancy. The several metabolic disorders in the pregnancy were revealed by the placenta. The pathogenesis of diabetes mellitus is associated with hyperglycemia, ...
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Background: One of the worldwide healthcare problems is Diabetes mellitus (DM), and the prevalence of this disease increases steadily, particularly in pregnancy. The several metabolic disorders in the pregnancy were revealed by the placenta. The pathogenesis of diabetes mellitus is associated with hyperglycemia, insulin resistance, and oxidative stress, and it negatively impacts the mother-placenta-fetus system. This research aims to compare the amount of leptin expression, as well as its score and intensity, in the placentas of women with diabetes with those of healthy controls.Materials and methods: In this work, we used a case-control methodology. Thirty women were diagnosed with diabetes and were placed in one group, while the other 40 served as a comparison. Primary monoclonal antibodies were used for the immunohistochemical analysis of leptin (Abcam, UK).Results: The patients group showed the greatest percentage (23%) of placental expression of leptin. The expression of leptin was high in around 53% of the patient population. The intensity of leptin expression was significantly higher in DM patient than control groups (P>0.05). About 77% of patients group had moderate intensity of leptin expression, while 37.5% of control group had no leptin expression.Conclusion: Diabetes mellitus was related with alterations in expressions of leptin as metabolic placental factor. Leptin may affect the pregnancy diverse disorders and pregnancy outcome.
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.
Reproductive Medicine
Marzieh Mehrafza; Azadeh Raoufi; Elmira Hosseinzadeh; Gholam Reza Pourseify; Tahereh Zare Yousefi; Termeh Shakery; Amirhossein Tamimi
Volume 7, Issue 6 , September and October 2022, , Pages 518-523
Abstract
Background & Objective: Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation ...
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Background & Objective: Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation failure patients. The aim of the present study was to describe the impact of intrauterine platelet-rich plasma infusion on the live birth rate in patients with repeated implantation failure.Materials & Methods: The present retrospective uncontrolled study was performed on 96 patients with more than two failed intracytoplasmic sperm injection cycles at Mehr medical institute between 2019 and 2021. Forty-eight hours before embryo transfer, patients received 1 mL lympho-platelet-rich plasma through an intrauterine insemination catheter. Patients were evaluated for pregnancy rate. Endometrial preparation for frozen-thawed embryo transfer was performed.Results: Participants' basal and stimulation characteristics, including gonadotropin dosage, the total number of oocytes, metaphase II oocytes and embryos, endometrial thickness, embryo transfer, quality of transferred embryos, and blastocyst transfer rate were evaluated. A total of 33 and 27 chemical (34.3%) and clinical pregnancies (28.1%) were achieved. Twenty (20.8%) and nineteen (20%) cycles resulted in ongoing pregnancies or live births, respectively. Conclusion: The current study suggests that platelet-rich plasma infusion 48 hours before frozen-thawed embryo transfer may be a good option for repeated implantation failure patients and results in 20% live birth.
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.
Obstetrics and Gynecology
Shahnaz Ahmadi; Elnaz Salarifar; Kambiz Ahmadi; Maryam Rahimi; Mahshid Bahraini
Volume 7, Issue 5 , July and August 2022, , Pages 399-404
Abstract
Background & Objective: Preeclampsia is associated with the release of soluble endoglin (sENG) into the maternal circulation. It inhibits sENG secretion, inhibiting the complex I of the mitochondrial electron transport chain. Therefore, using metformin may be helpful in the prevention of preeclampsia. ...
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Background & Objective: Preeclampsia is associated with the release of soluble endoglin (sENG) into the maternal circulation. It inhibits sENG secretion, inhibiting the complex I of the mitochondrial electron transport chain. Therefore, using metformin may be helpful in the prevention of preeclampsia. The aim of this study was to evaluate the effect of metformin in preventing superimposed preeclampsia.Materials & Methods: This single-blind randomized clinical trial was conducted on 60 pregnant women 25-40 years old with chronic hypertension before the 20th week of pregnancy. The patients were randomized and divided into two groups (n=30). The first group received 1000 mg metformin (tablet metformin 500 mg bid), and the second group received a placebo (2 tablets daily). Then the incidence of preeclampsia and intrauterine retardation growth of the fetus were compared in the two groups.Results: The metformin consumption significantly reduced the incidence of preeclampsia (P < /i>=0.04) and intrauterine growth restriction (P < /i>=0.035) compared to the control group. Conclusion: Metformin effectively reduced the incidence of superimposed preeclampsia and related factors in a pregnant patient with chronic hypertension.
Obstetrics and Gynecology
Marzieh Talebian; Niloofar Mehri; Maryam Mousavi Shirazi
Volume 7, Issue 5 , July and August 2022, , Pages 462-465
Abstract
Severe injury to the nervous system in pregnancy needs advanced critical care support to the mother and consideration of fetal effects. Managing persistent vegetative state (PSV) cases in pregnant patients is complex due to the lack of clear guidelines for medical and ethical reasons. This reports a ...
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Severe injury to the nervous system in pregnancy needs advanced critical care support to the mother and consideration of fetal effects. Managing persistent vegetative state (PSV) cases in pregnant patients is complex due to the lack of clear guidelines for medical and ethical reasons. This reports a gravida 4, maternal persistent vegetative state case due to a car accident for a 25-year-old woman at 20 pregnancy weeks. Aggressive support enabled the continuation of pregnancy toward 3th trimester without any impediment to the infant's development. A fetal scan for growth monitoring showed an estimated fetal weight near the 75th centile. Intervention in the pregnancy of a patient suffering PSV is not required if both mother and fetus are stable. Maternal malnutrition may adversely affect the fetus and neonate. In this case, high caloric nutrition with partial parenteral nutrition was employed. We monitored both the mother and her child in an attempt to gather data pertinent to the appropriate care of pregnancy in a persistent vegetative state and the potential sequel for offspring.
Obstetrics and Gynecology
Maryamsadat Hosseini; Farah Farzaneh; Mahsa Mirhadi; Seyed Ali Akbar Mahdavi Anari; Ladan Ajori; Saghar Salehpour; Tayebeh Jahed Bozorgan; Parichehr Pooransari; Shideh Ariana; Minoo Yaghmaei; Behnaz Nouri; Shahrzad Zadehmodarres; Sedighe Hosseini; Mehrdad Haghighi; Mir Mohammad Miri; Seyedpouzhia Shojaei; Ali Reza Mirkheshti; Dariush Abtahi; Tannaz Valadbeigi
Volume 7, Issue 4 , March and April 2022, , Pages 286-295
Abstract
Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation ...
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Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.Materials & Methods: In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.Results: The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.Conclusion: In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.
Obstetrics and Gynecology
Hamideh Gholami; Sanaz Fayazi; Maryam Shirshekan; Nima Motamed; Shabnam Tofighi
Volume 7, Issue 4 , March and April 2022, , Pages 335-340
Abstract
Background & Objective: Conflicting results have been reported about the association between vitamin D and preeclampsia. The aim of the current study is to compare the serum levels of vitamin D in preeclamptic, and non-preeclamptic pregnant women admitted to the Ayatollah Mousavi Hospital in Zanjan.Materials ...
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Background & Objective: Conflicting results have been reported about the association between vitamin D and preeclampsia. The aim of the current study is to compare the serum levels of vitamin D in preeclamptic, and non-preeclamptic pregnant women admitted to the Ayatollah Mousavi Hospital in Zanjan.Materials & Methods: In this case-control study, 120 pregnant women were selected using convenience sampling in Zanjan in 2018-2019. Then they were divided into two groups, preeclampsia and non- preeclampsia. Both groups were matched one by one. The data were collected using a demographic information questionnaire and a researcher-made checklist. After obtaining consent from participants, blood samples were collected using the peripheral venous catheter. Then the ELISA test was used to measure vitamin D in participants. Data were analyzed by SPSS version 16 using, independent t-test, and Chi-square test (P < /em>≤0.05).Results: Of the participants, 64 (53.4 %) were between 20-35 years old, 48 (40%) were older than 35 years, and 8 (6%) were younger than 20 years. Most of the participants' gestational age was between 34 and 39 weeks (89.1%). The Mean (SD) of serum level of vitamin D was significantly higher in healthy pregnant women (19.06 (7.48)) than women with preeclampsia (16.60 (5.87)) (P < /em><0.01). Among those with preeclampsia, the highest vitamin D level (17.17) was observed at 37-39 weeks of gestation. The lowest level (10.8) was for those with less than 34 weeks gestational age.Conclusion: This study demonstrated that vitamin D could be a protective factor for preeclampsia in pregnant women. However, further studies are recommended.
General Gynecology and Pelvic Floor
Sarah Lotfi; Abbas Ahmadi
Volume 7, Issue 4 , March and April 2022, , Pages 354-355
Abstract
Infertility is the failure of the male or female reproductive system to conceive after 12 months or more of regular unprotected sexual intercourse (1). Failure to ovulate, problems in the menstrual cycle, infections, inadequate egg maturation, ejaculation problems, antibodies that attack sperm and tumors ...
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Infertility is the failure of the male or female reproductive system to conceive after 12 months or more of regular unprotected sexual intercourse (1). Failure to ovulate, problems in the menstrual cycle, infections, inadequate egg maturation, ejaculation problems, antibodies that attack sperm and tumors are some of the reasons that can make a man or a woman infertile. COVID-19 is a disease caused by a new type of coronavirus; it is an infectious disease caused by the acute respiratory syndrome of coronavirus 2 (SARS-CoV-2).This article is about the fact that patients with COVID-19 are more prone to infertility than other normal people. There is a possibility that this coronavirus could have a pathophysiological effect on the testes. Additional data have shown that active COVID-19 infection significantly reduces the ratio of testosterone to LH, showing a significant effect on the response of Leydig cells to LH stimulation (2). Men are said to be more likely to get COVID-19 than women; even the mortality rate is higher (3). The testes can be a potential target for the SARS-CoV-2 virus, and testicular damage and subsequent infertility after COVID-19 infection can be explained theoretically (4). It was only in May that six semen samples were positive for SARS-CoV-2 (5).
Obstetrics and Gynecology
Esmat Barooti; Farzaneh Rashidi Fakari; Soodabeh Darvish; Narges Tavakoly
Volume 7, Issue 3 , January and February 2022, , Pages 226-229
Abstract
Background & Objective: In pregnancy, the serum level of cancer antigen-125 (CA-125) increases in the first trimester and abortion. However, different studies reported conflicting results about the use of serum CA-125 to determine the prognosis of threatened abortion. In the present study, we try ...
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Background & Objective: In pregnancy, the serum level of cancer antigen-125 (CA-125) increases in the first trimester and abortion. However, different studies reported conflicting results about the use of serum CA-125 to determine the prognosis of threatened abortion. In the present study, we try to determine if the measurement of CA-125 level could be used as a predictor of outcome in women with threatened abortion.Materials & Methods: This prospective case-control study was performed on 58 patients with threatened abortion and 58 healthy pregnant women with a gestational age of fewer than 20 weeks (as the control group). In both groups, serum CA-125 level was measured. The patients were followed to determine who completed the pregnancy period and who eventually miscarried. Finally, the levels of CA-125 in these groups were compared.Results: The mean age of patients was 28.47 and 27.84 in the case and control groups, respectively; there was no significant statistical difference between the two groups (95% CI: -1.94 to 3.18, P < /em>=0.632). Also, there was no significant difference between them for BMI (95% CI: -1.09 to 1.38, P < /em>=0.813), gestational age (95% CI: -1.31 to 1.04, P < /em>=0.816), and parity (P < /em>=0.51). The mean serum level of CA-125 in the control group was 22.51 ± 6.82 IU/mL, and in the threatened abortion group was 27.70 ± 7.50 IU/mL. This difference was statistically significant (P<0.001). Of the patients, 51.72% with threatened abortion continued their pregnancy, and 48.28% eventually miscarried. The mean serum levels of CA-125 were 25.30±6.63 IU/mL and 30.28±7.63 IU/ml in patients who continued the pregnancy and miscarried, respectively (P < /em>=0.01).Conclusion: A single measurement of the maternal CA-125 may be used as an available, inexpensive prognostic test to determine the outcome of threatened abortion. However, a small number of patients is the main limitation of the present study. More studies with a larger sample size are required to accept the role of maternal CA-125 in predicting the outcome of threatened miscarriage.
Maternal Fetal Medicine
Fatemeh Mirzaie; Khadije Rezaie Keikhaie; Mahin Badakhsh; Bahareh Khajehpour; Samira Ghofrani
Volume 7, Issue 2 , September and October 2021, , Pages 89-98
Abstract
Background & Objective: Pregnancy is a stressful event in and of itself, which may have an impact on the present prevalence of COVID-19 illness. It is crucial to think about what factors can help pregnant women cope with the anxiety brought on by the COVID-19 outbreak. The purpose of this study was ...
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Background & Objective: Pregnancy is a stressful event in and of itself, which may have an impact on the present prevalence of COVID-19 illness. It is crucial to think about what factors can help pregnant women cope with the anxiety brought on by the COVID-19 outbreak. The purpose of this study was to determine the prevalence of COVID-19 in pregnant women, as well as the impact of COVID-19 anxiety on pregnant women's Apgar scores and birth weights of newborns.Materials & Methods: From early January to late March 2021, 102 pregnant women were included in this descriptive cross-sectional study using any accessible sampling method. Questionnaires such as the "Demographic" and "Corona Anxiety Scale" were used to collect data. SPSS software version 22 was used to analyze the data.Results: The mean score of total anxiety caused by COVID-19 in pregnant women was 20.88 ± 21.08, which was moderate. Among the components of anxiety, the mean score of psychological symptoms (13.05 ± 5.31) of pregnant women was higher than physical symptoms (5.64 ± 5.72). There was no statistically significant link between demographic characteristics and COVID-19-induced anxiety (P < /em>>0.05). The findings also revealed no statistically significant connection between COVID-19-induced anxiety and newborn weight or Apgar score 1 and 5 minutes after birth (P < /em>>0.05).Conclusion: The definitive incidence of COVID-19 in pregnant women was low. They experienced a moderate level of anxiety caused by COVID-19, which requires the necessary measurements to be taken by the relevant authorities, family and others to reduce this anxiety during the coronavirus pandemic.
Obstetrics and Gynecology
Amirreza Naseri; Sepideh Seyedi Sahebari; Mohammad-Salar Hosseini
Volume 7, Issue 1 , September and October 2021, , Pages 1-6
Abstract
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a chief concern of the international community. As of May 2021, more than 150 million cases and 3.2 million deaths have been recorded. Considering the early struggle in treating COVID-19 ...
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The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a chief concern of the international community. As of May 2021, more than 150 million cases and 3.2 million deaths have been recorded. Considering the early struggle in treating COVID-19 patients, the researchers and clinicians have decided to try the previously available drugs according to their mechanisms of action. This article aims to review the potential drugs for COVID-19 patients during pregnancy and breastfeeding and their safety. PubMed and Scopus databases and Google Scholar engine were searched with the proper combination of the free keywords and MeSH Terms of COVID-19, SARS-CoV-2, Pregnancy, Breastfeeding, Treatment, Pharmacotherapy, Drug Therapy, and Drug Safety. All relevant clinical studies published until the end of 2020 were included in this review. Many antivirals, antibiotics, antiparasitics, and antipyretics have been proposed, but most of them are not registered for COVID-19 or have demonstrated little effect on the disease. Since there is still a long way to find an effective drug for the treatment of COVID-19, prevention is currently the most effective way. Also, prescribing drugs to these two groups of patients should be done according to the safety recommendations.
Reproductive Medicine
Mohammad Nasir Hematian; Mahnaz Ghiasi; Somayeh Baharian; Sedighe Safaie; Mojgan Rahmanian; ُُShirin Torabi; Samaneh Vahdatnia
Volume 7, Issue 1 , September and October 2021, , Pages 7-14
Abstract
Background and Objective: Concerns about adaptation to a new situation can cause anxiousness in pregnant women, which could lead to dangerous consequences. The aim of this study was to evaluate the severity of pregnancy anxiety in mothers with fetuses having cardiac anomalies and their association with ...
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Background and Objective: Concerns about adaptation to a new situation can cause anxiousness in pregnant women, which could lead to dangerous consequences. The aim of this study was to evaluate the severity of pregnancy anxiety in mothers with fetuses having cardiac anomalies and their association with birth outcomes.Materials and Methods: A number of 50 pregnant women were enrolled as the accessible sampling. The diagnosis of congenital heart anomaly was considered in prenatal ultrasound screening (NT ultrasound and anomaly scan). The General Health Questionnaire (GHQ-28), Spielberger State-Trait Anxiety Inventory (STAI), Cambridge Worry Scale (CWS), and Pregnancy Concern Questionnaire (PCQ) were used to evaluate fear, concern and anxiety. Data were analyzed using Wilcoxon statistical test.Results: Six infants had fetal outcomes including low birth weight (IUGR). Fetal prematurity was observed in only one infant. The highest and the lowest levels of anxiety were reported before the echocardiography and within one week after the echocardiography. There was a significant difference between maternal general health score before and 5 days after echocardiography as well as 5 days after echo and 35th week of pregnancy (P < /em><0.05). A significant difference between maternal general health score was observed before fetal echocardiography and at 35th week of pregnancy (P < /em><0.05).Conclusion: The results showed that mothers' anxiety increased significantly after the diagnosis of fetal cardiac anomaly. However, after fetal echocardiography and in the late pregnancy period, the anxiety level reduced in both stages. It was clear that receiving information about unhealthy fetus can cause significant anxiety in mothers.
Maternal Fetal Medicine
Ali Reza Norouzi; Mahsa Siavashi; Fatemeh Norouzi; Maryam Talayeh; Somayyeh Noei Teymoordash
Volume 6, Issue 4 , August 2021, , Pages 217-223
Abstract
Background & Objective: Gestational diabetes mellitus (GDM) is the most prevalent disorder during pregnancy, which is the result of insulin resistance and hyperinsulinemia due to the secretion of placental diabetogenic hormones. This study aimed to investigate the utility of glycated hemoglobin ...
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Background & Objective: Gestational diabetes mellitus (GDM) is the most prevalent disorder during pregnancy, which is the result of insulin resistance and hyperinsulinemia due to the secretion of placental diabetogenic hormones. This study aimed to investigate the utility of glycated hemoglobin A1c (HbA1c) alone and in combination with hematocrit for early detection of gestational diabetes mellitus.Materials & Methods: In this prospective cohort research, 373 pregnant women who referred to prenatal clinics were included. Hematocrit and HbA1c were determined at gestational age of 12 to 16 weeks and compared with the oral glucose tolerance test (OGTT) results at gestational age of 24-28 weeks.Results: The best cut-off hematocrit for determining pregnancy diabetes mellitus was 37.3. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 70.15%, 64.12%, 32.71 %, and 89.51% respectively.In terms of HbA1c, the best cut-off value to determine GDM in pregnant women was 5, with a sensitivity of 98.51%, specificity rate of 99.02%, PPV of 95.07%, and NPV of 99.49%. In terms of diagnosing GDM, the area under the ROC curve (AUC) for HbA1c was equal to 0.985 which was higher than the AUC for the combination of HbA1c with HCT.Conclusion: Measuring HbA1c can be useful as a screening test for GDM, which is an inexpensive and available test. The combined evaluation of HbA1c and hematocrit did not improve the diagnostic value of HbA1c in GDM screening compared to exclusive evaluation of HbA1c.
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?
Obstetrics and Gynecology
Robabeh MohammadBeigi; Ayda Fathollahpour; Asadolah Fathollahpour; Maryam Kashanian; Narges Sheikhansari
Volume 6, Issue 3 , June 2021, , Pages 116-121
Abstract
Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials ...
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Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials & Methods: The study was performed as a descriptive cross-sectional study on pregnant women who were admitted to the labor ward for delivery. Serum level of 25-hydroxyvitamin D [25(OH) D], was measured and compared in women and the umbilical cord blood. The relationship between 25(OH) D levels and anthropometric neonatal factors including birth weight, birth length and head circumference was evaluated.Results: A total of 106 pregnant women (53 Iranians and 53 Afghan refugees’ women) were evaluated. There was a significant correlation between maternal serum level of 25(OH) D and that of their neonates, both in Iranians and Afghans considering gestational age as a confounding factor (R=0.62, P < /em>=0.000). Maternal and neonatal 25(OH) D levels were significantly higher in Iranians than Afghans (27.2±11.5 ng/mL VS 21.9±12.7 ng/mL, P < /em>=0.026 and 26.5±11.2 VS 17.3±11.4, P < /em>=0.000) respectively. However, neonatal weight and head circumference (HC), were not different in Iranians and Afghans except for neonatal height which was higher in Afghans (P < /em>=0.015) irrespective of lower amount of neonatal 25(OH) D levels.The mean cord levels of vitamin D in boys and girls did not show a significant difference. There was no significant correlation between 25(OH) D serum level and pregnant women’s level of education, pre-labor rupture of membranes (PROM), past medical history (PMH), taking supplements and smoking.Conclusion: Maternal and neonatal 25(OH) D levels did not influence neonatal anthropometry.
Obstetrics and Gynecology
Farzaneh Rashidi Fakari; Zahra Kiani
Volume 6, Issue 3 , June 2021, , Pages 143-146
Abstract
COVID‐19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general ...
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COVID‐19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general population. On the other hand, given the previous experiences with SARS and MERS, pregnant women are likely to be at high risk for COVID-19 and its complications. Comparing the results of studies on COVID-19 during pregnancy and that of the general population, it can be concluded that pregnant women develop COVID-19 at a younger age than the general population. The results showed that due to changes during pregnancy, pregnant women have a higher risk for COVID-19 than other people, perhaps due to the lower mean age of COVID-19 in pregnant women, this leads to less COVID-19 on the adverse pregnancy outcomes.
Maternal Fetal Medicine
Maryam Kashanian; Arezoo HoseiniMoghaddam; Seyyed Ali Javad Moosavi; Narges Sheikhansari; Hoda Abdollahi
Volume 6, Issue 2 , March 2021, , Pages 65-71
Abstract
Background and Objective: Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.Methods: The study was designed as a historical ...
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Background and Objective: Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.Methods: The study was designed as a historical cohort among pregnant women with and without asthma. A total number of 583 asthmatic patients were allocated to the case group and 753 women without asthmatic history were placed in the control group. Pregnancy, labor and neonatal outcomes were compared between the two groups.Results: The baseline characteristics of the women in both groups did not show significant differences. Gestational hypertension was more in the asthmatic group [43 (7.37%) VS 26 (3.45%), P < /em>=0.001]. Also the rate of preterm delivery was higher in asthmatic women [72 (12.34%) VS 77 (10.22%) in the control group, P < /em>=0.04]. However, the rate of preeclampsia was less in the asthmatic group [29 (4.97%) VS 71 (9.42%), P < /em>=0.008]. Apgar score at minutes 1 and 5 was less in asthmatic group. Intra Uterine Fetal Demise (IUFD) [24 (4.1%) VS 13(1.7%), P value=0.009], and neonatal death [31 (5.31%) VS 10 (1.32%), P < /em>=0.001] were more in the asthmatic group. The maternal and neonatal complications did not show significant differences in various severities of asthma. Multivariate regression model showed more risks for neonatal death [adjusted odds ratio (AOR)=4.18; CI95% 2.03-8.60], IUFD (AOR=2.43; CI95% 1.22-4.82), gestational hypertension (AOR= 1.43; CI 95% 1.40-1.45), and lower risk for preeclampsia (AOR 0.37; CI95%0.17-0.79) in asthmatic women.Conclusion: Regardless of the fact that asthmatic mothers had higher frequencies of gestational hypertension, IUFD and neonatal death, the effect of asthma on perinatal outcome is minimal, probably because of efficient medical control.
Radiology
Maryam Rahmani; Behnaz Moradi; Masoumeh Gity; Mohammadreza Chavoshi; Sedigheh Hantoushzadeh; Soudabeh Kazemi Aski; Seyedeh Fatemeh Mahdipour Keivani; Narges Badraghe; Mohammad Ali Kazemi
Volume 6, Issue 2 , March 2021, , Pages 72-80
Abstract
Background and Objective: To evaluate the clinical course and CT findings of pregnant womenMethods: Fourthy (25 pregnant and 15 non-pregnant) patients were entered to the study. Chest CT features and clinical findings were evaluated between two groups. Data related to pregnancy and fetal status evaluated ...
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Background and Objective: To evaluate the clinical course and CT findings of pregnant womenMethods: Fourthy (25 pregnant and 15 non-pregnant) patients were entered to the study. Chest CT features and clinical findings were evaluated between two groups. Data related to pregnancy and fetal status evaluated in the pregnant group.Result: The average age of pregnant patients was 33.1±5.75 years and the non-pregnant group was 35.4±6.88 years. The gestational age ranged from 7 weeks to 39weeks+2days (mean =31weeks+5days). No significant difference was seen between the two groups about clinical findings except the duration of symptoms before CT which was more in pregnant patients (6.71 ± 5.5 days vs 3.53 ± 1.92 days). Two mortalities in pregnant and one in non-pregnant patients , 2(8%) cases of premature rupture of membranes (PROM), 3 (12%) cases of intra-uterine fetal death (IUFD), 3 (12%) cases of fetal distress and 2 (8%) cases of IUGR in pregnant group. Fifteen pregnant patients gave birth .No positive PCR result was detected in newborns. Unlike the control group, the common CT findings were ground-glass pattern.Conclusion: In summary, although we found the clinical findings in pregnant and control group were similar but pattern of CT involvement was different in pregnant patients and rate of ICU admission and mortality rate were more than control group. This viral pneumonia was associated with some important complications such as IUFD in severely involved mothers. CT could be an efficient tool for the early detection and severity assessment in the pregnant patients with COVID-19 pneumonia.
Maternal Fetal Medicine
Mona Taghavipour; Tahereh Galini-Moghaddam; Seyed Jaber Mousavi
Volume 6, Issue 1 , January 2021, , Pages 22-28
Abstract
Background and Objectives: Maternal serum levels of the first- and second-trimester markers for aneuploidy have been revealed to be associated with adverse pregnancy outcomes in the absence of neural tube defects or aneuploidy. This finding can guide clinicans for early diagnosis and management of such ...
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Background and Objectives: Maternal serum levels of the first- and second-trimester markers for aneuploidy have been revealed to be associated with adverse pregnancy outcomes in the absence of neural tube defects or aneuploidy. This finding can guide clinicans for early diagnosis and management of such outcomes. However, previous finding are conflicting in this regard. Therefore, this study evaluated the detection of adverse pregnancy outcomes by first- and second-trimester serum screening analytes.Methods & Materials: We prospectively recruited 972 females who underwent first and second-trimester aneuploidy screening. We gathered information on maternal demographic characteristics and serum biomarkers (free B-hCG and PAPP-A for the first-trimester; AFP, Β-hCG, Inhibin-A, and unconjugated estradiol for second-trimester). At the end of the study, adverse pregnancy outcome was recorded.Results: Abnormal screening results were reported in 34 (3.5%) patients. Two groups were significantly different in maternal age, BMI, and gestational period (P < /em>=0.017, 0.003 and 0.021, respectively). Among the measured adverse outcomes, preeclampsia was significantly more prevalent in the case group (P < /em><0.0001). Abnormal levels of Inhibin-A is associated with the incidence of preeclampsia (RR: 29.87, CI: 13.22-67.49, P < /em><0.0001). Additionally, patients with an abnormal level of Inhibin-A had a shorter gestational period (255.5 ± 24.53 vs. 264.79 ± 8.99, P < /em>=0.006). Likewise, patients with an abnormal level of maternal serum alpha-fetoprotein (MSAFP) had a shorter gestational period (252.0 ± 29.3 vs. 264.8 ± 8.93, P < /em>=0.001).Conclusion: First- and second-trimester maternal serum biomarkers could provide a possible screening tool for early detection of preeclampsia.
Maternal Fetal Medicine
Maryam Saraei; Pegah Estakhrian Haghighi; Hamed Amirifard; Arezu Najafi
Volume 6, Issue 1 , January 2021, , Pages 29-34
Abstract
Background & Objective: Gestational hypertension (GH) is considered as one of the important health-related issues of pregnant women. One of the raised problems in the pathogenesis of GH is obstructive sleep apnea (OSA). This study aimed to evaluate associated factors of OSA among an employed pregnant ...
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Background & Objective: Gestational hypertension (GH) is considered as one of the important health-related issues of pregnant women. One of the raised problems in the pathogenesis of GH is obstructive sleep apnea (OSA). This study aimed to evaluate associated factors of OSA among an employed pregnant population.Materials and Methods: In this study, 200 employed pregnant women with GH as the case group and 200 healthy pregnant ones as the control group were enrolled. Blood pressure >140/90 after 20 weeks of gestational age without proteinuria was defined as GH. Chi-square and Mann-Whitney tests were applied for statistical analysis.Results: Mean ± SD of age and body mass index (BMI) were 32.85 ± 5.45 (years) and 31.85±5.97 (kg/m2) among the case group, respectively. Participants with GH had higher mean BMI, neck circumference, and more frequency of snoring than the control group, which was statistically significant (P < /em><0.012, P < /em><0.025, and P < /em><0.007, respectively). Sales and service occupations consisted the group with the highest frequency of GH.Conclusion: Participants with GH had higher BMI, snoring, observed apnea, and neck circumference. This observation warrants comprehensive assessment of OSA and related risk factors among patients with GH.
Obstetrics and Gynecology
Mona Mohseni; Nasim Shokouhi; Elham Feizabad; Elham Khaghani
Volume 5, Issue 4 , December 2020, , Pages 167-171
Abstract
Background & objective: Pregnancy is a known risk factor for urinary incontinence (UI) due to physiological and anatomical changes, especially in the third trimester of pregnancy. This study aimed to determine the prevalence of UI in the third trimester of pregnancy and its related factors in ...
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Background & objective: Pregnancy is a known risk factor for urinary incontinence (UI) due to physiological and anatomical changes, especially in the third trimester of pregnancy. This study aimed to determine the prevalence of UI in the third trimester of pregnancy and its related factors in pregnant women.Materials & Methods: This cross-sectional study was conducted on 330 pregnant women in the third trimester of pregnancy, referred to the perinatal care clinic of Yas Hospital in 2016-2017. The sampling method was convenience sampling. Then, the prevalence of UI and its related factors were investigated in these participants.Results: The mean age of the subjects was 30±5 years old. Totally, 98 pregnant women (29.7%) had UI. The rate of urine leakage was mild at 26.4% and moderate or severe at 3.3%. The time of urine leakage in 6.4% of women with UI was before reaching the toilet, 1.2% was permanent, 19.4% was related to cough and sneezing, and 2.7% of women did not indicate a specific time. In evaluating the relationship between each of the variables and UI, three factors were identified to be completely related to UI, i.e., morbid obesity (P < /em>=0.038), gestational age between 32 to 37 weeks (P < /em>=0.012), and age ≥ 35 years old (P < /em>=0.009).Conclusion: It seems that one-third of pregnant women in the third trimester of pregnancy have UI, which is a multifactorial issue and therefore requires multidisciplinary programs to prevent it.
