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.
Reproductive Medicine
Zahra Rezaei; Mehrnaz Valadan; Pooneh Shojaee Asl
Volume 5, Issue 3 , November 2020, , Pages 84-87
Abstract
Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate ...
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Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate and regulation of the menstrual cycle following laparoscopic ovarian electrocautery (LOE).Materials & Methods: This prospective cohort study was conducted on 54 infertile metformin- and clomiphene citrate-resistant women with PCOS at Yas Hospital in 2007. These patients initially took a glucose tolerance test and then classified into two groups (i.e., insulin-resistant and non-insulin-resistant) based on the obtained results. Both groups, then, underwent LOE. Patients were evaluated for pregnancy rate and regulation of the menstrual cycle up to six months.Results: Out of 54 patients, 37 patients (68.5%) were non-insulin-resistant, and 17 patients (31.5%) were insulin-resistant. In the insulin-resistant group, after six months, menstrual cycles were less regular than those of the non-insulin-resistant group (OR=0.2; 95%CI, 0.07-0.87). Fifteen (40.5%) women in the non-insulin-resistant group became pregnant; in contrast, three (17.6%) women in the insulin-resistant group became pregnant. In the logistic regression analysis, the results demonstrated that age, duration of infertility, body mass index (BMI), and insulin resistance had no significant effects on pregnancy rate.Conclusion: Insulin resistance can be an important marker of the poor outcomes of PCOS infertility treatment, and LOE significantly improves insulin resistance in women with PCOS.
Obstetrics and Gynecology
Arash Moshiri; Maryam Ahmadian; Seyedeh Nafiseh Naseri; Shima Sheibani; Mahboobeh Shirazi; Baratoallah Akbari; Atefeh Hoseinzadeh
Volume 5, Issue 2 , October 2020, , Pages 49-53
Abstract
Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint ...
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Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint was a history of fever and chills in the recent past two days. Since there were no suspicious findings in favor of infections, related to obstetrics and gynecology, the patient was referred to Mostafa Khomeini Hospital in Tabas (June 2020). The initial clinical examination revealed no fever, chills, cough, respiratory distress, body aches, gastrointestinal problems or anything else. The patient’s oxygen saturation level was 98%. Routine laboratorytests were requested for the patient. WBC count was 14000, lymphocyte count was 875 (6.25%), and platelet count was 117000. According to the recent history of clinical symptoms and positive paraclinical results, COVID-19 was suspected. In the chest CT findings, bilateral ground glass opacities (GGO) and consolidations were observed, which were compatible with COVID-19 pattern. Based on the positive clinical and lab tests, COVID-19 was detected and positive RT-PCR COVID-19 test confirmed our diagnosis.Conclusion: The patient was asymptomatic at the time of admission to our ward; however, she reported fever and chills in the last two days, which raised our suspicion about COVID-19. Due to significant lymphopenia and the increase in granulocytes counts, and thrombocytopenia accompanied with complementary lab tests, severe COVID-19 was diagnosed and confirmed with positive RT-PCR test.
Maternal Fetal Medicine
Fahimeh Hassani; Farideh Movahed; Fatemeh Lalouha; Enayatollah Noori
Volume 5, Issue 1 , August 2020, , Pages 6-10
Abstract
Background & Objective: In this study, thyroid dysfunction in women with gestational diabetes mellitus was examined and compared to that in healthy pregnant women referred to Kowsar Hospital in Qazvin in 2017 and 2018.Methods: In this case-control study, 100 women with gestational diabetes mellitus ...
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Background & Objective: In this study, thyroid dysfunction in women with gestational diabetes mellitus was examined and compared to that in healthy pregnant women referred to Kowsar Hospital in Qazvin in 2017 and 2018.Methods: In this case-control study, 100 women with gestational diabetes mellitus and 100 non diabetic healthy pregnant women who referred to Kowsar Hospital in Qazvin from 2017 to 2018 were selected using the convenience sampling method, and their serum thyroxine, anti-TPO, and TSH levels were determined and compared. Moreover, Apgar scores and anthropometric variables were compared between the two groups.Results: In the present study, there were statistically significant differences between the groups in terms of the TSH level (P < /em>=0.012), assessed by the independent t-test, the thyroxine (P < /em>=0.0001) and anti-TPO (P < /em>=0.008) levels, both examined by the Mann-Whitney test, which associated with high levels of TSH and anti-TPO and low levels of thyroxine in the diabetic group. No differences were found regarding the Apgar scores and anthropometric variables between the groups (P < /em>>0.05).Conclusion: Overall, according to the obtained results, it can be inferred that thyroid dysfunction, realized as hypothyroid with high anti-TPO levels, was more prevalent in women with gestational diabetes mellitus compared to healthy pregnant women.
Obstetrics and Gynecology
Shahrzad Agha Amu; Fateme Silakhory; Setare Nassiri; Elham Saffarieh
Volume 5, Issue 1 , August 2020, , Pages 24-26
Abstract
Background & Objective: Spontaneous vulvar edema is not usual during pregnancy and can cause discomfort and anxiety for the patient. This is a serious situation that might be caused by some dangerous condition such as preeclampsia, diabetes vulvovaginitis, severe anemia, and neoplasms. The aim of ...
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Background & Objective: Spontaneous vulvar edema is not usual during pregnancy and can cause discomfort and anxiety for the patient. This is a serious situation that might be caused by some dangerous condition such as preeclampsia, diabetes vulvovaginitis, severe anemia, and neoplasms. The aim of this study was to evaluate and manage the vulvar edema.Case Report: In this case report we introduce a 22-year-old woman which is primigravia and have massive vulvar edema after Bronchitis and influenza at 17 weeks’ gestation. After using oseltamivir, the patient showed progressive edema during 4 hours. Her symptoms were including edema and pain in labia, then she was treated with Dexamethazone and the edema disappeared after 5 days. Conclusion: Vulvar edema is a critical situation during pregnancy that needs attention and should be treated carefully since it can cause pain and discomfort for the pregnant woman. Our experience in this case was treatment by corticosteroid that had good response.
Forough Mortazavi; Fateme Borzoee
Volume 4, Issue 2 , May and June 2019, , Pages 45-50
Abstract
Background & Objective: Fear of childbirth is an unpleasant and common condition that negatively affects pregnant women’s emotions and undermines the process of natural changes that occur during this period. This study was conducted to determine the relationship of fear of childbirth with the ...
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Background & Objective: Fear of childbirth is an unpleasant and common condition that negatively affects pregnant women’s emotions and undermines the process of natural changes that occur during this period. This study was conducted to determine the relationship of fear of childbirth with the severity of fatigue and the level of mental well-being in pregnant women.
Materials & Methods: This descriptive cross-sectional study followed by a correlation design was carried out on 525 pregnant women who referred to Sabzevar healthcare in 2017. Based on a cluster sampling method data collection was performed using demographic characteristics form, the Wijma Delivery Expectancy Questionnaire (WDEQ-A), the 5-item World Health Organization Well-Being Index (WHO-5), and the Multidimensional Assessment of Fatigue (MAF) scale. The data were analyzed by SPSS 16, using descriptive statistics, independent t-test, and Pearson correlation coefficient.
Results: 19% of the subjects scored above 85 and 6% of them scored higher than 100 on the WDE-Q. Also, 24.8% of these women scored less than 50 on the WHO-5. The studied women’s mean fatigue index was 20.3±12.7. Fear of childbirth had a positive correlation with fatigue (r=0.235) and a negative correlation with well-being (r=0.310) (P < /em><0.05).
Conclusion: Women experience various degrees of fear of childbirth during pregnancy. Providing mental support for pregnant women and using psychological techniques aimed at reducing their fear of childbirth during pregnancy are highly recommended.
Sima Giti; Khadijeh Abadian
Volume 4, Issue 2 , May and June 2019, , Pages 75-77
Abstract
Background & Objective: Despite the rarity of head and neck squamous cell carcinoma during pregnancy, the outbreak of its various malignant types is probable during pregnancy due to the increased maternal age and decreased age of cancer occurrence. Therefore, paying attention to any abnormal symptoms ...
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Background & Objective: Despite the rarity of head and neck squamous cell carcinoma during pregnancy, the outbreak of its various malignant types is probable during pregnancy due to the increased maternal age and decreased age of cancer occurrence. Therefore, paying attention to any abnormal symptoms in any period, such as pregnancy, seems necessary. This study aimed to report a case of tongue cancer diagnosed during pregnancy.
Case Report: A 31-year-old woman who was at 18 weeks of her first pregnancy noticed an Aphthous stomatitis on her tongue. Since the routine Aphthous stomatitis treatment failed to treat the lesion and it developed and swelled in the neck and mouth region, the patient referred to her physician again. After carrying out a biopsy of the lesion, squamous cell carcinoma of the tongue was diagnosed. The patient underwent chemotherapy and radiotherapy after terminating the pregnancy by a cesarean section, and the malignant tumor shrank.
Conclusion: It seems that a complete multidisciplinary study is needed to minimize fetal health risks and to optimize maternal treatment outcomes.
Atiyeh Mirfendereski; Khadijeh Abadian
Volume 4, Issue 2 , May and June 2019, , Pages 78-80
Abstract
Background & Objective: The history of infection is confirmed by serological tests and the incidence and severity of congenital Toxoplasma infection depend on the gestational age at the time of maternal infection. A precise serological diagnosis is important in the management of toxoplasmosis, and ...
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Background & Objective: The history of infection is confirmed by serological tests and the incidence and severity of congenital Toxoplasma infection depend on the gestational age at the time of maternal infection. A precise serological diagnosis is important in the management of toxoplasmosis, and timely treatment prevents the complications of the infection. This study aimed to manage a case of acute toxoplasmosis during pregnancy and its results.
Case Report: In the present study, a pregnant woman was diagnosed with acute toxoplasmosis by considering the positive result of antibodies specific to Toxoplasma gondii and was treated based on the principal treatment that prevented congenital toxoplasmosis in her fetus.
Conclusion: Preventing acute Toxoplasma infection is very effective during pregnancy. Timely treatment can prevent the fetal and neonatal complications of toxoplasmosis.
Mahboobeh Shirazi; Soheila Sarmadi; Shirin Niromanesh; Fatemeh Rahimi Sharbaf; Behrokh Sahebdel; Fatemeh Golshahi; Leila Asadi; Maedeh Rahmanzadeh
Volume 4, Issue 1 , March and April 2019, , Pages 12-15
Abstract
Background & Objective: Diagnosing fetal disorders and abnormalities in the early stages of pregnancy can prevent future adverse conditions for the infant and his/her family. This study aimed to evaluate the sensitivity and specificity of the first- and second-trimester screening tests for identifying ...
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Background & Objective: Diagnosing fetal disorders and abnormalities in the early stages of pregnancy can prevent future adverse conditions for the infant and his/her family. This study aimed to evaluate the sensitivity and specificity of the first- and second-trimester screening tests for identifying fetal chromosomal disorders in pregnant women.
Materials & Methods: A total of 960 pregnant women participated in this retrospective cohort study that was performed at Yas Hospital. The participants’ mean age was 31.07±0.17 years. In the present study, all pregnant women, who referred to Yas Hospital for their first- and second-trimester screening tests, were studied from 2015 to 2017.
Results: Most of the participants (43.4%) were primigravida. The sensitivity of the first-trimester screening test was 70%, and its specificity was 80.3%. The sensitivity and specificity of the second-trimester screening test were 45% and 94.5%, respectively.
Conclusion: Despite recent advances in the prenatal field, the accuracy of screening tests may still vary depending on maternal age and other existing characteristics. Consequently, in parents consulting, the possibility of false positives and negatives should be considered in the tests.
