Nahid Shahbazian; Mahvash Zargar; Mojgan Barati; Najmieh Saadati; Elham direkvand
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (TPO-Ab). However, whether women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of present study ...
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Background and Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (TPO-Ab). However, whether women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of present study was to comparison of pregnancy outcomes in pregnant women with positive and negative TPO-Ab. Methods: This cross-sectional study was conducted on pregnant women with positive anti-TPO Ab (n= 108) and negative anti-TPO Ab (n=340) referring to Imam Khomeini Hospital and Ahvaz clinics from January 2020 to December 2020. The pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, miscarriage, preterm birth, placental abruption, IUFD, IUGR, and TSH level, were compared between the two groups by SPSS software using student t-test and Chi-square test.Results: The mean TSH level was significantly different in women with negative TPO-Ab than those with positive TPO-Ab (Mean (SD): 2.25(1.47) vs. 4.82(9.38), P<0.0001). In addition, 81 (75.00%) women in the positive anti-TPO group and 104 (30.58%) in the negative anti-TPO group had high TSH (P<0.001). The frequency of GDM in positive anti-TPO Ab pregnant women was significantly higher than that in the negative anti-TPO Ab group (46.29% vs. 34.11%, P=0.029). The results also indicated an enhancement in the rate of miscarriage (15.74% vs. 4.11%, P<0.001) and preterm parturition (13.88% vs. 3.52%, P<0.001) in positive anti-TPO Ab women. Conclusions: Presence of positive anti-TPO Ab was significantly associated with preterm delivery, abortion and GDM in pregnancy. Treatment with Levothyroxine can reduce the risk of adverse pregnancy outcomes in women who are positive for TPOAb. .
Obstetrics and Gynecology
Seyed Mojtaba Alavi; Mohammad Hosein Arjmandnia; meysam feizollahjani; enayatollah Noori; Maryam Yousefi
Articles in Press, Accepted Manuscript, Available Online from 12 December 2023
Abstract
Background: Placenta Accreta Spectrum is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean deliveries, which have been increasing without medical indication. This study ...
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Background: Placenta Accreta Spectrum is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean deliveries, which have been increasing without medical indication. This study aims to explore the risk factors of PAS, clinical outcomes, and strategies to minimize maternal morbidity and mortality.
Materials and Methods: A total of 142 women who had undergone at least one cesarean delivery in the past were included in our evaluation. Among them, 85 women had placenta accreta spectrum (PAS) in their current pregnancy (group 1) while the remaining 57 did not have PAS (group 2). We gathered information about their demographics and previous gynecological history, including placenta previa.
Results: The risk of placenta accreta spectrum (PAS) is significantly higher in cases where there has been a previous cesarean delivery or placenta previa (p-value<0.05). There were no significant differences between past elective or emergent CD (p-value>0.05). PAS was associated with more emergent cesarean deliveries (p-value<0.001) and hysterectomies (p-value<0.001). 97% of patients with history of placenta previa developed PAS (p-value<0.001). Most of the patients who underwent hysterectomy had PAS and placenta previa (p-value<0.001). There was no significant correlation found between previous hysteroscopies and curettages and a higher risk of PAS. (p-value>0.05)
Conclusion: Women with previous cesarean delivery are significantly at risk of placenta accreta in their future pregnancies. Pregnant women should avoid insisting on elective cesarean delivery without medical indication. Planned cesarean delivery could reduce the maternal complications
Obstetrics and Gynecology
Soudabeh Kazemi Aski; Seyedeh Hajar Sharami; Morvarid Ghasab Shirazi; Ezat Hesni; Seyedeh Fatemeh Dalil Heirati; Misa Naghdipour; Alireza Forozan; Maryam Ghalandari; Forozan Milani
Volume 8, Issue 3 , May and June 2023, , Pages 268-276
Abstract
Background & Objective: The Covid-19 pandemic can cause complications for pregnant women and more serious maternal, fetal and neonatal care related to this disease should be considered in health systems. The aim of the present study was to investigate the maternal, fetal, and neonatal outcomes ...
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Background & Objective: The Covid-19 pandemic can cause complications for pregnant women and more serious maternal, fetal and neonatal care related to this disease should be considered in health systems. The aim of the present study was to investigate the maternal, fetal, and neonatal outcomes of pregnant women with COVID-19 disease.Materials & Methods: We performed a prospective study with a longitudinal design of all pregnant women hospitalized due to moderate and severe COVID-19 referred to Al-Zahra hospital, Rasht, Iran. After patient discharge, patients were followed until delivery, maternal, fetal, and neonatal outcomes were assessed by a 4-part researcher-made questionnaire.Results: In total, 166 pregnant women with Covid-19 were included in the study. The median gestational age in patients was 35.5 weeks and the median delivery age was 38 weeks. Delivery in 137 (82.5%) women were cesarean section and 29 (17.5%) had a vaginal delivery. The most common clinical symptoms among patients were fever, cough, and dyspnea with 50.9%, 38.5%, and 31.5% frequency, respectively, 9.6% had poor prenatal outcomes, 15 patients (9%) were admitted to ICU and 4 patients died (2.4%). Poor maternal outcomes were reported in 61.5% of patients with severe clinical symptoms, (p <0.001). There was no significant relationship between the severity of the disease and the type of delivery (p = 0.41).Conclusion: In our study we observed an increase in poor maternal, fetal and neonatal outcomes particularly in pregnant women with severe symptoms, although careful care is still recommended for affected pregnant women to reduce fetal, neonatal, and maternal complications. Further research will be needed to devise plan for pregnancy care and future health care crises.
Obstetrics and Gynecology
Fahimeh Ghotbizadeh; Zahra Panahi; Azam Tarafdari Manshadi; Saeed Soltani; Razieh Akbari; Mahdieh Parsapur
Volume 8, Issue 1 , January and February 2023, , Pages 68-75
Abstract
Background & Objective: Social factors which are integrated with health status are considered crucial in pregnancy morbidity. Mothers with a developed level of health literacy (HL) experience a lower risk of preterm delivery. This study aimed to evaluate the relationship between maternal HL ...
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Background & Objective: Social factors which are integrated with health status are considered crucial in pregnancy morbidity. Mothers with a developed level of health literacy (HL) experience a lower risk of preterm delivery. This study aimed to evaluate the relationship between maternal HL and prenatal care and pregnancy outcome.Materials & Methods: The research was a cohort study. A total of 323 participants were selected from prenatal clinics. The women were followed until delivery. Women who had gestational diabetes or preeclampsia or gestational hypertension during pregnancy were omitted. Data were collected with a survey.Results: The result found 34.1%, 33.1%, 23.8%, and 9% were categorized as having inadequate, problematic, sufficient, and excellent maternal HL. Women with sufficient and excellent literacy were meaningfully better in having earlier and more frequent antenatal care, earlier folic acid consumption, and exercise before and during pregnancy, pregnancy alarm sign awareness, neonatal birth weight, and breastfeeding.Conclusion: The results proposed that sufficient and excellent HL among women is related to good pregnancy outcomes and poor HL causes a poor chance to gain a positive pregnancy outcome. A cooperative work to grow maternal HL by considering HL levels, revision of educational materials into plain language, and provision of pregnant women with verbal and video instruction in addition to written materials are highly recommended.
Obstetrics and Gynecology
Shahnaz Ahmadi; Katayoon Farahani; Majid Aklamli; Kambiz Ahmadi; Niloufar Beheshti
Volume 7, Issue 3 , January and February 2022, , Pages 186-191
Abstract
Background & Objective: Spinal analgesia and Entonox analgesia are used as pain relief methods during labor. This cross-sectional study was conducted to determine the effect of spinal analgesia and Entonox analgesia on the duration of the first, second, and third stages of labor, Apgar score, and ...
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Background & Objective: Spinal analgesia and Entonox analgesia are used as pain relief methods during labor. This cross-sectional study was conducted to determine the effect of spinal analgesia and Entonox analgesia on the duration of the first, second, and third stages of labor, Apgar score, and maternal and fetal outcomes.Materials & Methods: Clinical information of 1,000 patients who delivered at Shahid Akbarabadi Hospital and underwent painless delivery with Entonox gas and spinal anesthesia was assessed; then, according to the inclusion criteria, 280 cases were divided into two groups: the spinal analgesia group (n=140) and Entonox analgesia group (n=140). In the spinal analgesia group, 25 μg of fentanyl and 1-2 mg of bupivacaine were administered. For the Entonox group, Entonox inhalation was administered via a face mask at the initiation of pain at each contraction. The duration of labor, mode of delivery, side effects, and maternal satisfaction were also compared in the two groups.Results: The duration of the first stage was significantly shorter in the spinal analgesia group than in the Entonox analgesia group (P < /em><0.001), but the duration of the second stage in the spinal analgesia group was longer (P < /em><0.001). There were no significant differences in the cesarean section rates, Apgar score, weight, and acidity (PH) and the partial pressure of carbon dioxide (pCO2) between the two groups. Measured pain was significantly lower in the spinal analgesia group (P < /em>=0.01) than in the Entonox analgesia group regarding visual analog scale (VAS) scores.Conclusion: Spinal analgesia is a safe, suitable, and effective method for pain reduction with no adverse effects on the outcome of labor compared to Entonox analgesia.
Sedigheh Borna; Nasim Khorami; Azin Ghamari; Fahimeh Ghotbizadeh Vahdani
Volume 4, Issue 1 , March and April 2019, , Pages 24-28
Abstract
Background & Objective: This prospective study aimed to determine the relationship between maternal and amniotic fluid (AF) lipid profiles in the second trimester with pregnancy outcomes.
Materials & Methods: One hundred-eighty singleton pregnant women, with a gestational age of 16-22 weeks, ...
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Background & Objective: This prospective study aimed to determine the relationship between maternal and amniotic fluid (AF) lipid profiles in the second trimester with pregnancy outcomes.
Materials & Methods: One hundred-eighty singleton pregnant women, with a gestational age of 16-22 weeks, were enrolled in this study. All women underwent amniocentesis, and 2 mL of AF was investigated for AF lipid profile. Furthermore, the serum maternal lipid profile was evaluated simultaneously. All participants were followed up until the delivery, and postnatal outcomes were recorded.
Results: Mean maternal age and body mass index (BMI) of all participants were 5.8±33 years and 25.6±2.8 kg/m2, respectively. Mean maternal estriol, cholesterol, and triglyceride levels, as well as mean cholesterol and triglyceride levels of AF, were significantly different between term and preterm; intrauterine growth retardation (IUGR) and non-intrauterine growth retardation (non-IUGR); and low birth weight and normal weight neonates (P < /em><0.001). The AF cholesterol level was an independent predictor of term or preterm delivery, while the maternal estriol level was an independent predictor of IUGR or normal growth.
Conclusion: Maternal and amniotic fluid lipid profiles could be good indicatives of fetus growth.
Mahboobeh Shirazi; Shirin Niroomanesh; Fatemeh Rahimi Shaarbaf; Maryam Rabiei; Mitra Eftekhariyazdi
Volume 1, Issue 1 , May and June 2016
Abstract
Introduction: The incidence of very echogenic amniotic fluid on ultrasonographic examination at term pregnancy is very low and its causes and significance in outcome of pregnancy are not well- understood. In previous studies, meconium was considered to be an important cause of very echogenic amniotic ...
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Introduction: The incidence of very echogenic amniotic fluid on ultrasonographic examination at term pregnancy is very low and its causes and significance in outcome of pregnancy are not well- understood. In previous studies, meconium was considered to be an important cause of very echogenic amniotic fluid and follow-up with amniocentesis and fetal well-being tests were recommended; however, in recent studies vernix caseosa has been identified to be an important cause. As a result, termination of pregnancy should not be performed due to discovery of ultrasonographic echogenic amniotic fluid because it is not associated with adverse pregnancy outcomes.
Case Presentation: We report a single term pregnancy with very echogenic amniotic fluid diagnosed by ultrasonography that was terminated by cesarean section.
Conclusions: There were no adverse outcomes for the mother or neonate and the amniotic fluid was clear at the time of delivery.
