Adibeh Mauwloudi; Laleh Eslamian; Vajiheh Marsousi; Ashraf Jamal; Maryam noorzadeh; Mahsa Naemi; Ali Reza Norouzi; Nazila Mesbah
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Epigenetic silencing of MLH1 in endometrial cancers is associated with larger tumor volume, increased rate of lymph node positivity, and reduced recurrence-free survival Background: The aim of this study was to determine which of the two drugs of ibuprofen, as a common non-steroidal anti-inflammatory ...
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Epigenetic silencing of MLH1 in endometrial cancers is associated with larger tumor volume, increased rate of lymph node positivity, and reduced recurrence-free survival Background: The aim of this study was to determine which of the two drugs of ibuprofen, as a common non-steroidal anti-inflammatory drugs NSAID, and acetaminophen would have the least effect on postpartum hypertension in patients with preeclampsia.Methods: Clinicodemographic data including age, gestational age at delivery, body mass index, parity, and route of delivery, were collected through interviews with patients and reviewing patient records. In this double-blind clinical trial, among 84 patients included in the study, 42 patients were randomly assigned into the acetaminophen (650 mg every 6 to 24 hours) and 42 patients into the ibuprofen (600 mg every 6 to 24 hours) group. Results: The two groups were not significantly different in terms of mean age (p = 0.322), body mass index (p = 0.950), route of delivery (p = 0.657), parity (p = 0.818), and mean systolic (p = 0.530) and diastolic blood pressure (p = 0.691). Following the intervention, the duration of blood pressure control (p = 0.182), mean systolic blood pressure (p = 0.371), and mean diastolic blood pressure (p = 0.13) were not significantly different in the acetaminophen and ibuprofen groups. There was no significant difference between the two groups in terms of the number of patients and the dosage of opioids used.Conclusion: The results revealed that in patients with preeclampsia, acetaminophen and ibuprofen to control postpartum pain have a similar impact on blood pressure.
Soudabeh Kazemi Aski,; Seyedeh Hajar Sharami; Azadeh Tavangar; ehsan Kazem Nezhad Leilie; Seyedeh Fatemeh Dalil Heirati; Atoosa Etezadi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus normal growth. The objective of this study was to compare the level ...
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Background and objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus normal growth. The objective of this study was to compare the level of PAPP-A in pregnancy weeks 11-14 in women with and without intrauterine growth restriction and to assess the ability of this marker to predict adverse outcomes in pregnancy. Methods: In this Comparative Cross-sectional study, 227 pregnant women were studied during 2017. Mothers were divided into two main groups with and without intrauterine growth restriction. The relevant data, including birth weight, preeclampsia, gestational diabetes, Apgar score, and PAPP-A, were recorded on special forms. Data analysis was done using SPSS-21 software. Results: The mean age of participating women in this study was 28.8 ± 5.6 years. The median (IOR) number of gravidity and Gestational weight gain was 1 (1) and 12 (7) kg respectively. The difference in median (IOR) PAPP-A in patients with and without IUGR was statistically significant 0.64(0.57) and 1 (0.57), respectively, P= 0.001.The cut-off point for PAPP-A was 0.73 with a sensitivity=72.2% (95% CI: 64.32-79.16%) and a specify =60.5% (95% CI: 48.65 -71.56%). Conclusion: The results of this study confirm the relationship between low levels of PAPP-A and adverse outcomes of pregnancy. In the present study, the optimal cut-off point (0.73) is higher than other studies, which can be due to racial and epidemiological differences.
Berikuly Duman; Ali Abdulhussain Fadhil; Samah Sajad Kadim; Ayad Abas Hasan; Naseer Mehdi Mohammed; Ebtihal Sattar Qasim; Tamara Muayad Abdullah
Articles in Press, Accepted Manuscript, Available Online from 09 February 2023
Abstract
Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications ...
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Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications in pregnant patients with preeclampsia, the present study was conducted.Materials & Methods: In 2020, in Alwiyah Hospital for Obstetrics and Gynecology in Baghdad, 87 pregnant women with preeclampsia and 160 healthy pregnant women participated in the present prospective study. The Doppler signal of the uterine arteries was evaluated during a supine abdominal Doppler ultrasound examination executed between 26 and 36 weeks of pregnancy. The survey form was updated with information about the birth of the children following the termination of the pregnancy. The data were evaluated using SPSS.19 and independent t, Mann-Whitney, and chi-square tests.Results: The mean uterine artery pulsatility index of mothers with preeclampsia had the greatest sensitivity, specificity, and positive predictive amount of predicting a baby's low birth weight at 54.8%, 87.3%, and 91.6%, respectively. In addition, the sensitivity, specificity, and positive predictive amount of the mean uterine artery resistance index for predicting a baby's low birth weight were 65.2%, 96.4%, and 95.4%, respectively.Conclusion: Although uterine artery indices in Doppler ultrasound do not have a high sensitivity for predicting neonatal complications, abnormal indices can predict low birth weight with high confidence.
Obstetrics and Gynecology
Mahsa Naemi; Maasoumeh Saleh; Mahboubeh Saleh
Volume 8, Issue 2 , January and February 2023, , Pages 125-130
Abstract
Preeclampsia (PE) is a major complication of pregnancy worldwide. Doppler ultrasound of maternal arteries, including uterine and ophthalmic arteries (OA), plays an important role in determining individuals progressing PE. The aim of this study is to compare OA indices in pregnant women with a diagnosis ...
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Preeclampsia (PE) is a major complication of pregnancy worldwide. Doppler ultrasound of maternal arteries, including uterine and ophthalmic arteries (OA), plays an important role in determining individuals progressing PE. The aim of this study is to compare OA indices in pregnant women with a diagnosis of PE and women without it. Out of 148 included participants, 48 cases progressed to PE at 35 to 37 weeks of gestation and 100 cases did not have PE at the same gestational age. All OA parameters including (First and second peak systolic velocities (PSV), Second to first PSV Ratio (PR) and Pulsatility Index (PI) in each eye; as well as, the average of these indices in both eyes) were assessed. PR and PI between the two eyes were statistically different in those with PE.
Obstetrics and Gynecology
Farzaneh Boroumand; Shiva Ghayur; Rasoul Gharaaghaji; Shabnam Vazifekhah
Volume 7, Issue 6 , September and October 2022, , Pages 524-529
Abstract
Background & Objective: Maternal obesity can increases pregnancy consequences like postpartum hemorrhage, preeclampsia, need for cesarean section, neonatal death, and fetal macrosomia. In this study, the efficacy of prophylactic use of metformin to prevent gestational diabetes mellitus in nondiabetic ...
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Background & Objective: Maternal obesity can increases pregnancy consequences like postpartum hemorrhage, preeclampsia, need for cesarean section, neonatal death, and fetal macrosomia. In this study, the efficacy of prophylactic use of metformin to prevent gestational diabetes mellitus in nondiabetic pregnant women with obesity was examined.Materials & Methods: This study was a clinical trial. Totally, 340 pregnant women who were in the first trimester were referred to the gynecology clinic of Motahhari hospital in Urmia after ensuring the absence of underlying diseases such as diabetes, hypertension, kidney, liver, and cardiovascular disease, without a history of allergy to metformin, in case of a singleton pregnancy, and Body Mass Index (BMI) above 30 were allocated to two equal groups. The intervention group was given 1000 mg of metformin, and the control group was given a placebo. Demographic information, including age, gravity, parity, live birth, birth, and maternal weight, previous delivery method, abortion, delivery method with its cause, polyhydramnios, NICU hospitalization, gestational age, mortality, and neonatal anomalies was also recorded. The results were analyzed using SPSS version 26.Results: In the control group, 15 mothers (9.4%) out of 160 people, and in the intervention group, 13 mothers (8.1%) had gestational diabetes (P < /i>=0.692). In the intervention group, the mean insulin dose was 10.8 ±3 units; in the control group, the mean insulin dose was 21.2±15.7 units (P=0.048). Twenty patients (6.7%) out of 297 obese patients and 8 patients (34.8%) in the morbid obesity group had diabetes (P < /i><0.001). In the control group, the mean weight of mothers was 8.04±2.5 kg; in the intervention group, it was 5.2±2.3 kg during pregnancy (P < /i><0.001). Gestational diabetes, delivery method, death one week after birth, preterm birth, polyhydramnios, and intensive care unit were similar in the two groups. Conclusion: Metformin in pregnant women with a BMI>30 deals with low maternal weight, reduced birth weight, and reduced insulin dose in diabetic mothers.
Obstetrics and Gynecology
Roshan Nikbakht; Raziye Mohammad Jafari; Mojgan Barati; Masume Jafari Nezhad; Maziar Shamsaei
Volume 7, Issue 6 , September and October 2022, , Pages 548-553
Abstract
Background & Objective: The objective of this study was to determine the association between the maternal serum concentration of PAPP-A and free B-HCG at 11-13(+6) weeks and the uterine artery pulsatility index (PI) at 30-34 weeks with the prediction of preeclampsia.Materials & Methods: This ...
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Background & Objective: The objective of this study was to determine the association between the maternal serum concentration of PAPP-A and free B-HCG at 11-13(+6) weeks and the uterine artery pulsatility index (PI) at 30-34 weeks with the prediction of preeclampsia.Materials & Methods: This cohort study was performed on 882 women with singleton pregnancies from March 2018 to November 2020 at the university hospital (referred center) in Ahvaz/Khuzestan. Maternal serum PAPP-A and free B-HCG at 11-13(+6) weeks and uterine artery PI at 30-34 weeks were measured and compared between women with and without PE. MOM PAPP-A<0.4, MOM-free B-HCG>3, and uterine artery pulsatility index >1 (>95%) were considered abnormal. Then The effect of each of the indicators on preeclampsia was determined by overlaying the layers and performing logical calculations in ARC GIS software. The distribution of PE in different cities of Khuzestan province was investigated.Results: The mean MOM PAPP-A was significantly lower (1.05 vs. 1.21 P < /i>=0.03), and uterine artery PI was significantly upper (0.93 vs. 0.88 P < /i><0.01) in preeclamptic women compared to women without PE. No significant differences were observed in the mean MOM-free B-HCG between women with and without PE (1.33 vs. 1.2 P < /i>=0.667). The highest percentage of PE was in two regions of Ahvaz (80%), but concerning women referred from different cities was in Andimeshk (75%). Conclusion: A low level of maternal serum PAPP-A and increased uterine artery PI promoted the chance of developing PE. The highest prevalence of PE was in two regions of the center of Khuzestan province, and the most preferred due to PE in different cities was in Andimeshk.
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.
Obstetrics and Gynecology
Mandana Mansour Ghanaei; Sude Amir Afzali; Ali Morady; Roxana Mansour Ghanaie; Seyed Mohammah Asghari Ghalebin; Elahe Rafiei; Roya Kabodmehri
Volume 7, Issue 3 , January and February 2022, , Pages 177-185
Abstract
Background & Objective: Accordingly, this study aimed to assess pregnancy outcomes and pathological findings of the placenta caused by intrauterine growth restriction (IUGR) with or without pre-eclampsia (PE).Materials & Methods: This cohort study was conducted on two groups: Group I was ...
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Background & Objective: Accordingly, this study aimed to assess pregnancy outcomes and pathological findings of the placenta caused by intrauterine growth restriction (IUGR) with or without pre-eclampsia (PE).Materials & Methods: This cohort study was conducted on two groups: Group I was PE-induced IUGR (PE-IUGR), and group II was idiopathic IUGR (I-IUGR). Pregnancy and neonatal outcomes were evaluated in both groups. The placental assessment was also performed based on pathological findings. Data were compiled and analyzed by SPSS 21. An analytical study was conducted on the groups based on t (or non-parametric Mann-Whitney), chi-square, and Fisher’s exact tests.Results: The findings of this study showed that maternal age, body mass index (BMI), the incidence of preterm delivery, and low birth weight were higher in the PE-IUGR group (P < /em><0.001 in all) than in the I-IUGR group, and the difference was statistically significant. Additionally, circulatory disorders and impaired anomalies were higher in the PE-IUGR group (P < /em>>0.001) than in the I-IUGR group.Conclusion: Placental disorders and reduced blood flow to the fetus due to placental disorders might lead to low birth weight and preterm delivery.
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.
Masoumeh Mirteimouri; Seyedeh Azam Pourhoseini; Fahimeh Ghaneie Motlagh
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: HELLP syndrome is a life-threatening complication of preeclampsia. We report a young pregnant woman with HELLP syndrome who was diagnosed, managed, and delivered in a timely manner.
Case Presentation: A 23-year-old second gravida twin pregnant woman was referred to our clinic due to high ...
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Introduction: HELLP syndrome is a life-threatening complication of preeclampsia. We report a young pregnant woman with HELLP syndrome who was diagnosed, managed, and delivered in a timely manner.
Case Presentation: A 23-year-old second gravida twin pregnant woman was referred to our clinic due to high blood pressure. After delivery, she experienced a hemolytic condition with elevated liver enzymes and thrombocytopenia, defined as HELLP syndrome. After confirmation of HELLP syndrome by laboratory tests, the patient underwent hemodialysis and plasmapheresis. 10 days later, she was discharged under good general condition.
Conclusions: Women with a history of HELLP syndrome are considered to have an increased risk of death. Therefore, this life threatening condition should be closely monitored and treated in a timely manner.
Zahra Shahraki; Khadije Rezaie Keikhaie; Nooshin Amjadi; Zohrehsadat Hashemi Bonjar; Hosseinali Jahantigh; Fatemeh Doosti; Mahboobeh Shirazi
Volume 2, Issue 2 , May and June 2017
Abstract
Background: Preeclampsia is one of the causes of maternal and prenatal mortality and morbidity. The 24-hour urine sample is considered as a gold standard for preeclampsia diagnosis and shortening the time of urine collection will result in the patients’ convenience and shorter hospitalization. ...
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Background: Preeclampsia is one of the causes of maternal and prenatal mortality and morbidity. The 24-hour urine sample is considered as a gold standard for preeclampsia diagnosis and shortening the time of urine collection will result in the patients’ convenience and shorter hospitalization. The goal of this study was to determine thee diagnostic accuracy of 4 hour urine protein in comparison with 24 hour urine protein in pregnant women.
Methods: One hundred pregnant women, with a gestational age of more than 20 weeks, and were suspicious to preeclampsia were enrolled. The 24-hour as well as the 4-hour urine sample were collected. All data were analyzed using the SPSS software, version 20 (SPSS Inc., Chicago, IL, USA). The correlation coefficient was used to determine relationship between the 4 and 24-hour urine proteins. receiver operating characteristic (ROC) curve was used to determine optimal cut-off values of 4 hour proteinuria.
Results: The mean age and mean gestational age of participants was 26.8 & 6.1 years and 34.1 & 3.4 weeks. The mean 4-hour urine protein was 165.6 & 170.2 mg and the mean 24 hour urine protein was 926 & 1013 mg. The mean age, 4-hour urine protein, and 4 as well as 24 hour urine volumes were significantly different between cases with no, mild, or severe proteinuria. Pearson correlation coefficient between 4 and 24 hour proteinuria was strong (r = 0.97 and p < 0.001). The best cut off point for 4-hour proteinuria to determine proteinuria was 69.5 mg with a sensitivity of 93% and specificity of 100%. (Area under the curve = 0.99, p < 0.001).
Conclusions: Women that are suspicious to have preeclampsia, the total 4-hour urine protein values positively correlated with values of 24-hour samples.
