Obstetrics and Gynecology
Hoora Amoozegar; Nayereh Rahmati; Zahra Naseri; samira Shah-Hamzehi; mostafa vahedian; enayatollah Noori; alireza moradi
Articles in Press, Accepted Manuscript, Available Online from 15 July 2023
Abstract
Background: To evaluate the risk of uterine rupture during pregnancy, researchers use two-dimensional (2D) transvaginal ultrasound to assess lower uterine segment (LUS) thickness in the third trimester of pregnancy. This study aimed to compare the thickness of the LUS provided in a 2D transvaginal ultrasound ...
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Background: To evaluate the risk of uterine rupture during pregnancy, researchers use two-dimensional (2D) transvaginal ultrasound to assess lower uterine segment (LUS) thickness in the third trimester of pregnancy. This study aimed to compare the thickness of the LUS provided in a 2D transvaginal ultrasound with the findings during a cesarean section (C/S) of pregnant women with a history of previous C/S.
Materials and Method: This cross-sectional study was performed on 40 pregnant women referred to Izadi Obstetrics and Gynecology Hospital in Qom. All the women underwent transvaginal ultrasound followed by C/S within a maximum of one week later. Also, an expert gynecologist classified LUS thickness into four grades in the operation room.
Results: The mean age of women was 31.58 ± 4.56 years, and the mean thickness of the LUS was 2.17 ± 0.51 cm. Moreover, 57.5% of the women have grade I of LUS based on intraoperative findings. Results indicated that the mean thickness of the LUS measured by ultrasound significantly differed between the three grades detected by the gynecologist (P=0.04). However, there were no significant differences between maternal age, gestational age, parity, and time of last C/S among women with different LUS grades (P˃0.05). Transvaginal ultrasound could be helpful in evaluating the risk of scar dehiscence and uterine rupture among women with LUS grades I and II with a history of previous C/S.
Maternal Fetal Medicine
Mahboobeh Shirazi; Fatemeh Rahimi Sharbaf; Fatemeh Golshahi; Behrokh Sahebdel; Elham Feizabad; Leila Asadi; Afsaneh Alimadad-Tafreshi; Arash Jafariyeh; Akram Valizadeh; tayebeh sedighi; Fatemeh Takaloo; Aazam Taghavi-Zahedkalaei
Articles in Press, Accepted Manuscript, Available Online from 09 December 2023
Abstract
Background & Objective: Clinical use of uterine artery (UtA) Doppler ultrasound imaging requires reference values but despite the common use of UtA Doppler examination during pregnancy, to the best of our knowledge, there is no such range for Iranian pregnant women. Hence, this study aimed to investigate ...
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Background & Objective: Clinical use of uterine artery (UtA) Doppler ultrasound imaging requires reference values but despite the common use of UtA Doppler examination during pregnancy, to the best of our knowledge, there is no such range for Iranian pregnant women. Hence, this study aimed to investigate uterine artery Doppler indices in Iranian normal pregnancies and compare these with the other country values.Materials & Methods: This observational longitudinal study was conducted on 486 low-risk pregnant women. The amount of plausibility index (PI) and resistance index (RI) as well as the presence of diastolic notch were assessed in weeks 11 to 14, 17 to 24, and 27 to 32 through Doppler ultrasound. Results: The bilateral notch for the gestational age of 11 to 14 weeks was detected at about 6%, for the gestational age of 17 to 24 weeks it was about 4.2% and for the gestational age of 27 to 32 weeks it was about 3.6%. Reference intervals for mean uterine artery PI according to gestational ages, show a significant (p<0.001) difference between different percentages. Also, there is a significant relation between the mean uterine arteries PI/RI and the presence or absence of pregnancy complications (IUGR, premature birth, IUFD) among the participants. Conclusion: The results of this research showed that there is a significant relation between PI and pregnancy complications, while this was not detected in RI and diastolic notch. These results are relatively consistent with the findings of researchers in other countries.
General Gynecology and Pelvic Floor
Mona K. Omar; Ayman S. Dawood; Samah Ahmed Radwan; Ahmed M. Ossman
Volume 9, Issue 2 , March and April 2024, , Pages 163-173
Abstract
Background & Objective: Conservative treatment of placenta accreta spectrum (PAS) become increasingly performed, especially due to acceptance of many obstetricians to preserve the uterus. To evaluate cesarean scar integrity following PAS conservative surgery using Shehata's technique and other conservative ...
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Background & Objective: Conservative treatment of placenta accreta spectrum (PAS) become increasingly performed, especially due to acceptance of many obstetricians to preserve the uterus. To evaluate cesarean scar integrity following PAS conservative surgery using Shehata's technique and other conservative techniques because more than one level of pelvic devascularization was used. This cross-sectional study was conducted at Tanta University in the period from June 1, 2019 to October 31, 2022.
Materials & Methods: All patients underwent conservative uterine sparing technique (Shehata's technique) were assessed by 2 D ultrasound at 6-18 months later to detect the integrity of the CS scar. Fifty women with a history of other conservative treatment of PAS used as control.
Results: Women who were operated with Shehata’s technique showed less incidence of scar dehiscence with less size of scar defects and more thickness of the myometrium over the scar site and more vascularity of these scars.
Conclusion: Shehata's technique resulted in a more integrated scar with less incidence of dehiscence and more vascularity of the compared to other conservative methods of treatment of PAS. Therefore, it is an effective and safe method in treatment of PAS.
Obstetrics and Gynecology
Shahla Mirgaloybayat; Sharareh Saneei; Marziyeh Ajdary; Saeedeh Sarhadi; Neda Eslahi; Foroogh Sadat Mousavi; Farahnaz Farzaneh
Volume 8, Issue 2 , March and April 2023, , Pages 120-124
Abstract
Background & Objective: Determining the correct date of pregnancy and fetal age has a very important role in the management of pregnancy from the first trimester to delivery, which makes it necessary to know the exact method in this field. Therefore, this study aimed to compare the accuracy ...
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Background & Objective: Determining the correct date of pregnancy and fetal age has a very important role in the management of pregnancy from the first trimester to delivery, which makes it necessary to know the exact method in this field. Therefore, this study aimed to compare the accuracy of ultrasound at 8-16 weeks with Naegele’s Revised Rule of the delivery date.Materials & Methods: This study was performed on 50 pregnant women. After recording demographic information and age of delivery, sonography of weeks 8-16 and Naegel’s Revised Rule were also recorded. A Paired t-test was used to compare data.Results: The results of our study showed that the average difference between the Naegele’s Revised Rule and real age was 3.52 days, which is a significant difference. However, the average difference between the estimated date by ultrasound and real age is 0.58 days, which is not a significant difference. Ultrasound is more accurate than the Naegele’s Revised Rule, which still did not differ significantly from the actual date of delivery by grouping by age, sex of the fetus, number of pregnancies, and deliveries.Conclusion: Ultrasound has more accuracy in accurately estimating the date of delivery, and therefore using this method and relying on it has more reliability than the Naegele’s Revised Rule.
Obstetrics and Gynecology
Fatemeh Golshahi; Behnaz Moradi; Forough Jabbari; Marjan Ahmadi
Volume 7, Issue 6 , September and October 2022, , Pages 574-577
Abstract
Fraser syndrome is a rare genetic disorder characterized by multiple structural abnormalities, above all of which are cryptophthalmos and syndactyly. According to reviews of reported cases, diagnostic criteria have been established. Here, we report a case of 18 weeks pregnancy diagnosed with Fraser syndrome ...
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Fraser syndrome is a rare genetic disorder characterized by multiple structural abnormalities, above all of which are cryptophthalmos and syndactyly. According to reviews of reported cases, diagnostic criteria have been established. Here, we report a case of 18 weeks pregnancy diagnosed with Fraser syndrome presenting with cryptophthalmos, syndactyly, kidney agenesis, and hyper-echogenic lungs during an ultrasound examination. The pregnancy was terminated, and diagnostic features of the syndrome were confirmed afterward. Since the imaging characteristics are unique, it is of value that clinicians become familiar with the appearance of the syndrome to provide families with the opportunity to make timely decisions regarding pregnancy termination and use the prenatal diagnostic tools to have healthy children in subsequent pregnancies.
Gynecology Oncology
Shahrzad Sheikhhasani; Mohades Peydayesh; Narges Zamani; Somayeh Nikfar; Mona Mohseni
Volume 7, Issue 4 , March and April 2022, , Pages 348-350
Abstract
Perivascular epithelioid cell tumors (PEComas) are a group of mesenchymal neoplasms with different biological presentations from benign to malignant types. Hence, we report the first description of PEComa presenting with an acute surgical abdomen. Her definite diagnoses were made based on the histomorphology ...
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Perivascular epithelioid cell tumors (PEComas) are a group of mesenchymal neoplasms with different biological presentations from benign to malignant types. Hence, we report the first description of PEComa presenting with an acute surgical abdomen. Her definite diagnoses were made based on the histomorphology results at Imam Khomeini Hospital, Tehran University of Medical Sciences, in 2020.Considering different clinical presentations, unknown characteristics of imaging, and rarity of PEComa, preoperative diagnosis of it seems impossible. However, IHC can play an important role in its diagnosis.
Maternal Fetal Medicine
Laleh Eslamian; Ashraf Jamal; Vajiheh Marsosi; Marjan Ahmadi; Alireza Golbabaei; Paria Boustani
Volume 7, Issue 3 , January and February 2022, , Pages 165-170
Abstract
Background & Objective: IUGR (intrauterine growth restriction) fetuses have been known as a significant concern in clinical practice. It is associated with fetal mortality and morbidity and prenatal adverse cardiac remodeling. The aim of this study is the evaluation of the relation between MPI (myocardial ...
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Background & Objective: IUGR (intrauterine growth restriction) fetuses have been known as a significant concern in clinical practice. It is associated with fetal mortality and morbidity and prenatal adverse cardiac remodeling. The aim of this study is the evaluation of the relation between MPI (myocardial performance index) abnormalities and doppler findings in both normal and IUGR fetuses.Materials & Methods: In this cross-sectional study, 400 consecutive pregnant women in Shariati Hospital, Tehran, Iran, in 2019 and 2020 underwent ultrasound assessment at 28-40 weeks, in which among the 400 performed ultrasounds, 47 fetuses with IUGR were selected as a case group, and 47 fetuses with normal weight were selected based on AGA (appropriate gestational age). Cardiac function was evaluated by measuring MPI in diastolic and systolic function in two groups. The results were compared to the IUGR (case group) and control group by SPSS software version 20.Results: In receiver operating characteristic (ROC) analysis, the AUC (area under the curve) for left ventricular MPI (LV MPI) was 0.929 (CI95%: 0.868-0.991; P < /em>=0.001), and the sensitivity and specificity values were 87% and 69.4% with a cut-off point of 0.2850. In ROC analysis, the area under the curve for RV MPI was 0.842 (CI95%: 0.741-0.942; P < /em>=0.001), and the sensitivity and specificity values were 78.3% and 63.9%, with a cut-off point 0.2850. Left and right ventricular MPI showed a significant difference statistically between the case and the control groups.Conclusion: The study showed a significant rise of MPI in IUGR fetuses. MPI can be considered as a useful parameter for evaluating the severity of growth restriction in IUGR fetuses.
Obstetrics and Gynecology
Fatemeh Golshahi; Mahboobeh Shirazi; Shirin Torabi; Fatemeh Rahimi Sharbaf; Farzaneh Nazari
Volume 6, Issue 3 , June 2021, , Pages 147-151
Abstract
Currently, ultrasound is a well-known clinical modality for pregnancy management and has a prominent role in clinical decision-making. Accordingly, developing guidelines to outline the minimum performance standards of using ultrasound is necessary for different areas of obstetric ultrasound. The fetal ...
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Currently, ultrasound is a well-known clinical modality for pregnancy management and has a prominent role in clinical decision-making. Accordingly, developing guidelines to outline the minimum performance standards of using ultrasound is necessary for different areas of obstetric ultrasound. The fetal brain is one of the most important assessments in anomaly scan. For a basic brain assessment, 3 axial planes are routinely defined. According to most guidelines, the fetal skull’s integrity, shape, and bone density should be assessed while measuring the head size. In this paper, we present 2 cases of skull bony defect with normal routine 3 axial planes. For better detection of CNS anomalies, it is necessary to add other views such as sagittal view to three routine planes. It leads to early detection of anomalies especially in first and early second trimester. Consequently, it helps in deciding for termination, planning interventions and further management.
