Maternal Fetal Medicine
Tajossadat Allameh; Zahra Allameh; Zahra Javanmardi; Elham Moazam; Maryam Dehghan
Volume 8, Issue 2 , March and April 2023, , Pages 131-136
Abstract
Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean ...
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Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean section in Isfahan province.Materials & Methods: In this one-year descriptive cross-sectional study, 49889 pregnant women who had the natural childbirth (29631 deliveries), elective repeat Cesarean section (20148 deliveries) and VBAC delivery (110 deliveries) were enrolled, then maternal and neonatal complications were compared in three groups.Results: There was a significant difference between the three groups based on the maternal and neonatal outcome, Apgar scores in the first and fifth minutes after delivery and the need for resuscitation at birth (P <0.05). Neonatal outcome was better in natural delivery and then VBAC compared to repeat C-section, respectively. Maternal outcome was better in VBAC and then repeat C-section than the natural childbirth. Apgar scores in the first and fifth minute were better in VBAC, and later natural delivery than repeat C-section. Resuscitation at birth demonstrated better results for natural delivery and then VBAC than repeat C-section.Conclusion: Utilizing VBAC and natural delivery have better maternal and fetal outcomes compared to C-section, along with being more satisfactory and safer.
Maternal Fetal Medicine
Sedigheh Hantoushzadeh; Taraneh Geran Orimi; Mohammad Reza Zarkesh; Tahmineh Geran Orimi
Volume 7, Issue 6 , September and October 2022, , Pages 471-478
Abstract
Several studies have described multisystem inflammatory syndrome (MIS) in children, but very few investigations presented this syndrome among neonates (MIS-N). The present study has reviewed the current knowledge about MIS-N, its etiology, symptoms, and outcomes to attract special attention with an eye ...
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Several studies have described multisystem inflammatory syndrome (MIS) in children, but very few investigations presented this syndrome among neonates (MIS-N). The present study has reviewed the current knowledge about MIS-N, its etiology, symptoms, and outcomes to attract special attention with an eye on earlier diagnosis and treatment of newborns affected by perinatal SARS-CoV-2-infection. A narrative review study was conducted (Tehran, Iran, 2021). All types of full English articles (up to October 1 2021) were included. Detailed research on academic search engines was performed. The implemented Mesh-based keywords were "SARS-COVID-2" OR "COVID-19" OR "coronavirus" AND "Neonate" OR "Neonatal" OR "Newborn" AND "Multisystem Inflammatory Syndrome" OR "MIS-N" OR "inflammatory response syndrome" AND "Pregnancy" OR "Perinatal" OR "prenatal". Finally, 15 Full-text articles were included that met the eligibility criteria. Available data related to the disease, its etiology, presentations, and its outcome were collected and discussed. The cause of MIS-N is the transmission or production of SARS-CoV2 antibodies in response to SARS-CoV2 infection. By involving different organs, the clinical manifestations of MIS-N may mimic sepsis, toxic shock syndrome, RDS, Kawasaki disease, necrotizing enterocolitis, myocarditis, meningitis/encephalitis, aortic thrombosis, ETC. Besides the clinical presentations, detecting reactive anti-SARS-CoV-2 IgG antibodies could be a notable clue in MIS-N diagnosis. Supportive therapy, suppressing the autoimmune and inflammatory responses, anti-platelet agents, and anticoagulants were reported as effective therapeutic agents to improve the outcome. The present study highlighted the possibility of MIS-N as an infrequent but severe syndrome consequent to perinatal COVID-19 infection. Although the diagnosis is still controversial, clinical suspicion, laboratory findings, and early treatment initiation could improve the outcome of this immunological disease.
Maternal Fetal Medicine
Mahboobeh Shirazi; Mohammadreza Zarkesh; Maliheh Fakehi; Marjan Ghaemi
Volume 7, Issue 4 , March and April 2022, , Pages 329-334
Abstract
Background & Objective: This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.Materials & Methods: This retrospective cohort study was recruited in an academic hospital affiliated ...
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Background & Objective: This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.Materials & Methods: This retrospective cohort study was recruited in an academic hospital affiliated with Tehran University of Medical Sciences between June 2018 and June 2020. The subjects of the study were the women who were scheduled for elective CS and divided into 3 groups according to the gestational age (38 0/7 to 38 6/7 as group A, 39 0/7 to 39 6/7 as group B, and 40 0/7 to 40 6/7 as group C). The neonatal outcomes and the growth and development status were evaluated by ages and stages questionnaires® (ASQ) after 12 months and compared between groups.Results: Totally, 952 neonates were eligible for this study. In groups A, B, and C, CS was performed in 314, 409, and 229 neonates, respectively. The first minute Apgar was significantly lower in the neonates with lesser gestational age at delivery (P < /em>=0.026). Indeed, neonatal hospitalization, hypoglycemia, and jaundice in group A were significantly higher than in other groups (P < /em><0.001). Regarding psychomotor development, the scores related to gross motor and problem-solving abilities in group A were significantly lower than those in other groups (P < /em><0.05).Conclusion: It is suggested to plan elective CS beyond 39 weeks of gestation to decrease prenatal morbidities and improve psychomotor development one year after birth.
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.
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.
