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 ...
Read More
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.
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 ...
Read More
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.
Shahrzad Sheikhhasani; Azamsadat Mousavi; Monireh Mirzai; Mitra Modares Gilani; Setareh Akhavan
Volume 3, Issue 2 , May and June 2018, , Pages 79-82
Abstract
Introduction: Timely diagnosis of gestational trophoblastic neoplasia (GTN) is essential for successful management of the condition and preservation of fertility. The aim of the present study was to describe a case of misdiagnosis GTN with brain and lungs metastasis.
Patient information: The present ...
Read More
Introduction: Timely diagnosis of gestational trophoblastic neoplasia (GTN) is essential for successful management of the condition and preservation of fertility. The aim of the present study was to describe a case of misdiagnosis GTN with brain and lungs metastasis.
Patient information: The present case study was conducted in Imam Khomeini hospital, Tehran, Iran, in 2017. A 35-year-old woman presented with acute headaches and left hemiplegia one month after the conclusion of her term pregnancy. The patient was previously diagnosed as a case of subarachnoid hemorrhage and inferior sagittal sinus thrombosis and was unsuccessfully treated with anticoagulant drugs leading to worsening signs and symptoms. Her initial β-hCG at admission to the hospital was 22,000,000IU/L, which lead to diagnosis of GTN with extensive metastatic lesions in the lungs and brain. Due to extensive intracranial hemorrhage, the patient was first treated with whole brain radiation therapy for 10 sessions daily (Total Dose=3000cGy). EMA-EP treatment was initially withheld due to concern for bleeding during concurrent radiation therapy. Following the brain radiation therapy, the chemotherapy was started for the patient. Upon completion of 3 cycles of EMAEP, the patient’s hCG was lowered to 5IU/L. The treatment was continued for 5 more cycles and resulted in hCG reading of under 2IU/L at her last visit.
Conclusion: This case highlights the variable presentation of GTN which might easily cause misdiagnosis and delayed treatment and shows excellent response to treatment despite late treatment and massive tumor burden with some modifications to plan of treatment
