Obstetrics and Gynecology
Shaimaa Abdulamer Nasir
Volume 9, Issue 2 , March and April 2024, , Pages 212-217
Abstract
Background & Objective: The aim of the current study was comparison of the effectiveness of intravenous iron sucrose versus oral ferrous fumarate for the treatment of iron deficiency anemia during pregnancy.
Materials & Methods: This is a prospective randomized clinical trial enrolling 100 pregnant ...
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Background & Objective: The aim of the current study was comparison of the effectiveness of intravenous iron sucrose versus oral ferrous fumarate for the treatment of iron deficiency anemia during pregnancy.
Materials & Methods: This is a prospective randomized clinical trial enrolling 100 pregnant women with iron deficiency anemia who visited the Al-diwaniya Educational Hospital for maternity and children from October 2022 to July 2023 whose ferritin level was less than 15 ng/ml and Hb level was between 70-10.9g/L. They were treated with either intravenous iron sucrose or oral ferrous fumarate for four weeks. Formerly, patients were allocated into two groups. The patients in the group I received ferrous fumarate pills, each enclosed with elemental Iron 100 mg. Group II got 100 ml of 0.9% NaCl containing a dose of iron sucrose dissolved in it and calculated by a specific equation. After four weeks, serum ferritin and hemoglobin levels were assessed, and the adverse effects were also monitored.
Results: Comparing hemoglobin levels produces a substantial pre- and post-treatment difference (P=0.001). Serum Ferritin Level harvest significant differences pre- and post-treatment (P=0.001). The post-treatment comparison of the two groups showed a significant difference in each group (P= 0.001).
Conclusion: Maternal iron reserves are more effectively increased by intravenous ferrous sucrose than by oral ferrous fumarate.
Obstetrics and Gynecology
Sedigheh Ghasemian Dizaj Mehr; Robabeh Bahadori
Volume 9, Issue 2 , March and April 2024, , Pages 231-234
Abstract
Management of hemoperitoneum due to ruptured ovarian cyst in patients on anticoagulation is a dilemma. Low threshold of surgery intervention may increase the risk of some events operatively. There is a trend for less invasive treatment in highly selected patients. We present two cases of ...
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Management of hemoperitoneum due to ruptured ovarian cyst in patients on anticoagulation is a dilemma. Low threshold of surgery intervention may increase the risk of some events operatively. There is a trend for less invasive treatment in highly selected patients. We present two cases of massive hemoperitoneum due to ruptured ovarian cyst that were on anticoagulation. Successful conservative management was done in both of them and one patient, due to refractory abdominal pain, required interventional radiologic drainage, instead of surgery approach with good outcome. Ovulation suppression was started in both of them with regular uneventful follow up heretofore. Less invasive management is preferred in carefully selected patients of hemoperitoneum in women on anticoagulation. Ovulation suppression to avoid recurrence must be emphasized.
Obstetrics and Gynecology
Putri Aini Daulay; Sarah Dina; Soekimin Soekimin
Volume 9, Issue 2 , March and April 2024, , Pages 235-239
Abstract
Endometrial cancer is the 6th most common cancer in women worldwide. Rarely does occur in the postpartum period. Fifteen cases of endometrial cancer in the postpartum period have been reported before, but the diagnosis of endometrial carcinoma as a cause of secondary postpartum hemorrhage is hardly predicted. ...
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Endometrial cancer is the 6th most common cancer in women worldwide. Rarely does occur in the postpartum period. Fifteen cases of endometrial cancer in the postpartum period have been reported before, but the diagnosis of endometrial carcinoma as a cause of secondary postpartum hemorrhage is hardly predicted. A 37-year-old, Para 4, presented two weeks after a cesarean section and had recurrent vaginal bleeding. The patient was treated conservatively. While being observed, vaginal bleeding still occurred with more volume. We decided to perform a total abdominal hysterectomy. Histopathology confirmed a low-grade endometrioid carcinoma of the corpus uteri. Endometrial cancer might cause a secondary postpartum hemorrhage, with the hypothesis that the depth of tumor invasion into the uterine muscle causes a distorted tissue architecture and the formation of new blood vessels that easily disrupt. The most common type of endometrial cancer in a postpartum woman is low grade with a favorable prognosis.
Obstetrics and Gynecology
Soudabeh Kazemi Aski; Seyedeh Hajar Sharami; Azadeh Tavangar; Ehsan Kazemnezhad; Seyedeh Fatemeh Dalil Heirati; Atoosa Etezadi
Volume 9, Issue 1 , January and February 2024, , Pages 14-21
Abstract
Background & 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 in normal growth. The objective of this study was to compare the level ...
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Background & 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 in 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.Materials & 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 one (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 one (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 specificity =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.
Obstetrics and Gynecology
Roshan Nikbakht; Narges Dibavand; Shabnam Salemi; Ali Reza Sattari; Maryam Farzaneh
Volume 9, Issue 1 , January and February 2024, , Pages 22-28
Abstract
Background & Objective: The presence of air in the catheter was found to affect the success of embryo transfer into the uterine cavity. This study determined the chances of achieving pregnancy using the intrauterine insemination (IUI) method with different air volumes inside the IUI catheter.Materials ...
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Background & Objective: The presence of air in the catheter was found to affect the success of embryo transfer into the uterine cavity. This study determined the chances of achieving pregnancy using the intrauterine insemination (IUI) method with different air volumes inside the IUI catheter.Materials & Methods: This clinical trial study was performed on 521 IUI cycles among 270 couples from 2013 to 2014. The patients were divided into three groups (each group of 90 patients), based on three volumes of air inside the catheter (0.0 ml, 0.5 ml, and 1 ml). Other variables, include the woman’s age, menstrual cycle status, duration of infertility, type of infertility, sperm morphology, total motile sperm count (TMSC), number of motile sperm inseminated (NMSI), and pregnancy rate or the success rates of IUI were evaluated.Results: The mean age of women and men were 33 and 30 years, respectively. Based on three volumes of air inside the catheter (0.0 ml, 0.5 ml, and 1.0 ml), the pregnancy rates were 5%, 9.4%, and 16.5%, respectively. TMSC of more than 5.6x106 and NMSI of more than 3.4x106 were associated with the chance of IUI achievement. At the same time, there was no significant relationship between the woman’s age, irregular menstrual cycles, and duration of infertility with the success rate of IUI. We found that the air volume of 1.0 ml inside the IUI catheter significantly increased the pregnancy rate compared to other groups.Conclusion: The volume of air within the catheter had a significant relationship with the success rate of IUI.
Obstetrics and Gynecology
Katayoun Haryalchi; Mandana Mansour Ghanaei; Mohammad Rajabi; Maryam Ghazizadeh; Fakhroddin Aghajanpour; Pouya Koochakpoor; Mahmood Abedinzade
Volume 9, Issue 1 , January and February 2024, , Pages 29-35
Abstract
Background & Objective: Studies have shown contradictory results regarding the use of pregabalin and melatonin as analgesic agents. Because the analgesic effects of these drugs as preemptive have not been compared in abdominal hysterectomy, one of the most common surgical procedures in women ...
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Background & Objective: Studies have shown contradictory results regarding the use of pregabalin and melatonin as analgesic agents. Because the analgesic effects of these drugs as preemptive have not been compared in abdominal hysterectomy, one of the most common surgical procedures in women with moderate to severe pain, under general anesthesia. The aim of this study was to compare the pretreatment effects of melatonin and pregabalin on postoperative pain intensity in total abdominal hysterectomy (TAH).Materials & Methods: Ninety Patients were randomly divided into three groups (N=30): the first group received oral melatonin (6 mg), the second group received pregabalin (50 mg), and the third one who took no drug. Serum melatonin and beta-endorphin levels were measured before and after the surgery. Pain intensity was assessed by the Numerical Rating Scale at 1,6,12, and 24 hours after the surgeries.Results: At 12 hrs after the surgery, mean pain intensity in the melatonin group was significantly lower than the pregabalin group, and in the pregabalin group was significantly lower than the third group (P<0.05). At 24 hrs after the TAH, the mean pain intensity in the melatonin group was significantly lower than the third group (P<0.05).Conclusion: Injection preventive melatonin is more effective than pregabalin to reduce pain throughout the first 24 hrs after the TAH.
Obstetrics and Gynecology
Ahmed Elkhyat; Amal Elsokary; Shereef Elshwaikh
Volume 9, Issue 1 , January and February 2024, , Pages 70-75
Abstract
Background & Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Materials & Methods: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by ...
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Background & Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Materials & Methods: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by dietary modifications. Patients were classified later into respondent and non-respondent. All patients were stimulated with Letrozole 2.5 mg twice daily for five days for six cycles. Ovulation and pregnancy rates were assessed.Results: From 84 patients who were enrolled in our study, 33 patients were allocated into non responder group and 28 patients were allocated to the responder group, and it was found that despite there was statistical difference between both groups as regard weight gain, weight after six months and BMI after six months, there was no significant difference between both groups as regard the ovulation rate, pregnancy rate and complications to ovulation induction ovarian hyperstimulation syndrome (OHSS).Conclusion: weight gain in lean PCOS patients - although non-significant- but it may improve the reproductive outcomes (ovulation rate and pregnancy rate) and the need of further study with larger number and longer duration of follow up for confirmation of these results.
Obstetrics and Gynecology
Fatemeh Hosseinabadi; Narjes Noori; Marzieh Ghasemi; Motahare Bitaghsir Fadafan; Erfan Ayubi
Volume 9, Issue 1 , January and February 2024, , Pages 83-87
Abstract
Background: Ectopic pregnancy (EP) is one of the important issues in the field of obstetrics and gynecology. Proper assessment of fallopian tube patency following medical treatment of an EP in women who wish to have future children seems reasonable. Therefore, the purpose of this study was to investigate ...
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Background: Ectopic pregnancy (EP) is one of the important issues in the field of obstetrics and gynecology. Proper assessment of fallopian tube patency following medical treatment of an EP in women who wish to have future children seems reasonable. Therefore, the purpose of this study was to investigate the patency of fallopian tubes after clinical and surgical treatment of EP.Methods: In this quasi-experimental study, our research population was 270 people who were referred to Ali-Ibn-Abitaleb hospital in Zahedan with a definite diagnosis of EP in 2020. Patients were divided into three groups: drug treatment (90 people), surgical treatment (90 people) and expectant treatment (90 people). For each patient, the patency of the left and right fallopian tubes was investigated and the obtained data were statistically analyzed by t-test and chi-square test methods using SPSS software version 22 (IBM, USA).Results: A total of 270 patients were examined. The mean age of the patients in the drug treatment, surgical therapy and expectant treatment groups were 32.34 ± 6.17, 32.02 ± 6.12 and 32.12 ± 6.40 years, (P=0.389). Moreover, there was no statistically significant difference between the right fallopian tubes (P=1.00), and the left fallopian tubes in the investigated groups (P=0.08).Conclusion: Based on the results of this study, there was no statistically significant difference between the drug treatment and the surgery treatment groups. The findings of this study revealed that the uterine tube opening was similar on both sides after drug treatment, surgical treatment and expectant treatment.
Obstetrics and Gynecology
Sara A. Al-Rawaf; Enas T Mousa
Volume 9, Issue 1 , January and February 2024, , Pages 88-94
Abstract
Introduction: Inducing labor is a common practice in obstetrics to prevent maternal and fetal complications. There are several methods of labor induction, including pharmacological and mechanical approaches. The objective of this study was to determine the most effective approach for labor induction.Method: ...
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Introduction: Inducing labor is a common practice in obstetrics to prevent maternal and fetal complications. There are several methods of labor induction, including pharmacological and mechanical approaches. The objective of this study was to determine the most effective approach for labor induction.Method: A cross-sectional study at Al-Kadhimiya Teaching Hospital compared labor induction in pregnant females at their third trimester using Misoprostol & Foley Catheter (group A) and Misoprostol alone (group B). The study collected data on maternal age, gestational age, BMI, time frames, mode of delivery, and neonatal outcomes such as Apgar scores and ICU admissions.Results: In a cross-sectional study comparing labor induction with Misoprostol & Foley Catheter (group A) vs. Misoprostol alone (group B), most females in both groups had no cesarean section inductions, normal vaginal deliveries, and no complications. The study found significant differences in BMI, time frame, and time for ripening between the two groups, with group A having lower values for these variables.Conclusion: Foley's with vaginal misoprostol results in a shortened time between induction and delivery than misoprostol alone.
Obstetrics and Gynecology
Minoo Yaghmaei; Ladan Ajori; Mojgan Mokhtari
Volume 9, Issue 1 , January and February 2024, , Pages 95-101
Abstract
Background & Objective: Although the safety of cesarean sections has increased, there are still considerations, especially for women with a history of repeated cesarean sections. This study was conducted with the aim of investigating maternal and neonatal outcomes in candidates for cesarean sections ...
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Background & Objective: Although the safety of cesarean sections has increased, there are still considerations, especially for women with a history of repeated cesarean sections. This study was conducted with the aim of investigating maternal and neonatal outcomes in candidates for cesarean sections due to repeat cesarean sections according to the number of previous cesarean sections.Materials & Methods: This prospective descriptive study was conducted from April 2020 to June 2022 at Taleghani Hospital. All candidates for cesarean sections due to repeated cesarean sections were included in the study. According to the number of previous cesarean sections, they were divided into three groups. Statistical analysis was performed with Kruskal-Wallis, Chi-squared and Fisher’s exact tests. A P value < 0.05 indicated statistical significance.Results: A total of 345 women were included in the study. The results of this study showed that these three groups were significantly different in terms of duration of surgery (P<0.001), abnormal placental adhesion (0.012), and the presence of intraperitoneal adhesions (P<0.001), but there was not a significant difference in terms of other maternal and neonatal outcomes (P<0.05).Conclusion: The results of this study showed that an increase in the number of previous cesarean sections does not increase most maternal and neonatal complications during a current cesarean section. Of course, it should be noted that the number of women with a history of three or more previous cesarean sections was small in this study, and for this reason, more studies are needed.
Obstetrics and Gynecology
Leila Mousavi Seresht; Amir Reza Farhadi Dehkordi; Azar Danesh Shahraki; Pegah Hedaiat; Fedyeh Haghollahi
Volume 9, Issue 1 , January and February 2024, , Pages 102-105
Abstract
Invasive angiomyxoma as a mesenchymal tumor with a high recurrence rate has been reported mainly in reproductive age according to its association with the estrogenic level of plasma. Above that, it seems there is a need for further treatment despite complete resection of the tumor, to eliminate the hormonal ...
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Invasive angiomyxoma as a mesenchymal tumor with a high recurrence rate has been reported mainly in reproductive age according to its association with the estrogenic level of plasma. Above that, it seems there is a need for further treatment despite complete resection of the tumor, to eliminate the hormonal state. In the present study, we sought to introduce a rare case of invasive angiomyxoma in a post-menopausal but high-risk woman, discuss the relativity of risk factors in all hormonal-dependent gynecological malignancy, and intend to seek help from colleagues' opinions and experiences about treatment. It is clearly of great importance to emphasize the role of individualized medicine in such a rare case, in conclusion, there is not any debate on the role of surgical resection but the necessity of changing in lifestyle or adjuvant systemic or local therapy, and the needed duration is doubtful.
Obstetrics and Gynecology
Zahra Rafiei-Sorouri; Zahra Haghparast Ghadim-limudahi; Azade Mahmoodi Isaabadi
Volume 9, Issue 1 , January and February 2024, , Pages 106-109
Abstract
Mucinous carcinoma is a tumor composed of gastrointestinal-type cells with intracytoplasmic mucin. They are unilateral solid-cystic masses. A 38-year-old G2 L2 woman with a complaint of rapidly increasing severe abdominal distension was referred. Surgery was performed and a huge complicated mass showed ...
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Mucinous carcinoma is a tumor composed of gastrointestinal-type cells with intracytoplasmic mucin. They are unilateral solid-cystic masses. A 38-year-old G2 L2 woman with a complaint of rapidly increasing severe abdominal distension was referred. Surgery was performed and a huge complicated mass showed up. We sucked about 42 liters of brown color fluid out of the cyst and then we could extract the residual mass. Chemotherapy protocol began under the supervision of oncologic service. Despite diagnostic delay, before any dissemination the cystadenocarcinoma was removed. To our best knowledge, our patient had the biggest tumor among other previous case presentations.
Obstetrics and Gynecology
Arian Karimi Rouzbahani; Nazanin Zarrinkoub; Golnaz Mahmoudvand; Fatemeh Yari
Volume 9, Issue 1 , January and February 2024, , Pages 110-113
Abstract
Single umbilical artery (SUA) is an uncommon yet clinically noticeable anomaly that has been suspected to be correlated with a wide range of pregnancy complications. We hereby present a 30-year-old pregnant woman who was diagnosed with SUA fetus in the 20th week of her pregnancy and was admitted to our ...
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Single umbilical artery (SUA) is an uncommon yet clinically noticeable anomaly that has been suspected to be correlated with a wide range of pregnancy complications. We hereby present a 30-year-old pregnant woman who was diagnosed with SUA fetus in the 20th week of her pregnancy and was admitted to our center in the 33rd week. During the hospitalization, Doppler studies were performed to monitor fetal development. Later, fetoplacental insufficiency and brain-sparing effect were reported on Doppler ultrasound, indicating asymmetrical Intrauterine growth restriction (IUGR). SUA might be associated with concurrent fetal anomalies including cardiological, nephrological, gastrointestinal, and nervous disorders. Moreover, there is an increased risk of small for gestational age and IUGR compared with normal pregnancies. It is crucial to assess the umbilical cord anatomy during pregnancy to diagnose SUA at lower gestational ages and schedule a precise follow-up to prevent adverse outcomes.
Obstetrics and Gynecology
Mahdi Seyfi-Ghale-Jogh; Marjan Mehrali; Rezvaneh Rakhshanimehr; Fatemeh Mohammadyari; Elahe Safari; Mohammad Salehi-Shadkami; Sepehr Nanbakhsh; Katayoun Haryalchi
Volume 8, Issue 6 , November and December 2023, , Pages 542-548
Abstract
The COVID-19 pandemic has disrupted people’s lives all over the world, and vaccination is one of the best ways to eradicate this pandemic and save people’s lives. Despite this, vaccines have many known and unknown side effects like fever, fatigue, headache, etc. Fertility is an important ...
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The COVID-19 pandemic has disrupted people’s lives all over the world, and vaccination is one of the best ways to eradicate this pandemic and save people’s lives. Despite this, vaccines have many known and unknown side effects like fever, fatigue, headache, etc. Fertility is an important aspect of human life, but there are too many concerns about its relationship with COVID-19 and its vaccines. Women are complaining of menstrual irregularities like postmenopausal bleeding, heavy menstrual bleeding, polymenorrhea and fertility concerns after receiving the second dose of the COVID-19 vaccine. The immunologic reactions between vaccine ingredients and the immune system of the body seem to be responsible for this global issue. Angiotensin-converting enzyme 2 (ACE2) and Basigin (BSG) are the receptors for SARS-COV-2. ACE2 is expressed in the human respiratory system, kidney, vagina, uterus and particularly widely in the ovaries, and BSG is expressed in the uterus, ovary stroma and granulosa cells. Therefore, SARS-COV-2 can invade the target cells by attachment to ACE2 and BSG and modulate their expression, and through these probable mechanisms, it can disturb female reproduction and menstruation. According to this accumulated evidence, in this study we aimed at summarizing the recent studies with a focus on probable mechanisms by which SARS-COV-2 and COVID-19 vaccines affect menstruation irregularities and reproduction complications.
Obstetrics and Gynecology
Ali Massoudifar; Nozhan Alimi; Ainaz Boostan; Atoosa Etezadi; Ezzatalsadat Haji Seid Javadi; Misa Naghdipour Mirsadeghi
Volume 8, Issue 6 , November and December 2023, , Pages 549-555
Abstract
Background & Objective: Because childbirth is a natural process, pain is therefore part of the process. The amount of labor pain is probably directly related to the pregnant woman's mood, familiarity, awareness and self-confidence. Therefore, it is illogical to accept the complications of surgery ...
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Background & Objective: Because childbirth is a natural process, pain is therefore part of the process. The amount of labor pain is probably directly related to the pregnant woman's mood, familiarity, awareness and self-confidence. Therefore, it is illogical to accept the complications of surgery and anesthesia and harm to the baby in order to escape the pain. Therefore, the aim of current study was investigating the relationship between the perception of labor pain and the number of deliveries.Materials & Methods: This study is descriptive-analytical correlational study. Two questionnaires were used for gathering information: one on personality traits and the other on labor pain. One hundred participants were chosen according to their demographic information, from a pool of pregnant women at maternal ward of the Persian Gulf Hospital in Bandar Abbas City, Iran. The data was analyzed by means of descriptive_ analytical measures such as Pearson Factor.Results: The mean age of women was 27.15±4.6. Collected data showed that 31% of women were gravida 1, 33% gravida 2, 15% gravida 3, 10% gravida 4, 5% gravida 5, 4% gravida 6, and 2% were gravida 7. a significant relationship was found between pain in the first delivery and pain in the second, third, fifth and sixth deliveries, so that the pain in the first delivery was more than the pain in the second, third, fifth and sixth deliveries.Conclusion: According to the results of this study the severity of labor pain in primiparous and multiparous women was not statistically significant and the intensity of reported pain level was high in all mothers.
Obstetrics and Gynecology
Atefeh Kazemi; Vahideh Rashtchi; Masoomeh Ghomi
Volume 8, Issue 6 , November and December 2023, , Pages 556-562
Abstract
Background & Objective: Some types of major surgeries are associated with postoperative pain, sometimes during the days after surgery. These pains mainly lead to the use of various analgesics and, ultimately, patient dissatisfaction. In the present study, we evaluated the effect of gabapentin ...
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Background & Objective: Some types of major surgeries are associated with postoperative pain, sometimes during the days after surgery. These pains mainly lead to the use of various analgesics and, ultimately, patient dissatisfaction. In the present study, we evaluated the effect of gabapentin at doses of 600 and 1200 mg on relieving pain due to cesarean section.Materials & Methods: In this randomized clinical trial, patients were randomly divided into three equal-size groups (25 patients in each group) through balanced block randomization. The first group was given 600 mg of gabapentin, the second group was given 1200 mg of gabapentin one hour before surgery, and the control group received a placebo. The pain intensity, nausea, vomiting, and drowsiness, as well as the need for postoperative analgesics, were assessed initially and at 2, 6, and 12 hours after surgery. The occurrence of nausea and drowsiness between groups was compared using the chi-square and Fisher's exact tests.Results: The mean (SD) age of patients in the gabapentin 1200 mg, gabapentin 600 mg, and placebo groups was 26.32±6.15, 27.43±6.38, and 26.59±5.88, respectively (P=0.34). Pain intensity and the rate of analgesic consumption at different time points during the first 12 hours of surgery were significantly lower in the receiving gabapentin groups than in the placebo group (P<0.05). Comparing the prevalence rates of nausea and vomiting and also drowsiness, as the drug-related side effects don’t show a significant difference across the three groups at the different investigated time points (P>0.05).Conclusion: Gabapentin with a minimum therapeutic dose can successfully reduce postoperative pain intensity and also needs analgesic use after a cesarean section.
Obstetrics and Gynecology
Aditi Agarwal; Rajiv Acharya; Shikha Agarwal; Vineeta Gupta
Volume 8, Issue 6 , November and December 2023, , Pages 563-570
Abstract
Background & Objective: The maintenance of an appropriate weight before and during pregnancy has a significant effect on pregnancy outcomes. Therefore, this study attempts to explore the relationship between pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in the Indian ...
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Background & Objective: The maintenance of an appropriate weight before and during pregnancy has a significant effect on pregnancy outcomes. Therefore, this study attempts to explore the relationship between pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in the Indian antenatal population. This was a prospective study.Materials & Methods: This study was conducted on a total of 301 pregnant women who fulfilled the inclusion criteria booked from the first trimester till delivery in the department of Obstetrics and Gynecology, SGRRIM & HS, from January 2020 to June 2021. The weight and height of the participants were recorded at their first visit to the antenatal clinic using standard protocol. BMI was recorded and GWG was calculated at each antenatal clinic visit. BMI and GWG were correlated with antepartum, intrapartum and postpartum complications with the application of appropriate statistical tests.Results: In our study, higher pre-pregnancy BMI and GWG significantly increased the risk of perinatal adverse outcomes. Increased rates of cesarean section (57.1%), operative vaginal delivery (9.5%), gestational diabetes mellitus (9.5%), and pre-eclampsia (28.6%) were observed in obese women as compared to women with normal pre-pregnancy BMI and gestational weight gain. These were found to be statistically significant (p-value <0.001).Conclusion: Appropriate nutrition prior to and throughout the pregnancy plays an important role in determining the health of both mother and fetus. There is a positive correlation between early pregnancy BMI and GWG, and the course of pregnancy, and its outcome.
Obstetrics and Gynecology
Nahla W. Shady; Amed A. Taha; Hany F. Sallam
Volume 8, Issue 6 , November and December 2023, , Pages 579-586
Abstract
Background & Objective: To determine the safety and adequacy of intravenous (IV) carbetocin compared to IV tranexamic acid (TA) plus sublingual misoprostol in reducing hemorrhage during and following cesarean delivery (CD) in women with at least one risk factor for postpartum hemorrhage.Materials ...
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Background & Objective: To determine the safety and adequacy of intravenous (IV) carbetocin compared to IV tranexamic acid (TA) plus sublingual misoprostol in reducing hemorrhage during and following cesarean delivery (CD) in women with at least one risk factor for postpartum hemorrhage.Materials & Methods: This clinical study was randomized. We randomly assigned 400 term pregnant women who were candidates for elective CD to receive either a 100 μg intravenous infusion of carbetocin or 1gm. IV TA along with 400 μg of sublingual misoprostol after delivery. Comparing the quantity of blood loss at and six hours following a CD was the primary result. We also disclosed the necessity for any extra medications and any adverse drug reactions.Results: When compared to the misoprostol plus tranexamic acid group, the carbetocin group's total mean blood loss was considerably higher (829.7 293.3 mL vs. 609.33 211.5 mL; P = 0.0001). Following the administration of carbetocin and misoprostol with TA, respectively, 9.5% and 26.5% of patients required further uterotonics treatment (P = 0.0001). When compared to the carbetocin group, the misoprostol group's side effects, such as a bad taste in the mouth and fever, were much greater (P = 0.0001).Conclusion: When it comes to minimizing overall blood loss during and after CD, IV tranexamic acid combined with sublingual misoprostol is superior to IV carbetocin.
Obstetrics and Gynecology
Mina EL Hiyani; Sakhr Ahizoune; Asmaa Mdaghri Alaoui; Othmane Benlenda; Amal Thimou Izgua
Volume 8, Issue 6 , November and December 2023, , Pages 587-598
Abstract
Background & Objective: The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and ...
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Background & Objective: The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and pregnant women who have contracted COVID-19. Therefore, this study aimed to establish a risk map for managing dyspneic parturients suffering from COVID-19-related pneumopathy during delivery.Materials & Methods: This study focuses on examining potential risks beforehand in the context of the management of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery, executed using the method FMECA (Failure Mode, Effects and Criticality Analysis); this was conducted from September to December 2021 in the maternity service of the Hospital Center ElJadida, Morocco.Results: The risk analysis of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery revealed thirteen failure modes. Proposed are corrective measures aimed at addressing the failure modes of criticality class C3 whose vital risks are linked to the care of the dyspneic parturient suffering from COVID-19-related pneumopathy at the level of the reanimation service and the level of the neonatal intensive care unit.Conclusion: Employing risk mapping is a fundamental instrument for the ongoing enhancement of quality to maximize the safety of the parturient care process by changing the organizational culture from a reactive to a preventive approach.
Obstetrics and Gynecology
Abdaladeem Yousif Jasem; Mohammed Shnain Ali; Abas O. Hadi; Shaymaa Abdulhameed Khudair; Shamam Kareem Oudah; Mutni A Majeed; Zainab H. J. Alhassona
Volume 8, Issue 6 , November and December 2023, , Pages 607-613
Abstract
Background & Objective: The birth weight is an essential indicator of a baby's health. The birth of infants with low birth weight (LBW) is one of the most significant health issues and one of the leading causes of infant mortality. The current study aimed to investigate the impact of demographic ...
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Background & Objective: The birth weight is an essential indicator of a baby's health. The birth of infants with low birth weight (LBW) is one of the most significant health issues and one of the leading causes of infant mortality. The current study aimed to investigate the impact of demographic and delivery factors on low- and normal-weight infants.Materials & Methods: The current retrospective study collected data from all 2,731 babies born in Basra in 2022 and their mothers from electronic files. The data consists of demographic information and delivery factors. Babies were divided into two groups based on their weight: LBW (n=192) and normal (n=768). Data analysis was performed with SPSS version 19 and the chi-square, Fisher, Mann-Whitney, and logistic regression tests. The level of statistical significance was determined to be equal to 0.05.Results: The results showed that the variable of intrauterine age less than 37 weeks increases the risk of having a baby with LBW by 1.84 times (0.95CI=0.52-3.12), age less than 20 years increases the risk by 1.76 times (0.95CI=0.83-2.64), BMI in the thin range increases the risk by 1.42 times (0.95CI=0.87-1.84), and anemia with hemoglobin less than 11 g/dl increases the risk by 1.34 times (0.95CI=0.76-1.86).Conclusion: The results revealed that age, BMI, anemia, and intrauterine age impact birth weight. Therefore, controlling the risk factors mentioned above in mothers before becoming pregnant can reduce the number of LBW babies.
Obstetrics and Gynecology
Alaa Abdul Hussein Kareem Al-Daamy
Volume 8, Issue 6 , November and December 2023, , Pages 620-628
Abstract
Background & Objective: Increasing urinary tract infections (UTI) in pregnant women was a reason for which this study aimed to find out the spread of bacteria in them and also study the resistance of bacteria to antibiotics and the type of resistance.Materials & Methods: During November ...
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Background & Objective: Increasing urinary tract infections (UTI) in pregnant women was a reason for which this study aimed to find out the spread of bacteria in them and also study the resistance of bacteria to antibiotics and the type of resistance.Materials & Methods: During November 2022, 50 urine samples were collected from pregnant women with symptoms of UTI. Direct microscopy tests were conducted on the samples. The samples were cultured on the media of MacConkey agar (MAC) and blood agar. Biochemical tests were performed and diagnosed using the VITEC-2 system. Antibiotic susceptibility screening test was done for all isolates.Results: Of the 50 bacterial isolates diagnosed and isolated from pregnant women with UTI, 84% were gram-negative and 16% were gram-positive. The most prevalent bacteria were E. coli, with a rate of 60%, followed by Proteus mirabilis, with a rate of 12%. All E. coli isolates were resistant (100%) to the AMOX antibiotic, and the isolates showed high resistance (87%) to CFR, CN, CZ, CXM, CAE, CPD, CRO NA and SXT antibiotics. 13.3% of E.coli isolates were extended detection and response (XDR), 50% and 25% of Staphylococcus hominis and aureus isolates were XRD, respectively.Conclusion: E. coli is the most common and most resistant bacteria of type XRD, and gram-positive bacteria, staph bacteria, showed resistance to type XRD. In addition, gram-negative bacteria showed high resistance to many antibiotics, including AMOX, CFR, CN, CZ, CXM, and CAE. Gram-positive bacteria showed complete resistance against BENPEN, OXA, CLIN, TEC, VAN, TET, FUS and VAN.
Obstetrics and Gynecology
Somayeh Khanjani; Shamin Ghobadi; Farahnaz Mardanian; Leila Mousavi Seresht
Volume 8, Issue 6 , November and December 2023, , Pages 629-632
Abstract
Cesarean scars in pregnancy have become a worrisome obstetric problem. Furthermore, given the challenge of diagnosis in cases of low suspicion in the initial prenatal sonographic screening, there is still debate over the standard of management. According to rare reported cases, the most acceptable recommendation ...
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Cesarean scars in pregnancy have become a worrisome obstetric problem. Furthermore, given the challenge of diagnosis in cases of low suspicion in the initial prenatal sonographic screening, there is still debate over the standard of management. According to rare reported cases, the most acceptable recommendation is still termination of pregnancy to decrease the chance of further maternal dreadful complications. A case of twin pregnancy had been terminated at gestational age of 34 weeks with a history of diagnosis of cesarean scar pregnancy. Since pregnancy at the site of a previous cesarean section is very rare, but due to the complications of this type of pregnancy, choosing a suitable clinical approach for these patients is desirable. This type of pregnancy can increase the value of antenatal care if it can be continued until the fetus is viable and its complications, including placenta accreta and bleeding, are managed.
Obstetrics and Gynecology
Sowmya Shree Thimmappa; KB Suma
Volume 8, Issue 6 , November and December 2023, , Pages 641-644
Abstract
Guillain-Barré syndrome is a rare neurological complication that presents in pregnancy and postpartum. We present a case of a 23-year-old Gravida 2 Para 1 Living 1 with 39 weeks of gestation and previous lower (uterine) segment cesarean section (LSCS) who presented with nonspecific symptoms ...
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Guillain-Barré syndrome is a rare neurological complication that presents in pregnancy and postpartum. We present a case of a 23-year-old Gravida 2 Para 1 Living 1 with 39 weeks of gestation and previous lower (uterine) segment cesarean section (LSCS) who presented with nonspecific symptoms in the antenatal period and progressed to develop symmetrical progressive ascending paralysis in the postpartum period with no antecedent history of infection. The patient was managed by a multidisciplinary team and treated with plasma exchange, with complete recovery at follow-up. We are reporting this case because of the rarity of Guillain-Barre syndrome in pregnancy and postpartum and the nonspecific initial presentation with an unexpected diagnosis in the immediate postpartum.
Obstetrics and Gynecology
Mahin Najafian; Mahtab Shariati; Roshan Nikbakht; Sara Masihi
Volume 8, Issue 5 , September and October 2023, , Pages 438-445
Abstract
Background & Objective: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension.Materials ...
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Background & Objective: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension.Materials & Methods: This randomized controlled clinical trial study was conducted on 60 pregnant women with a diagnosis of gestational hypertension and chronic hypertension. Women were randomly divided into the control (n=30) and the DASH diet (n=30) groups for 2 months and were followed until delivery. The outcomes of maternal pregnancy including the incidence of preeclampsia, placental abruption and preterm delivery (<37 weeks) were assessed during follow-up examinations. Birth weight and minute 1 and minute 5 Apgar score of the infant were also assessed.Results: After 1 and 2 months of intervention, systolic and diastolic blood pressure in the DASH diet group was significantly lower than the control group (P<0.05). The incidence of preeclampsia (P=0.035), preterm delivery (P=0.020) and placental abruption (P=0.007) in the DASH diet group was significantly lower than the control group. The mean gestational age at the time of termination of pregnancy was not significantly different between the two groups (P = 0.467). There was no significant difference between minute 1 and minute 5 Apgar scores of the infants and the mean birth weight of the infants was not significantly different between the DASH and control groups (P = 0.756, P = 0.115 and P = 0.101, respectively).Conclusion: The DASH diet could be used as an effective strategy to improve the clinical outcomes of pregnant women with gestational and chronic hypertension.
Obstetrics and Gynecology
Nadia Azadi; Yousra Alsinani; Mohammad Hemmatinafar; Maryam Koushkie Jahromi
Volume 8, Issue 5 , September and October 2023, , Pages 472-480
Abstract
Background & Objective: Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms ...
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Background & Objective: Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms in two aquatic and land-based trained groups before and after cessation of exercise due to COVID-19 outbreak.Materials & Methods: 90 postmenopausal women participated in the study voluntarily. The daily and sport physical activities and menopausal symptoms were assessed through interviews three months after cessation of sport activities and qestions were designed and obtained from daily physical activity form and menopausal rating scale (MRS) questionnaire respectively.Results: Before the cessation of exercise, the somatic, psychological, and sexual symptoms of menopause were lower in both active groups than the inactive group, while there was no significant difference in three categories of menopausal symptoms between aquatic and land-based exercise groups. After the cessation of exercise, menopausal symptoms in the two groups of previously active women increased significantly compared to the inactive group, so that there was no significant difference in menopausal symptoms between the exercise and inactive groups.Conclusion: aquatic and land-based exercise reduces the symptoms of menopause similarly, while the beneficial effects of exercise on menopausal symptoms can disappear after the cessation of exercise for three months.
