Evaluation of vitamin D status, parathyroid hormone, and calcium among Iranian pregnant women with preeclampsia: A case-control study

Background: Preeclampsia is considered as a serious life-threatening condition that could affect both maternal and fetal outcome. Many studies have examined the association of nutritional factors with the incidence of preeclampsia. However, little is known about the possible role of vitamin D in the development of preeclampsia among the Iranian population. Objective: The aim of the present study was to evaluate the association between vitamin D status and preeclampsia. Materials and Methods: A total of 120 pregnant women who were referred to Kamali and Alborz General Hospital located in the Karaj City were enrolled in this study and categorized into preeclamptic and control groups (n = 60/each). The clinical details of patients such as demographic characteristics and laboratory findings were obtained from the patients. The serum levels of vitamin D, calcium, phosphorus, and parathormone were also measured. Multivariate logistic regression analysis was used to assess for independent predictors of preeclampsia. Results: The mean age among pregnant women with preeclampsia and control group were 31.48 ± 5.25 and 29.01 ± 5.28, respectively. The mean body mass index among the preeclamptic group was 27.92 ± 4.98, which was significantly higher compared to the control group (p < 0.001). The serum vitamin D levels were significantly lower in women with preeclampsia compared to the control subjects (p = 0.007). Moreover, no correlation between vitamin D deficiency and predisposing factors of preeclampsia was observed after adjusting for confounding factors. Conclusion: Our study revealed that serum vitamin D level is significantly lower in among the pregnant women diagnosed with preeclampsia compared to the healthy subjects. However, no correlation was observed between the vitamin D status and the risk of preeclampsia development. Key words: Preeclampsia, Vitamin D, 25-Hydroxyvitamin D, Pregnancy

Medical management of ectopic pregnancy with high HCG levels: a case series

Objective: To evaluate the efficacy of medical management of ectopic pregnancy with high HCG levels . Design: Case series. Setting: A teaching hospital in Tehran University. Materials and Methods: Selecting 6 patients with unruptured ectopic pregnancy and HCG levels above 12000 IU/L to be managed medically. Results: All patients were managed successfully. Conclusion: In selected patients with high pre-treatment HCG levels medical management may be successful and that high HCG level is not a contraindication for medical management by itself

Preventing preterm birth in high-risk pregnant women: cerclage or Pessary? A retrospective cohort study

Although preterm birth is considerably more prevalent in pregnant women with a history of previous preterm birth, there is no universal consensus on how to prevent preterm birth in high-risk pregnant women individually. Pessary and cerclage are currently among the two main approaches for preventing preterm birth; however, each method's effectiveness in different high-risk pregnant women is relatively unknown. Therefore, the present study compared the use of cerclage and pessary as methods to prevent preterm birth in high-risk pregnant women. In the current retrospective cohort study, data regarding 88 high-risk pregnant women who were admitted to Kamali Hospital, Karaj, Iran, and had short cervical lengths were collected. Each pregnant woman was either implanted with a pessary or had a cerclage performed. Regression modeling was performed to adjust for the possible confounders, and the odds of preterm birth before the 37th week in each treatment group was calculated. The regression modeling showed that pregnant women who received a pessary implant had lower odds of preterm birth (OR=0.3, 95%CI= 0.1-0.9, p<0.05). Age, gestational age, and cervical length at the time of receiving treatment were considered as the confounding variables. The present study shows that pessary is a more effective method for preventing preterm birth in high-risk pregnant women with cervical lengths ≤25 mm in comparison to the cerclage

The comparison of pregnancy outcomes in fresh and frozen embryo transfer: A cross-sectional study

Abstract Background: The benefits of frozen embryo transfer (FET) vs. fresh embryo transfer for in vitro fertilization (IVF) have been discussed in previous studies. Objective: To determine and compare the pregnancy outcomes following FET and frozen embryo transfer in women who underwent assisted reproductive techniques. Materials and Methods: In this cross-sectional study, 233 women candidates for IVF/intra cytoplasmic sperm injection who referred to the Kamali Training Medical Center, Karaj, Iran during 2019-2020 were evaluated in 2 groups of fresh (n = 127) and frozen (n = 106) embryo transfers. The rates of pregnancy outcomes including chemical and clinical pregnancy, live birth, preeclampsia, ectopic pregnancy, still birth, and pregnancy loss were compared between groups in 3 age subgroups ( < 25, 25-35, and 35-40 yr old). Results: No significant difference in terms of chemical and clinical pregnancy and live birth rates were observed between groups in women aged < 25 yr. Chemical and clinical pregnancy and live birth rates were significantly higher in the FET group compared to fresh group in 25-35-yr-old women (p = 0.01, p = 0.03, and p = 0.01, respectively). In 35-40-yr-old women, no significant differences were observed in terms of chemical and clinical pregnancy rates, but live birth rate was found to be significantly higher in the FET group (p = 0.02). The pregnancy loss was lower in the FET group (p = 0.038). Conclusion: In conclusion, the FET method in women aged 25-35 yr significantly increases the chance of successful IVF/intra cytoplasmic sperm injection

Evaluation of the effect of endometrial scratch by hysteroscopic scissors on frozen embryo transfer outcomes: A historical cohort study

Background: Endometrial scratch (ES) has been suggested to improve assisted reproductive techniques success rates by investigating implantation failure. Objective: In this study, we evaluated the effect of ES on the outcomes of frozen embryo transfer (FET) in women with at least 2 failed embryo transfer cycles. Materials and Methods: In this historical cohort study, medical data of 236 infertile women who underwent in-vitro fertilization-FET at Ebne-sina Infertility Center, Tehran, Iran, from January 2015-December 2021 was extracted from their medical records. Based on having ES before FET, they were assigned to either the scratch (n = 118) or the no-scratch group (n = 118). We compared these groups regarding pregnancy rates and outcomes. Results: The demographic characteristics were similar in both groups regarding weight, body mass index, the number of previous embryo transfers, and the duration of infertility. However, the scratch group had a slightly higher mean age (32.31 vs. 29.96 yr, p < 0.001). No statistically significant difference was observed between groups regarding pregnancy rate (p = 0.89). No significant association was observed between scratch, infertility duration, the number of previous FET attempts, and the likelihood of pregnancy in a logistic regression model. No major complications were observed. Conclusion: Hysteroscopic endometrial scratching with scissors probably has no effect on FET outcomes, including pregnancy or live birth rates