'Perinatal outcome in preterm premature rupture of membranes with Amniotic fluid index < 5 (AFI < 5)

Abstract Background Our purpose was to determine whether AFI Methods We performed a prospective cohort study of 95 singleton pregnancies complicated by preterm premature rupture of the membranes (PPROM) with delivery between 26 and 34 weeks gestation. Patients were categorized in two groups on the basis of amniotic fluid index2 and Fisher exact tests. Continuous data were evaluated for normal distribution and tested for significance with the student t test. All 2-sided p values Results Both groups were similar with respect to selected demographics, gestational age at rupture of the membranes, gestational age at the delivery, birth weight. Both groups were similar with respect to selected variable, latency until delivery, early onset neonatal sepsis, RDS and neonatal death. Patients with AFI Conclusions An AFI<5 cm after PPROM between 26 and 34 weeks gestation is associated with an increased risk of maternal infections and frequency of C/S.</p

Effect of progesterone as maintenance tocolytic therapy on the prevention of recurrent preterm labor: a randomized clinical trial

Objective: The study evaluated the efficacy and safety of vaginal rogesterone on prevention of recurrent preterm labor. Materials and methods: Total number of 70 patients with preterm labor treated with intravenous magnesium sulfate in perinatology department of valiasr hospital entered to a randomized clinical trial. Treatment group after inhibition of preterm labor with magnesium sulfate received progesterone suppository (400 mg) daily until delivery and control group received no treatment. Latency until delivery, recurrence of preterm labor and neonatal outcomes were studied. Statistical significance was defined as p< 0.05. Results: Mean latency until delivery (p< 0.05), low birth weight (p< 0.05), birth weight (p< 0.01) were significantly different between the two groups. Recurrence of preterm labor was not significantly different between the groups. Conclusions: The use of vaginal progesterone suppository after successful parenteral tocolysis associated with a longer latency preceding delivery but failed to reduce the incidence of recurrent preterm labor

Comparing the size and weight of placenta and birth weight in normal pregnancy and gestational diabetes: brief report

Background: Diabetes can cause undesirable changes in structure of the placenta, re-sulting increase in size and weight of placenta. The aim of this study was, to investigate the placenta weight, size and birth weight of infants in pregnant women with controlled gestational diabetes compared with normal pregnancy. Methods: This study was conducted from October, 2012 to February, 2014 in two dif-ferent hospitals, Valiasr and Shariati Hospitals in Tehran. Sixty-seven healthy singleton pregnant and 42 pregnant women with diabetes were selected during 26-28 weeks of gestational ages. Glucose tolerance tests (GTT) were performed to evaluate blood glu-coses. Blood glucoses were controlled in diabetic cases very well. Length and width of the placentas were measured using ultrasonography during pregnancy. After termina-tion of pregnancy, placental weights were measured and recorded using weighting scale with 10 gram accuracy by someone who didn't know about diabetes status. Baby weights were measured after birth and initial stabilisation. Results: In this study, there were no significant differences between gestational diabe-tes mellitus (GDM) and healthy groups in Body Mass Index (BMI) factors. There was no statistically significant differences between the mean weight of infants born with gestational diabetes and control groups. There were no statistically significant differ-ences between the mean placental weights between two groups. Ratio of the placental weights to the birth weights between the two groups were not statistically significant. The mean placental length, width and placenta length times by width in two groups had no significant differences, but the mean gravidities in healthy group was 1.7910 and in gestational diabetes mellitus was 1.9762 that are significantly different (P=0.0217). The mean parities respectively were 0.6567 and 0.8100 which was not sig-nificantly different (P=0.0183). Conclusion: The present study has shown there was no significant differences between fetal and placental weights in normal pregnancies and women with controlled gesta-tional diabetes

Plasma lipids relationship with results of Oral Glucose Challenge Test in pregnancy

Objective: This study aimed to evaluate the correlation between plasma lipid levels at first trimester of pregnancy and results of Oral Glucose Challenge Test (OGCT). Materials and methods:  In a cross - sectional descriptive analytic study, two hundred eligible primigravida women without history of Diabetes Mellitus referring to Vali-e-Asr Hospital were evaluated. Plasma levels of triglyceride and cholesterol were measured at first trimester of pregnancy and Oral Glucose Challenge Test was done for all women at  24th - 28th gestational week. Pre-pregnancy BMI, and plasma levels of triglyceride and cholesterol at first trimester of pregnancy were compared with the results of OGCT. Results were analyzed using SPSS version 14. p-values ≤ 0.05 was considered statistically significant. Results: In 45 (22.5%) of the women OGCT was positive.  Pre pregnancy BMI and the rate of positive result for OGCT were both correlated with the plasma levels of triglyceride and cholesterol at first trimester of pregnancy. Conclusion: Plasma lipid levels in first trimester can predict the result of OGCT at 24- 28 weeks of pregnancy

Heterotopic Pregnancy in a Natural Conception Cycle: Case Report

Heterotopic pregnancy is a rare event in natural conception cycles. The prevalence of heterotopic pregnancy is known to be increasing in part due to more precise diagnostic techniques and widespread use of of assisted reproductive technology. A case of an incidental heterotopic pregnancy diagnosed at 10 weeks of gestational age is reported here in which laparotomy was scheduled and right salpingectomy was performed immediately after diagnosis. The intra uterine pregnancy proceeded without any problem until term and a healthy male infant weighing 3680 grams was born. As this case demonstrates, early diagnosis is the key of successful treatment. Early detection and appropriate intervention in order to save the intra uterine pregnancy and the prevention of associated maternal morbidity and mortality are emphasized

Prevalence of immunity to toxoplasmosis among Iranian childbearing age women: Systematic review and meta-analysis

Background: Our information regarding immunity to toxoplasmosis among reproductive age women is indeterminate and there is significant variation between reported results; it is necessary to perform a Meta-analysis study on subjects to obtain required findings and develop preventive measures accordingly.\ud Objective: Estimation level of immunity to toxoplasmosis in reproductive ages.\ud Materials and Methods: All published papers in main national and international databases were systematically searched for some specific keywords to find the related studies up to 2012. We selected only original articles that either reported percentage of positive anti toxoplasma IgG or total anti toxoplasma antibody by using ELISA or IFAT method (provided that the titer ≥1.20 is considered positive for IFAT) in childbearing age women.\ud Results: Studies involved a total of 13480 participants. The maximum and minimum reported prevalence rates of anti-toxoplasma IgG antibody using IFTA serological method were 21.8% and 54%; and using ELISA serological method were 23% and 64%, respectively. The overall estimation for prevalence of anti-toxoplasma IgG antibody using IFTA serological method was 34.5% (95% CI: 28.5-40.5); and using ELISA method was 37.6% (95% CI: 30.4-44.9). The overall estimation for prevalence of anti-toxoplasma total antibody was 39.9% (95% CI: 26.1-53.7).\ud Conclusion: In Iran, screening of toxoplasma is not routinely performed yet, while the incidence of toxoplasmosis is too high to justify routine screening. Prenatal screening can help to identify mothers susceptible to infection. Screening for the presence of antibodies allows primary prevention of toxoplasmosis infection where eating habits and hygiene practices have clearly been identified as risk factors

Evaluation of cardiac sphericity index among intrauterine growth restriction and normal fetuses

Foetal growth restriction (FGR) describes the pregnancy complications of pathological reduced foetal growth, leading to significant perinatal mortality and morbidity, and subsequent long-term cardiovascular outcomes. This prospective case-control study was performed on pregnant women referred to the hospitals of Tehran University of Medical Sciences in 2017–2019. All pregnant women underwent ultrasound scan and doppler sonography. FGR was defined as a sonographic estimation of foetal weight below the tenth percentile for a given gestational age. Cardiac sphericity index, including basal-apical length (BAL), transverse length (TL), global sphericity index (GSI), umbilical artery pulsatility index (PI), middle cerebral artery (MCA) PI and cerebroplacental ratio (CPR) were assessed. Mean gestational age in FGR and control groups were 233.90 ± 22.00 days and 229.00 ± 25.02 days, respectively. Foetal size index and estimated foetal weight in FGR foetuses were significantly lower than the control group (p < .05). BAL, TL and GSI were significantly affected by FGR (p = .0001, p = .018 and p = .0001, respectively). Abnormal GSI, MCA PI, umbilical artery PI and CPR were significantly more prevalent among FGR foetuses (p = .017, p = .0001, p = .0001 and p = .0001, respectively). Cardiac sphericity index, as well as uterine PI, MCA PI and CPR, were the determinants of FGR in foetuses with normal Doppler and abnormal GSI.IMPACT STATEMENT What is already known on this subject? Foetal growth restriction (FGR) describes the foetus that does not grow to its expected biological potential in utero, and is a relatively common complication of pregnancy. FGR is accosted with negative birth outcomes and long-term cardiovascular outcomes. One of the indicators of FGR is cardiac sphericity. What do the results of this study add? The findings of this study revealed that the cardiac sphericity index as well as umbilical PI, MCA PI and CPR ratio change in FGR foetuses. What are the implications of these findings for clinical practice and/or further research? It is recommended that more studies be performed to follow FGR foetuses longitudinally and evaluate the long-term cardiac abnormalities in infancy and childhood and compare it between FGR foetuses and normal foetuses