Viable Extreme Preterm Birth and Some Neonatal Outcomes in Double Cerclage versus Traditional Cerclage: A Randomized Clinical Trial

The pregnant women at higher risk of preterm labor, referred to the perinatal clinic of Kosar University Hospital in Urmia district of Iran, were enrolled into a parallel randomized clinical trial. In the investigational arm of the clinical trial, a double cervical cerclage procedure was performed addition to McDonald cerclage. In the control group however, only McDonald cerclage was performed. Extreme preterm labor (GA < 33 weeks) was the primary endpoint of this clinical trial. Age, gestational age at cerclage time, and gravidity were not found to be statistically different between the groups. Means of gestational age were 37.4 and 36.2 weeks, respectively, for the investigational and control groups. The gestational age was 1.2 weeks longer for double cerclage group but the difference was not found to be statistically significant. Preterm birth before 33 weeks of gestation was not experienced by any of the patients who received double cerclage, but five women in control group developed such an extreme preterm labor (P < 0.05). The absolute risk reduction in using double cerclage over traditional method was 18 percent (95% confidence interval, 4%–32%). Double cerclage appeared to have higher efficacy than traditional cerclage in preventing preterm labor <33 weeks of gestation

Predictive Values of Maternal Serum Levels of Procalcitonin, ESR, CRP, and WBC in the Diagnosis of Chorioamnionitis in Mothers with Preterm Premature Rupture of Membrane

Background: Premature rupture of membrane (PROM) refers to the rupture of fetal membranes at least 1 hour before the onset of labor pain. We aimed to determine the predictive value of maternal serum level of procalcitonin in the early diagnosis of chorioamnionitis in mothers with preterm (PPROM).Methods: In this prospective cohort study, 48 patients with PPROM were selected due to limited financial resources and in accordance with previous similar articles. The study was carried out in Kosar ward of Motahhari Hospital of Urmia, Iran. The inclusion criteria were leaking amniotic fluid, positive nitrazine and fern tests, gestational age of 28-33 weeks, and lack of fetal tachycardia. The exclusion criteria were chronic vascular and congenital heart diseases as well as the use of nonsteroidal anti-inflammatory drugs (NSAIDs). To analyze the data, we used descriptive statistics, Chi-square test (OR), independent t-test, and Pearson in SPSS, version 19.Results: The present study was conducted on 48 pregnant women and their neonates. About 39.6% of the mothers were pathologically infected with chorioamnionitis, while 60.4% of the patients were not infected with the disease. Moreover, 68.8% of the neonates had a five-minute Apgar score of ≥ 7. There was a significant correlation between the mothers’ infection with histopathologic chorioamnionitis and neonatal hospitalization in neonatal intensive care unit (

A study of the diagnostic value of Inhibin A Tests for occurrence of preeclampsia in pregnant women

Background: Hypertensive disorders are common during pregnancy, and are among 3 important causes of maternal death. Preeclampsia occurs in 3 to 5% of pregnancies. Early diagnosis of this disorder can lead to better pregnancy outcomes. Objective: The aim of this study was to determine the relationship between inhibin A serum levels during second stage pregnancy screening tests, and incidence and severity of preeclampsia. Methods: In this study, 300 pregnant women who referred to Kowsar Hospital and carried out second stage pregnancy screening tests from September 2014 to March 2015 in Urmia city, Iran, were enrolled. Five ml venous blood samples were obtained from each participant, and inhibin A serum levels were evaluated in all cases. Finally, all the necessary information was obtained from the pregnancy files of participants after delivery, and gathered in a questionnaire. The data were analyzed using SPSS software version 18 and independent t-test, ANOVA and descriptive statistics were used. P-values less than 0.05 were considered significant. Results: Among the 300 pregnant women who were studied, the gestational age at the time of acquiring blood samples was as follows: 169 cases (56.3%) at 16-17 weeks, 77 cases (25.7%) at 18-19 weeks and 14 cases at 20 weeks (4.7%). In this study, MOM of inhibin A was more than 1.25 in 12 cases that finally, preeclampsia occurred in them. This relationship was statistically significant (p=0.001). The relationship between MOM of inhibin A and severe preeclampsia was evaluated, and the relationship was significant (p=0.004). The relationship between MOM of inhibin A and pregnancy hypertension was not significant (p=0.643). Conclusion: Considering the results of this study, we can conclude that MOM of inhibin A levels in maternal serum during second stage pregnancy screening tests can predict incidence and severity of developing preeclampsia in pregnant women. This is not true in cases of pregnancy hypertension