Evaluation of Thyroid Dysfunction in Women with Gestational Diabetes Mellitus Compared to Healthy Pregnant Women Referred to Kowsar Hospital in Qazvin from 2017 to 2018

Background & Objective: In this study, thyroid dysfunction in women with gestational diabetes mellitus was examined and compared to that in healthy pregnant women referred to Kowsar Hospital in Qazvin in 2017 and 2018. Materials & Methods: In this case-control study, 100 women with gestational diabetes mellitus and 100 non diabetic healthy pregnant women who referred to Kowsar Hospital in Qazvin from 2017 to 2018 were selected using the convenience sampling method, and their serum thyroxine, anti-TPO, and TSH levels were determined and compared. Moreover, Apgar scores and anthropometric variables were compared between the two groups. Results: In the present study, there were statistically significant differences between the groups in terms of the TSH level (P=0.012), assessed by the independent t-test, the thyroxine (P=0.0001) and anti-TPO (P=0.008) levels, both examined by the MannWhitney test, which associated with high levels of TSH and anti-TPO and low levels of thyroxine in the diabetic group. No differences were found regarding the Apgar scores and anthropometric variables between the groups (P>0.05). Conclusion: Overall, according to the obtained results, it can be inferred that thyroid dysfunction, realized as hypothyroid with high anti-TPO levels, was more prevalent in women with gestational diabetes mellitus compared to healthy pregnant women

Comparing troponin I level between women with preeclampsia and gestational hypertension and pregnant women with normal blood pressure

Background and purpose: Hypertensive disorders of pregnancy are still one of the major issues in obstetrics. So far, few studies are conducted on the troponin I level of pregnant women and preeclampsia but their results are not conclusive. In this study the troponin levels were compared between patients with severe preeclampsia, mild preeclampsia, gestational hypertension, and normal blood pressure. Materials and methods: A case control study was conducted in four groups of pregnant women (n=35 per group) with severe preeclampsia, mild preeclampsia, gestational hypertension, and normal blood pressure attending Kosar Center, Qazvin, Iran 2014-2015. The troponin I level in the groups were studied. Data was analyzed in SPSS V.19 applying ANOVA, Chi-square, and T-test. Results: The mean age of patients was 29.1±6.6. The level of troponin was lower than 0.01 ng/ml in patients with severe preeclampsia, mild preeclampsia, gestational hypertension and normal blood pressure. But in one case with severe preeclampsia this level was 0.15. The findings indicated no significant difference between the groups (P=0.4) Conclusion: The level of troponin was not different in patients with severe preeclampsia, mild preeclampsia, gestational hypertension, and normal blood pressure. Keywords: troponin I, severe preeclampsia, mild preeclampsia, gestational hypertension, normal blood pressur

Effect of pethidine (meperidine) on decreasing the duration of first and second stages of labor

Introduction: Pethedine is used to decrease labor pain. According to some studies, pethidine can be effective on labor progress. This study was performed with aim to determine the effect of pethidine on decreasing the duration of the first and second stages of labor. Methods: This clinical trial was performed on 120 nulliparous women with term singleton pregnancy who needed induction of labor for pregnancy termination in Kosar hospital, Qazvin in 2013. They were randomly assigned in two groups of intervention and control (n=60). A single dose of 50 mg pethidine was injected intravenously at 4 cm cervical dilatation in intervention group. In control group, normal saline was injected as placebo. The intervals between the injection and complete cervical dilatation, the complete cervical dilatation and the end of delivery, and the injection and the end of delivery were measured. Data were analyzed by SPSS software (version 19) and student T-test and Chi-square test P<0.05 was considered significant. Results: The mean interval between the injection of pethedine and complete cervical dilatation was 129±70 min in intervention group and 133±75 min in control group and the difference was not statistically significant (P=0.7). The mean duration of second stage of labor was 45±26 min in intervention group and 41±16 min in control group and the difference was not statistically significant (P=0.3). The mean interval between pethidine injection and end of delivery was 175±79 min in intervention group and 174±83 min in control group and the difference was not statistically significant (P=0.39). Conclusions: There is no significant relationship between pethidine injection and progression of the labor stages

Effect of melatonin on postpartum hemorrhage in vaginal delivery: a prospective randomized double-blind study

BSTRACT Background. The similarities between the melatonin and oxytocin signaling could promote myometrium contractility. We conducted this study to determine the effect of melatonin on the bleeding during and after vaginal delivery. Methods. The current double-blind randomized clinical trial was conducted on 140 pregnant women at term with labor pain. Subjects in the melatonin group received three sublingual doses of melatonin from labor room staff as follows: 6 mg in 7 cm dilatation, 3 mg after delivery of the fetus and 3 mg one hour after the delivery. The same schedule was conducted for the subjects in the placebo group by giving the placebo. The hemoglobin levels before and 24 hours after vaginal delivery, the hemodynamic variables were recorded. Results. There was a significant difference between the groups regarding the mean of hematocrit changes in the melatonin (3.59 ± 2.89) and placebo (5.29 ± 3.19) groups (P = 0.001). The mean variation of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) show a significant difference among two groups of the study (P = 0.021, P = .020 and 0.001, respectively). Conclusions. The sublingual of melatonin to pregnant women with labor pain could reduce the amount of blood loss after the vaginal delivery. Furthermore, melatonin could provide hemodynamic stability

Diagnostic value of NIPT assay for fetal aneuploidy screening in pregnant women with moderate risk of trisomy in first stage screening

Introduction: Aneuploidies are of the most important fetal abnormalities. Diagnostic value and efficacy of NIPT assay in the groups with abnormal results for first trimester combined screening test is not well defined. Therefore, this study was performed aimed to survey the sensitivity and specificity of NIPT for aneuploidies diagnosis in women with moderate risk for trisomy at first trimester combined screening test. Methods: This prospective cohort study was performed in 2017-2018 on 447 women with singleton pregnancy and gestational age of 11 to 13 weeks and 6 days who had moderate risk for trisomy. NIPT analysis was done in all women with moderate risk (1/250 to 1/1500) and was compared with the results from karyotype and phenotype analysis in neonates. NIPT diagnostic accuracy for chromosomal abnormalities was calculated. Data were analyzed using SPSS statistical software (version 22). Results: Two cases with trisomy 21 (0.06%) and one case with trisomy 18 (0.03%) were diagnosed. These three cases were confirmed with amniocentesis and the pregnancy was ended. The neonates' analysis showed normal phenotype results in all of them and NIPT diagnostic accuracy for trisomy 21 and 18 was calculated 100%. Conclusion: In addition to maintain combined screening test benefits, using NIPT is accompanied by high diagnostic accuracy for fetal chromosomal abnormalities assessment

Effect of vitamin D administration in vitamin D-deficient pregnant women on maternal and neonatal serum calcium and vitamin D concentrations: a randomised clinical trial

There are several studies in which a correlation between maternal vitamin D deficiency and serum mineral disorders in the mother and the newborn has been reported. The present randomised clinical trial was designed to investigate the effect of vitamin D administration on maternal and fetal Ca and vitamin D status. The trial was carried out on 160 pregnant women. Vitamin D-deficient (25-hydroxyvitamin D (25(OH)D) ,30 ng/ml) pregnant women were recruited at 26–28 weeks of pregnancy. In the control group, a multivitamin supplement containing 400 IU vitamin D3/d was given. Patients in the treatment group were treated with 50 000 IU vitamin D3 weekly for a total duration of 8 weeks. At delivery, maternal and fetal Ca and 25(OH)D levels in both groups were compared. In total, 81 % of pregnant women were vitamin D deficient. At the time of delivery, Ca and vitamin D levels were higher in the treatment group compared with the control group (92 (SD 3) v. 85 (SD 4) mg/l, respectively, P¼0·001 for serum Ca; 47·8 (SD 11·1) v. 15·9 (SD 6·6) ng/ml, respectively, P,0·001 for vitamin D). At the time of delivery, 32·7 % of women in the control group had hypocalcaemia, while no hypocalcaemic case was detected in the vitamin D-treated group. Mean neonatal serum 25(OH)D was higher in the treatment group compared with the control group (27·7 (SD 5·2) v.10·9 (SD 4·4) ng/ml, respectively, P,0·01). The neonatal Ca level in the treatment group was significantly higher than that of the control group (99 (SD 3) v. 91 (SD 3) mg/l, respectively, P,0·001). The administration of vitamin D to pregnant women with vitamin D deficiency improves both maternal and neonatal Ca levels

Appropriate neck/waist circumference cut-off points for gestational diabetes prediction in Iranian pregnant women: The baseline analysis of the Qazvin maternal and neonatal metabolic study (QMNMS), Iran

Abstract Background: Gestational diabetes is the most common complication during pregnancy and it is essential to identify the high-risk groups for gestational diabetes mellitus (GDM) in the first trimester. A large neck circumference (NC) in the first trimester is a measure of obesity. Objective: The present study investigated whether pregnant women's first-trimester NC and waist circumference (WC) measurements present a predictive index for GDM diagnosis. Materials and methods: This longitudinal cohort study was conducted on 676 pregnant women aged ≥20 years. Pregnant women at 12-14th (baseline) gestational weeks underwent measurement of neck and other anthropometric indices. GDM was diagnosed with 75-g oral glucose tolerance test at 24-28th gestational week. Results: GDM was developed in 110 (16.3%) pregnant women. The logistic regression analysis showed that baseline NC > 33.5 cm (OR: 2.037, 95% CI: 1.313-3.161; P = 0.002) and WC > 90.5 (OR: 2.299, 95% CI: 1.510-3.501; p 33.5 cm, with 68.5% sensitivity and 48.3% specificity, and for baseline WC it was >90.5.50 cm, with 57% sensitivity and 63.4% specificity. Conclusion: Pregnant women with an NC > 33.5 cm and a WC > 90.5 cm at baseline (12-14th gestational weeks) had a higher chance of developing GDM. first-trimester NC and waist circumference (WC) measurements present a predictive index for GDM diagnosis. Keywords: Cut-off points; Gestational diabetes mellitus; Neck circumferences