مقایسه سطح سرمی هوموسیستئین و فولیک اسید در دیابت بارداری و بارداری طبیعی

مقدمه وهدف : سطوح بالاي هوموسيستئين عامل خطر شناخته شده اي براي ايجاد مقاومت به انسولين، بروز ديابت و عوارض قلبي- عروقي است. اين مطالعه به منظور تعيين و مقايسه سطح سرمي هوموسيستئين و فوليك اسيد و بررسي رابطه آن دو در ديابت بارداري و بارداري طبيعي انجام شد. 1392 انجام شد . 120 زن - روش كار : اين مطالعه اپيدم يولوژيك تحليلي مورد - شاهدي در بيمارستان كوثر قزوين درسال 1394 24 هفته بر اساس تست تحمل گلوكز خوراكي دو ساعته با 75 گرم گلوكز در دو گروه ديابت - باردار تك قلو با سن بارداري 28 بارداري ( 60 نفر) و بارداري طبيعي ( 60 نفر) قرار گرفتند. سطح سرمي هوموسيستئين و فوليك اسيد دردوگروه سنجيده شد . تجزيه وتحليل شد. correlation و روش t-test داده ها با آزمون آماري بالاتر و فوليك اسيد با اختلاف معني داري (P< نتايج: در ديابت بارداري سطح سرمي هوموسيستئين بطور معني داري ( 0.001 پايين تر از بارداري نرمال بود. بين سطح سرمي هوموسيستئين وفوليك اسيد در هيچ كدام از دو گروه رابطه (P<0.001) معني داري ديده نشد. سطح سرمي فوليك اسيد در هر دو گروه ارتباط معني داري با قند خون ناشتا داشت كه اين ارتباط در .( P=0.001, r= و در گروه بارداري طبيعي، مستقيم بود ( 0.417 (r= -0.512, P< گروه ديابت بارداري، معكوس( 0.001 نتيجه نهايي: بنظر مي رسد فوليك اسيد در تنظيم سطح سرمي هوموسيستئين و قند خون نقش دارد. كليد واژه ها: اسيد فوليك / ديابت آبستني / هموسيستئي

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

Effect of Vaginal Progesterone and Dydrogesterone on Pregnancy Outcomes in patients with Threatened Abortion: A Randomized Clinical Trial

Introduction: Despite the positive evidence on the effect of progesterone on protection of pregnancy in patients with threatened abortion, the results of studies regarding its drug type have been controversial. This study was performed with aim to compare the effect of vaginal progesterone and dydrogesterone on pregnancy outcome in cases with threatened abortion. Methods: In this single-blind randomized clinical trial, 160 pregnant women with threatened abortion who referred to Qazvin Kowsar Hospital in 2018 were randomly assigned to receive dydrogesterone (Duphaston) 10 mg twice daily or vaginal progesterone (Cyclogest) 400 mg daily. Finally, pregnancy outcomes were compared between the two groups. Data were analyzed by SPSS software (version 18) and Chi-square, independent t-test and Mann-Whitney tests. P<0.05 was considered statistically significant. Results: Frequency of cesarean section was 27 (33.7%) in the dydrogesterone group and 25 (31.2%) in the vaginal progesterone group (P = 0.736). In general, the incidence of preterm labor was 97 (60.6%) and there was no significant difference between the two groups (P >0.05). In addition, incidence of preeclampsia, gestational diabetes mellitus, placenta previa and intrauterine fetal death as well as neonatal weight were not significantly different between the two groups (P >0.05). Finally, maternal and neonatal complications showed no significant difference between the two groups (P = 0.675). Conclusion: Pregnancy outcomes after administration of dydrogesterone are not different with vaginal progesterone in the treatment of threatened abortion

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

Evaluation of Pregnancy consequences in Women with Polycystic Ovary Syndrome: A Case-Control Study in Qazvin, Iran

ABSTRACT Background and Aim: Polycystic ovary syndrome (PCOS) is a common disorder in women of childbearing age that can be associated with adverse pregnancy complications. The aim of this study was to compare the adverse pregnancy consequences between pregnant women with PCOS and control group in Qazvin. Materials and Methods: In this study, 150 pregnant women with PCOS aged 18-35 years with gestational age of more than 20 weeks were selected as our case group based on Rotterdam criteria and our control group included 150 pregnant women without PCOS. The groups were compared in terms of pregnancy complications including gestational diabetes, preeclampsia, preterm delivery, low birth weight, and neonatal admission to the neonatal intensive care unit (NICU). Results: There were no significant differences between the two groups in terms of demographic data including age, weight, height and BMI. In the case group (PCOS) we found gestational diabetes in 33 cases (64.7%) (P=0.021), preeclampsia in 44 cases (67.7%) (P=0.002), and preterm delivery 70 in cases (75.3%) which indicated a significant difference between the case and control groups (P<0.0001). The case group had higher neonatal complications than control group in regard to low birth weight (40 cases, 64.5%, P=0.008) and NICU admission (30 cases, 66.7%, P=0.015). Conclusion: The results of this study showed that PCOS, due to its metabolic effects, may increase the incidence of gestational diabetes, preeclampsia, preterm delivery, low birth weight or macrosomia and long term NICU admission. Keywords: Polycystic ovary syndrome, Premature birth, Gestational diabetes, Pre-eclampsi

Evaluation of Pregnancy consequences in Women with Polycystic Ovary Syndrome: A Case-Control Study in Qazvin, Iran

Background and Aim: Polycystic ovary syndrome (PCOS) is a common disorder in women of childbearing age that can be associated with adverse pregnancy complications. The aim of this study was to compare the adverse pregnancy consequences between pregnant women with PCOS and control group in Qazvin. Materials and Methods: In this study, 150 pregnant women with PCOS aged 18-35 years with gestational age of more than 20 weeks were selected as our case group based on Rotterdam criteria and our control group included 150 pregnant women without PCOS. The groups were compared in terms of pregnancy complications including gestational diabetes, preeclampsia, preterm delivery, low birth weight, and neonatal admission to the neonatal intensive care unit (NICU). Results: There were no significant differences between the two groups in terms of demographic data including age, weight, height and BMI. In the case group (PCOS) we found gestational diabetes in 33 cases (64.7%) (P=0.021), preeclampsia in 44 cases (67.7%) (P=0.002), and preterm delivery 70 in cases (75.3%) which indicated a significant difference between the case and control groups (P<0.0001). The case group had higher neonatal complications than control group in regard to low birth weight (40 cases, 64.5%, P=0.008) and NICU admission (30 cases, 66.7%, P=0.015). Conclusion: The results of this study showed that PCOS, due to its metabolic effects, may increase the incidence of gestational diabetes, preeclampsia, preterm delivery, low birth weight or macrosomia and long term NICU admission. Keywords: Polycystic ovary syndrome, Premature birth, Gestational diabetes, Pre-eclampsi

The Effect of Topical Lidocaine Gel, Intrauterine Lidocaine Injection and Combination of these Two Methods for Relieving Pain during Curettage: A Double Blind Randomized Clinical Trial

Introduction: Curettage is one of the most common gynecological surgeries in women. Its complication is pain which increases dissatisfaction in patients. Therefore, it is necessary to find a way to treat this complication. This study was performed with aim to compare the effects of three methods of using lidocaine gel in the cervix, intrauterine injection of lidocaine, and a combination of two methods to reduce pain during curettage. Methods: This clinical trial study was performed in 2017 on 120 patients candidates for curettage in Qazvin Kosar Hospital. Patients were randomly divided into three groups of topical lidocaine gel in the cervix, intrauterine injection of lidocaine and a combination of these two methods, and the drugs were prescribed before curettage. Vital signs and pain were recorded in patients and other information was collected by completing the questionnaire. Data analysis was performed using statistical software (version 22) and chi-square and ANOVA tests. P<0.05 was considered statistically significant. Results: The intrauterine and intra cervical injection of lidocaine (0.3±0.72) and then injection of intra cervical lidocaine (0.45±0.84) alone significantly reduced pain during curettage in women (P=0.04). On the other hand, no severe hemodynamic changes were observed in these patients. No complications such as nausea and vomiting and no instability of vital signs were observed in any of the groups (P>0.05). Conclusion: Intrauterine administration along with addition of topical lidocaine gel to the cervix can be used as a simple, low-cost, and safe method as to control pain during and after curettage