Effect of the Fractional CO2 Laser on the Quality of Life, General Health, and Genitourinary Symptoms in Postmenopausal Women With Vaginal Atrophy: A Prospective Cohort

Introduction: After menopause women experience vaginal atrophy related to hormonal changes and estrogen deficiency. The purpose of this paper was to evaluate the effect of the fractional CO2 laser on the quality of life, vaginal atrophy symptoms, and urine incontinency in menopause women.Methods: This prospective study was conducted among 140 women from 2017 to 2018 in Yas hospital, Tehran University of Medical Sciences. They encountered the fractional microablative CO2 laser system three times at four-week intervals. The short form of the Health Questionnaire (SF-12) and the Female Sexual Functional Index (FSFI) questionnaire were utilized to assess the participants’ quality of life. Also, the standard measuring tools including the vaginal health index (VHI) and International Consultation on Incontinence Questionnaire (ICIQ) Form were used to evaluate the vaginal atrophy symptoms.Results: The quality of life improved significantly in somatic, social function, and mental health. In the sexual context, arousal and satisfaction status improved significantly. Also, the frequency of urinary incontinence, enuresis, urgency, and the leak improved significantly (P < 0.05). Among the scale variables for urinary function, it was seen that the urgency impact had no improvement. All vaginal indices improved (P < 0.05).Conclusion: The fractional CO2 laser can be effective in treating vaginal atrophy and urinary symptoms. Besides, it improved the quality of life and the sexual function o

Comparing Perinatal Outcome in Twin and Singleton Pregnancies Regarding Doppler Evaluation of Uterine Artery Indices in the Second Trimester

Background: Prediction of adverse perinatal and postnatal outcomes could be possible by using ultrasound Doppler evaluation, however there are some controversies regarding this issue in the literature. The goal of present study was to evaluate predictive value of Doppler indices in single and twin pregnancies during second trimester. Materials and Methods: This prospective study was conducted in Yas Hospital, Tehran, between February 2015 and January 2016. The number of 71 singleton pregnancies and 59 twin pregnancies enrolled in this study. A single expert perinatalogist / sonographer did all Doppler ultrasound exams and followed up cases until the end of pregnancy. To compare Doppler indices and pre-postnatal outcomes between singleton and twin groups, the Student’s t-test, Pearson χ2 test and Fisher’s exact test were used for continue and categorical variables, respectively. Results: Rates of preterm delivery and SGA were significantly higher in twin pregnancies compared with singletons (

Prenatal Diagnosis of Leukocyte Adhesion Deficiency Type-1 (Five Cases from Iran with Two New Mutations)

Leukocyte adhesion deficiency type-1(LAD-1) is one of the autosomal recessive immunodeficiency diseases that results from mutation in integrin beta 2 (ITGB2) gene. The aim of this study was to investigate molecular prenatal diagnosis of LAD-1. Four pregnant women with five fetuses (one twin fetus) with clinical and laboratory diagnosis of LAD-1 in their previous children were studied. The chorionic villus sampling (CVS) was obtained when mothers were in 10-12th weeks of gestation. Mutation analysis of ITGB2 gene for affected children revealed 3 misssense mutations (c.382G>A,   a   novel   mutation,   c.2146G>C,   and   c.715G>A)   and   one   splice  site novel mutation (c.1877+2T>C). All parents were heterozygous for these mutations. Consideration of affected gene regions for five CVS samples showed two homozygotes and one heterozygote for mutant allele and two homozygotes for normal allele. Interestingly, one  of  the  twin  fetuses  was  affected  and  another  was  normal.  Briefly, two  cases  of CVS samples were affected and three cases of remained CVS samples were unaffected. This is the first report of prenatal diagnosis of LAD-1 from Iran with two new mutations that can be used for genetic and prenatal diagnosis for all patients suspected to LAD1 and can be helpful to prevent the birth of affected children with LAD-1. This  abstract  was presented  in  the  Second  International  Congress  of  Immunology, Asthma and Allergy, Tehran, Iran 2013

A Comparison Between Sublingual Misoprostol and Intravenous Oxytocin for Inducing labor in Women with Term Pregnancy

Objective: In this study efficacy of sub lingual Misoprostol was examined in comparison to Oxytocin (I.V.) for inducing of labor in term pregnancy. Materials and methods: Seventy patients were allocated by blocked randomization to Groups A (n=35, sub lingual Misoprostol 25 μg four hourly to maximum of 5 doses) and B (n=35, continuous Oxytocin infusion). Results: Delivery active phase and total labor phase were shorter with sublingual Misoprostol in comparison to intravenous Oxytocin (p< 0.001) and the rate of cesarean section was lower in Misoprostol group (p<0.04) but delivery latent phase, meconium staining, uterine hypertonisity and apgar score (1&5 minute) were similar in two groups. Conclusion: sublingual Misoprostol is better than intravenous Oxytocin for induction of labor at term

Effect of Metformin on Diabetes Mellitus Prevention in Pregnant Women with Risk Factors

Objective: This study evaluated the efficacy and safety of metformin on prevention of gestational diabetes mellitus in women with high risk of GDM. Materials and methods: Total number of 189 pregnant women aged between 25 to 35, and 10 to 14 weeks pregnancy,admitted to  Mirza Koochakkhan Hospital, Tehran in January 2008 - January 2009 entered to this randomized controlled clinical trial. The women had one of the three risk factors; history of GDM, family history of diabetes, or BMI ≥ 30 kg/m2, with normal results in the glucose challenge test (GCT) or the glucose tolerance test (GTT). Subjects were randomly split to two groups; 63 women (group A) who received metformin (500 mg, twice a day) and 126 women (group B) did not use metformin. Incidence  of gestational diabetes was compared between two groups. Results: The incidence  of gestational diabetes was significantly different between two groups (%1.4 in group A, %15.4 in group B) (p<0.001). The study also showed that the insulin requirement was significantly different between two groups after developing GDM (group A %3.6, group B %9.5, p=0.001). Conclusion: Using Metformin can effectively reduce the incidence of GDM in pregnant women at risk

Does chorionic villus sampling increase the risk of preeclampsia or gestational hypertension?

Background: Chorionic villus sampling (CVS) and amniocentesis are two methods for prenatal diagnosis. The goal of this study was to compare amniocentesis and CVS-related complications in a large sample of Iranian women. Methods: Medical records of 1624 women who underwent amniocentesis or CVS due to medical indications between 2008 and 2016 were reviewed. Data regarding age, gravidity, parity, gestational age, type of procedure, neonatal weight (and percentile), trisomia, abortion, intrauterine growth restriction (IUGR), severe IUGR, preeclampsia, and gestational hypertension were recorded. Results: Finally, 1215 cases were evaluated. Mean maternal age, gravidity, and gestational age were significantly different between two groups. Preeclampsia, gestational hypertension, IUGR, severe IUGR, and intrauterine fetal death were not significantly different between two groups. Trisomy 18 and 21 were common in cases underwent amniocentesis. Conclusions: Women who underwent CVS are not at higher risk for developing hypertensive disorders than women underwent amniocentesis

Investigating the Medical Complaints Related to Normal Vaginal and Caesarean Section Delivery

Introduction: One of the goals of the health reform program (HRP) which was started in 2014, was normal vaginal delivery (NVD) promotion. Although, HRP has been successful in increasing NVD, it seems medical complaints related to the delivery have been rising during this program. Therefore, this study examined the complaints related to the NVD and cesarean section in 2011 to 2017. Materials and Methods: In this retrospective study, the complaints registered in the field of obstetrics and gynecology surgery in the sub-branch of midwifery, in the Forensic Medicine Organization and the Police Department of Tehran were investigated (before and after the HRP) randomly. Results: The results of this study showed that in 18 cases (16.3%) of the investigated medical complaints, malpractice occurred, 14 cases of which (77.8%) related to before and 4 cases (22.2%) related to after the implementation of the HRP. Conclusion: The results of this study showed that some medical malpractices are avoidable. Health system managers should pay more attention to avoidable malpractice to improve the quality of the services. The results of this study showed that the implementation of the HRP did not cause an increase in the number of registered complaints related to the delivery

Comparison of Maternal and Neonatal Outcome Following Cesarean Section at 38-40 Weeks

Background: The rate of Cesarean section is increasing which may be due to maternal and neonatal issues. Preterm Cesarean (at 38-39 weeks) has several morbidities and leads to maternal problems. The goal of this study was to compare neonatal and maternal complications following the performance of the Cesarean section after 38 weeks.Methods: This cross-sectional study evaluated 1010 subjects with term Cesarean section that referred to Yas hospital, in Tehran, Iran during 2015-7. The participants were divided into three groups based on the week of delivery. Afterward, they were studied for different neonatal and maternal complications.Results: According to the findings, the risk of adverse neonatal outcomes had a statistically negative relationship with the progress of gestational age. Moreover, the rate of hypoglycemia and hyperbilirubinemia and stillbirth was higher in neonates delivered before 38 weeks. Among the maternal complications, the rate of massive bleeding during cesarean section or in the postpartum period was significantly higher in deliveries before 39 weeks, whereas the rate of pelvic infection was higher in deliveries after 40 weeks.Conclusion: Based on the results of this study, the best time for the Cesarean section is the 39th week of pregnancy which led to the elimination of maternal and neonatal complications