A case report of an advanced abdominal pregnancy with live fetus

زمینه و هدف: حاملگی شکمی پیشرفته یک مورد در هر 85000 تولد گزارش شده است. معمولاً در اکثر حاملگی های خارج رحمی به دنبال سقط لوله ای یا داخل صفاقی، محصولات حاملگی جذب می شود ولی به صورت نامعمول ممکن است اتصال جفتی آنها باقی بماند یا در جای دیگری مجدداً لانه گزینی کند و به صورت حاملگی شکمی رشد نماید. میزان مرگ و میر مادری و جنینی در حاملگی شکمی افزایش می یابد. در این مطالعه یک مورد حاملگی شکمی 32 ای هفته با جنین زنده گزارش می شود. گزارش مورد: بیمار خانم 36 ساله ایرانی بود که به دلیل افت قلب در سن حاملگی 32 هفته با شک به دکولمان تحت لاپاراتومی اورژانس قرار گرفت. جنین پسر زنده 1800 گرمی که به دنبال پارگی پرده های جنینی در داخل حفره شکم غوطه ور شده بود خارج گردید و مادر هیسترکتومی شد. نتیجه گیری: با توجه به میران مرگ و میر بالای حاملگی شکمی باید در هر حاملگی بخصوص در صورت وجود عوامل خطر حاملگی شکمی و در بیماران دارای علائم مشکوک به این تشخیص توجه شود و اقدامات لازم و به موقع به عمل آید

A systematic review of iranian medicinal plants effective on female infertility

Infertility is one of the common and rising problems of women. To treat female infertility, medicinal plants may be used in addition to chemical drugs and assisted reproductive technology. To conduct this review, the terms Fertility and Pregnancy in combination with Medicinal plants, Herb, and Phyto were used to search for and retrieve relevant publications indexed in international databases ISI and PubMed and domestic databases Iran Medex and ISC. The articles that fulfilled the inclusion criteria were analyzed. In this systematic review article, the medicinal plants that were found to be effective on female infertility indices were reported. These plants, according to this review article, are Nigella sativa, Panax ginseng, Phoenix dactylifera L., salep, Glycyrrhiza glabra, Apium graveolens L., and Foeniculum vulgare Mill. The medicinal plants used by Iranian people have been reported to exert optimal effects on female fertility in animal studies through antioxidant properties, increasing follicogenesis, hormonal compounds, and other effective compounds on hormonal system as well as enhancing sex cells viability. © 2009-2016, JGPT

The effect of Entonox on severity of pain and mother hemodynamic and fetus apgar in natural vaginal delivery

زمینه و هدف: درد زایمان از جمله شدیدترین دردهایی است که توسط انسان تجربه می‌شود و ترس از این درد باعث انتخاب سزارین در مادران می‌گردد. یکی از روش‌های دارویی سالم و ارزان جهت تسکین درد زایمان گاز انتونکس است. این مطالعه با هدف بررسی اثرات انتونکس بر شدت درد و وضعیت همودینامیک مادر و آپگار جنین در زایمان طبیعی انجام شد. روش بررسی: در این مطالعه کارآزمایی بالینی 60 زن کاندید زایمان طبیعی مراجعه کننده به مرکز آموزشی درمانی هاجر شهرکرد که شرایط یکسان برای ورود به مطالعه داشتند، به طور در دسترس انتخاب و به صورت تصادفی به 2 گروه تقسیم شدند. پس از شروع فاز فعال زایمان انتونکس توسط ماسک در اختیار مادران گروه مداخله قرار ‌گرفت و مادران تا پایان مرحله دوم زایمان از این گاز استنشاق ‌کردند. میانگین شدت درد، وضعیت همودینامیک مادر در حین دریافت گاز و آپگار جنین پس از تولد ثبت ‌و با گروهی که انتونکس دریافت نکردند، مقایسه شد. داده‌ها با استفاده از آزمونt مستقل مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: میانگین شدت درد درمرحله اول زایمان در گروه مداخله 7/2±98/3 و در گروه شاهد 8/3 60/5 بود (03/0=P) و در مرحله دوم زایمان به ترتیب 6/0±20/7 و 10 (04/0P=) بود. بین دو گروه تفاوت معنی‌داری در میزان فشار خون مادر، میانگین ضربان قلب جنین و نمره آپگار دقایق 1 و 5 جنین وجود نداشت. میانگین تعداد تنفس و ضربان قلب مادر در گروه مداخله بیشتر از گروه شاهد بود (05/0

Comparison of the Efficacy of Intravenous, Subcutaneous, and Suppository Morphine in Reducing Post Hysterectomy Pain

Background and aims: Postoperative pain has always been considered by surgeons because of its various complications. The aim of this study was to compare the effect of intravenous, subcutaneous and suppository morphine in reducing post-hysterectomy pain. Materials and Methods: In this clinical trial, 90 patients undergoing hysterectomy were randomized into three groups of 30 each using simple randomization, namely, intravenous, subcutaneous, and suppository morphine (10 mg). Before intervention and 4, 8, 12, and 16 hours after intervention, pain intensity was measured using visual analogue scale (VAS). Relative frequency of nausea, vomiting, itching, bradypnea, and apnea in all groups was recorded. Data were analyzed by SPSS version16.0. Results: Mean pain severity at 0 hour postoperatively (P=0.004), 4 hours postoperatively (P=0.009), 8 hours postoperatively (P=0.009), and 12 hours postoperatively (P=0.001) was significantly higher in the suppository morphine group than in the other two groups. There was no significant difference in pain severity at 16 hours postoperatively among the three groups (P=0.446). According to the results of repeated measures ANOVA, changes in pain severity at the five intervals were statistically significant in all three groups (subcutaneous, intravenous, and suppository morphine groups) (P<0.001). There was also a statistically significant difference in pain severity at the studied intervals among the three groups (P<0.001). The frequency of nausea (P=0.05) and vomiting (P=0.84) was higher in the suppository group than in the other two groups, although the difference was not statistically significant (P=0.05). Conclusion: The results of this study indicated better efficacy of subcutaneous and intravenous morphine in reducing post-hysterectomy pain compared with suppository morphine. Keywords: Morphine, Hysterectomy, Pai

Evaluating the Effect of Dill (Anethum graveolens L.) Seed Essence on Pain and Vital Sign of Cesarean Delivery with Spinal Anesthesia

Background & objectives: Pain is one of the most common post-operative complications of cesarean section, which is very important for mother in nursing a baby and breastfeeding. Finding ways to overcome this pain has always been a concern for researchers. Considering the application of plants in traditional medicine as sedatives, this study evaluated the effect of Dill seed oil on post-operative pain in patients with spinal anesthesia. Methods: This double-blind, clinical trial was conducted on pregnant women who met the inclusion criteria and referred to Hajar hospital in Shahrekord, Iran during 2015-2016. By simple random sampling, the patients were divided into two groups. In the first group, 10 cc Dill (Anethum graveolens L.) seed oil was prescribed at intervals of half an hour and one hour before spinal anesthesia and half an hour , one hour and two hours after spinal anesthesia. In the second group, placebos (standard treatment) were prescribed at the same intervals. Pain and vital signs, including blood pressure, nausea , vomiting, heart rate, bleeding , use of narcotics and NSAID and any additional medications (such as atropine and ephedrine) were recorded and rechecked during surgery , thirty minutes after spinal anesthesia and one hour, four hours and twelve hours after cesarean section. Results: The findings showed a significant difference between the two groups in the third stage of the study (4 hours after cesarean section) only in respiratory rate and in the fourth stage of the study (12 hours after cesarean section) in all vital signs (p<0.05). Also, the pain and nausea rate in the third and fourth stages of the study in the case group (Dill seed oil) were lower than those of the control group, indicating a significant difference in the pain level (p<0.05). The bleeding rate and use of NSAIDs and opioids twelve hours after caesarian section in the case group were significantly lower than those of the control group (p<0.05). Conclusion: considering the effect of Dill (Anethum graveolens L.) seed oil on reducing pain, bleeding rate and use of narcotics and NSIADs, it can be used in women undergoing cesarean section

The effect of zinc supplementation in delayed preterm delivery and biometric of neonates suspected with preterm delivery in mothers suspected of having a preterm delivery

Background and aims: Micronutrient deficiency in women of reproductive age is considered as a major health problem in many developing countries. Therefore, it is important to prevent micronutrient shortage before pregnancy. This study aimed to evaluate the effect of zinc (Zn) supplementation on delaying preterm delivery and biometric neonates with suspected preterm birth. Methods: In this semi-experimental study, 140 women with preterm delivery were selected by a gynecologist in the Hajar hospital of Shahrekord University of Medical Sciences in 2016. The women were divided into four groups. Then, the serum Zn level of the mother’s blood and the umbilical cord was measured First group had a normal level; Zn level in the second group was between 50-70 mg/dL; in the third group between 20-50 mg/dL; and in the fourth group fewer than 20 mg/dL. Three groups received <20-70 mg/dL oral Zn and the normal group was given a placebo. Next, the serum Zn levels of mothers were measured and recorded at the end of the eighth month and delivery time. Infant anthropometric parameters at birth, 1 month to 3 months were measured as well. Overall, 71 (50%) and 69 (49.3%) infants were males and females, respectively. The data were analyzed using descriptive statistics and analytical statistics tests. Results: The average age of 140 pregnant women was 30.39±5.33 years old and their age range was between 18 and 41 years. In addition, the maternal Zn serum level was 56.52±33.38 mg/dL on admission and the serum level on the cord blood at birth was 53.22 ± 66.94 μg/ dL. A significant relationship was reported between the level of serum Zn on cord blood and the maternal serum Zn level on admission with growth in babies at birth and the first, second, and third month (P<0.05). Conclusion: In general, Zn is effective in children’s growth and the use of Zn supplementation can be suggested during pregnancy. Keywords: Zinc, Premature birth, Child developmen

Study of the association between serum zinc concentration in pregnant women and preterm birth

Background and aims: Preterm birth can cause high morbidity and mortality in women. Previous evidence has confirmed the association between zinc (Zn) deficiency in x women and some pregnancy complications. This study investigated the association between serum Zn concentration in pregnant women and preterm birth. Methods: This case-control study focused on evaluating 76 pregnant women with preterm birth (case group) and 62 pregnant women with term birth (control group) and was conducted in the obstetrics ward of Hajar hospital, Shahrekord, Iran in 2014. The Zn level was measured by spectrophotometry and data were analyzed by SPSS, version 15. Results: The prevalence of Zn deficiency was 95.6%. The mean of serum Zn concentration was 39.62±11.83 and 59.81±8.8 in the preterm and term delivery groups, respectively (P<0.001). Similarly, the mean of serum Zn concentrations was 43.06±15.6 and 50.46±13.8 in women with and without the rupture of pregnancy membranes, respectively (P=0.01). Based on the findings, the serum Zn concentration was not significantly associated with parity (P=0.634). Conclusion: Although a decrease in the serum Zn concentration could lead to premature rupture of membranes during pregnancy and preterm birth, it could not be considered as the main factor for preterm birth. In addition, Zn deficiency was highly prevalent in pregnant women. Therefore, nutritional interventions should be performed to prevent complications due to the deficiency of micronutrients such as Zn so that to increase health maintenance in mothers and children. Keywords: Serum, Zinc, Pregnant women, Preterm birt

The relationship of serum vitamin D, calcium, and phosphorus levels of mothers with growth indices of their newborns in pregnant women admitted to Hajar hospital of Shahrekord in 2016

Background and aims: Vitamin D deficiency is a known pandemic problem which has thousands of bad health outcomes. The aim of the current study was to investigate the effect of maternal vitamin D, Ca, and PO4 levels on growth indexes of newborns at birth and 1 month and 3 months after delivery in pregnant women admitted to Hajar hospital of Shahrekord, Iran in 2016. Materials and Methods: This descriptive-analytical study was conducted on 196 pregnant women admitted to the hospital. During pregnancy, 5 mL of mother’s blood and 5 mL of umbilical cord blood were taken. Serum calcium and phosphorus levels were determined immediately after sampling and then centrifuged. After collecting the samples, 25-OHD levels were measured by ELISA method. Neonatal growth indexes such as weight, height, and head circumference atbirth,1 month, and 3 months were measured. Data were analyzed using independent samples t test, ANOVA, and correlation coefficient by SPSS version 16.0. Results: Deficiency of vitamin D, phosphorus, and calcium was observed in 76%, 1%, and 25% of women, respectively. Moreover, deficiency of vitamin D, phosphorus, and calcium was reportedin56.1%, 15.8%, and 9.2% of newborns, respectively. There was a significant relationship between calcium level in newborns and their weight and height at birth, one month, and three months of age ( P<0.05). Levels of vitamin D, calcium and phosphorus of mother and newborns were significantly correlated ( P<0.05). Conclusion: More than two-thirds of mothers and more than half of the newborns were deficient in vitamin D. There was also a lack of calcium in one third of mothers and 9.2% of newborns, and phosphorus deficiency was observed only in 1% of mothers and 15.8% of newborns. Due to the low intake of these materials through nutrition, the supplementation of these substances, especially vitamin D and calcium, is required during pregnancy. Keywords: Vitamin D, Calcium, Phosphor, Biometry, Newbor

The medicinal plants effective on female hormones: A review of the native medicinal plants of Iran effective on estrogen, progesterone, and prolactin

Reproduction and female hormones is an important fertility health issue which is highly important in population planning. Given the significance of fertility and reproduction, and the side effects due to chemical drugs, the aim of this review article is to report the most important native medicinal plants of Iran effective on female hormones-estrogen, progesterone, and prolactin. The relevant articles, indexed in the databases Google Scholar, Scopus, Islamic World Science Citation Center, and Scientific Information Databases, were searched for by the key words-estrogen, progesterone, prolactin, female hormones, fertility, medicinal plants, and Iran. According to the study findings, Aloe vera, Foeniculum vulgare, Anethum graveolens, Portulaca oleracea L, Phoenix dactylifera and Allium sativum were effective on estrogen, A. graveolens, and P. dactylifera, on progesterone, and F. vulgare, and Vitex agnus-castus L. on prolactin. Out of these plants, A. graveolens, F. vulgare, and P. dactylifera exerted more pronounced effects on female hormones. In addition to protecting reproductive organs through antioxidant effects, the compounds of these plants can regulate female hormones through affecting the glands that secrete female hormones

Betamethasone versus dexamethasone on the fetal movement index in the women with preterm labor: A cross-sectional study

Background and aims: Biophysical evaluation of fetal profile and movements is a useful tool for assessing fetal health, which even has significant effects on neonatal health. This study aimed to compare the biophysical parameters of the profile – fetal movement index, in particular – before and after corticosteroid administration in two groups receiving dexamethasone and betamethasone. Methods: In this descriptive/analytical study, 200 patients diagnosed with preterm delivery and admitted to the gynecology section of Hajar Hospital in Shahrekord in 2016 were investigated. Their demographic findings and medical histories were collected using a checklist form. Then their biophysical profiles 24 to 48 hours after corticosteroid administration were assessed. Finally, the data were analyzed by SPSS v. 18 software using t test, chi-square and Fisher exact test. Results: According to our study results, there was a significant difference in fetal movements before and after receiving corticosteroids, and the decrease in the percentage of movements was greater in the betamethasone group (P<0.001). Also, the biophysical profile was significantly different in the dexamethasone group compared to the betamethasone group (P<0.001). No significant difference was found between two groups in terms of fetal respiration and non-stress test (NST) before and after receiving corticosteroids (P=0.47 and P=0.65, respectively). Conclusion: Dexamethasone administration had less effect on reducing fetal movement index than betamethasone administration. As the result, the biophysical profile was significantly different in the dexamethasone group compared to the betamethasone one. Keywords: Fetal movement, Betamethasone, Biophysical profile, Dexamethasone, Preterm deliver