Comparison of the effects of gonadotropin-releasing hormone and raloxifeneon the size of uterine leiomyoma

BACKGROUND: Uterine leiomyoma is a prevalent benign tumor. Several studies have shown the positive effects of raloxifene in the treatment of leiomyomas. Since raloxifene has fewer side effects than the gonadotropin-releasing hormone (GnRH) agonist, if proven effective, it can be applied easily. This study aimed to compare the medical effects of raloxifene and GnRH on uterine leiomyoma size. METHODS: This clinical trial included 53 women with uterine leiomyoma. Participants were randomly divided into 2 groups of raloxifene and GnRH. The GnRH group received 1 dose per month (intramuscular injection) and the raloxifene group received 60 mg raloxifene orally/day for 3 months. The size of the leiomyoma, prior and during the intervention, was determined by a sonographist. During the study, repeated measurement was used for comparing the trend of alterations in the tumor size. RESULTS: Analysis of changes in leiomyoma tumor size (log of tumor size) by repeated measurement showed that decrease in tumor size in the raloxifene group was significantly higher than GnRH group (P = 0.042). The trends of changes in endometrial thickness were different in the 2 groups and the reduction of thickness was more significant in the GnRH group (P = 0.026). CONCLUSION: This study showed that raloxifene is an appropriate medicine to reduce the size of uterine leiomyoma and is more effective than GnRH.

Comparison of the effects of gonadotropin-releasing hormone and raloxifeneon the size of uterine leiomyoma

BACKGROUND: Uterine leiomyoma is a prevalent benign tumor. Several studies have shown the positive effects of raloxifene in the treatment of leiomyomas. Since raloxifene has fewer side effects than the gonadotropin-releasing hormone (GnRH) agonist, if proven effective, it can be applied easily. This study aimed to compare the medical effects of raloxifene and GnRH on uterine leiomyoma size. METHODS: This clinical trial included 53 women with uterine leiomyoma. Participants were randomly divided into 2 groups of raloxifene and GnRH. The GnRH group received 1 dose per month (intramuscular injection) and the raloxifene group received 60 mg raloxifene orally/day for 3 months. The size of the leiomyoma, prior and during the intervention, was determined by a sonographist. During the study, repeated measurement was used for comparing the trend of alterations in the tumor size. RESULTS: Analysis of changes in leiomyoma tumor size (log of tumor size) by repeated measurement showed that decrease in tumor size in the raloxifene group was significantly higher than GnRH group (P = 0.042). The trends of changes in endometrial thickness were different in the 2 groups and the reduction of thickness was more significant in the GnRH group (P = 0.026). CONCLUSION: This study showed that raloxifene is an appropriate medicine to reduce the size of uterine leiomyoma and is more effective than GnRH

The Effects of Vitamin D Supplement on Prevention of Recurrence of Preeclampsia in Pregnant Women with a History of Preeclampsia

Introduction. Preeclampsia is a pregnancy-specific syndrome. One of the hypotheses concerning the etiology of preeclampsia is vitamin D deficiency during pregnancy. Method and Materials. The present study is a randomized controlled clinical trial which aims to determine the effect of vitamin D supplement on reducing the probability of recurrent preeclampsia. 72 patients were placed in control group while 70 patients were randomized to the intervention group. The intervention group received a 50000 IU pearl vitamin D3 once every two weeks. The control group was administered placebo. Vitamin D or placebo was given until the 36th week of pregnancy. Results. The patients in intervention group have significantly lower (P value = 0.036) probability of preeclampsia than patients in the control group. The risk of preeclampsia for the control group was 1.94 times higher than that for the intervention group (95% CI 1.02, 3.71). Conclusion. The intended intervention (i.e., prescription of vitamin D) has a protective effect against recurrent preeclampsia. Vitamin D supplementation therapy in pregnancy could help in reducing the incidence of gestational hypertension/preeclampsia. Registration. This study has been registered in Iranian Registry of Clinical Trials (IRCT) site with ID number IRCT2017010131695N1

Effect of early amniotomy on labor outcome in nulliparous women: a randomized clinical trial

Early amniotomy is one of the main interventions to enhance the labor progress and prevent dystocia in pregnant women. However, the efficacy of amniotomy has not been approved via labor-related indices and outcomes and has remained a subject for debate and future research. The present study was conducted to evaluate the effect of early amniotomy on labor indices and outcomes in nulliparous women. This randomized clinical trial was performed on 151 singleton pregnant women who were referred to Besat Hospital in Sanandaj, Iran, from March 2016 to March 2018. Participants were randomly divided into an early amniotomy (EA) group and a control group. Duration of the first and second phases of labor, corioamionit, dystocia rate, Apgar score at the first and fifth minutes, prolonged labor and post-partum haemorrhage were evaluated and compared between the two groups. Data were recorded in a checklist and analysed using SPSS Version 23. The p value <0.05 was considered significant. Results showed that labor indices such as duration of the first and second phases, Apgar score one and five minutes after delivery and frequency of prolonged labor, foetal distress and postpartum haemorrhage were significantly improved in patients of the early amniotomy group, compared with the control group (p≤0.05). Early amniotomy significantly decreased the total labor duration without significant increase in the rate of maternal and neonatal complications