Relationship Between Body Mass Index, Weight Gain During Pregnancy and Birth Weight of Infants

Introduction: Birth weight is one of the most important indicators for growth in infants. Therefore identifying the associated risk factors of abnormal birth weight is necessity. This study has been designed to detect body mass index, weight gain during pregnancy and its correlation with birth weight of infants. Methods: Between October 2010 and October 2011 in a cross sectional and descriptive study 1376 pregnant women age range between 18-35 years and gestational age <12 weeks of pregnancy were enrolled. BMI was measured at first prenatal visit and prenatal care was done according to health ministry curriculum. A questionnaire that included demographic, medical history and midwifery data was filled up for each case and preterm delivery cases were recorded. The collected data were analyzed using the SPSS software, logistic regression, student t-test, Fisher’s exact chi-square test. Results: Univariate analysis showed that LBW was related to mothers in overweight groups, although the differences was not statistically significant (P=1.00). Also the incidence of childbirth with birth weight above 4 kg in overweight and obese mothers was more (P=0.001). On the other hand our statistical analysis results showed an important role for abnormal weight gain during pregnancy, so that weight gain during pregnancy as BMI was affective to predict birth weight of infants (P=0.000, P=0.004). Discussion: Results of this study showed an association between abnormal BMI, weight gain during pregnancy and abnormal birth weight. Therefore consultation with a specialist in nutrition for women in reproductive aged could reduce the chance of LBW

Comparison of the Effects of Transcervical Ccatheter, Laminaria and Isosorbide Mononitrate on Cervical Ripening

BACKGROUND AND OBJECTIVE: Cervical ripening plays a pivotal role in successful induction of labor. Considering the importance of vaginal delivery, numerous methods have been proposed to ripen the cervix before proceeding with labor induction. This study aimed to compare the effects of transcervical catheter, Laminaria, and Isosorbide mononitrate on cervical ripening. METHODS: This clinical study was conducted at Kosar Teaching Hospital of Qazvin, Iran on 75 singleton nulliparous women with gestational age of ≥39 weeks and Bishop score of less than four. Participants were randomly divided into three groups of transcervical catheter, Laminaria, and isosorbide mononitrate. In the first group, oxytocin was administered after the spontaneous discharge of catheter, and immediately after obtaining the Bishop score of >4 in the other groups. The following parameters were recorded and compared between the study groups: interval between the time of labor induction and cervical ripening, Bishop score at the time of induction, interval between oxytocin administration and full cervical dilation, duration of the second and third labor phases, mode of delivery, and maternal and neonatal complications (IRCT: 2014012616368N1). FINDINGS: In this study, mean duration of cervical ripening was 150±42.42 minutes in the catheter group, 337.77±99.38 minutes in the Laminaria group, and 732.63±105.03 minutes in the isosorbide mononitrate group (p=0.001). Bishop scores at the time of labor induction and during the interval between induction and full cervical dilation were significantly lower in the transcervical catheter group (p=0.001). Moreover, no significant differences were observed between the study groups in terms of the duration of the second and third labor phases, mode of delivery, and maternal and neonatal complications. CONCLUSION: According to results of this study, use of transcervical catheter led to the improvement of the Bishop score and reduced length of labor phases

Effect of N-acetylcysteine with letrozole to induction of ovulation in infertile women with polycystic ovarian syndrome

Background and Objective: Polycystic ovary syndrome (PCOS) is the most endocrine disorder in women. This study was done to determine the effect of N-acetylcysteine with letrozole to induction of ovulation in infertile women with polycystic ovarian syndrome. Methods: This clinical trail study was carried out on forty PCOS women with normal TSH, prolactin, hysterosalpingographies and normal spermograms. The patients in control group were received letrozole 5 mg/d for 5 days starting at day 3 of the cycle. The patients in interventional group were received letrozole 5 mg/d with NAC 1.2 g/d (group II) for 5 days starting at day 3 of the cycle. On 14th day of cycle, transvaginal ultrasonography was performed to evaluate endometrial thickness and follicles properties. If mature follicle detected, hCG was injected and timed coitus at 12, 36 and 60 hours later advised. β-hCG level was checked on day 16 after hCG injection. Results: The mean of endometrial thickness and follicles ovulation in hCG injection day was similar in the two groups. The pregnancy rate was 15% and 20% in control and interventional groups, respectively. This difference was not significant. The mean of follicles number was 1.13% and 1.47% in control and interventional groups, respectively. This difference was not significant. Conclusion: NAC as an adjuvant to letrozole was not effective for ovulation induction in patients with PCOS

Predictors of single-dose methotrexate treatment success in ectopic pregnancies: a retrospective cohort study

Objective The present study investigated the predictors of single-dose (50 mg/m2) methotrexate (MTX) treatment success in ectopic pregnancies. Method A retrospective cohort study was conducted using information databases from a single academic tertiary care hospital among 396 participants referred for treatment of ectopic pregnancy (EP). Data were collected on age, history of EP, basal level of β-hCG, features of vaginal ultrasound (left or right), mass size, presence of hematoma around the mass and free pelvic fluid, and demand of subsequent doses of MTX or surgery. The patients were divided into success and failure groups based on whether they were treated with a single-dose of methotrexate (single dose MTX), or required subsequent doses of MTX or surgery. Results The success rate of single-dose MTX treatment was approximately 74%. The failure chance was significantly higher in right adnexal masses (OR: 3.45), history of EP (OR: 28.19), presence of hematoma on ultrasound (OR: 26.69), and serum β-hCG > 719 mIu/ml (OR: 5.19). A mass size > 19 mm was associated with a 79% increased chance of failure (p = 0.10). These variables accounted for approximately 45–66% of the failure variance for single-dose MTX treatment. Based on ROC curve analysis, initial β-hCG level of 719 mIu/ml was the best cutoff for patients with EP (with a sensitivity of 82% and specificity of 63%). Conclusion The treatment outcome of single dose MTX can be successfully predicted based on the previous history of EP, the presence of hematoma on ultrasound, mass location, and measurement of β-hCG levels before treatment