Background. Macrosomia is defined as an infant's birth weight of more than 4000 g at term which is to different maternal and neonatal complications. Several studies have been done on factors influencing risk of macrosomia, but there is lack of information and study in our country regarding macrosomia complications. Objective. The aim of this study was to determine the prevalence of macrosomia and its complications. Method. A cohort study was conducted from 2007 to 2011 at Obstetrics and Gynecology Department, Razi Hospital in Ahvaz city, Iran. All pregnant mothers who were referred to Obstetrics and Gynecology Department for delivery were included in this study. The total number of 201,102 pregnant mothers was recruited and divided into case and control groups after delivery (macrosomia (case) and normal weight infants (control) groups). Results. Out of total deliveries (201,102), there were 1800 macrosomia, (9%). Gestational diabetes, maternal obesity (BMI), maternal aged and positive history of previous macrosomia were the major risk factors for macrosomia which were compared with the normal weight infant groups (P < 0.001 for all parameters). Neonatal complications associated with macrosomia included humerus—clavicle fractures and arm—brachial plexus injury which were significant compared to the control group (P < 0.001 for all parameters). Conclusion. The macrosomia is potentially dangerous for the mother and the neonate. It is important to recognize the suspected fetal macrosomia to prevent its risk factors and complications. There is a need to provide all delivery facilities and care services to prevent and reduce the maternal and neonatal macrosomia complications.

Background:Ectopic pregnancy (EP) is one of the most dangerous complications of pregnancy and without prompt diagnosis and treatment, it could become a major cause of maternal morbidity and mortality.Objectives:In this randomized controlled study, we compared single and double dose of methotrexate (MTX) therapy in the treatment of ectopic pregnancy.Patients and Methods:This study was performed on 76 patients who were admitted to Obstetrics Ward with primary diagnosis of ectopic pregnancy based on their medical history, physical examination, beta subunit (β-HCG) level, and transvaginal ultrasonography. Using random block allocation, the patients were classified in two groups of single dose and double dose administration of MTX. In single dose group, 50 mg/m2 of MTX was given at day 0 and in double dose group, the patients received two doses of MTX at day 0 and 4. The level of β-HCG was measured at day 0, 4, 7 in both groups. The successful treatment was defined as 15% reduction in β-HCG level between day 4 and 7. The two groups were compared with each other with regard to their need for operation, or extra dose of MTX; duration of hospitalization; and MTX complications.Results:Results showed that the rate of success in double dose method was more than single dose one (79% versus 69%) but the difference was not significant (P = 0.29). Although the need for operation and extra dose of MTX were lower in the double dose group (15.8% vs. 18.8% and 5.26% vs. 13.2%, respectively), these differences were not significant too. Duration of hospitalization was significantly lower in double dose compared to the single dose (11.55 d vs. 14.76 d, P < 0.001).Conclusions:Single dose therapy of MTX has sufficient power and efficacy in the treatment of ectopic pregnancy, however in patients with higher serum level of β-HCG, the successful treatment increases by using double dose method. Using double dose also could decrease the necessity of operation, re-administration of MTX, and duration of hospitalization.

The frequency of GBS culture from rectal samples was higher than vaginal samples. However, the detection percentage of GBS using PCR from vaginal samples was higher than rectal samples. By contrast, the culture is a time-consuming method requiring at least 48 hours for GBS fully identification but PCR is a sensitive and rapid technique in detection of GBS, with the result was acquired during 3 hours.

Background: Since labor and delivery units often serve as emergency units for pregnant women, the use of obstetric triage systems with poor or inadequate quality can lead to unintended consequences such as over and under-triage and so a waste of humans and financial resources. Therefore, this systematic review was conducted to evaluate the measurement properties of obstetric triage tools. Methods: PubMed, EMBASE, and Medline were searched to identify studies in October 2018 and were updated in May 2019. The risk of bias COSMIN checklist was used to evaluate the quality of the studies. The quality of every measurement property was appraised by the update criteria of COSMIN. Evidence quality was judged using the modified GRADE approach. Results: A total of 444 studies were retrieved in initial search. Six studies evaluating 4 tools were included in this study. All the included studies reported only content validity and reliability. The quality of evidence varied from very low to moderate. The quality of content validity and reliability of the included tools was sufficient except for the reliability of the maternal-fetal triage index. The obstetric triage acuity scale (OTAS) was found to have higher reliability than other tools. Conclusions: Due to insufficient evidence, the conclusions about the quality of measurement properties of each obstetric triage tool may be uncertain. This review emphasizes the necessity for further studies with robust methodological quality on the measurement properties of obstetric triage tools.

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Our results demonstrate that measurement of sHLA-G protein level may be helpful as a primary diagnosis for the pathogenesis of PE. Overall, this study suggests that the association between HLA-G 14 bp polymorphism and serum sHLA-G level in different ethnic populations of PE should be taken into consideration.

Evaluation of the e fect of platelet-rich plasma (PRP) containing platelet-derived growth factor on in vitro fertilization (IVF) failure patients. Methods: In this clinical trial, 80 eligible patients (infertile women with at least two IVF failures) were randomly assigned into two groups, including patients who received an intrauterine infusion of PRP (n: 40) and controls (n: 40). Before PRP therapy, standard hormone replacement therapy was performed for all patients to endometrial thickness preparation. A ter sonographic assessment of endometrium, PRP was injected into all patients' endometrium whether they had an appropriate endometrial thickness or not. Then, the embryo transferring was done through IVF. Eventually, the consequences of fertility, embryo implantation, and pregnancy were evaluated. Data analysis was performed using SPSS version 22. Results: The rate of successful IVF [6 (15%)], pregnancy rate [5 (12.5%)], and live birth [5 (12.5%)] were relatively higher in patients undergoing PRP therapy compared with controls [2 (5%), 1 (2.5%) and 0, respectively]. However, their statistical di ference was not significant between the two groups (P > 0.05). Conclusion: Our findings suggest that endometrial injection of platelet-rich plasma for IVF failure patients did not significantly improve the IVF process, pregnancy, and live birth rates.

Objective: The aim of this study was to assess the effect of fennel on sexual function in postmenopausal women. It was a randomized controlled trial in 60 postmenopausal women with sexual dysfunction who were randomly assigned to two groups receiving either fennel vaginal cream (n=30) or placebo (n=30). Vaginal atrophy in the women was assessed using symptoms such as pallor, dryness, dyspareunia, itching and burning. The pH of the vagina and cytology of the vaginal mucosa were also measured at baseline and 8 weeks after the intervention. All participants were requested to fill out the Female Sexual Function Index (FSFI) at baseline and after 8 weeks. The intervention group was requested to use fennel vaginal cream (5 grams) every night, while the control group used placebo each night for 8 weeks. The data were analyzed using the independent t-test and Chi-square, Mann-Whitney and Wilcoxon tests. All areas of sexual function including arousal, lubrication, orgasm, sexual satisfaction and pain improved in both fennel and placebo groups after 8 weeks; however, the differences in the fennel group were more evident (p<0.05). The total FSFI score was significantly higher in the fennel group compared to the control group (8.2 ±9.4 and 8.03±10.36 before the intervention and changing to 33.79±0.7 and 18.99±1.09 after the intervention in the fennel and placebo groups, respectively; p<0.001). Discussion: According to our results, fennel vaginal cream is an effective means of improving sexual activity in postmenopausal women. The use of this product in women who have sexual dysfunction and contraindications for hormone therapy is recommended.