Background. Low adherence of pregnant women to the content of prenatal care guidelines (PCGs) is one of the most significant issues in obstetrics.Objective. This study aimed to improve the well-being of the mother and fetus by preventing maternal and neonatal complications using the adherence to antenatal care (ANC). Patients and methods. An integrated retrospective-prospective longitudinal study with participating 604 pregnant women was carried out in the Iranian community. A valid researcher-made tool was used to implement this three-stage research approach. The results of demographic and obstetric characteristics, the adequacy of adherence to PCGS, and pregnancy outcomes were analyzed using multivariate logistic regression to assess the compliance of women with pregnancy outcomes. Results. 71.36% of the total population had a complete adherence (≥ 80%) to the PCGs. The women with higher education levels substantially showed more adherence to this healthcare program guideline (p = 0.0001). In relation to pregnancy outcomes, there was a significant relationship between women's adherence to PCGs and neonatal complications (p < 0.05). Conclusion.The assessment of PCGs content was successful in evaluating ANC quality. The complete adherence to first ANC guidelines could efficiently promote neonatal outcomes, whereas it showed no effect on maternal outcomes. SOMMARIOBackground. La scarsa aderenza delle donne incinta al contenuto delle linee guida per l'assistenza prenatale (PCG) è una delle questioni più significative dell'ostetricia. Obiettivo. Questo studio mira a migliorare il benessere della madre e del feto, prevenendo le complicazioni materne e neonatali con l'aderenza alla cura prenatale (ANC). Pazienti e metodi. Nella comunità iraniana è stato condotto uno studio longitudinale retrospettivo/prospettivo integrato con 604 donne incinta partecipanti. Per implementare in tre fasi questo approccio di ricerca è stato utilizzato un valido strumento per ricercatori. I risultati delle caratteristiche demografiche e ostetriche, l'adeguatezza dell'aderenza al PCGS e gli esiti della gravidanza sono stati analizzati utilizzando la regressione logistica multivariata, al fine di valutare la conformità delle donne agli esiti della gravidanza. Risultati. Il 71,36% della popolazione totale ha avuto una completa aderenza (80%) ai PCG. Le donne con livelli di istruzione superiore hanno mostrato sostanzialmente una maggiore aderenza a questa linea guida del programma sanitario (p -0,0001). Per quanto riguarda gli esiti della gravidanza, c'è stata una relazione significativa tra l'aderenza delle donne ai PCG e le complicazioni neonatic (p < 0,05). Conclusione. La valutazione dei contenuti dei PCG è risultata efficace per la valutazione della qualità dell'ANC. La completa adesione dell'ANC alle prime linee guida potrebbe promuovere efficientemente i risultati neonatali, mentre non ha mostrato alcun effetto sui risultati materni.
10.30699/jambs.28.128.151 Background & Objective: Gestational trophoblastic disease (GTD) is a type of disease which is characterized by increased production of B-HCG by placental cells. Increased β-HCG production is due to increased proliferation of beta cells and lack of apoptosis. If left untreated, it can lead to malignancy. Almost 30-50 of GTD progresses to gestational trophoblastic neoplasia (GTN) in women over 40 years old. This study aimed to evaluate the effect of vitamin A doses (100,000 IU and 200,000 IU) on the decrement of β-HCG levels. Materials & Methods: The study included three groups: two patients and one control, and each group contained 22 individuals. Two groups of patients (A and B) received 100,000 IU and 200,000 IU doses of vitamin A, respectively, in addition to suction curettage. β-HCG levels were then measured by radioimmunoassay (RIA). Results: The β-HCG drop-in group B, which received 200,000 IU of vitamin A, was higher than that of group A. It was significant in the third and fourth weeks after the treatment compared to the control group. There was also a significant relationship between the three groups in terms of Gravid (P<0.001). All the patients were followed up for 6 months. Conclusion: Considering that in the long run, the dose of 200,000 IU compared to the dose of 100,000 IU of vitamin A did not significantly reduce the B-HCG, therefore, in order to prevent the complications of high doses, the single dose of 100,000 IU was used for GTD patients.
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