Objective Evaluation of vitamin D supplementation on ovarian reserve in women with diminished ovarian reserve and vitamin D deficiency. Methods The study is a before-and-after intervention study that was performed on women with diminished ovarian reserve referred to Shahid Mofteh Clinic in Yasuj, Iran. Eligible women were prescribed vitamin D tablets at a dose of 50,000 units weekly for up to 3 months. Serum levels of vitamin D and AMH were evaluated at the end of 3 months. Significance level was also considered P ≤ 0.05. Results Our results have been showed there was a statistically significant difference in vitamin D levels of participants before [12.1(6.5)] and after [26(9.15)] the intervention (P < 0.001). Moreover, there was a statistically significant difference in serum AMH levels of participants before [0.50(0.44)] and after [0.79(0.15)] the intervention (P=0.02 ). Conclusion In conclusion, the results of the current study support a possible favorable effect of vitamin D on increase AMH expression by acting on the AMH gene promoter. Therefore, it is possible that vitamin D increases AMH levels without changing the antral follicle count/ovarian reserve.
Objective Determining the effect of discharge time after elective cesarean section on maternal outcomes. Methods This study is a randomized clinical trial that performed on 294 women who undergo elective cesarean section. The patients were randomized in two groups by simple randomization method: Group A (discharge 24 h after cesarean) and group B (discharge for 48 h after cesarean). In both groups, during the first 24 h, they received intravenous antibiotic (cefazolin as routine order) and pethidine at the time of pain. The patients were discharged with the hematinic and mefenamic acid. The main outcome variables were satisfaction of the patient, surgical site infection, separation of incision, endometritis, urinary tract infection, gastrointestinal complications, rehospitalization, secondary postpartum hemorrhage and pain of the patient on discharge day, one and six weeks after cesarean. Results Satisfaction scores and pain score at discharge day, one and six weeks after discharge were not significant different in the study groups (P > 0.05). Another key finding of this paper was no significant difference in the incidence of surgical site infection, separation of incision, endometritis, urinary tract infection, gastrointestinal complications, rehospitalization, secondary postpartum hemorrhage at one and six weeks after discharge in the study groups(P > 0.05). Conclusion The time of discharge can be reduced to 24 h after surgery if the mother to be at good general condition, the vital signs are stable, the patient has no underlying problem and disease, and it is financed for the patient and the health system.
Background In this prospective cohort study, the perinatal outcome in idiopathic polyhydramnios compared with normal pregnancies was examined. Methods This was a prospective cohort study of 180 singleton pregnancies who received care at the referral gynecology clinic of Yasuj, Iran between 2018–2020. The inclusion criteria comprised singleton pregnancies, gestational age > 34 weeks; fetuses without structural and chromosomal abnormalities in pregnancy screening test, no maternal diabetes, negative TORCH negative screening test, no Rh factor isoimmunization. Polyhydramnios was defined as: (i) amniotic fluid index ≥ 24 cm; (ii) maximal vertical pocket of ≥ 8 cm. Perinatal outcomes were recorded in both groups. Results Postpartum hemorrhage (7.8% vs. 2.2; OR: 1.60; 95% CI 1.09–2.34) and cesarean delivery (51.11% vs. 21.11; OR: 1.88; 95% CI 1.42–2.50) and respiratory distress (4.4 v vs. 0; OR: 2.04; 95 C CI 1.75–2.80) was significantly higher in the idiopathic polyhydramnios (P ≤ 0.05) compared to normal pregnancy, which increased with severity of idiopathic polyhydramnios. Conclusion In conclusion, the results of the current study, suggest that idiopathic polyhydramnios may be associated with a higher rate of postpartum hemorrhage, cesarean delivery, and respiratory distress than a normal pregnancy.
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