Background Despite the large number of pregnant women with the coronavirus disease 2019 (COVID-19), there is not enough analytical study to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies. This cohort study aimed to compare maternal and fetal consequences of COVID-19 infected with non-infected pregnancies. Methods We included pregnant women with and without COVID-19 who were admitted to Arash Hospital in Tehran, Iran from March 1 to Sep 1, 2020. Clinical features, treatments, and maternal and fetal outcomes were assessed. Results One hundred and ninety-nine women enrolled, including 66 COVID-19 infected and 133 non-infected pregnant women prospectively. Caesarean Section (CS) was carried out in total 105 women (52.76%). A significant difference was found in term of delivery type between COVID-19 infected and non-infected pregnant women (aRR: 1.31, 95%CI: 1.04, 1.65, p = 0.024). No significant association was found between COVID-19 infection and preterm birth (PB) (aRR: 1.16, 95%CI: 0.54, 2.48, p = 0.689), low birth weight (LBW) (aRR: 1.13, 95%CI: 0.55, 2.31, p = 0.723), gestational diabetes (GDM) (aRR: 1.67, 95%CI: 0.81, 3.42, p = 0.160), preeclampsia (aRR: 2.02, 95%CI: 0.42, 6.78, p = 0.315), intrauterine growth restriction (IUGR) (aRR: 0.16, 95%CI: 0.02, 1.86, p = 0.145), preterm rupture of membrane (PROM) (aRR: 0.19, 95%CI: 0.02, 2.20, p = 0.186), stillbirth (aRR: 1.41, 95%CI: 0.08, 18.37, p = 0.614), postpartum haemorrhage (aRR: 1.84, 95%CI: 0.39, 8.63, p = 0.185), neonatal intensive care unit (NICU) admission (aRR: 1.84, 95%CI: 0.77, 4.39, p = 0.168), neonatal sepsis (aRR: 0.84, 95%CI: 0.48, 1.48, p = 0.568). The percentage of patients (4/66, 6.06%) being admitted to the ICU was significantly higher than the control group (0%) (p < 0.001). Conclusion Basically, although pregnancy and neonatal outcomes were not significantly different, the need for ICU care for pregnant women with COVID-19 was significantly higher compared with those without COVID-19.

Objectives: To evaluate effectiveness of combined treatment with cervical pessary (CP) and vaginal Progesterone (VP) for the prevention of preterm birth in singleton pregnancies with cervical consistency index (CCI) ≤ 5th percentile at 11-13 weeks' gestation. Methods: Prospective study from January 2016 to February 2017 was performed and transvaginal CCI and cervical length (CL) measurement were taken at 11-13.6 weeks' gestation in 615 singleton pregnancies. Patients with CCI ≤ 5th percentile were offered combined treatment with CP and VG 200 mg/day. VP was given until 34 weeks; CP was removed at 36 weeks or at the onset of labour. Patients with uterine contractions, bleeding or premature rupture of membranes were excluded. Preterm birth defined as born before 37 weeks of gestation, was match (1:3) by gestational age and CCI. Results: 36 pregnant women of study group (who received treatment) had an average CL measurement of 37.4 mm, CCI of 51% and the mean gestational age at enrolment was 12.3 weeks compared to the control group (12 patients who did not receive treatment) 40.4 mm, 53% and 12.1 weeks respectively. Combined treatment compared to no treatment was associated with a statistically significant increase at the gestational age at delivery (33.3 VS 28.4 weeks; p <0.001). Conclusions: Combined treatment with CP and VP in singleton pregnancies with CCI ≤ 5th percentile at 11-13.6 weeks increases the gestational age at delivery. Supporting information can be found in the online version of this abstract P01.08 Comparison of preventive measures for preterm deliveries in twin pregnancies between pessary-progesteron and cerclage alone Objectives: To compare the combination of pessary-progesterone and cerclage in twin pregnancies with high risk of preterm delivery. Methods: Between 2006 and 2016, all twin pregnancies at a tertiary referral centre in Ankara for high-risk pregnancies were reviewed. All those etiology of preterm twin deliveries were investigated and different preventive measures for preterm deliveries were compared. High-risk of preterm delivery by obstetric history and cervical assessment of transvaginal ultrasonography was determined. Cervical length less than 25mm were considered high-risk for preterm delivery. Chi-square, Fisher's, Student T-test and Mann-Whitney U tests were used for the statistical analyses. P value less than (p>0.05) is considered statistically significant. Results: Total number of twin pregnancies were found to be 6.7% (449/6727). Of those, 32.1% (144/449) and 79.9% (359/449) were delivered before 34 weeks and 37 weeks of gestation, respectively. Among the high-risk patients, two different approaches to prevent preterm birth were compared. Cerclage (Group I) was used on 21 patients and Pessary-Progesteron (Group II) together was performed on 21 patients too. Total of 395 twin pregnancies were without cerclage or pessary-progesteron. The mean age of the groups were 32 in both groups. There was no statistical difference between the groups in terms of obstetric history (gravida...

BackgroundPlatelet-rich plasma (PRP) is a human plasma product enriched by platelets, growth factors, and fibrinogen with high hemostatic and healing properties.ObjectivesThe aim of this study was to evaluate the effect of autologous PRP on wound healing in high-risk women undergoing cesarean sections.Patients and MethodsIn this balanced, randomized, and controlled trial, 140 patients were admitted to Arash women’s hospital, Tehran, Iran from May of 2013 to November of 2014 for elective cesarean surgery. The patients were randomly assigned into two groups. The intervention group received PRP after surgery, whereas the control group received the usual care. All patients were evaluated at baseline, five days, and eight weeks after the cesarean section. The primary endpoint used the REEDA scale for assessing the changes in wound healing. The secondary outcome measures used were the Vancouver scar scale (VSS) and the visual analog scale (VAS). All scale scores were analyzed using a repeated measures test for variance.ResultsAt the end of study, the PRP group showed a greater reduction in the edema ecchymosed discharge approximation (REEDA) score compared to the control group (85.5% reduction in the PRP group; 72% in the control group) (P < 0.001). Compared with the control group, the PRP group had a significantly greater reduction in the VAN score, beginning on the fifth day after the cesarean section (-0.7, 38% reduction in PRP group; -0.8, 33% in control group) (P < 0.001), and this trend was stable at the end of the eighth week (-0.6, 54% reduction in PRP group; -0.3, 18% in control group). Furthermore, patients treated with PRP experienced a 93% reduction in the VAS score at the end of follow-up, but the control group only observed a 79% reduction (P < 0.001).ConclusionsIt seems that applying PRP is an effective therapeutic approach for wound healing, and faster wound healing is expected due to the presence of more platelets and growth factors.

BackgroundGrowing evidence indicates that the risk of obstetric and perinatal outcomes is higher in women with assisted reproductive technology (ART). However, there is little known about pregnancy related complications and co-morbidity in gestational diabetes mellitus (GDM) following singleton pregnancies achieved by ART in comparison with spontaneous conception (SC).MethodsTwo hundred sixty singleton pregnant women conceived by ART and 314 pregnant women conceived by spontaneous conception (SC) were participated in this prospective cohort study. All participants were enrolled after GDM screening through one-step oral glucose tolerance test (OGTT) and then grouped into GDM and non-GDM groups. Women were followed for pregnancy outcomes including pregnancy-induced hypertension (PIH), preeclampsia, antepartum hemorrhage (APH), cesarean section (CS), preterm birth (PTB), intrauterine growth restriction (IUGR), being small or large for gestational age (SGA or LGA), macrosomia, low birth weight (LBW), respiratory distress, neonatal hypoglycemia, NICU admission and perinatal mortality from antenatal visits to delivery. Confounding factors were adjusted in logistic regression model in order to estimate adjusted odds ratios (aORs).ResultsAmong 260 ART and 314 SC, 135 and 152 women were GDM women, respectively. Higher maternal age and pre-gravid BMI, shorter duration of gestation and lower gestational weight gain were observed in GDM groups (ART-GDM and SC-GDM) compared to those of the SC group. ART-GDM group had a higher risk (95% confidence interval) of obstetric complications including PIH [aOR:7.04 (2.24–22.15)], preeclampsia [aOR:7.78 (1.62–37.47)], APH [aOR:3.46 (1.28–9.33)], emergency CS [aOR:2.64 (1.43–4.88)], and perinatal outcomes such as PTB [aOR:3.89 (1.51–10.10)], LBW [aOR:3.11 (1.04–9.30)] and NICU admission [aOR:4.36 (1.82–10.45)], as well as neonatal hypoglycemia [aOR: 4.91 (1.50–16.07)], compared to SC group. SC-GDM group showed a higher risk of PIH [aOR: 4.12 (1.31–12.89)], emergency CS [aOR: 2.01 (1.09–3.73] and LGA [aOR: 5.20 (1.07–25.20)], compared to SC group. Additionally, ART group had a higher risk of PIH [aOR: 3.46(1.02–11.68), preeclampsia 5.29 (1.03–27.09), and NICU admission [aOR: 2.53 (1.05–6.09)] compared to SC. Insulin requirement (41.8% vs. 25.7%) was significantly higher in ART-GDM group compared to SC-GDM group.ConclusionThe findings of this study suggest that GDM occurring after ART conception increases the risk of adverse obstetric and perinatal outcomes.

Objective To determine the impact of a history of spontaneous abortion on pre‐eclampsia during a subsequent pregnancy. Methods A cross‐sectional study enrolled pregnant women admitted to obstetrics and gynecology wards at 103 hospitals in Tehran, Iran for delivery between July 6 and July 21, 2015. Consenting participants were interviewed by midwives; data were collected using a five‐part questionnaire and patients' medical records were retrieved. Patient data were analyzed by multiple logistic regression to identify variables associated with increased odds of pre‐eclampsia. Results In total, 5170 patients were interviewed and 252 had experienced pre‐eclampsia. The number of previous spontaneous abortions was found to be associated with pre‐eclampsia, and a higher number of previous spontaneous abortions was associated with increased odds of patients having experienced pre‐eclampsia (adjusted odds ratio 1.28, 95% confidence interval 1.03–1.59; P=0.025). Conclusion A history of spontaneous abortion was associated with increased odds of pre‐eclampsia during a subsequent pregnancy.

Ovarian tissue cryopreservation together with follicle culture provides a promising technique for fertility preservation in cancer patients. The study aimed to evaluate follicle parameters in a culture medium supplemented with VEGFA165 and/or fetuin. Vitrified-warmed ovarian cortical pieces were divided randomly into four culture groups consisting of basic culture medium (control), and the basic culture medium supplemented with VEGFA165, fetuin or both. After six days of culture, we evaluated the following: percentage of resting, primary and secondary growing follicles; survival rate; steroid hormones production; levels of reactive oxygen species, lipid peroxidation and total antioxidant capacity; and developmental and antioxidant gene expression. The addition of VEGFA165 alone or in combination with fetuin to the culture medium caused resting follicle activation and increased the number of growing follicles. In the VEGFA165 group, we found a significant increase in the concentrations of 17β-estradiol at day 6 and progesterone from 4th day of the culture period. In the VEGFA165 + fetuin group, the concentration of 17β-estradiol rose at day 4 of the culture period. The levels of BMP15, GDF9 and INHB mRNAs were increased in all treated groups. In the fetuin and fetuin + VEGFA165 groups, we observed a high level of total antioxidant capacity and expression of SOD1 and CAT genes, low reactive oxygen species and lipid peroxidation levels and increased number of viable follicles. In conclusion, the present study provides useful evidence that supplementation of culture medium with VEGFA165 + fetuin leads to primordial follicle activation and development and increased percentage of healthy secondary growing follicles.

The route of progesterone administration, previous OHSS risk and history of PCOS seem to be putative risk factors for GDM in women conceived by ART.

No abstract