Background Vaginal pH is acidic in pregnancy, but there is no information about pH changes in pregnancy, and contradictory results have been reported from the effectiveness of Misoprostol at different vaginal pH. This study aimed to evaluate the effect of vaginal washing before Misoprostol insertion on cervical ripening before induction of labor in comparison with the control group. Methods This randomized single‐blind clinical trial was performed on 148 pregnant women who were candidates for induction of labor. Subjects were randomly divided into two groups of intervention (vaginal washing with 20 cc of normal saline 0.9% before Misoprostol insertion) and the control group (without vaginal washing). Vaginal pH and Bishop scores were measured before and after the intervention. The two groups were compared in demographic‐obstetric variables, the success rate of induction of labor, maternal and neonatal outcomes, and Misoprostol dose. Results After the intervention, there was no statistically significant difference between the pH before and after in the group with vaginal washing. There was no significant difference between the two groups in the type and duration of labor, and maternal and neonatal outcomes (P > .05). The frequency of normal delivery less than 12 hours in the intervention group was higher than in the control group. Although this difference was not statistically significant due to the small number of subjects, it is clinically significant. Conclusion The results of the present study showed that vaginal washing with normal saline before Misoprostol insertion for induction of labor did not affect the success of induction and duration of labor.
Background and Aim: Increased maternal age at the time of pregnancy and labor is believed to have potential complications. To evaluate the effects of maternal age on the mode of delivery among nulliparous women with term pregnancies who underwent labor induction. Methods: In this retrospective cohort study, 313 women with the gestational age of at least ≥37 weeks, were enrolled. They were divided based on their maternal ages as: Group A < 35 years old (y/o) and Group B ≥ 35 y/o patients. Demographic features and other variables (i.e., past medical history, social history, indications and methods of labor induction, causes of cesarean delivery) were recorded from patients' files. Final outcomes were categorized as: primary (i.e., rate of cesarean section: C/S) and (b) secondary (i.e., duration of labor, postpartum complications, neonatal variables). All data were analyzed by the SPSS ver.21 software.Results: Median and interquartile ranges of gestational age were not significantly different, comparing the two groups (p = 0.415), although these variables were significantly different regarding maternal height among the two groups (p = 0.007).There was a significant relationship between the methods of labor induction among the two groups (p = 0.005). There was a prominent statistical relationship between (a) C/S deliveries and also (b) indications of C/S among the two groups (p = 0.004 and p = 0.033, respectively). Univariate logistic regression test revealed maternal age groups, neonatal weight, and history of underlying diseases had significant results (p < 0.05).Conclusions: Increased maternal age is associated with higher rates of CS among nulliparous women with term pregnancies who underwent labor induction.
Background Premature ovarian failure (POF)/premature ovarian insufficiency (POI) is characterized by disrupting ovarian function under 40 years old. A major health problem of this disorder is female infertility. There are no proven treatments to increase the rate of pregnancy with autologous oocytes in these patients. This review aims to summarize our present knowledge about POI-induced infertility treatments and to highlight the importance of future researches in the discovery of diagnostic biomarkers and treatment of patients with this disorder. Methods A literature review was carried out using PubMed and Google Scholar databases by relevant keywords, such as POI, POF, premature ovarian failure, premature ovarian insufficiency, and biomarkers. Results Two hundred three studies were included in the study following the search for the keywords. Titles and abstracts of the identified articles were evaluated for detecting relevant full-length articles. Conclusion Anti-Mullerian hormone (AMH) level appears to have considerable value as a diagnostic test for POI, but it is not reliable enough to be able to predict accurately the timing of onset of impending POI. Using an accurate biomarker, POI can be diagnosed early and infertility treatment that is concerned about can be done on time. Biomarkers in combination with other diagnostic tests could result in prediction of POI before the development of complete ovarian failure.
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