Objectives: Preeclampsia is considered as one of the most important causes of death among pregnant women all around the world. This study aimed to study the predictive value of uterine artery Doppler ultrasonography in the incidence of preeclampsia and the intrauterine growth restriction (IUGR) in pregnant women who attended Fatemieh hospital. Materials and Methods: This study was performed by the prospective cohort method and the statistical population included 108 pregnant women, in their 18-22 weeks of pregnancy, with a singleton pregnancy who referred to the prenatal Fatemieh Hospital of Hamadan during 2013-2016. The uterine artery Doppler ultrasonography was performed and the incidence of IUGR and the occurrence of preeclampsia in the followed pregnancy was evaluated in these patients. Data were analyzed by SPSS 16.0 using the chi-square and Mann-Whitney U statistical tests. Results: The mean difference of pulsatility index (PI) in patients with preeclampsia was statistically significant compared to healthy individuals (P=0.001). In addition, the mean difference of PI in individuals with infants suffering from IUGR was statistically significant compared with the infants not suffering from the IUGR (P=0.001). Further, the incidence of preeclampsia and IUGR in women with a bilateral notch in ultrasonography was significantly greater than those of the women with no report of a bilateral notch in ultrasonography (P=0.001). Conclusions: Therefore, Doppler ultrasonography of the uterine artery has a predictive value in preeclampsia among pregnant women.
Introduction: One of the concerns of painless deliveries is the safety of neonates. This clinical trial study aimed to compare the effects of epidural and spinal anesthesia on the mortality rate of neonates. Methods: This clinical trial was conducted in Hamadan Hospital in Iran. Ninety women, ages 18 to 45, were randomly assigned to receive epidural or subdural anesthesia. Using a checklist, the following were collected: demographic information, midwifery, hemodynamic status, mothers' pain intensity, and analyses of the baby's umbilical cord blood. The data were analyzed by SPSS version 16 for statistical analysis. Twenty-two of the patients with spinal anesthesia and epidural anesthesia were excluded from the study. Results: There was no significant difference between the two groups in terms of age, gestational age, parity, and severity of pain before or after anesthesia. The hemodynamic status of the mothers before and during the first postoperative period was in the normal range, except that in the spinal group, a decrease in systolic blood pressure was observed in normal range compared with the epidural anesthesia group. In blood gas analysis, the mean pH, partial pressure of carbon dioxide (PCO2), and bicarbonate (HCO3) did not show significant differences between the two groups (p > 0.05). The only complications were acidosis and epidural anesthesia. Conclusion: Based on the findings of the present study, both spinal and epidural opioids have no adverse effects on the health of neonates. However, both spinal and epidural opioid are preferred due to fewer changes in the hemodynamic changes in mothers and in umbilical cord blood gas.
Objectives: Foeniculum vulgare due to phytoestrogens is important in the treatment of female sexual dysfunction including infertility. Accordingly, this study was conducted to investigate the effect of the F. vulgare seed extract on the fertility results of assisted reproductive technology (ART) in women with a poor ovarian response (POR). Materials and Methods: In this before-after intervention, 19 infertile women with POR were enrolled by a convenience sampling method. T h e amounts of luteinizing hormone ( LH) and follicle-stimulating hormone (FSH), ovarian ultrasound volume, the number of preantral follicles, and the size of the prominent ovary were measured before treatment with F. vulgare. Then, patients were treated with F. vulgare for two months, followed by initiating the in vitro fertilization (IVF) cycle. The number of embryos transferred in previous and current cycles was investigated after IVF. Finally, the data were analyzed in SPSS 16. Results: There was a significant difference in the serum LH level (P=0.002), LH/FSH (P=0.049), the number of follicles and ovules (P=0.003), endometrial thickness (P=0.04), and ovarian volume (P=0.03) between before and after treatment with F. vulgare. Moreover, a significant difference regarding the decreased number of required days for induction was observed between before and after treatment with F. vulgare (P=0.022). Conclusions: In general, the use of F. vulgare had positive effects on improving t h e quality of oocytes and female fertility indices in women with POR.
Women have anatomically different perineal sizes. Different perineal sizes in primiparous women may be related to episiotomy and its consequences. The aim of this study was to investigate the relationship between perineal size and episiotomy during delivery. 376 primiparous women referred to Fatemieh Hospital in Hamadan with single pregnancies, in the first stage of labor, and with a gestational age of 37 weeks and more, out of which 372 participated in this study. Before entering the first stage of labor, they underwent perineal measurements, such as perineal body (PB), genital hiatus (GH), and anogenital area (AGD), in a forced position. Then, they were followed up for episiotomy and vaginal wall rupture until the end of the second stage of labor. Our outcome in this study was an episiotomy during delivery. The mean gestational age was 39.10±1.21 weeks, and the neonatal weight was 3107.37±42.39 g. 86.3% of women had an episiotomy, and 5.4% experienced perineal tear (laceration). Mean perineal size was 3.99±0.77, genital hiatus was 3.040±0.74, GH+PB was 7.39±1.05, and AGD was 8.49±1.22 cm. There was a statistically significant relationship between perineal body size episiotomy (P=0.011), GH+PB (P=0.003), AGD (P=0.017), neonatal birth weight (P=0.021), as well as grade 1 and 2 rupture (P<0.001). The size of GH+PB at the cut-off point of 6.25 cm and AGD at the cut-off point of 9.25 cm significantly increased the chance of performing an episiotomy. In primiparous women with a gestational age of 37 to 42 weeks, vaginal delivery, shorter perineum, vaginal hiatus, and anogenital distance significantly increased the likelihood of an episiotomy. On the other hand, performing an episiotomy significantly reduced grade 1 and 2 perineal tear rates.
Introduction: Missed abortion is one type of abortions in which the product of a pregnancy is dead and does not leave the cervix, despite a long period of time. Missed abortion requires urgent action due to serious maternal complications. The purpose of this study was to investigate and compare the effects of using misoprostol on the treatment of missed abortions by two different methods. Methods: In this retrospective study, 100 women with missed abortions at the pregnancy age of 4-6 weeks, who had been referred to Fatemieh Hospital of Hamadan and were candidates for termination of pregnancy, were randomly allocated into two equal groups. In the first group, 600 µg of misoprostol was administered sublingually, and in the second group, 600 µg of misoprostol was given vaginally. The treatment was repeated for both groups at intervals of 6 hours (3 times). Then, the patients were assessed at the 3 rd , 6 th and 12 th hours after treatment for onset of bleeding and success of treatment (as well as abortion, with sonography). Data were analyzed by SPSS software version 16 with 95% confidence interval. Results: In this study, the percentage of complete abortion in women receiving vaginal and sublingual misoprostol was 90% and 96%, respectively (p>0.05). The mean (±SD) of misoprostol use was 1164 (±467.02) and 924 (±367.87) µg, respectively (P=0.004). The mean (±SD) time interval between the use of the first tablet and the incidence of bleeding in women receiving misoprostol by sublingual and vaginal methods were 5.64 (±1.85) and 7.47 (±2.72) hours, respectively. Also, the time until the complete abortion for those receiving the sublingual and vaginal method was 7.10 (±1.90) and 9.38 (±2.53) hours, respectively (P<0.001). Conclusion: In women with a missed abortion, prescribing 600 µg of misoprostol by sublingual method caused a bleeding event of shorter duration than the vaginal method, and complete abortion was achieved with a higher success rate.
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