Prevalence of subclinical hypothyroidism in pregnant women in Tehran-Iran

Background: Maternal subclinical hypothyroidism during pregnancy is associated with various adverse outcomes. Recent consensus guidelines advocate universal thyroid function screening during pregnancy. There are no data from Iran about the prevalence of thyroid hypofunction in pregnancy. This study aims to find the prevalence of thyroid dysfunction

Materials and Methods: In this descriptive cross sectional study, thyrotropin [TSH] was measured in 3158 pregnant women irrespective of gestational age from October 2008-March 2012. If TSH was more than 2.5 mIU/L in the first trimester or more than 3 mIU/L in the second or third trimester, free T4 was measured to diagnose subclinical/ overt hypothyroidism. If serum free T4 was in the normal range [0.7-1.8 ng/dl] the diagnosis was subclinical hypothyroidism and if below the normal range, overt hypothyroidism was diagnosed

Results: A total of 3158 pregnant women were evaluated. One hundred forty seven of them were diagnosed as hypothyroidism. Subclinical hypothyroidism and overt hypothyroidism were present in 131 [89.1%] and 16 [10.9%] women respectively. Prevalence of subclinical hypothyroidism was 4.15%. Most of the subclinical and overt hypothyroidism cases were diagnosed in the first trimester

Conclusion: It appears logical to check TSH during pregnancy due to the observed prevalence of subclinical hypothyroidism

effect of progesterone suppositories on threatened abortion: a randomized clinical trial

Threatened abortion is a common complication of pregnancy. In order to prevent miscarriage in the cases with threatened abortion, this study was conducted to determine whether progesterone suppository is effective in allowing pregnancy to proceed beyond week 20 in women with threatened abortion. This single-blind clinical trial study was done on 60 pregnant women with threatened abortion. Pregnant women, who had vaginal bleeding until 20 weeks of their pregnancy, were assessed for inclusion. Participants were divided into two groups by random allocation; the control group, which did not undergo any treatment and the case group. The case group was given 400 mg of vaginal progesterone suppository [Cyclogest] each day until their bleeding stopped in less than one week. Participants were followed up until the end of their pregnancy. The treatment was considered successful if pregnancy continued beyond 20 weeks of gestation. Qualitative and quantitative variables were analyzed statistically by Chi Square and T- test respectively. The p-values of less than 0.05 were considered significant. There was no statistically significant difference between the case and the control groups in terms of background variables. The number of abortions in the case group [6 cases, 20%] was lower than the control group which had 10 abortions [33.3%]. The study demonstrated that the rate of abortion was reduced in women treated with progesterone suppositories. However, the difference was not statistically significant

Tuboplasty as a reversal macrosurgery for tubal ligation, is pregnancy possible? A case series

Reversal of tubal ligation is requested by some women for various reasons. The present study aims to determine the rate of pregnancy after tubal ligation reversal. In these case series, we reported fifteen women who requested tuboplasty after tubal ligation. In these cases reversal of tubal ligation was done in 15 women. Pregnancy occurred in 4 women [26.6%]. Two term pregnancy and 2 abortions were determined. The success rate of pregnancy after macro surgical reversal of tubal ligation is good and can be considered before in vitro fertilization. The type of tubal ligation and the procedure used will determine the best procedure for reversal and have a major impact on chance of success for reversal surgery

role of cervical cerclage in pregnancy outcome in women with uterine anomaly

Congenital uterine malformations are the result of disturbances in mullerian duct development. In patients with recurrent miscarriage, the reported frequency of uterine anomalies varies widely, from 1.8% to 37.6%. There are reports in which cervical cerclage has been shown to prevent preterm labor in uterine anomalies. The aim of this study was to compare the role of cervical cerclage in the pregnancy outcome of women with uterine anomaly. In this historical cohort study, 40 pregnant women with uterine anomaly were investigated for outcomes of pregnancy in regards to preterm and term deliveries. The participants were divided into two groups: the case group included 26 women with uterine anomaly for whom cervical cerclage was done and the control group was composed of 14 women with uterine anomaly in whom cervical cerclage was not performed. Comparison between the two groups was done and the data were analyzed by the use of chi square, Fisher's exact test and t-test with SPSS software [version 11] and p <0.05 was considered significant. In patients with bicornuate uterus and cervical cerclage, term delivery occurred in 76.2% and preterm delivery in 23.8%. In patients with bicornuate uterus and without cervical cerclage, term delivery occurred in 27.3% and preterm delivery in 72.7% [p <0.05]. In patients with arcuate uterus and cervical cerclage, term and preterm deliveries were equal [50% vs. 50%], but in patients with arcuate uterus and without cervical cerclage, term and preterm deliveries occurred in 66.6% and 33.3% of the participants, respectively. Cervical cerclage is an effective procedure in bicornuate uterus for the prevention of preterm deliveries but it has no effect on the outcome of pregnancy in arcuate uterus

Pregnancy outcome in kidney transplant patients

Advances in surgical techniques and immunosuppressive therapy have improved the survival and quality of life in organ transplant patients. Thus, the number of organ transplant women at their reproductive age has also increased. We sought to investigate the allograft and obstetric outcomes in pregnant kidney recipients. Seventy-four kidney recipient women with 95 conceptions during their posttransplant period were evaluated. Pregnancy outcome, kidney allograft function, and maternal, fetal, and neonatal complications were evaluated in these patients. The mean interval between kidney transplantation and pregnancy was 41.0 +/- 9.5 months. Twenty-three pregnancies [24.2%] were unsuccessful due to abortion and stillbirth. The mean birth weight was 2385.0 +/- 161.7 g and 45 newborns [62.5%] had a birth weight less than 2500 g [low birth weight]. The mean Apgar score of the live babies was 7.9 +/- 0.7. Forty-four [61.1%] babies were admitted to neonatal intensive care unit and early neonatal death happened in 4 [5.5%]. Fifteen mothers [15.78%] had an uneventful perinatal period. The most common maternal complications in the 95 pregnancies were anemia in 62 [65.3%] and preeclampsia in 45 [47.4%]. Three patients 3 [3.2%] lost their graft and 6 [6.3%] had impaired kidney allograft function 2 years after pregnancy. Pregnant kidney allograft recipients should be considered as high-risk patients needing special care under the supervision of a team of obstetricians and nephrologists