ABSTRACT
Background: preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians
Objective: to elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor
Materials and Methods: in this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length. Patients were registered in the hospital and a unit number was given. Based on the unit numbers, patients were randomly assigned to two groups using a computerized random digit generator. All participants were managed accordingly [n=65] or to receive tocolysis as planned [n=55]. Tocolysis was prescribed when cervical length was <15 mm while those with cervical length >/=15 mm were managed expectantly. Delivery within 7 days of the presentation was the primary outcome
Results: this RCT showed in case group, 78.9% of patient with cervical length <15 mm were delivered within 7 days and only 21.1% of them maintained their pregnancy. Of those with cervical length >/=15 mm, only 15.2% were delivered within the study period and the rest [84.8%] maintained their pregnancy [p<0.001]
Conclusion: "our results indicate that in women who presented preterm labor symptoms, cervical length measurement will result in decreased unnecessary tocolytic treatment. Women with cervical length >/=15mm should not receive tocolysis, however, withholding corticosteroid therapy in these patients needs further evidence
ABSTRACT
Objectives: Gestational Dabetes Mellitus [GDM] is a pregnancy-induced Impaired Glucose Tolerance [IGT] and insulin resistance occurs and diagnoses during pregnancy and gradually disappears after delivery. A mild to moderate physical activity is suggested as an adjuvant treatment for GDM; in addition, aerobic and resistance trainings might be effective in preventing or controlling GDM in the different manners. The current study aimed at comparing aerobic and resistance trainings plausible effects on insulin resistance and homeostasis model assessment of beta-cell function in females with GDM
Materials and Methods: A total of 34 females with GDM at 24[th] week of pregnancy undergoing insulin treatment were enrolled and randomly assigned into 3 groups; 12 subjects participated in an aerobic training program [3 day/week, 30 to 45 minute/day, 50% to 70% maximum Heart Rate [HR], 11 patients participated in a resistance training [3 day/week, 2 to 3 minutes set of 15 repetitions, 50% to 70% maximum HR], and 11 participants comprised the control group and not participated in any exercise program. Fasting blood samples were obtained from the subjects to assess clinical parameters
Results: The results of covariance analysis indicated a significant difference on insulin plasma levels [P=0.031] and insulin resistance index [the homeostasis model assessment-estimated insulin resistance [HOMA-IR] [P=0.008] among the groups. The resistance training program significantly reduced the level of fasting blood sugar [P=0.031] and increased HOMA-beta [P=0.031]
Conclusion: The exercise can offer a different method to patients with GDM, which benefit from several molecular pathways, and also can be proposed as a framework to design effective GDM treatment regimens and prevention programs. However, further consecutive studies are required in order to achieve the deeper and conclusive findings and obtain the mechanisms underlying the changes on the GDM acquired by exercise