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Objectives: To determine serum biomarkers in detection of preeclampsia severity among pregnant women
Methods: Among 450 pregnant women with various severity of preeclampsia, serum biomarkers ofaspartate aminotransferase [AST], alanine aminotransferase [ALT], lactate dehydrogenase [LDH], hemoglobin [Hb], platelet count [PLT], uric acid, direct bilirubin, total bilirubin, creatinine, and alkaline phosphatase were compared using area under the Receiver operating characteristic [ROC] curve and Area Under the Curve [AUC]
Results: The mean age of women was 30.63 +/- 6.43 years and with mean gestational age of 34.69 +/- 3.97 weeks. The mean level of LDH, ALT, uric acid, and creatinine were significantly higher in the women with severe type of preeclampsia compared to those with mild type. LDH level had ROC and AUC of more than 0.80, with highest sensitivity, and moderatespecificityin comparison to other markers
Conclusion: Biomarkers such as ALT, uric acid, and LDH were shown to be prognostic in detection of theseverity of preeclampsia. LDH was demonstrated to significantly be a better prognostic test in detection of preeclampsia severity
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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
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Background: This study was conducted to assess the prevalence of low birth weight and its risk factors in Fars province, south of Iran, 2014
Methods: In this cross-sectional study, we collected data of 3,600 neonates through multi-stage random sampling. At first, we divided the hospitals into two strata, private and public. Then by stratified random sampling, we selected the neonates from delivery list in each hospital. In univariate analysis, the variables in which the p-value was less than 0.2 were entered into multivariate logistic regression analysis model for adjusting. Two-sided P<0.05 were statistically considered significant
Result: The prevalence of low birth weight in Fars province was 8.7% [95% CI: 7.8%-9.7%]. In term birth, factors such as mother's age>35 years, multiple birth and duration <24 months with previous pregnancy were risk factors of low birth weight [P<0.05] and just the father's literacy was a protective factor for low birth weight
Conclusion: The prevalence of low birth weight in Fars province was low in comparison to that of the world and other districts of Iran. But we should plan for reduction of low birth weight to achieve world health organization's goal. Variables of pregnancy interval of less than 2 years, multiple births, mother's age over 35 years and father's level of education could predict low birth weight of the neonates
Subject(s)
Humans , Male , Female , Infant, Newborn , Prevalence , Risk Factors , Cross-Sectional StudiesABSTRACT
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
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One of the readily available sources of mesenchymal stem cells [MSCs] is menstrual blood-derived stem cells [Men-SCs], which exhibit characteristics similar to other types of MSCs. This study was performed to determine the growth kinetics, plasticity, and characterization of Men-SCs in women. During spring 2014 in the southern Iranian city of Shiraz, menstrual blood [5 mL] was obtained from 10 women on their third day of menstruation in 2 age groups of 30 to 40 and 40 to 50 years old. Ficoll was used to separate the mononuclear cell fraction. After the Men-SCs were cultured, they were subcultured up to passage 4. Growth behavior and population doubling time were evaluated by seeding 5×10[4] cells into 12- and 24-well culture plates, and the colonies were enumerated. The expression of CD44, CD90, and CD34 was evaluated. The osteogenic potential was assessed by alizarin red staining. The Men-SCs were shown to be plastic adherent and spindle-shaped. Regarding the growth curves in the 12-24-well culture plates, it was demonstrated that in the women aged between 30 and 40 years, population doubling time was 55.5 and 62 hours, respectively, while these values in the women aged between 40 and 50 years were 70.4 and 72.4 hours, correspondingly. Positive expression of CD44 and CD90 and negative expression of CD34 were noted. In the osteogenic differentiation medium, the cells differentiated toward osteoblasts. As human Men-SCs are easily collectable without any invasive procedure and are a safe and rapid source of MSCs, they can be a good candidate for stem cell banking and cell transplantation in women
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Background: Uterine synechiae or Asherman's syndrome is a condition that can cause infertility. The present experimental study was designed to establish the rabbit as an animal model for human Asherman's syndrome using the endometrial curettage
Methods: In an experimental study, female adult rabbits [n=18] were randomly divided into intact and ovariectomized groups. One third of caudal part of both uteri was submitted to traumatic endometrial curettage. One group was simultaneously ovariectomized. The intact rabbits were artificially induced ovulation during 10 days after surgery. One third of cranial part of both uteri was selected as the control. Synechiae occurring, luminal area/total area [LA/TA], endometrial area/total area [EA/TA], myometrial and perimetrial area/total area [MPA/TA], endometrial area/uterine wall area [EA/UWA], and myometrial and perimetrial area/uterine wall area [MPA/UWA] ratios of both uteri in six subdivided groups [n=6] were analysed in curetted and intact control parts. On days 15, 30 and 45 following surgery by two-way ANOVA and LSD test [p<0.05]
Results: Histopathologic findings showed significant epithelial damage together with significant inflammatory reaction in the intact curettage group. The LA/TA ratios of the intact curettage group on days 15 and 45 were more than the intact control group on day 15. The EA/TA ratio of the intact curettage group on day 30 was less than the intact control group on day 30
Conclusion: Uterine fibrosis was observed in intact curettage group, and this modified animal model showed a pathogenesis condition similar to intrauterine adhesions observed in human
Subject(s)
Animals , Rabbits , Models, Animal , Curettage , Uterus , FibrosisABSTRACT
Assessment of quality of life [QOL] is of paramount importance for improving postpartum QOL which will in turn enhance QOL of mothers, children, individuals, and the community. The present study aimed to evaluate and compare postpartum QOL after Cesarean Section [CS], Normal Vaginal Delivery [NVD], and water birth delivery. This descriptive analytical, cross-sectional study was conducted on postpartum women referred to urban health centers and two public hospitals in 2012-13 in Shiraz, Iran. Overall, 59 women with NVD, 39 with CS, and 39 with water birth, all at 2 months postpartum, were recruited into the study through multi-stage sampling. Postpartum QOL was measured using Short Form Health Survey [SF-36] which hadbeen adapted previously in Iran. Then, the data were analyzed using descriptive statistics and one-way analysis of variance [ANOVA] in SPSS, version 18. The results showed that the NVD group had the highest mean score in physical health domains; the women with water birth had the highest mean score in mental health domains and total QOL. Regarding postpartum QOL the results of one-way ANOVA showed no statistically significant differences between the three modes of delivery. Women with water birth and NVD had the highest and second highest total QOL mean scores, respectively; women with NVD and water birth experienced better physical health. Thus, providing more information to pregnant women to encourage them to use NVD and water birth is suggested
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Sex workers and HIV seropositive women are at high risk of abnormal cervical cytology. The objective of this study was to compare the cervical cytology among three groups of women: active sex workers, HIV-infected women, and general population in Iran. This was a cross-sectional study performed in Hazrat Zeinab, Lavan clinics and drop in center [DIC] in Shiraz, Iran. This study was performed from October 2009 to October 2011. A total of 266 patients were assigned into three groups: sex-workers [85], HIV positive patients [100], and general population [81]. Pap smear was performed for all participants from the exocervix and endocervix, using a plastic Ayres's spatula and cytobrush. The samples were sent to a pathology center, using a liquid-based media. The risk of cervical infection in sex workers and HIV positive women was greater than the general population [OR=5.47, 95% confidence interval [CI]:2.24, 13.40], [OR=3.71, 95% CI:1.52, 9.09], respectively. The frequency of abnormal cervical cytology in the HIV positive and sex worker groups was higher than the general population [OR=6. 76, 95% CI:2.25, 20.32], [OR=3. 80, 95% CI:1.19, 12.07], respectively. Low-grade squamous intraepithelial lesion [LSIL] and high-grade squamous intraepithelial lesion [HSIL] were associated with CD4 cell count<200I106/L, P=0.021 and P<0.001, respectively. Vaginal infections were seen more often in the sex worker group, and abnormal cervical cytology was greater in the HIV positive group
Subject(s)
Humans , Female , HIV , Sex Workers , Cross-Sectional Studies , Papanicolaou TestABSTRACT
To determine the frequency of asymptomatic bacteriuria in pregnant women referred to a University College Hospital in Shiraz, Iran for perinatal care, and also to determine the relation between asymptomatic bacteriuria and pyuria. This cross-sectional case series study included 389 healthy pregnant women who were referred to Hafez Hospital, Shiraz, Iran, antenatal care unit for regular perinatal care between May and August 2007. A specimen from each candidate was collected and processed following the standard microbiological technique. All the subjects were evaluated for bacteriuria. The mean age of the patients was 26.3 +/- 4.2 years. The prevalence of asymptomatic bacteriuria was 5.1%. From 75 [19.2%] patients who had >/= 5 pus cells in high power field, only 12 [16%] had positive urine culture. The most common isolated microorganism was Escherichia coli [70%] followed by Staphylococcus aureus [20%] and Group B Streptococcus [5%].We found a rate of bacteriuria in our cohort of asymptomatic pregnant subject that is well within the reported range from the literature. A negative test for pyuria is not a reliable indicator of the absence of asymptomatic bacteriuria in pregnant women. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit
Subject(s)
Humans , Female , Pregnancy , Prevalence , Pyuria , Hospitals, University , Cross-Sectional StudiesABSTRACT
Background: Herpes Simplex Virus [HSV] Type 2 is a widespread human infectious agent responsible for persistent and latent infections
Objectives: To estimate the regional seroprevalence of anti HSV-2 antibody in Shiraz, Iran and to investigate the possible correlation of seropositivity with malignant changes in subjects' Papanicolaou [Pap] tests
Methods: Data were collected in a cross-sectional study. A randomly selected population of 915 women, from nine primary health care centers according to regional population size, was recruited in this study. HSV type specific serum IgG was determined by an Enzyme Linked Immunosorbent assay
Results: The overall seroprevalence of HSV-2 antibody was 258/915 [28.19%]. Most of the seropositive cases [87.6%] were categorized in the group of less educated women. None of the individuals with positive serum antibody had malignant change in the uterine cells obtained with the help of Pap smear
Conclusions: HSV-2 infection is relatively common and largely unrecognized among our study participants. The HSV-2 antibody was more prevalent in the studied popu-lation in comparison with European and American women, and less prevalent than African women. Although HSV-2 is reported to be in correlation with cervical cancer, none of our studied subjects had any malignant change in cervical cells