Outcomes of total versus subtotal abdominal hysterectomy

There is still controversy about the best technique for hysterectomy to reduce postoperative adverse effects. This randomized clinical study in Babol, Islamic Republic of Iran, compared some clinical complications and sexual functioning following subtotal [SAH] and total abdominal hysterectomy [TAH]. A total of 150 women [50 allocated to SAH and 100 to TAH] were followed up at 6 months postoperatively. Length of hospitalization was 4.40 [SD 1.90] days after SAH and 4.48 [SD 1.67] days after TAH. Haemoglobin level, postoperative fever, symptoms of dyspareunia and frequency of sexual intercourse were not significantly different between the 2 groups of women. SAH did not show any significant benefits over TAH

Maternal hematocrit status affecting pregnancy outcome

Low and high maternal hematocrit can influence outcome of pregnancy.Anemia is frequently observed during pregnancy. This study was performed to determine the maternal hematocrit status affecting pregnancy outcome in babol, northern Iran. The present cohort control study was conducted from Dec 2001 to Dec 2002 and comprised 609 randomly selected pregnant women who attended Yahyanejad Hospital for antenatal care and delivery. Women with hemoglobinopathies such as thalassemia were excluded from the study. Maternal characteristics including hematocrit values were recorded at the first antenatal care visit when 3ml blood collected from each woman was sent to the laboratory for CBC. Anemia marked by hematocrit<34% in the first trimester was associated with a significantly increasing risk of low birth weight [<2500 g] and preterm delievery which was indicated by the gestational age of less than 37 weeks. High hematocrit values [>40%] did not increase the risk of low birth weight or preterm delivery. The risk of low Apgar score, operative deliveries and admittance to the newborn intensive care unit [NICU] were significantly increased in women with high and low hematocrit. Thus pregnant women with abnormal hematocrit are at high risk and due awareness is required of how to prevent complication and dismal outcome of pregnancies by special clinical care

Study of relationship of sperm parameters with successful IUI in Fatemeh Zahra Infertility Center in Babol

Intrauterine insemination [IUI] after ovulation induction is one of the infertility treatment methods that is used before more invasive assisted reproductive techniques [ART] because of its simplicity and low expenditures. This procedure is performed in different kinds of sub-fertility such as those related to male factors, cervical factors and unexplained infertility. The aim of this study was to determine the relationship of sperm parameters with IUI success. In this cross sectional descriptive analytical study, 223 infertile couples who had undergone 413 IUI cycles were studied. Sampling method was census and based on available medical records of the patients in 2004. Number of IUI cycle and sperm parameters of the patients were reviewed. Semen analysis was done on the basis of NAFA-ESHRE guide manual [2001]; data were collected and then analyzed statistically by means of X[2], T and Fisher exact tests. p<0.05 was considered significant. Pregnancy rate was 7.7% for every IUI cycle and 14.3% for every couple. Those who had progressive sperm [grade 3 and 4] in their first semen analysis, had more pregnancy rate [19.8% vs. 8.9%] [p=0.016]. Those with 15% and more morphologically normal sperm had higher pregnancy rate [18.3%], but, in other subjects with less than 15%, the pregnancy rate declined to 9.8% [p=0.143]. In the study of sperm count after washing, the pregnancy rate in the wives of the men with total sperm count of more than 20 million was 16%, while total sperm count of less than 20 million, led to a pregnancy rate of 3.4% [p=0.054]. According to our study the existence of progressive sperms [grade 3 and 4] in semen analysis before washing, is one of the most important factors in prediction of IUI success

[Peripartum cardiomyopathy: a case report]

Peripartum cardiomyopathy is a rare but sometimes fatal form of heart failure during the period of 1 month antepartum to 5 months postpartum. The aim of this report is to assess the clinical presentation, management and crucial role of echocardiography in women with peripartum cardiomyopathy. A 22 year-old woman, with previously healthy primipara, was admitted to the emergency ward with sever dyspnea, cough, and bloody hemoptesis and a preliminary diagnosis of pulmonary embolism [PE] two weeks after cesarean section. Neither perfusion scintigaphy nor Doppler sonography test of lower extremities and pelvis showed any evidence of PE or deep venous thrombosis. Echocardiography revealed features of left ventricular failure. A diagnosis of peripartum cardiomyopathy was made, appropriate treatment was administered and the patient improved. It is possible to misdiagnose peripartum cardiomyopathy with PE. Echocardiography is a valuable tool in the differential diagnosis. As a noninvasive procedure, it should be performed at the bedside as soon as possible to introduce proper treatment and to avoid potentially fatal errors

Comparison of fetal and maternal complication in twin and singleton pregnancies

Reflecting the wide variability of assisted reproduction technologies, the incidence of twin and higher order multiple gestation is increased which associated with complications and prenatal and maternal morbidity and mortality. The purpose of this study was to compare fetal and maternal complication in twin and singleton pregnancies. This prospective study was performed on 108 twin pregnant women [case group] and 201 singleton pregnant women who referred to Babol Yahyanejad hospital during 2001-2003. Data related to patients were recorded in a questionnaire and the complication rate in both groups was compared. T-test and fishers exact test were used when appropriated. Frequency of twin pregnancy was 1.4%. Preterm delivery was 60.2% in twin and 2.7% in singleton [p<0.05]. Low birth weight and growth retardation was in 45.8% and 38.4% of twin and 7.5% and 10% of singleton, respectively. It was statistically significant [p<0.05]. Frequency of placental abruption, previa, preeclampsia, fetal anomaly and death were not statistically significant. Results show that fetal complications such as preterm delivery, growth retardation and low birth weight were seen with higher frequency in twin pregnancies compared to singleton pregnancies. Since, this may cause high prenatal morbidity and mortality, therefore more attention is required to reduce complication

Correlation between basal antral follicle count and mean ovarian diameter with ovarian responsiveness in ART cycles

Since, ovarian response during assisted reproductive technology [ART] depends on ovarian reserve so it is important to evaluate ovarian reserve before the ART cycle. The purpose of this study was to determine correlation between basal antral follicle count and mean ovarian diameter before treatment with ovarian responsiveness. This study was performed on 94 infertile women who consecutively underwent ART in Fatemeh Zahra Center in Babol for one year. FSH, LH and FSH/LH were measured on day 3 of cycle, and basal antral follicle count and mean ovarian diameter were determined by vaginal sonography. GnRH Agonist was administered for hypophysial down regulation and then gonadotropin was administered for induction of ovulation. Ampules of gonodotropin, days of stimulation, numbers of oocytes, pregnancy rate and cycle cancellation were recorded. A positive linear correlation was seen between basal antral follicle count with recovered oocytes [p<0.05]. Also, pregnancy rate had a positive linear correlation with recovered oocyte, fertilized ovum and basal antral follicle count [p< 0.05]. A negative linear correlation was observed between basal antral follicle count with ampules of gonadotropin, days of stimulation that was not statistically significant [p>0.05]. It was not seen a significant correlation between mean ovarian diameter and pregnancy rate, recovered oocytes, days of stimulation and ampules of gonodotropin. The results show that antral follicle count on cycle day 3 has positive correlation with oocyte count and pregnancy rate. It is an easy and reliable method to predict ovarian responsiveness that allows physicians to evaluate patients immediately before ART stimulation and to optimize stimulation protocols

effect of ginger biscuit on nausea and vomiting in early pregnancy

Nausea and vomiting of early pregnancy [NVP] are often alleviated by eating dried biscuits or food. Natural products such as ginger have been suggested as herbal medicine for its treatment. The purpose of this study was to determine the effectiveness of ginger in biscuit form for the treatment. This study was performed on 65 pregnant women with NVP before 17 weeks' gestation during 2004-2005. The subjects were randomized in a double-blind design and divided into two groups to take biscuits. Ginger [0.5 g] as fine powder was incorporated in each biscuit. Subjects received 5 ginger biscuits per day or an identical placebo biscuit for 4 days. They graded their severity of nausea using visual analog scales and recorded the number of vomiting episodes in the previous 24 hours and again during 4 consecutive days. Obtained data between two groups were compared using Mann-Whitney, Wilcoxon Sumrank and Kruskall-Wallis H tests. All subjects except 3 in the ginger group remained in the study. The visual analog scores of post-therapy minus baseline nausea decreased significantly in ginger [2.6 +/- 1.83] compared with the placebo group [1.4 +/- 1.97, p=0.015]. The number of vomiting episodes also decreased in ginger [0.96 +/- 1.2] and placebo group [0.6 +/- 1.4]. Ginger in biscuit form is effective for relieving the severity of nausea and vomiting of pregnancy

[Relationship between the serum B-HCG and preeclampsia and its severity]

Preeclampsia as the most common complication of pregnancies has unknown physiopathology. Because the role of serum Beta-human Chorionic Gonadotropin [B-hCG] in pathophysiology of preeclampsia is not well known, we decided to determine the correlation between serum concentration of B-HCG and preeclampsia. This case-control study performed on two groups of 40 preeclamptic nulliparous and 40 healthy term pregnant women at obstetrics and gynecology ward of Sh. Yahyanejhad Hospital in Babol during 2003-4. Serum B- hCG concentration was measured in all patients. Patients with chronic hyprtension, diabetes, multiple pregnancies or medial diseases were excluded. The data were analyzed using Chi-square, T-Test and ANOVA, Mann-Whitney and Kruskall-Wallis tests. The maternal serum Beta hCG levels in patients with preeclampsia were [39840 +/- 24630] IU/L which is higher in comparison with healthy ones [27460 +/- 25862] IU/L [P=0.031]. The mean of serum beta hCG levels were 31991 +/- 16758 and 84312 +/- 9257 in mild and severe preeclampsia [P<0/0001]. Serum Beta hCG level is higher in preeclamptic women than normal pregnancies. It is also noticed that the higher the levels of serum Beta hCG the more severe the preeclampsia. This finding, in turn, reinforces the association between elevated HCG concentrations and placental damage

[Comparison of anti Chlamydia antibodies in tubal and non-tubal infertile patients]

Chlamydia trachomatis infection is one of the most prevalent bacterial sexually transmitted infection in most countries. This organism may stay in genital tract for long time and cause subtle yet progressive damage in fallopian tubes. In this study we evaluate the correlation between chlamydia antibodies and tubal and other factors of infertility. In this case control study, 28 patients with tubal factor infertility, 28 patients with non tubal factor infertility and 30 normal patients were enroled. Presence or absence of tubal factor was assessed by direct vision via laparscopy, then titres of IgA and IgG were evaluated in all of them using ELISA method in the same labratory. Data were recoded and analyzed using SPSS software and chi-square, Fisher's exact, T-test and Mann- Whitney test. Positive titre of IgG was higher in tubal factor infertility but it was not statistically significant between three groups [p>0.294]. Positive titres of IgA were more common in non tubal factor infertility [p=0.007]. Though positive and negative titres of IgA [P=0.224] and IgG [P=0.273] were not statistically different in fertile and infertile patients. Positive and negative titres of IgA and IgG were also not statistically different in patients with or without PID [p>0.05]. No correlation was found between the positive titres of IgG and IgA against Chlamydia and tubal factor infertility

Fetal ovarian cyst in the 37th week of pregnancy: a case report

Fetal ovarian cysts are rare abdominal tumors with unknown pathogenesis. They may be diagnosed accidentally during ultrasonography. Fetal ovarian cysts pose the risk of rupture or torsion with subsequent loss of the affected ovary. Diagnosis and appropriate management reduce acute and long-term complications. The case was the fetus of a 26 year old primigravida in the 37th week of gestation in Babol in 2005. A unilateral fetal simple ovarian cyst with a diameter of 30 mm was diagnosed during ultrasonography. The case was delivered by cesarean section due to fetal distress a week later. The neonate was followed up after birth and the cyst was spontaneously disappeared after 45 days. In fetal ovarian cysts, there may be good outcomes following conservative management. After delivery, decrease of hormonal stimulation may lead to the spontaneous resolution of ovarian cysts. Surgical procedures are performed if complications such as trosion or rupture of the cyst develop