[Comparison of closure of subcutaneous tissue versus non-closure in relation to wound infection and disruption after cesarean section delivery in obese patients]

Wound disruption after cesarean section is a common complication; and obesity has been identified as strong independent risk factor for wound complications. The aim of this study was to test the hypothesis that closure of the subcutaneous fat decreases the incidence of wound infection and disruption after cesarean delivery. In a clinical trial study conducted in Yazd, a hundred women with at least 2 cm of subcutaneous fat and cesarean delivery were included in the study. In 50 patients, subcutaneous tissue was closed using synthetic suture [group A], while in 50 control patients subcutaneous tissue was not closed [group B]. Two groups were compare in relation to wound infection and disruption. Data were analyzed using student and X[2] tests. Complications leading to wound infections [positive culture] were 2 women in group A and 5 women in group B [P<0.05] and disruption or opening of the incision were in 7 women in group A and in 17 women in group B [P<0.01]. Closure of the subcutaneous tissue can significantly reduce the rate of postoperative wound disruption in women with at least 2 cm of subcutaneous adipose tissue

[Effect of estradiol prescribed during luteal phase of art cycles and pregnancy outcome]

Implantation is one of the most important steps in ART cycles and it depends upon embryo and endometrial reception. Different protocols have been suggested for getting better endometrium. It seems estrogen increases the endometrial reception and pregnancy rate by inducing changes in the hormonal status. The aim of this study was to evaluate the effect of estradiol[E2] on luteal phase support and pregnancy rate in ART cycles. This prospective randomized study was done in Yazd at the IVF center from March until December, 2002. 68 patients who had undergone IVF or ICSI were enrolled in the study. Exclusion criteria was age>40, endometriosis and ovarian hyper stimulation syndrome. Induction ovulation protocol was long suppression with GnRH analogues.After embryo transfer, patients were divided in two groups randomly. Both groups received 100mg progesterone IM daily from the transfer day. Estradiol valerate 2 mg/day was added from the 7th transfer day to progesterone in Group I and continued if the BhCG became positive. Abortion and malformations were measured in all patients. Data analyzed with SPSS 11.0 and P value <0.05 considered statistically significant. Pregnancy rate in the 34 patients of estradiol group [group I] was 26.5%which was significantly higher than 11.8 %[ 4 cases] in the other group [Pvalue=0.034]. Abortion rate was higher in estradiol group [3 cases], but there was no abortion in the progesterone group[P=0.119]. 2 cases of major fetal malformations were observed in E2 supplementation group [P=0.246]. E2 suplementation to progesterone in the luteal phase of ART cycles, especially in the long GnRH analogues causes higher endometrial receptivity and pregnancy rate

[Comparison of the efficacy of VIT B1 [thiamine] and ibuprofen in treatment of primary dysmenorrhea in young girls, Yazd, 2003]

This study was performed in order to compare the efficacy of vitamin B1and Iboprofen in thetreatment of primary dysmenorrhea.180 women aged between 11-17 years with primary dysmenorrhea were divided to 2 groups:Group A: [n: 60] received 100mg vit B1 daily in leuteal phase for 3 months. Grope B:[n: 60] Received 400mg Ibuprofen 3 times/day for 5days [3 days before and 2 days after start ofmenses] for 3 months.80% of group A and 88.4% of group B were treated as compared to control [P=0001], but in group B,side effects were more and the regimen was less tolerated as compared to group A.Vit B [Thiamine] is well tolerated and effective drug without side effects in primary dysmenorrhea

efficacy of vaginal misoprostol in treatment of missed abortions

Missed Abortion is a important obstetric and gynecology complication because of its serious outcomes such as DIG, infection, shock, hemorrhage and death. There are various medical and surgical methods for treatment of missed abortion. Medical treatment of missed abortion is safe, effective, acceptable and an inexpensive alternative. Misoprostal is a synthetic prostaglandin [El] and recommended by PDA for treatment of missed abortion. There are different views about its safety, dosage and effectiveness. This study was designed in order to determine the efficacy of vaginal misoprostol for termination of pregnancy in women with missed abortions admitted in Shahid Sadoughi, Madar and Mojibian hospitals of Yazd from 2003 to 2004. The method of study was semi-experimental. [Clinical trial without control group] 50 women with missed abortion and the required criteria [age 15-45 years, gestational age

[Infections in recurrent miscarriage]

Abortion is one of the prevalent complication in pregnancy and this definition is cerifined to the termination of pregnancy for many reason before 20 week's gestation based upon the data of the first day of the last noromal mens if this processes happenes three or more it will be reffered to recurrent miscarriege one of the machanisms responsible for abortion is infection and this problem is more important in spontaneous abortion. In this situation, many infections factors are interfering. Most of them are effective only spontaneous abortion but their role on recurrent abortion aren't demonstrated one of the most infection disease during pregnancy is Torch Syndrome that leads Pregnancy to Spontaneous abortion. Despite unrepeatedly syndrome but in many cases unfortunately doing Torch lab exam is the first request Now adays many studies that support the role of Mycoplasma hominis, Ureaplasma Urealyticum, chlamydia trachematis and Syplise with less Importance have affection on spontaneous abortion also many studies have been showed that CMV is left in body and can be isolated from urine, Saliva, and the other liquid. Because there is no treatment in subsequent pregnancy with it's tratogenic affect can Resulting Recurrent abortion. There are many different diagnostic Methods including microorganism culture, Serological lab with ELISA, PCR etc that it seems PCR is more accurat. So after diagnose the cause of infection patient should be treated completely before Renewed pregnancy. It should be noticed that with the exception of viruses most of microorganisms reply to medical treatment

[ Study of Complications in 1120 Cases of Transvaginal Ultrasound - guided Oocyte Pick-up in IVF Centre of Yazd]

To determine the prevalence of oocyte pick up complications in 1120 cycles of IVF. In this prospective study 1120 pationts that were reffered to infertility clinics for IVF were enrolled. The patients with the infertility following COH by regimens of CC + hMG/hCG, hMG/hCG, hMG + GnRH-a/hCG were punctured by transvaginal sonography, preformed after injection of sedatives. The follicular aspiration was performed only by vaginal preparation with sterile distilled water .The patients were discharged in an hour. Vaginal bleeding was observed in 190 cases [17%], who were not severe and treated with vaginal pack and discharged after 2 hours after exit the vaginal pack. 15 patients [1.3%] with severe abdominal pain were hospitalized for 24 hours, one with hypovolemic signs was operated by laparoscopy and ruptured ovary was cauterized. 3 cases [0.35%] with fever, chills and abdominal pain managed with diagnosis of PID. One patient with history of 2 previous laparatomy before IVF cycle, didn't respond to medical treatment and after further investigation pararectal abscess diagnosed which was managed surgically. Considering the number of patients, transvaginal follicular puncture is a safe procedure in oocyte retrieval.In patients with history of PID, previous surgery and endometrioma prophylactic antibiotic was given at the time of oocyte puncture

[Does intracytoplasmic sperm injection overcome the reduce of fertilization rate by increasing maternal age?]

The aim of this study was to determine the effects of maternal age in fertilization rate of intracytoplasmic sperm injection comparison with IVF. In this prospective clinical trial study, 200 couples with male subinfertility that referred to infertility clinic were enrolled. Couples were selected on the basis of semen parameters and divided randomly into two groups of IVF and ICSI. Couples were divided into different subgroups based on age of females .The fertilization rate of every subgroups were assessed and compared together. Results were analyzed by Chi-square method. After induction ovulation with standard protocols, 525 oocytes were retrieved during egg collection in ICSI groups versus 474 in IVF. After selection of good quality oocytes, IVF and ICSI was done as routine .The fertilization rate of every age group was measured and compared with age increased. In IVF group, the fertilization rate was 41.3% in patients <35 years versus 26.7% in older than 35 years old .The mean fertilization rate was 89.3% in patients <35 comparison with 75.2% in women >35 years old by ICSI .On the other hand, the mean cleavage rate of IVF cycles was significantly lower in patients >35 years in IVF [49.5%] versus younger patients [P value<0.001] but this finding was not observed by ICSI [85.17% VS 85.15%].Reduction of fertilization rate with increase of female age was statistically meaningful [P value <0.001] in IVF and ICSI. These findings suggest that fertilization of oocyte reduce consequently with maternal age increased, therefore, ICSI can not overcome this problem their cause is not clear and may refer to chromosomal or structural abnormality in oocytes