Evaluation of Side Effects Associated with COVID-19 Vaccines in Pregnant Women.

Background: A variety of vaccinations have been developed to fight the coronavirus disease 2019 (Covid-19) 2 years after the coronavirus epidemic spread globally. During clinical studies, these vaccinations were linked to mild to severe side effects. This study aimed to evaluate the short-term side effects of Covid-19 vaccination in pregnant women in Zabol (Iran). Methods: This cross-sectional study was conducted between August and October 2021 to collect data on the adverse side effects of Covid-19 vaccinations among 117 pregnant women in Zabol (Iran). A questionnaire was used to collect demographic data, vaccination information, and vaccine complications. SPSS software Version 22 was used to analyze the data at 2 levels descriptive and inferential statistics. Results: A total of 117 pregnant women aged 27.67 ± 5.14 years were included. After the first and second doses of Covid-19 vaccinations, 91 (86.7%) and 84 (71.8%) pregnant women, respectively, suffered adverse effects. Moreover, after the first dose, 55(51.4%) and 60 (56.1%) of pregnant women reported fatigue and headache, and after the second dose, 39 (33.3%) and 37 (31.6%) reported fatigue and headache, respectively. Conclusion: The side effects reported in our study after receiving Covid-19 vaccinations in pregnant women were similar to those described in clinical studies of vaccines and were mild to moderate, showing that injectable vaccines had safe profiles. More research is needed, however, to assess the long-term side effects of existing vaccines.

Prediction of fetal anemia by different thresholds of MCA-PSV and Delta-OD in first and second intrauterine transfusions.

BACKGROUND: Our aim was to compare different thresholds of middle cerebral artery peak systolic velocity (MCA-PSV) and amniotic fluid delta optical density (Delta-OD) with fetal hemoglobin (Hb) during first and second intrauterine transfusions (IUT). METHODS: We determined serial MCA-PSV and Delta-OD in 27 red blood cell alloimmunized fetuses who needed IUT. Before the second IUT, MCA-PSV was measured. The sensitivity and specificity of MCA-PSV and Delta-OD were calculated and compared with fetal hemoglobin  levels. RESULTS: From 27 fetuses, first time IUT MCA-PSV with a normal median value (MOM) cutoff of > 1.29 detected 60% of the moderate and 100% of the severe anemia cases. MCA-PSV of MOM > 1.5 detected none of the moderate and 93% of severe anemia cases. Delta-OD detected 50% of moderate anemic and 80% of severe anemic cases. At the second IUT, 91% of severe anemia cases were confirmed by MCA-PSV with MOM > 1.5 whereas MCA-PSV with MOM > 1.29 confirmed all cases. One case of moderate anemia was de-tected by MCA-PSV of MOM > 1.29 and none were detected by MCA-PSV with MOM > 1.5. CONCLUSION: Different thresholds of MCA-PSV have higher sensitivity and specificity for detecting moderate and severe fetal anemia compared with Delta-OD. It also has a high sensitivity at the second IUT.

Mid-trimester amniotic fluid C-reactive protein, ferritin and lactate dehydrogenase concentrations and subsequent risk of spontaneous preterm labour.

BACKGROUND: Preterm delivery is a serious problem in obstetrics. A pre-existing inflammation in the first half of gestation has been proposed as a possible condition that leads to preterm delivery. AIM: Our aim was to compare C-reactive protein (CRP), ferritin and lactate dehydrogenase (LDH) concentrations in mid-trimester amniotic fluid of patients with preterm and term deliveries and to found out their predictive values for preterm delivery. METHODS: The study was conducted on 90 pregnant women who underwent genetic amniocentesis between the 15th and the 20th weeks of gestation. The samples were carried immediately to the laboratory for cytogenetic and biochemical examination. Non-parametric tests and receiver-operating characteristic curve analysis were used for statistical purpose. RESULTS: This study showed women with preterm delivery at < 37 weeks (n = 17) had a higher median of amniotic fluid LDH concentration than those women who delivered at term (n = 73) (P = 0.003). Amniotic fluid LDH concentration of > 120 IU/L had a sensitivity of 59% and a specificity of 81% in the prediction of spontaneous preterm delivery at < 37 weeks. Maternal serum alpha-fetoprotein levels were higher in patients delivered preterm compared with term deliveries (P = 0.036). CONCLUSION: Mid-trimester LDH is found to be quite effective in the prediction of preterm delivery. Pre-existing intrauterine inflammatory process early in gestation may be an important risk factor for preterm delivery.

Middle cerebral artery peak systolic velocity and ductus venosus velocity in the investigation of nonimmune hydrops.

PURPOSE: This study was performed to investigate the cause of nonimmune hydrops fetalis by measuring the peak systolic velocity (PSV) in the middle cerebral artery (MCA) and velocity waveforms of the ductus venosus (DV) with Doppler. METHODS: This cross-sectional study was done on 19 pregnancies referred to three university teaching hospitals for further investigation of nonimmune hydrops fetalis in 2007 and 2008. The MCA-PSV and DV velocity waveforms were recorded in all fetuses. Anemia was investigated in cases with MCA-PSV values greater than 1.50 MoM (multiple of the median). Cardiovascular causes and chromosomal abnormalities were investigated in fetuses with abnormal DV velocity. RESULTS: Four of 19 fetuses had MCA-PSV values greater than 1.50 MoM. The causes of anemia were cytomegalovirus, parvovirus B19 infections, congenital heart disease, and Turner syndrome. Four cases had reversed flow in the DV; three of them had congenital heart disease on echocardiography; and one had a normal echocardiogram, but an abnormal karyotype was detected. CONCLUSION: Assessment of the MCA-PSV and DV velocity waveforms during sonographic examination of fetuses with nonimmune hydrops fetalis may improve our knowledge about the etiology of this condition.

Atypical postpartum eclampsia: status epilepticus without preeclamptic prodromi.

BACKGROUND: Eclampsia remains as a major obstetric problems that plagues a large percentage of women resulting in a large percentage of maternal and perinatal morbidities. In general, most women will have a classical presentation of preeclampsia. However, studies have suggested that some women will develop eclampsia without the classical findings. CASE REPORT: We report a case of postpartum eclampsia with the first manifestation of convulsions resistant to diazepam and magnesium sulfate. In this patient high blood pressure was first detected after the seizures. Electroencephalography and CT scan of brain were normal. Patient's blood pressure returned to normal 1 month after parturition. CONCLUSION: Postpartum eclampsia can manifest without a preceding preeclampsia phase. Therefore, eclampsia is not always preventable. Pregnancies complicated by eclampsia require a well-formulated management plan.

Contributing factors of preterm delivery in parturient in a University Hospital in Iran.

OBJECTIVE: Preterm labor is one of the common causes of prenatal morbidity and mortality. With considering the importance of preterm labor and lack of sufficient studies about the relationship between preterm labor and some factors such as cigarette smoking and opiate-using, the present study was designed. METHODS: We performed this descriptive-analytic study on 988 pregnant women referring to the Delivery Ward of Afzalipour Hospital, Kerman, Iran from February 2005 to September 2006. We analyzed the data using t-test and Chi-square test. RESULTS: From 988 subjects, 39.4% had preterm labor and 60.6% had term delivery. There was no significant difference between preterm and term groups in regard to their mean age (26.7 +/- 5.6 and 26.5 +/- 5.7 years), job, gravidity, educational level, abortion history, and periodontal or urinary infection (p>0.05). In preterm group, the rate of previous history of preterm labor (56%) and family history of preterm labor (88%) were significantly more in comparison to term delivery (p<0.1 and p<0.001). In women with a cigarette smoker husband, the rates of preterm labor was 44,6% and term labor was 55.4%, while in the case of both couples being cigarette smoker the rate of preterm labor was 69.2% and term labor was 31.9% (p<0.0001). In couples that were cigarette smoker and substance consumer, the rate of preterm was 77.4% and term labor was 22.6% (p<0.0001). CONCLUSION: The results of this study showed that women with personal and family history of preterm labor and women cigarette smokers and opiate-using should be considered as a major risk for preterm labor.