The relationship between microbial contaminations of embryo transfer catheters with pregnancy outcome after embryo transfer.

Background: Different stages of assisted reproductive technologies are susceptible to contamination by various microorganisms. Objective: The aim of the study was to investigate the relationship between microbial contamination of embryo transfer catheters and the pregnancy outcome after embryo transfer. Methods: This cohort study was conducted on 60 patients candied for in vitro fertilization and embryo transfer cycles from 2021 to 2022. All embryos were transferred using a sterile syringe. The catheter contamination was checked by the microbial culture method, and in the case of microbial culture that were negative, polymerase chain reaction was done to confirm the result. The data analyzed using STATA 17 to determine the impact of catheter contamination on the clinical pregnancy rate. Results: The average age of peoples whose microbial culture was positive was lower than that of people whose microbial culture was negative (P<0.05). Also the results showed that people who live in villages have more positive microbial cultures than people who live in cities (P<0.05). Also there is no difference between the number of successful implantations and the pregnancy outcome between people whose microbial culture results were positive or negative. Conclusion: The results of the current study showed that the contamination of the embryo transfer catheter with microorganisms under our investigation did not affect the pregnancy outcome.

Platelet Indices and CXCL12 Levels in Patients with Intrauterine Growth Restriction.

BACKGROUND: Intrauterine growth restriction (IUGR) is a multifactorial condition, and the precise mechanism is still unknown. In the current study, we aimed to determine the relationship between the platelet (PLT) indices and CXC12 levels in patients with IUGR. PATIENTS AND MATERIALS: In this study, 36 patients with IUGR and 36 healthy pregnant mothers were enrolled as the case and control groups, respectively. Gestational age for both groups was between 24 and 40 years. Blood samples were taken, and platelet indices were examined by a full-diff cell counter. Serum levels of CXCL12 were measured by ELISA, and the data were analyzed using an independent Student's t-test. RESULTS: In this study, we observed that the mean value of PLT count (154.3 ± 50 vs 236 ± 36) and plateletcrit (0.124 ± 0.038 vs 0.178 ± 0.021) were significantly lower in the case than the control group. In contrast, the mean platelet volume (7.94 ± 0.55 vs 7.62 ± 0.53) and platelet distribution width (17.57 ± 0.7 vs 16.96 ± 0.59) were significantly higher in the case than the control group. More importantly, we found that the serum levels of CXCL12 were significantly higher (5.3 ng/mL± 3.1 vs 2.8 ± 1.6) in the patients compared to the pregnancy controls. CONCLUSION: Our data show that platelet indices are changed in IUGR, and the levels of circulating CXCL12 are increased in patients with IUGR. These findings provide a base for further studies to better defining the pathophysiology of IUGR.

Maternal Outcomes Associated with Caesarean versus Vaginal Delivery.

INTRODUCTION: To choose the best mode of delivery (vaginal versus caesarean section) still remains a contentious issue. Caesarean section is a major abdominal surgery with its related medical, anesthetic and surgical complications. Maternal mortality and morbidity is higher in caesarean section compared with vaginal delivery. The most common causes of maternal mortality during caesarean section are due to anesthesia, bleeding and infection. AIM: The aim of this study was to determine the mode of delivery and maternal outcomes in Sanandaj's hospital, Iran, during one year. MATERIALS AND METHODS: The study population included all women who were admitted for delivery in Sanandaj's Hospital. Data collection instrument was a researcher made questionnaire. Data were entered into SPSS version 20.0 and analyzed using Chi-square test. Desired outcomes were entered into multiple logistic regression models. For estimating the parameters and increasing the level of significance we used bootstrap to generate 1000 samples. RESULTS: During the study, a total of 5984 deliveries were conducted in Sanandaj Hospital, of which 3423 (57.20%) were vaginal (vaginal, vaginal + episiotomy, instrumental delivery) and 2561 (42.80%) were caesarean section. The results showed a statistically significant association between delivery mode and demographic variables such as age, occupation and level of education; whereas, no significant association was found between place of residence and parity. CONCLUSION: The finding of this study showed that caesarean section delivery rate in Sanandaj was 42.80% in 2012-2013 which is higher than caesarean section rate recommended by WHO. Also, there was a relationship between mode of delivery and maternal outcomes.

Comparison of Vaginal and Oral Doses of Misoprostol for Labour Induction in Post-Term Pregnancies.

INTRODUCTION: Considering maternal complications, it is preferred to induce labour after 40 weeks. Labour induction is a procedure used to stimulate uterine contractions during pregnancy before the beginning of the labour. AIM: The aim of this study was to compare oral misoprostol with vaginal misoprostol for induction of labour in post-term pregnancies. MATERIALS AND METHODS: This double blind clinical-trial study was performed on 180 post-term pregnant women who were admitted to the labour ward of Besat Hospital Sanandaj, Iran in 2013-2014. Participants were equally divided into three groups using block randomization method. The induction was performed for the first group with 100 µg of oral misoprostol, for the second group with 50 µg of oral misoprostol, and for the third group with 25 µg of vaginal misoprostol. Vaginal examination and FHR was done before repeating each dose to determine Bishop Score. Induction time with misoprostol to the start of uterine contractions, induction time to delivery, and mode of delivery, systolic tachycardia, hyper stimulation and fetal outcomes were studied as well. RESULTS: First minute Apgar scores and medication dosage of the study groups were significantly different (p=0.0001). But labour induction, induction frequency, mode of delivery, complications, and 5 minutes Apgar score in the groups had no significant difference (p>0.05). The risk of fetal distress and neonatal hospitalization of the groups were statistically significant (p=0. 02). There was no significant difference between the three groups in terms of mean time interval from the administration of misoprostol to the start of uterine contractions (labour induction), the time interval from the start of uterine contractions to delivery and taking misoprostol to delivery. From the administration of misoprostol to start of the uterine contractions the mean difference between time intervals in the three groups were not statistically significant. CONCLUSION: Based on our findings it can be concluded that prescribing 100µg oral misoprostol is effective than 50 µg oral or 25 µg vaginal misoprostol in terms of induction time, maternal and neonatal outcomes in post- term pregnancy. However, the best dose and route should be decided according to evidence based information.

Asymptomatic uterine torsion in a pregnant woman.

Some degree rotation of the gravid uterus in the third trimester of pregnancy is not an abnormal finding. However, extreme uterine torsion of 180° around its cervical junction is a relatively rare event in obstetrical practice. We report here such a case that detected at laparotomy for an emergency cesarean section due to rapture of amniotic membrane.