Search

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Increased total plasma homocysteine (Hcy) is an accepted risk factor of cardiovascular disease (CVD), stroke, preclampsia, recurrent abortion and diabetes type I and II. The aim of the current study was to assess serum homocysteine and its relation with serum folat, vitamine B12 and lipid profile in gestational diabetes mellitus and to compare these with those of pregnant women."n"n Methods: In a prospective controlled survey 80 pregnant women (24-28 weeks) with uncomplicated pregnancies were evaluated. They were assigned to one of two groups according to the results of 100g-OGTT. In the case group there were pregnant women with gestational diabetes mellitus according to the OGTT and in the control group women who had normal OGTT results were put. Levels of fasting glucose, homocysteine, vit B12, and folic acid, uric acid, total cholesterol, triglyceride, Low Density Lipoprotein cholesterol (LDL) and High Density Lipoprotein cholesterol (HDL) were measured in both groups."n"nResults: The mean level of homocysteine in GDM group was significantly higher than control group (p=0.000). The mean level of folic acid and vit B12 was significantly lower than the level in control group (p=0.001, p=0.004 respectively). Body mass index (BMI) in GDM group was higher (p=0.000) and HDL level was lower (p=0.006) than control group. There were no significant differences among the groups with respect to levels of total cholesterol and triglyceride."n"n Conclusion: We found that patients with gestational diabetes have higher homocysteine level than normal pregnant women. This increased level seems to be related to an abnormal OGTT. Further investigations are needed to follow up these patients in the postpartum period and later on.

"n Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Preterm birth which is defined as delivery before 37 completed weeks was implicated in approximately two thirds of neonatal death. Also preterm labors are the most common cause of mortality and morbidity of infants in recent years and it costs high prices for health system. We evaluate the relationship between prepregnancy maternal body mass Index (BMI) and spontaneous and indicated preterm birth."n"n Methods: This study included 250 healthy pregnant women, without any risk factors of preterm birth, were classified into categories that were based on their body mass index. Association between BMI, weight gain and rout of delivery were examined. Rates of indicated and spontaneous preterm birth were compared."n"n Results: Obese women delivered at a more advanced gestational age. (38/34±1/66 weeks vs 37/61±2/44, p=0/006). Obese patients had significantly lower incidence of spontaneous preterm birth at < 37 weeks of gestation (16/8% vs 31/2% p=0/008). Obese women had larger infants (3354/95±596/75 vs 311.24±558/357 p=0/001), and had more frequent cesarean delivery (69/6% vs 52/8%, p=0/006). Weight gain during pregnancy is poorly correlated with prepregnancy BMI (14/41±7/93 kg vs 13/78±4/94kg, p=0/4) and preterm birth."n"n Conclusion: In this survey, there was adverse correlation between body mass index (BMI) before pregnancy and preterm labor less than 37 completed weeks and we suggest more study for evaluation between spontaneous and induced preterm labor mechanism and in obese and non obese women. However according to this survey obesity before pregnancy is associated with a lower rate of spontaneous preterm birth.

"nBackground: The Biophysical Profile (BPP) is a noninvasive test that predicts the presence or absence of fetal asphyxia and, ultimately, the risk of fetal death in the antenatal period. Intervention on the basis of an abnormal biophysical profile result has been reported to yield a significant reduction in prenatal mortality, and an association exists between biophysical profile scoring and a decreased cerebral palsy rate in a given population. The BPP evaluates five characteristics: fetal movement, tone, breathing, heart reactivity, and amniotic fluid (AF) volume estimation. The purpose of study was to determine whether there are different degree of acidosis at which the biophysical activity (acute marker) are affected. "nMethods: In a prospective study of 140 patients undergoing cesarean section before onset of labor, the fetal biophysical profile was performed 24h before the time of cesarean and was matched with cord arterial PH that was obtained from a cord segment (10-20cm) that was double clamped after delivery of newborn. (using cord arterial PH less than 7.20 for the diagnosis of acidosis). "nResults: The fetal biophysical profile was found to have a significant relationship with umbilical blood PH. The sensitivity, specificity, positive predictive value, negative predictive value of fetal biophysical profile score were: 88.9%, 88.6%, 50%, 98.1%. "nConclusion: The first manifestations of fetal acidosis are nonreactive nonstress testing and fetal breathing loss; in advanced acidemia fetal movements and fetal tone are compromised. A protocol of antepartum fetal evaluation is suggested based upon the individual biophysical components rather than the score alone.

"nBackground: Maternal zinc deficiency during pregnancy has been related to adverse pregnancy outcomes. Most studies in which pregnant women have been supplemented with zinc to examine its effects on the outcome of the pregnancy have been carried out in industrialized countries and the results have been inconclusive. It has been shown that women with gestational diabetes (GDM) have lower serum zinc levels than healthy pregnant women, and higher rates of macrosomia. Zinc is required for normal glucose metabolism, and strengthens the insulin-induced transportation of glucose into cells by its effect on the insulin signaling pathway. The purpose of this study was to assess the serum zinc levels of GDM patients and evaluate the effect of zinc supplementation. "nMethods: In the first stage of this prospective controlled study, we enrolled 70 women who were 24-28 weeks pregnant at the Prenatal Care Center of Mirza Kochak Khan Hospital, Tehran, Iran. The serum zinc level of each subject was determined. In the second stage, among these 70 subjects, the diabetics receiving insulin were divided into two groups, only one of which received a zinc supplement and the other group was the control group. Birth weight of neonates and insulin dosages were recorded. "nResults: The mean serum zinc level in the GDM group was lower than that of the control group (94.83 vs. 103.49mg/dl, respectively) and the mean birth weight of neonates from the GDM women who received the zinc supplement was lower than that of the control group (3849g vs. 4136g). The rate of macrosomia was lower in the zinc supplemented group (20% vs. 53%). The mean of increase of insulin after receiving the zinc supplement was lower (8.4u vs. 13.53). "nConclusion: Maternal insulin resistance is associated with the accumulation of maternal fat tissue during early stages of pregnancy and greater fetoplacental nutrient availability in later stages, when 70% of fetal growth occurs, resulting in macrosomia. In our study, zinc supplementation is associated with a reduction in the rate of fetal macrosomia among pregnant women with GDM.

Background: The aim of this survey was to evaluate the prevalence of some perinatal complications in birth weight discordance (BWD) among twin pregnancies. Methods: In a descriptive analytical cross-sectional study, 490 twin neonates (245 twin pregnancies) born at Mirzakoochakkhan Hospital from 1999 to 2003 were evaluated. Maternal and neonatal data of each delivery were collected for BWD, gestational age, maternal age, parity, infant gender, neonatal death, neonatal septicemia, mode of delivery, hyperbilirubinemia, blood transfusion and duration of hospitalization. Results: The average age of the mothers was 26±4.78 years, of which 51.8% were nullipara. The average gestational age was 35.02±2.73 weeks, with 15.9% before 32 weeks of gestation. The neonatal death rate was 7.8%, the majority of which involved male neonates and multiparas. The average duration of hospitalization was 6.07±4.45 days, 8.5 days for those twins with BWD≥20%, and longer (9.14 days) for neonates with mothers younger than 20 years old. Septicemia was most frequent (31.3%) in twins with BWD of 30-34%, as was hyperbilirubinemia requiring blood transfusion (25%). Hyperbilirubinemia was more common in neonates with mothers aged less than 20 years and more than 35 years.. Conclusions: BWD in twins is a predictive factor for septicemia and hyperbilirubinemia requiring transfusion. Therefore, healthcare workers and hospital wards dealing with twins with BWD should be especially ready and equipped to provide the additional care needed for these patients.

Background: Preterm labor is defined as delivery before 37 weeks of gestation. Recurrence of preterm labor in future pregnancies is 6-8%. History of preterm labor is a strong risk factor for future preterm labor. Preterm labor is the leading cause of neonatal mortality in developed countries, but permanent morbidity in these premature neonates has many side effects for the newborn as well as their family members and society. For this reason we conducted a survey to identify risk factors for recurrent preterm delivery among primiparous women with previous preterm delivery. Methods: This prospective case–control study included patients from three university hospitals, namely Imam Khomeini, Shariati and Mirza Koochakkhan Hospitals, all in Tehran, Iran. Subjects, including 539 primiparous women who delivered preterm (22–36 weeks), were divided into two groups: 47 had a second preterm delivery (study group) and 492 had first preterm delivery (control group). Exclusion criteria were induced preterm delivery due to medical indications in mother and primigravid. Data collection and analysis was performed using SPSS 10 and t-test and χ2 test were used to analyze the significance of the results. Results: From a total of 6,537 deliveries, we found 539 cases of preterm delivery, among which 47 cases were identified as recurrent preterm delivery. The control group was composed of 492 deliveries. The recurrence of preterm delivery was 8.7%. Uterine anomaly, cardiovascular, renal and thyroid disease in mother and blood group A had a significant correlation with recurrent preterm delivery. Conclusion: Expectant mothers with uterine anomalies, cardiovascular, renal or thyroid diseases or group A blood type should receive extra care, observation and instructions in order to limit the risk of preterm delivery and its subsequent effects.

Background: We conducted this study To find relationship between maternal glucose challenge test (GCT) levels and fetal body weight (BW). Materials and Methods: We analyzed five hundred women with singleton pregnancy, who had GCT at 24-28 week during pregnancy. All of them had no history of hypertension and diabetes mellitus or other medical disease before pregnancy or during previous pregnancy, and all of them had weight gain appropriate with their pre pregnancy body mass index (BMI). Also nobody had history of drug abuse or smoking. In this descriptive–analytic survey, maternal age, gravidity, BMI,GCT level ,gestational age (GA) , sex of neonate, rout of delivery , newborn weight and apgar score were evaluated .The student’s T-test and logistic regression were used for statistical analysis. We used Pearson coefficient and receiver operating characteristic (ROC) curve and chi-square test for determination GCT threshold. Results: We found rate of small for gestational age (SGA) in newborns statistically was significant, who their maternal GCT level was ≤ 80mg/dl, P value: 0/018, specificity 89%, sensitivity 58% and confidence interval: 95% (0/162-0/545). Conclusion: Low GCT level has association with SGA and can be used as a predictive test and may be an indication for dietary intervention.

Caudal regression syndrome (Caudal dysplasia sequence) is a rare congenital malformation. It has a spectrum ranging from simple anal atresia to the absence of sacral, lumbar and possibly lower thoracic vertebrae and the most severe form called sirenomelia (Mermaid syndrome). Sirenomelia has a sole characteristic, which is the limbs fusion, with multiple internal structural abnormalities particularly in the renal tract (bilateral renal agenesis). This is a rare condition with a relative risk of 200-250 in diabetic pregnancies. The etiology of this syndrome is not well known. Maternal diabetes in considered to be other possible factors. We present birth of an infant with great congenital defect, which was categorized as the most intense form of caudal regression syndrome (sirenomelia). The baby was born from an uncontrolled diabetic mother who was ignorant of her diabetes. She had a sonographic report at early third-trimester of pregnancy, which had shown severe oligohydramnios and according to this reason the anomaly of the fetus was not detected at that time (antenatal). Since sirenomelia is a lethal abnormality, the infant died a few hours after birth. As notes above caudal regression syndrome is strongly associated with maternal diabetes; due to metabolic derangement in uncontrolled serum glucose.

Caudal regression syndrome (Caudal dysplasia sequence) is a rare congenital malformation. It has a spectrum ranging from simple anal atresia to the absence of sacral, lumbar and possibly lower thoracic vertebrae and the most severe form called sirenomelia (Mermaid syndrome). Sirenomelia has a sole characteristic, which is the limbs fusion, with multiple internal structural abnormalities particularly in the renal tract (bilateral renal agenesis). This is a rare condition with a relative risk of 200-250 in diabetic pregnancies. The etiology of this syndrome is not well known. Maternal diabetes in considered to be other possible factors. We present birth of an infant with great congenital defect, which was categorized as the most intense form of caudal regression syndrome (sirenomelia). The baby was born from an uncontrolled diabetic mother who was ignorant of her diabetes. She had a sonographic report at early third-trimester of pregnancy, which had shown severe oligohydramnios and according to this reason the anomaly of the fetus was not detected at that time (antenatal). Since sirenomelia is a lethal abnormality, the infant died a few hours after birth. As notes above caudal regression syndrome is strongly associated with maternal diabetes; due to metabolic derangement in uncontrolled serum glucose.

Limb bud first appears during the third week of gestation with the upper limb buds appearing a few days before the lower limb buds. Complete absence of one or more limbs, called Amelia, occurs prior to the eighth week of gestation. We report a case of Amelia in a twin gestation.