مجله زنان مامائی و نازائی ایران
سال هفدهم شماره 135 (هفته اول اسفند 1393)

Two methods of general anesthesia and spinal analgesia are used for cesarean section. Each of these methods has special side effects and benefits for the mother and fetus. The effect of each of these methods on newborn’s Apgar score is different. Some study showed no difference between newborn’s Apgar score، but in some studies، the newborns with spinal anesthesia had lower Apgar score. This study was performed with the aim to compare the effects of used drugs in general anesthesia and spinal analgesia on newborn’s Apgar score.

This quasi-experimental study was performed on 378 mothers who were candidate for cesarean section and referred to Obstetrics clinic of Semnan Amiralmomenin Hospital. The mothers were divided in two groups of general anesthesia and spinal analgesia according to cesarean indication. After the newborn''s birth، the information related to the mother and newborn along with 1 and 5 minutes Apgar scores were recorded. Data was analyzed using SPSS software (version 18)، and Chi-square، Kolmogorov – Smirnov، T، Mann -Whitney and linear regression tests.

The mean first minute Apgar score in women with general anesthesia was 7. 81± 0. 57 and in women with spinal analgesia 8. 80 ± 0. 42 that the difference was significant (P < 0. 001). The mean fifth minutes Apgar score in women with general anesthesia was 9. 98± 0. 15 and in women with spinal analgesia 10/00 ± 0. 00 that the difference was not significant (P=0. 143). In mothers of high risk group، the mean 1st and 5th minutes Apgar score in general anesthesia were 7. 64± 0. 78 and 9. 94±0. 33 and in spinal analgesia 7. 60 ± 0. 63 and 9. 97 ± 0. 16، respectively. first minute Apgar score was significant between two groups (P < 0. 001)، but fifth minutes Apgar score was not significant between two groups (P = 0. 65).

The effect of spinal analgesia on first minute Apgar score is less than general anesthesia; therefore، it is recommended that to use spinal analgesia as much as possible in cesarean section.

Polycystic ovary is a range of endocrinal and metabolic disorders in the complicated patients. Studies in recent decades report that chronic low-grade inflammation is due to this syndrome being long-term. This study was performed with the aim to evaluate the role of the immune system and the regulatory role of cytokines of Tumor necrosis factor-alpha، Interlukins of 1alpha، 1beta، and 17 A in the patients with polycystic ovary in order to more knowing about these relationships be effective in the etiology or cause of polycystic ovary syndrome and consequently، effective drug-therapy be possible. This study was performed on the patients referred to …. Infertility center in 2012. 85 patients with infertility caused by polycystic ovarian syndrome were placed in intervention group and 86 cases in control group. Four cytokines of 1alpha، 1beta، 17 A and tumor necrosis factor alpha were evaluated in blood serum of both groups. Data was analyzed using SPSS software (version 19)، and t test، chi-square and Mann-Whitney tests. Interlukin 1 (alpha، beta) was higher PCO group than control group، this difference was completely clear in interleukin 1α (P<0. 001) and increased interleukin 1beta was also significant (P=0. 017). Inflammatory mediator of IL-17 was significantly lower in serum of patients with PCOS than control group (P<0. 001). TNFα mediator showed no significant change in two groups (P=0. 119). Polycystic ovaries can be a mild chronic inflammatory disease. Because cytokines 1 alpha and beta، particularly alpha، show greatly increased in these patients.

Gestational diabetes is defined as carbohydrate intolerance with different severity which is first diagnosed or occurred during pregnancy. Pregnancy as a stressful situation increases the secretion of cortisol. Therefore، considering the relation between cortisol hormone and gestational diabetes، this study was performed with the aim to evaluate and compare serum and urinary cortisol levels in healthy pregnant women and women with gestational diabetes. This cross-sectional study was performed on 42 women with Gestational Diabetes Mellitus and 42 healthy pregnant women who had referred to Kermanshah diabetic center in 2013. In 24th gestational weeks، 24-h urine sample and no fasting blood sample were provided to assess cortisol level. Data was analyzed using SPSS software (version 16) and statistical tests of independent-t، Pearson correlation، multivariate covariance analysis، and Mann-Whitney. According to multivariate analysis of covariance analysis، there was significant difference between serum and urinary cortisol levels in two groups of healthy pregnant women and women with gestational diabetes (P<0. 001). In the evaluation of under the ROC curve، 0. 855 was obtained for serum cortisol and 0. 866 for urinary cortisol، and to diagnose the gestational diabetes، sensitivity and specificity of serum cortisol were obtained 79. 5% and 82. 9%، and sensitivity and specificity of urine cortisol 84. 6 % and 90. 2%، respectively. Serum and urinary cortisol levels is significantly higher in women with gestational diabetes compared to healthy pregnant women. Perhaps with performing studies، these criteria can be used as a criterion to diagnose gestational diabetes. Urinary cortisol level with higher sensitivity and specificity and more non-invasive method is preferred to serum cortisol test.