marjan ghaemi

Influenza causes significant mortality and morbidity in pregnant women and neonates especially in developing countries. This study aimed to investigate the maternal and neonatal outcomes in pregnant women with influenza and compare them with non-infected mothers.

This case-control single-center cohort study was conducted during the influenza season in 2022 and included all pregnant women with influenza during pregnancy. Baseline characteristics including age, body mass index, job, vaccination, and ethnicity were documented and outcomes including premature rupture of membranes (PROM), preterm labor, cesarean section, neonatal distress, and neonatal hospitalization were evaluated and compared with the control group.

In this study 39 pregnant women in each case and control group were evaluated. There was no significant difference in demographic data between the two groups. None of the participants in the case group received the influenza vaccine during pregnancy. The rate of cesarean section (63.2% vs 43.5%), neonatal distress (38.5% vs 12.8%), and neonatal hospitalization (43.5% vs 15.3%) was significantly higher in the case group than in healthy women (P-value=0.022, 0.010, 0.006 respectively).  Although, the rate of PROM was not significantly different between the two groups (P=0.556). Preterm labor was higher in the case group than in the control group, but the difference was insignificant (P=0.135).

The study findings suggest that pregnant women infected with influenza are at higher risk of neonatal complications and vaccination is helpful in these mothers as preventive measures to reduce complications.

Noninvasive perinatal testing is a new method of screening for aneuploidy called cell-free DNA (cfDNA). Fetal fraction (FF) plays a crucial role in assessing the reliability of aneuploidy detection through noninvasive perinatal testing.

We aimed to investigate the association between the amount of FF in cfDNA testing and adverse pregnancy outcomes.

This cohort study was conducted on 619 singleton pregnant women who were candidates for cfDNA testing and were referred to the perinatology clinics of Shariati hospital and Arash Women’s hospital, both affiliated with Tehran University of Medical Sciences, Tehran, Iran from March 2019 to June 2020. The FF was extracted from the cfDNA test results, and the participants were followed until delivery.

A total of 619 singleton pregnant women with a mean ± SD age and FF of 34.4 ± 4.85 and 8.39 ± 3.95, respectively, participated in the study. A significant association between maternal age and FF was not found (p = 0.12). A lower FF was associated with a rise in the incidence of gestational diabetes mellitus (p = 0.02) and a higher FF was associated with a rise in the incidence of fetal growth restriction (p < 0.001). However, high or low FF was not associated with pre-eclampsia, premature rupture of membranes, birth weight, or delivery time. No significant association was found between FF and multiple of the median of pregnancy-associated plasma protein-A and free β-human chorionic gonadotropin.

The amount of FF may be considered a predictor of certain adverse pregnancy outcomes. Therefore, maternity care should be performed more carefully for women with high or low FF.

COVID-19 infection during pregnancy could be associated with placental histopathological changes such as vascular diseases and malperfusion. There are studies showing that mRNA vaccines are not associated with significant placental pathological changes. Our objective was to evaluate the placental histopathology in pregnant women who received Sinopharm, an inactivated virus vaccine, during pregnancy.

The study included placental samples collected from mothers who gave birth of living singletons through elective cesarean sections performed between March 2022 and May 2022 at Imam Khomeini Hospital Complex. The study included women who had no history of positive reverse transcription polymerase chain reaction (RT-PCR) testing for COVID-19 during pregnancy, and had received at least one dose of COVID-19 vaccine during their pregnancy. Humoral levels of anti-SARS-CoV-2 spike IgG were measured in both the mothers and neonates.

The study included 20 mother-neonate pairs. The mean maternal age was 34±3.6 years, and all mothers received Sinopharm vaccine as their first and second doses. The last vaccine dose was administered during pregnancy, with 3 mothers receiving it in the first trimester, 9 in the second trimester, and 8 in the third trimester. The histopathological findings in the placental samples included decidual vasculopathy, subchorionic thrombosis, and chronic histiocytic intervillositis. All mothers and neonates, except one pair, were positive for anti-spike antibody.

Multiple abnormal histopathological findings were reported in placenta of vaccinated mothers. However, similar to previous studies, these placental findings are considered mild lesions and have been observed in both vaccinated and unvaccinated mothers.

Given the significance of patient care in obstetrics and gynecology, we aimed to assess the satisfaction of Tehran University of Medical Sciences residents with their training program in this field.

In this cross-sectional descriptive study, 77 obstetrics and gynecology residents from the first to fourth year at Tehran University of Medical Sciences participated with informed consent, adhering to ethical principles, from April to October 2023 across four teaching hospitals: Imam Khomeini, Shariati, Mohib Yas, and Arash.The researcher developed a questionnaire consisting of 62 online questions, including 15 demographic questions and 47 related to satisfaction. Most of the questions are statements with five response options: strongly agree, agree no opinion, disagree, and strongly disagree. Each criterion was assessed and classified on a scale from one to five. The assistants' satisfaction levels were assessed in various areas, yielding an overall score of 47-235. Scores above 70% indicate high satisfaction, 50-69% reflects average satisfaction, and below 50% signifies dissatisfaction. It's important to clarify that the areas include clinics, with specific focus on rotation shifts for assistants in gynecology, oncology, prenatal care, and infertility. Data analysis was conducted using SPSS software, Version 22. Descriptive statistics included the median and range for continuous variables (number of surgeries and satisfaction scores) and frequency and percentage for nominal variables (quality of satisfaction) across three defined levels of desirability: appropriate, relatively appropriate, and unfavorable.

Satisfaction with the number of surgeries and educational quality at Imam Khomeini Hospital was higher than at other hospitals (P=0.07). Significant differences were noted in the gynecology and pelvic surgery departments, with residents at both Imam Khomeini and Arash hospitals reporting greater satisfaction in gynecology (P=0.018) and pelvic surgery (P=0.036). Additionally, regarding the conference program and educational mornings, Shariati Hospital reported a higher level of satisfaction in this area (P=0.47).

The satisfaction scores in various areas indicate that 64.5% of assistants at Imam Khomeini Hospital rated their educational status as appropriate, while 60% at Arash Hospital rated it as relatively good, and 25% at Yas Hospital found it unfavorable.

Genitourinary syndrome of menopause (GSM) is a common complication secondary to estrogen depletion which leads to tissue changes in the female genitourinary tract. Here, we sought to investigate the short- and long-term effects of CO2 laser therapy on symptoms of GSM in postmenopausal women.

In this clinical trial, 47 postmenopausal women with symptoms of GSM were included. Participants underwent vaginal and extra-vaginal CO2 fractional laser treatment in three sessions, with intervals of one month between each session. Symptom severity, including itching, dyspareunia, vaginal discharge, and dryness, was assessed at each session using a modified Vaginal Health Index (VHI), where the intensity was rated on a Visual Analog Scale (VAS) from 1 to 10 (1 indicating minimal symptoms and 10 representing maximum severity). Additionally, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was administered. Patients were followed for one to three years after the final laser treatment session.

The scores of all subscales, including itching, dyspareunia, urinary incontinence, vaginal discharge, and dryness, improved significantly following three sessions of CO2 fractional laser (p values < 0.001). However, except for the urinary incontinence domain (P = 0.058), none of the symptoms maintained improved after one to three years from the last intervention.

CO2 fractional laser treatment is appropriate for treating symptoms related to GSM. But it seems that it needs to be used continuously for the maintenance effect on itching, dyspareunia, urinary incontinence, vaginal discharge, and dryness. The exact timing of laser sessions should be identified in further studies since the beneficial outcomes of the intervention seem temporary.

Several guidelines have been published regarding intrapartum oxytocin infusion for labor induction or augmentation; however, many of them lack specificity.

Therefore, this study aimed to assess oxytocin dose administered during labor and evaluate its association with maternal characteristics and short-term perinatal outcomes.

This retrospective cross-sectional study was conducted on 162 term pregnant women who were admitted to the labor ward for vaginal delivery in two academic hospitals during 2021 - 2022. Maternal demographic features, obstetric and medical history data, labor process details (initial Bishop score, membrane status on admission and at the time of labor induction or augmentation, latent and active phase duration, oxytocin dose, delivery mode, and neonatal outcomes) were obtained and recorded. Participants were divided into two main groups based on the intrapartum oxytocin dose, and the desired outcomes were reported and compared between the groups.

The median maternal age was 28 years (range: 16 - 46). The median oxytocin dose administered during labor induction was 10 mU/min (range: 2.5 - 25 mU/min). Oxytocin dose was significantly correlated with gestational age (P < 0.001), cervical dilation and effacement (P < 0.001), fetal head station (P < 0.001), cervical consistency (P < 0.001), and cervical Bishop score before labor induction (P < 0.001). The cervical dilation at the time of membrane rupture was also positively correlated with the intrapartum oxytocin dose (P = 0.013). Higher gestational age was correlated with a higher required oxytocin dose (P < 0.001). The cesarean rate was 22.8% in the study population, and it was positively correlated with intrapartum oxytocin dose (P < 0.001).

The cervical Bishop score and its components, except for cervical position, were correlated with the intrapartum oxytocin dose. In other words, the less favorable the cervix, the higher the likelihood of requiring higher doses of oxytocin and consequently experiencing a longer duration of labor. Additionally, the cesarean rate was higher in those who needed oxytocin doses of more than 10 mU/min; however, short - term neonatal outcomes were not different.

The research combined different bibliometric techniques to analyze systematically recurrent pregnancy loss (RPL) documents from 1970 to 2023.

Overall, 1287 documents from the Web of Science database associated with recurrent pregnancy loss between 1970 and 2023 were identified for more than 300 journals. The data were analyzed with VOSviewer software.

The trend of paying attention to the topic of RPL can be divided into three periods. The number of publications on RPL increased significantly after 2010. Most of the papers were published in Obstetrics and Gynecology and Reproductive Biology areas. Utilizing co-occurrence and co-citation analysis, our study found that the most influential documents mapped the knowledge structure, and projected future research directions. The co-occurrence analysis showed five clusters even though the co-citation analysis designates four.

RPL has increased in recent years exponentially and some areas were explained carefully, therefore these results could be used as a research agenda for the future direction by a range of interested beneficiaries.

This study aimed to measure the correlation of sperm DNA fragmentation with semen parameters, lifestyle, and fertility outcomes after intracytoplasmic injection (ICSI).

The partners who were candidates for ICSI with a history of one In vitro fertilization (IVF) failure or male factor were recruited in the study. Semen parameters including sperm count, motility, and morphology as well as DNA fragmentation index (DFI) (that were divided into 2 groups as high (>15%), and low (≤15%) fragmentation scales) were evaluated either. The correlation of DFI with semen parameters, lifestyle, and clinical pregnancy after ICSI were compared between groups.

In 120 included couples, 59 men (49.2%) had DFIs ≤ 15% and 61 (50.8%) cases had DFIs >15%. In the group with higher DFI, abnormal morphology (p=0.010) was higher whereas, progressive motility (p=0.001), total motility (p<0.001), and total count (p<0.001) of sperm were significantly lower. In addition, the DFI was significantly higher in the subgroup of male infertility (0.012). Logistic regression showed that a lower risk of DFI>15% was associated with higher values of progressive motility (OR=0.97, p=0.001), total motility (OR=0.96, p=<0.001), count (OR=0.96, p=<0.001) and even clinical pregnancy (OR=0.27, p=0.011). However, a history of testicular surgery was associated with a higher risk of DFI>15% (OR=3.37, p=0.046). Although no correlation was found between male age and lifestyle components with DFI, the number of embryos was lower in DFI≥15% (p<0.001).

DFI provide a clinically important measurement of sperm quality and have an impact on IVF outcomes; however, lifestyle components may not correlate with DFI.

The aim of this study was to identify the associated risk factors of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM).

This retrospective case-control study was conducted at Firooz-abadi Hospital between 2019 and 2021. The study included 90 pregnant women diagnosed with PROM or PPROM (case group), compared with 90 women without this complication (control group) who presented to the hospital during the specified period. Demographic and clinical information of the case group was collected and compared with data from 90 pregnant women in the control group, matched for gestational age and other relevant factors. Statistical analysis was performed to assess the differences between the groups.

Maternal age and weight were found to be significantly lower in the case group compared to the control group (P=0.02, P<0.001, respectively). This suggests that younger age and lower maternal weight may be risk factors for PROM and PPROM. Furthermore, the number of women with a history of PROM or PPROM was significantly higher in the Case group (P<0.001), indicating that a previous occurrence of membrane rupture increases the risk of subsequent incident. In addition, the study findings showed a significantly higher rate of smoking among pregnant women in the case group compared to the control group (P=0.04). Moreover, the occurrence of urinary tract infections during pregnancy and chorioamnionitis was significantly higher in the case group (P<0.001), suggesting that these infections may contribute to membrane rupture.

In conclusion, our study provides valuable insights into the risk factors associated with PROM and PPROM. It highlights that lower maternal age and weight, a history of PROM or PPROM, lower gestational age, a history of gestational diabetes mellitus and first-trimester bleeding, smoking, and urinary tract infections during pregnancy are significantly associated with an increased risk of PROM and PPROM. These findings emphasize the importance of early identification and management of these risk factors in order to prevent or mitigate the occurrence of PROM and PPROM, ultimately improving maternal and neonatal outcomes. Further research and public health initiatives are warranted to raise awareness and promote preventive measures targeting these identified risk factors.

The recognized role of Anti-Müllerian hormone (AMH) as a marker for women's biological age and ovarian reserve prompts debate on its efficacy in predicting oocyte quality during IVF/ICSI. Recent findings challenging this view compelled us to conduct this study to examine the correlation between AMH levels and quantity/quality of oocytes in IVF/ICSI procedures.

The data were collected retrospectively from the medical records of 320 women between 25-42 years old. The included patients were divided into two groups: the high AMH group (>1.1 ng/ml) and the low AMH (=<1.1 ng/ml) group. The high AMH group comprised 213 patients, while the low AMH group consisted of 107 patients. Spearman's correlation coefficient and Multinomial logistic regression were computed to assess the relationships between different variables.

Significant positive correlations were detected between AMH level and the number of aspirated follicles (rho=0.741, p<0.001), retrieved oocytes (rho=0.659, p< 0.001), M2 oocytes (rho=0.624, p<0.001), grade A embryos (rho=0.419, p<0.001), and grade AB embryos (rho=0.446, p<0.001. In contrast, AMH levels had negative associations with the number and duration of cycles (p<0.05). AMH emerged as a statistically significant independent predictor of the number of M2 oocytes.

Serum AMH level could represent the quantity and quality of oocytes following IVF/ICSI treatments. Future studies should aim to delve deeper into the correlations between AMH levels and both the quality and quantity of embryos. Additionally, it would be beneficial to consider the influence of sperm factors, as well as assess pregnancy rates.

Pre-eclampsia (PE) is a multiorgan disorder that affects 2-5% of all pregnant women. Present recommendations for when to start aspirin in high-risk women are after 11 wk of gestation.

We present a protocol to investigate the effectiveness of aspirin use from early pregnancy, which is a randomized controlled trial to assess whether prescribed low-dose aspirin from early pregnancy reduces the prevalence of early and late-onset PE. Additionally, to compare the effectiveness of aspirin administration before and after 11 wk in reducing the occurrence of PE?

All pregnancies at risk of PE, according to demographic and midwifery history, who are referred to the Maternal-Fetal Clinic of Tehran University hospital, Tehran, Iran were invited to take part in the trial. The outcomes of pregnancy and newborns will be gathered and analyzed. The first registration for the pilot study was in January 2023, and the participants were recognized as high-risk for PE. In addition, enrollment in the main study will begin as of October 2023.

Maternal health care is one of the main challenges worldwide, especially in low- and middle-income countries (LMICs) such as Iran. In this cross-sectional study, we introduce an electronic health software for maternal care that is active under the supervision of the Valiasr Reproductive Health Research Center of Tehran University of Medical Sciences in providing maternal health education to Iranian pregnant women. In addition to describing the details of this open-source software and encouraging LMICs health policymakers to develop such software, this manuscript also provides a cross-sectional report and statistical analysis on anonymous Iranian pregnant women who registered in this system.

Since 2015, we have launched an electronic health software in Iran called "niniMED Pregnancy Calendar" in Persian. This system has multiple educational and motivational features for pregnant women, including momentary weight recommendations based on pregnancy week and recommended dates for common tests during pregnancy according to the first day of the last menstrual period in Jalali calendar format. Additionally, we measured user satisfaction with this system using a questionnaire.

From 2015 to 2017, 1,217 anonymous Iranian pregnant women registered in this system. The average age of pregnant Iranian women was 30.67 years (30 years and 8 months). Users had a body mass index (BMI) of 24.68 kg.m-2, which had a significant direct relationship with their gestational age (P=5.81e-05) and indicated an improvement in appropriate weight for Iranian women compared to previous studies. We showed that there was a significant direct relationship between the age of Iranian pregnant women and the likelihood of a high-risk pregnancy (P=0.008). We also observed a significant inverse relationship between pregnancy week and their tendency to receive pregnancy-related education (P=0.018). Finally, we found that more than 88% of pregnant Iranian women assessed membership in such systems as completely useful for pregnancy.

The development of such electronic health systems for informing pregnant women can provide low-cost maternal education to LMICs pregnant women and potentially assist in managing weight gain during pregnancy and reducing associated risks. It can also be widely accepted by pregnant women.

 Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.

 Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.

 Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.

Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.

This study aimed to evaluate the effectiveness of selective laser photocoagulation of communicating vessels (SLPCV) on cardiac function in twins with twin-to-twin transfusion syndrome (TTTS).

This retrospective cohort study evaluated 178 women with twin pregnancies complicated with TTTS and scheduled for SLPCV between 16 and 26 weeks of gestation. The severity of TTTS was determined by Quintero staging and the severity of cardiovascular disorders by the CHOP (Children’s Hospital of Philadelphia) score. Patient survival was evaluated through a one-month-after-birth follow-up of fetuses.

The study revealed significant improvements in Doppler indices in both donors and recipients after SLPCV. The CHOP score also significantly decreased after the intervention. One-month-after-birth survival rates were 55.1% in donors and 56.7% in recipients. Some Doppler indexes of fetuses before SLPCV could predict survival until one month after birth.

The study suggests that SLPCV can improve cardiac function in fetuses with TTTS and that some Doppler indexes can predict survival outcomes. Additionally, the severity of TTTS can be a powerful indicator of the severity of cardiovascular complications.

In 15% of all clinical pregnancies, a miscarriage can occur, but the exact cause of this phenomenon is not fully understood. However, it is believed that a faulty placenta, which triggers an inflammatory response in the mother's body, may be one of the causes. Medical literature has increasingly focused on 2 indicators of inflammation, the platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR). Despite this, there has yet to be a study conducted that examines the rates of PLR and NLR in cases of miscarriage.

This study aims to determine whether there is an increase in complete blood count inflammatory parameters such as NLR and PLR in women who experience miscarriages.

This retrospective case-control study was conducted from March 2021 to March 2022, across 3 academic hospitals in Tehran, Iran. A total of 240 participants were enrolled comprising individuals with either miscarriages or normal pregnancies (n=120/each). Data were collected from the medical records of participants aged between 18-42 yr old, with gestational age ranging from 6-13 wk. The demographic information, including age, body mass index, parity, history of abortion, number of abortions, number of living children, hematocrit and hemoglobin levels, platelet distribution width (PDW), PLR, NLR, mean platelet volume, and platelet were extracted from their records. The gestational age was also recorded.

A total of 240 participants were recruited for the study. PDW, NLR, PLR, and lymphocyte values were higher in the miscarriage group compared to the healthy normal pregnant women (p < 0.001). Mean platelet volumes were found to be lower in the miscarriage group compared to the healthy normal pregnant women (p < 0.001).

Although, no statistically significant difference was observed in the hemoglobin, hematocrit, platelets, and neutrophils in these 2 groups of pregnant women. The higher inflammatory markers including PDW, NLR, and PLR could potentially aid in the speculation of defective placentation as a contributing factor to the development of miscarriage. Measurement of these markers may be useful to predict pregnancy leading to miscarriage.

Corticosteroid administration may impair blood sugar control and cause other adverse effects in pregnant women with moderate to severe COVID-19. To our knowledge, there have been no studies on the effect of corticosteroid therapy on pregnant women with COVID-19 infection in terms of hyperglycemia or insulin needs.

The purpose of this study was to compare 2 different regimens of corticosteroid therapy, specifically dexamethasone, and methylprednisolone, in terms of their impact on newly diagnosed hyperglycemia in pregnant women infected with COVID-19, as well as the duration of this condition.

The current cohort study was conducted from August to November 2021 on hospitalized pregnant women with severe COVID-19. They received either the first protocol, which involved daily administration of 2 mg/kg of methylprednisolone intravenously, or the second protocol, which included daily intravenous administration of 6 mg of dexamethasone. The study aimed to compare the incidence and duration of hyperglycemia until delivery between these 2 groups.

A total of 59 participants were recruited after meeting the inclusion criteria. There were no significant differences in the demographic and clinical characteristics of patients between the 2 groups. Among the 59 pregnant women included in the study, 24 (40.7%) developed hyperglycemia that required insulin therapy. The incidence of hyperglycemia did not significantly differ between the 2 treatment regimens (P-value = 0.069). In the follow-up period, hyperglycemia resolved in both groups within up to 4 weeks after treatment, and they no longer required insulin.

Corticosteroid-treated pregnant patients are associated with transient hyperglycemia, the incidence of which is unrelated to the type of corticosteroid used. Therefore, corticosteroid administration should be initiated with caution and monitored appropriately in pregnant women with COVID-19 infection. 

In this report, a brief historical overview of preprints focuses on the impact of the COVID-19 pandemic on the distribution of preprints in obstetrics and gynecology, and the benefits and drawbacks of preprints are described. Preprints are manuscripts that are published before peer review. They are widely available even though they are recent in biomedical science. The COVID-19 pandemic enhanced the number of preprints prominently. It is known that 5% of all preprint articles issued during the pandemic were in obstetrics and gynecology. Some benefits include the increased pace of being available and the exposure rate. Also, it provides an opportunity to check for plagiarism and prevent malpractice earlier. Challenges to the distribution of preprints also exist, such as the potential lack of quality, premature data, and the possibility of misguiding normal people. Given the high importance of data release in obstetrics and gynecology, both the authors and the publishers should regulate strict yet rational guidelines before letting the information become widely accessible.

 Parabens (PBs) may have potential endocrine disruption effects and may affect fertility.

 This study aimed to find the relationship between the urinary concentration of PB derivatives, including methylparaben (MP), ethylparaben (EP), propylparaben (PP), and butylparaben (BP), with the hormonal profile and in vitro fertilization (IVF) outcomes of infertile women.

 This case-control study was conducted in an academic center in Tehran from April to December 2021. The demographic data and lifestyle components as well as the urinary MP, EP, PP, and BP among the infertile and fertile women were evaluated and compared. Also, in infertile patients, the correlation between the hormonal profile and IVF outcomes (the number and quality of oocytes and embryos) with urinary PBs was assessed and reported.

 A total of 206 women were included in the study. The distribution of urinary PB concentrations between groups was not significantly different. The frequency and comparison of used personal care products, cosmetics, detergents, and foodstuffs for some items except folic acid were significantly higher in the control group. Comparing the effects of PBs on hormones, a significant impact of MP on estradiol was observed for the second, third, and fourth quantiles. The follicle-stimulating hormone was significantly affected by the fourth quartile of EP. Additionally, the effect of EP on anti-mullerian hormones was negative and significant for the fourth quartile compared to the first quartile.

 Urinary PB levels may not be an indicator for infertility and hormonal distribution, at least for a short duration, and did not impact IVF outcomes.

In this report, a brief historical overview of preprints focuses on the impact of the COVID-19 pandemic on the distribution of preprints in obstetrics and gynecology, and the benefits and drawbacks of preprints are described. Preprints are manuscripts that are published before peer review. They are widely available even though they are recent in biomedical science. The COVID-19 pandemic enhanced the number of preprints prominently. It is known that 5% of all preprint articles issued during the pandemic were in obstetrics and gynecology. Some benefits include the increased pace of being available and the exposure rate. Also, it provides an opportunity to check for plagiarism and prevent malpractice earlier. Challenges to the distribution of preprints also exist, such as the potential lack of quality, premature data, and the possibility of misguiding normal people. Given the high importance of data release in obstetrics and gynecology, both the authors and the publishers should regulate strict yet rational guidelines before letting the information become widely accessible.

Comparing the maternal and neonatal complications of COVID-19 with a healthy control group is important to identify the most accurate and up-to-date information about the effects of this disease on the health of mothers and neonates.

The study aimed to determine the maternal and neonatal complications and consequences related to COVID-19 infection.

This case-control study was conducted from February 2021 to February 2022 on women who were infected with COVID-19 during their pregnancy to evaluate the short and medium-term maternal and neonatal outcomes and compare them in the control group. Maternal outcomes, such as the rate of miscarriage, preterm delivery, stillbirth, and type of delivery, as well as gestational diabetes and preeclampsia, were evaluated. Indeed, neonatal complications, including hearing impairment, low birth rate, intrauterine growth restriction, and the rate of hospitalization in the neonatal intensive care unit, were evaluated and compared between groups.

In total, 600 women (300 cases in each group) participated in the study. The results showed that the frequency of cesarean delivery in patients with COVID-19 was 38%, while this rate was 20% in the control group. This difference was significant. It was also found that pregnant women suffering from COVID-19 had significantly more preterm labor. Babies born to mothers infected with COVID-19 had a significantly higher hospitalization rate in the intensive care unit than in the control group. Other maternal and neonatal complications were not significantly different between the two groups.

Women who are infected with COVID-19 during pregnancy face new maternal and newborn complications. Therefore, it is necessary to carry out further research on the long-term effects of COVID-19 on the health of the mother and baby in order to determine the appropriate strategies for the prevention and treatment of these complications. 

 The cesarean section rate has increased in the last decade, a significant risk factor for intra-abdominal adhesion. This study investigated the diagnostic accuracy of cesarean scar indicators for intra-abdominal adhesions in pregnant women.

 This cross-sectional study was conducted on pregnant women with a previous cesarean section who were candidates for elective repeated cesarean section. We gathered demographic information, including age, number of prior cesarean sections, past medical and surgical history, the time since the last operation, and the inspection of the cesarean incision. The evidence of pelvic adhesion was calculated in the operating room by the Manchester scar scale, and intra-abdominal adhesions were graded using a modified Nair's classification. The data were analyzed by proper tests.

 One hundred pregnant women were included in the study and divided into two groups with high and low incision indices. In the low incision index group, 82.1% had a history of one cesarean section, and 1.3% had three or more, and in the group with a high incision index, 54.5% had a history of one cesarean section, and 13.6% had three times or more (P < 0.05). Women with a high incision index had a higher adhesion rate than the other group (P < 0.001). The sensitivity and specificity of the scar index in the diagnosis of adhesions were 57.48% and 92.30%, respectively.

 It is challenging to accurately predict the severity of adhesions resulting from cesarean section, but it is urged to prevent an unnecessary cesarean section.