به جمع مشترکان مگیران بپیوندید!

تنها با پرداخت 70 هزارتومان حق اشتراک سالانه به متن مقالات دسترسی داشته باشید و 100 مقاله را بدون هزینه دیگری دریافت کنید.

برای پرداخت حق اشتراک اگر عضو هستید وارد شوید در غیر این صورت حساب کاربری جدید ایجاد کنید

عضویت

جستجوی مقالات مرتبط با کلیدواژه "pregnancy" در نشریات گروه "پزشکی"

  • اعظم ظفربخش، الهام فاطمی نیا، آناهیتا بابک، سمیه خانجانی، مامک شریعت، فدیه حق اللهی*
    زمینه و هدف

    پارگی زودرس پرده ها (PPROM) یکی از مهمترین علل مرگ ومیر پری ناتال است که عوارض آن در دو دسته ی مادری و جنینی می باشد. هدف از انجام این مطالعه بررسی فراوانی عوامل خطر مادری، پیامدهای مادری و جنینی و بررسی نقش مراقبت در بروز پیامدها می باشد.

    روش بررسی

    این مطالعه مقطعی گذشته نگر می باشد که بر روی 317 زن باردار مبتلا به پارگی زودرس پرده ها (PPROM) با سن حاملگی کمتر از 37 هفته از فروردین 1398 تا فروردین 1400 در بیمارستان شهید بهشتی شهر اصفهان انجام شد. کلیه اطلاعات لازم شامل متغیر دموگرافیک، عوامل خطر و پیامدهای مادری و نوزادی از پرونده بیماران جمع آوری و به دو گروه تحت مراقبت (34-24 هفته بارداری) و ختم بارداری (بیشتر از 34 و کمتر از 24 هفته) تقسیم شدند. برای تجزیه وتحلیل متغیرهای کیفی از Chi-square test و برای متغیرهای کمی از Student’s t-test استفاده شد.

    یافته ها

    نتایج این مطالعه نشان دادکه وجود سوابق سقط 2/20%، عفونت ادراری 2/20%، نارسایی سرویکس 18%، دیابت بارداری 6/13%، از بیشترین موارد عوامل خطر PPROM می باشد. از نظر پیامدهای مادری کوریوامنیونیت و سزارین اورژانس در گروه مراقبت بیشتر گزارش شد (0001/0=P). بستری در NICU در گروه مراقبت بیشتر بود (001/0=P).

    نتیجه گیری

    نتایج این مطالعه نشان داد که سابقه سقط، عفونت ادراری، نارسایی سرویکس، دیابت بارداری از بیشترین عوامل خطر در بروز PPROM می باشد. درمان انتظاری PPROM در مقایسه با گروه ختم بارداری دارای عوارض نوزادی و مادری بیشتری می باشد.

    کلید واژگان: پیامد, بارداری, پارگی پیش از موعد و زودرس کیسه آب
    Azam Zafarbakhsh, Elham Fateminia, Anahita Babak, Somayeh Khanjani, Mamak Shariat, Fedyeh Haghollahi*
    Background

    Preterm premature rupture of membranes (PPROM) significantly impacts perinatal mortality and maternal-fetal outcomes. The purpose of this study is to investigate the frequency of maternal risk factors, maternal and fetal outcomes and the role of care in the occurrence of outcomes.

    Methods

    This retrospective cross-sectional study involved 317 pregnant women with premature rupture of membranes (PPROM) at Shahid Beheshti Hospital in Isfahan, between April 2020 and April 2022. Data were collected from medical records, including demographic information, risk factors, and maternal and neonatal outcomes. Patients were categorized into two groups: those receiving care (24-34 weeks of gestation) and those undergoing pregnancy termination (less than 24 weeks or more than 34 weeks). The chi-square test was used for qualitative variables, while the T-student test was applied for quantitative variables.

    Results

    In this study, the average age of patients was 29.42±6.56 years. The most common risk factors for PPROM were 20.2% for abortion records, 20.2% for urinary infections, 18% for cervical insufficiency, and 13.6% for gestational diabetes. Comparing maternal outcomes between the two groups revealed that chorioamnionitis occurred more frequently in the care group (18% vs. 2%, P=0.0001), as did emergency cesarean sections (37% vs. 4.5%, P=0.0001) and NICU hospitalization (71% vs. 17%, P=0.001). In the next stage, a regression test identified the independent effects of variables on maternal and newborn outcomes without intervention or confounding factors. The analysis indicated that mothers in the care group experienced significantly more complications than those in the pregnancy termination group, and their babies also faced significantly more complications.

    Conclusion

    The study results indicate that a history of abortion, urinary infections, cervical insufficiency, and gestational diabetes are significant risk factors for PPROM. Expectant management of PPROM is associated with more neonatal and maternal complications than pregnancy termination. Thus, timely identification of these risk factors allows healthcare providers to educate mothers and potentially prevent and manage them, significantly reducing the incidence of PPROM and its complications.

    Keywords: Outcome, Pregnancy, Preterm Premature Rupture Of The Membranes (PPROM)
  • Sajjad Ghane Ezabadi, Fereshteh Ashtari, Seyed Mohammad Baghbanian, Nastaran Majdi-Nasab, Elham Madreseh, Hamidreza Hatamian, Fardin Faraji, Asghar Bayati, Hoda Kamali, Ehsan Sharifipour, Hossein Mozhdehipanah, Mohammadamin Shahrbaf, Saeideh Ayoubi, Mohammadali Sahraian, Sharareh Eskandarieh *
    Background

    Multiple sclerosis (MS) predominantly affects women of childbearing age, significantly impacting their quality of life (QOL). The diagnosis of MS can influence pregnancy intention, and the level of disability associated with MS may change before and after pregnancy. This study aims to analyze the reproductive characteristics of Iranian female patients with MS (PwMS) and their association with the Expanded Disability Status Scale (EDSS) and pregnancy tendency, providing valuable insights into disease progression and the development of tailored treatments.

    Methods

    A cross-sectional study was conducted using data from the nationwide MS registry of Iran (NMSRI) from 2018 to 2021. Patients without a documented history of pregnancy, MS type, or EDSS score were excluded from the study. Various statistical methods, including nonparametric tests, the generalized estimating equation (GEE) model, and multiple logistic regression, were employed to analyze the data.

    Results

    The study included 1120 PwMS with a median diagnostic age of 31 and a disease duration of 6 years. The majority had relapsing-remitting MS (RRMS) and the mean EDSS score at bassline was 1.5 ± 1.4. A history of pregnancy or abortion was associated with higher EDSS scores. Multiparity before MS diagnosis was linked to EDSS score ≥ 5, while this EDSS range was associated with decreased parity after MS diagnosis (all P-values < 0.05).

    Conclusion

    Pregnancy and parity can affect the disability in female PwMS irrespective of clinical symptoms, diagnosis age, and MS type. Moreover, the chance of parity may be affected by a higher disability score, which should be considered in the clinical setting.

    Keywords: Multiple Sclerosis, Pregnancy, Parity, Abortion, Disability, Iran
  • Mojgan Kalai Moghadam, Mohammadnasir Hemmatian, Majid Mirmohammadkhani, Mojgan Rahmanian
    Background

    This study aimed to evaluate the effects of overt maternal diabetes on fetal cardiac function.

    Methods

    In this case-control study, 26 pregnant women with overt diabetes (the case group) and 26 women with uncomplicated pregnancies (the control group) were examined using tissue Doppler echocardiography. Cardiac function was assessed twice in the fetal period (18–22 weeks and 28 weeks of gestation) and once in the neonatal period (1 week postnatal). Fetal cardiac function was assessed using early-diastolic maximum velocity index (Em), end-diastolic maximum velocity index (Am), Em/Am, left ventricular myocardial function index (LVMPI), and interventricular mechanical delay index (IVMDI).

    Results

    The case and control groups were not significantly different in maternal and gestational age in fetal Doppler evaluation. Em (P=0.007), Am (P<0.001), LVMPI (P=0.003), and IVMDI (P=0.026) were significantly higher in the case group than in the control group, while there was no significant difference in Em/Am (P=0.264). Eight fetuses (30.8%) of diabetic mothers had dyssynchrony, while no cases of dyssynchrony were seen in fetuses of non-diabetic mothers (P=0.004). Infants of diabetic mothers were 8.8 times more likely to develop adverse neonatal outcomes than infants of healthy mothers (RR: 8.8, 95% CI: 1.71 to 45.31, P=0.009).

    Conclusion

    The findings of the current study revealed significant cardiac dysfunction and dyssynchrony in fetuses of diabetic pregnant women. Additionally, IVMDI and LVMPI can be used to predict adverse neonatal outcomes in pregnancies complicated with overt diabetes.

    Keywords: Pregnancy, Diabetes Mellitus, Fetus
  • زهرا رحمانی، مریم عبدی ولیک چالی*، طاهره گلینی مقدم، شهاب الدین قره ویسی
    سابقه و هدف

    آنمی در دوران بارداری یک مشکل سلامت عمومی مخصوصا در کشورهای در حال توسعه محسوب می گردد و با پیامدهای نامطلوب بارداری همچون تولد زودرس، کاهش وزن هنگام تولد(LBW)  و اختلال رشد جفتی (تغییرات عروقی و حجم جفت) همراه است. اختلال رشد جفت از مهم ترین علل مرگ و میر مادری و حین تولد نوراد و یکی از عوامل مهم عقب ماندگی رشد جنین محسوب می گردد. لذا با توجه به تاثیر انواع آنمی بر بارداری و ایجاد تغییرات عروقی جفتی و پیامدهای بلند مدت و کوتاه مدت ناشی از آن، این مطالعه به منظور بررسی شاخص های سونوگرافیک داپلر عروق اسپیرال جفتی در زنان باردار با آنمی فقر آهن و بتا تالاسمی مینور و مقایسه آن با زنان باردار سالم در نیمه نخست بارداری انجام گردید.

    مواد و روش ها

    این مطالعه مورد شاهدی روی90 زن باردار مراجعه کننده به کلینیک مراقبت های بارداری بیمارستان امام خمینی ساری که معیارهای ورود به مطالعه را داشتند، از تاریخ 1399/02/23 لغایت 1399/12/26، انجام شد. افراد مراجعه کننده در سه گروه آنمی فقر آهن، بتاتالاسمی مینور و سالم (30 نفر در هر گروه) مورد بررسی قرار گرفتند. بیماران در نیمه نخست بارداری تحت سونوگرافی کالرداپلر جفتی قرار گرفتند و متغیرهایی چون: حجم جفت، شاخص ضربانی، شاخص مقاومت شریان مارپیچی جفت، شاخص ضربانی و شاخص مقاومت شریان بندناف در محل اتصال جفت در آن ها اندازه گیری شد. برای بررسی اختلاف میانگین سه گروه مذکور از نظر متغیرهای اندازه گیری شده از روش مدل خطی کلی (GLM) و برای بررسی ارتباط بین متغیرها از روش همبستگی پیرسون استفاده شد. هم چنین جهت تجزیه و تحلیل داده ها از نرم افزار آماری SPSS 23 استفاده شد (0/05>P).

    یافته ها

    نتایج نشان داد که تفاوت آماری معنی داری بین میانگین شاخص مقاومت شریان مارپیچی جفت در بین سه گروه مذکور وجود داشت. این شاخص در گروه مبتلایان به آنمی فقر آهن، بتاتالاسمی مینور و افراد سالم به ترتیب برابر با 2/34، 0/7 و 0/99، 0/03=P بوده است. به طوری که شاخص مقاومت شریان مارپیچی جفت در زنان باردار مبتلا به آنمی فقر آهن بیش تر از دو گروه دیگر بوده است. هم چنین میانگین شاخص ضربانی شریان مارپیچی جفت (PIP) در مبتلایان به بتاتالاسمی مینوز نیز به طور معنی داری کم تر از گروه افراد سالم گزارش شد (به ترتیب 1/44 و 2/02، 0/02.P=). بررسی همبستگی بین شاخص های مختلف سونوگرافیک نیز همبستگی مثبت معنی داری بین شاخص ضربانی شریان بندناف در محل اتصال جفت (PIU) و شاخص مقاومت شریان بندناف در محل اتصال جفت (RIU) را نشان داد (0/879.P=0/001 ، r=).

    استنتاج

    از آن جایی که یافته های مطالعه حاضر در ارزیابی مادران باردار جهت بررسی بهتر شاخص های جفتی کمک کننده بوده است و با توجه به افزایش شاخص مقاومت شریان مارپیچی جفت در زنان با آنمی فقر آهن، لزوم پیگیری توسط متخصصین و مراقبین بهداشتی جهت پیشگیری، ارزیابی و درمان آنمی در زنان باردار ضروری می باشد. با این وجود پیشنهاد می گردد مطالعات بیش تری جهت ارزیابی و مقایسه واسکولاریزاسیون عروق جنینی و جفتی و پیامدهای بارداری در زنان باردار با انواع آنمی انجام شود.

    کلید واژگان: عروق مارپیچی جفت, سونوگرافی داپلر, آنمی فقر آهن, بتا تالاسمی مینور, زنان باردار
    Zahra Rahmani, Maryam Abdi Valikchali*, Tahere Gelini Moghaddam, Shahabodin Gharahveysi
    Background and purpose

    Anemia during pregnancy is a public health issue, particularly in developing countries, and is linked to adverse pregnancy outcomes such as premature birth, low birth weight (LBW), and placental growth disorders (vascular changes and placental volume). Placental growth disorder is a leading cause of perinatal and maternal mortality and a significant factor in fetal growth restriction. Given the effects of different types of anemia on pregnancy, placental vascular changes, and both long- and short-term outcomes, this study aims to examine Doppler sonographic indicators of placental spiral vessels in pregnant women with iron deficiency anemia and beta thalassemia minor and compare these with healthy pregnant women during the first half of pregnancy.

    Materials and methods

    This case-control study was conducted on 90 pregnant women who met the inclusion criteria and attended the pregnancy care clinic at Imam Khomeini Hospital in Sari from February 23, 2019, to December 26, 2019. The participants were divided into three groups: women with iron deficiency anemia, those with minor beta-thalassemia, and healthy women (30 individuals per group). In the first half of pregnancy, participants underwent placental color Doppler ultrasound, and variables such as placental volume, pulsatility index, and resistance index of the placental spiral artery, as well as the pulsatility and resistance indices of the umbilical cord artery at the placental junction, were measured. The general linear model (GLM) was used to assess the mean differences among the three groups for these variables, and Pearson correlation was used to examine relationships between variables. Data were analyzed using SPSS statistical software version 23 (P<0.05).

    Results

    The results indicated a statistically significant difference in the mean resistance index of the placental spiral artery among the three groups. This index was higher in pregnant women with iron deficiency anemia compared to the other two groups (2.34 in the iron deficiency anemia group, 0.7 in the beta-thalassemia minor group, and 0.99 in the healthy group; P=0.03). Additionally, the mean pulsatility index of the placental spiral artery (PIP) was significantly lower in patients with beta-thalassemia minor compared to the healthy group (1.44 vs. 2.02, P=0.02). Analysis of the correlations between different sonographic indices showed a significant positive correlation between the pulsatility index of the umbilical artery at the placental junction (PIU) and the resistance index of the umbilical artery at the placental junction (RIU) (r=0.879, P=0.001).

    Conclusion

    The findings of this study support the value of evaluating placental indices in pregnant women, particularly highlighting the increased resistance index of the placental spiral artery in women with iron deficiency anemia. This underscores the need for follow-up by healthcare providers to prevent, assess, and treat anemia in pregnancy. Further studies are recommended to evaluate and compare vascularization of fetal and placental vessels and pregnancy outcomes in women with various types of anemia.

    Keywords: Pregnancy, Placental Spiral Vessels, Doppler Ultrasound, Iron Deficiency Anemia, Minor Beta- Thalassemia
  • Samaneh Tahmasebi Ghorabi, Arian Karimi Rouzbahani, Masoumeh Ghafarzadeh, Mojgan Kaviani, Banafsheh Derikvand, Azin Niazi, Fatemeh Yari
    Background

    The current and alarming situation of the COVID-19 pandemic may cause anxiety in pregnant women.

    Objectives

    Given the importance of both physical and mental health for expectant women, this study investigated COVID-19 anxiety among pregnant women referred to Asalian Hospital in Khorramabad during 2021 - 2022.

    Methods

    This descriptive cross-sectional study was conducted among pregnant women referred to Asalian Hospital in Khorramabad. A total of 253 pregnant women were included in the study based on the study criteria and the available sampling method. The Corona Virus Anxiety Scale was used to collect data through a questionnaire. The data were analyzed using SPSS version 22, and analysis of variance (ANOVA) and t -tests were employed to examine the data, with the significance level set at 0.05.

    Results

    The mean age of expectant women was 27.7 ± 3.56 years. The average anxiety score among the pregnant women was 4.39 ± 3.99, with physical and mental dimension scores of 1.67 ± 1.89 and 2.71 ± 2.15, respectively. There was a statistically significant difference in the average anxiety scores related to COVID-19 based on education, place of residence, and the number of pregnancies (P < 0.05).

    Conclusions

    The present study found that pregnant women experienced a low level of anxiety in response to COVID-19. The average score for the psychological aspect of COVID-19-related anxiety among these women was greater than that for the physical aspect. Therefore, by increasing public awareness about COVID-19 and providing positive psychological programs in the media aimed at managing stress, anxiety in pregnant women can be effectively reduced.

    Keywords: COVID-19, Anxiety, Pregnant Women, Pregnancy, Corona
  • فرزانه رحیمی*، مهشید معینی مهر، فریبا اسلامی
    مقدمه

    دوران بارداری و پس از زایمان از عواملی است که با ایجاد تغییرات جسمی و روانی در زنان می تواند به عنوان یک عامل جدی در پیدایش یا تشدید اختلالات جنسی تلقی شود. در مطالعات مختلف اقدامات پرستاری و مامایی متفاوتی به عنوان شیوه های درمانی جایگزین در جهت بهبود رضایت جنسی در زنان در دوره بارداری و پس از زایمان مورد استفاده قرارگرفته است که این مطالعه با هدف مرور و جمع بندی این اقدامات انجام شده است.

    روش بررسی

    در این مطالعه مروری سیستماتیک اطلاعات مورد نظر از پایگاه های اطلاعاتی Science Direct و Scopus ،Pubmed ،SID ، Google Scholar و مرکز ثبت کارآزمایی های بالینیIRCT  از ابتدای سال 2000 تا اوایل سال2023 جمع آوری گردید.

    نتایج

    40 مطالعه (13 مقاله فارسی و 27 مقاله لاتین) مورد بررسی قرار گرفته است. 9روش مختلف در جهت بهبود رضایت جنسی در دوره بارداری (17 مطالعه) و پس از زایمان (23 مطالعه) مورد استفاده قرار گرفته است. تاثیر روش آموزش به مادران در زمینه های مختلف (14 مطالعه) در طی دوران بارداری و مشاوره گروهی و جنسی (10 مطالعه) و آموزش ورزش های لگنی و ورزش کگل (9مطالعه) در دوره پس از زایمان به میزان بیشتری نسبت به سایر روش ها در مطالعات توسط محققین مورد بررسی قرار گرفته است.

    نتیجه گیری

    روش آموزش به مادران در زمینه های مختلف و مشاوره جنسی و ورزش لگنی و کگل با توجه به آسان بودن و در دسترس بودن و کم هزینه بودن می تواند به میزان موثری در طی دوران بارداری و پس از زایمان توسط کارکنان مامایی در مراکز ارائه خدمات و مطب ها مورد استفاده قرار گرفته و منجر به بهبود رضایت جنسی و بهبود کیفیت زندگی جنسی زنان و سازگاری بهتر آنان با دوره بارداری و پس از زایمان شان شود.

    کلید واژگان: رضایت جنسی, زنان, بارداری, پس از زایمان
    Farzaneh Rahimi*, Mahshid Moenimehr, Fariba Slam
    Introduction

    The period of pregnancy and postpartum is characterized by physical and psychological changes in women, which can significantly contribute to the onset or exacerbation of sexual disorders. Various nursing and midwifery interventions have been used as alternative therapeutic methods to improve sexual satisfaction in women during pregnancy and after childbirth, and this study aims to review and summarize these interventions.

    Methods

    A total of 40 studies (13 Persian articles and 27 Latin articles) have been examined. Nine distinct approaches have been utilized to enhance sexual satisfaction during pregnancy (17 studies) and following childbirth (23 studies). The influence of educational techniques for mothers across various areas (14 studies) during pregnancy, along with group and sexual counseling (10 studies) and group and sexual counseling (10 studies) and instruction on pelvic and leg exercises (9 studies) in the postpartum phase, appears to be more prevalent than other approaches in the research.  is more frequent than other methods in the studies. Researchers have conducted an investigation. .

    Results

    Uncoordinated movement was noted in 75% of mice following prolonged acetaminophen use (p<0.01) while pretreatment with Stevia entirely counteracted the effects of acetaminophen. Acetaminophen was significantly (p<0.01) increased serum AST and ALT and Sativa extract dose dependently mitigated the effects of acetaminophen. Pretreatment with both doses of stevia leads to a decrease in symptoms of liver necrosis caused by chronic acetaminophen use.

    Conclusion

    The approach of educating mothers in different areas, including sexual counseling and pelvic and Kegel exercise, is effective during pregnancy and post-delivery by midwifery professionals in the centers due to simplicity, accessibility, and affordability. Offering services and clinics have been utilized to enhance sexual satisfaction and improve the quality of women's sexual experiences, helping them better adjust to their pregnancy and postpartum periods.

    Keywords: Sexual Satisfaction, Women, Pregnancy, Postpartum
  • Faezeh Zakerinasab, Jamshid Jamali, Tahereh Sadeghi, Nafiseh Jahanpak, Mahbobeh Mahmoudinia, Maliheh Mahmoudinia *, Azadeh Masroori
    Background & aim

    Infection with COVID-19 during pregnancy increased some of the complications such as preterm labor, Intensive Care Unit (ICU) admission, maternal mortality, and adverse neonatal outcomes. The aim of the present study was evaluation of symptoms, critical illness, and mortality among pregnant patients with COVID-19 in Mashhad, North East Iran.

    Methods

    This descriptive retrospective study included pregnant women with COVID-19 diagnoses referred to one of the teaching hospitals in Mashhad between February 20, 2020, and September 21, 2022, using census method. . The patients were stratified into symptomatic mild, moderate, and severe cases, according to the National Institute of Health (NIH), USA. Data analysis was done using SPSS 26 by Student's t-test, logistic regression, and chi-square test.

    Results

    Out of 460 pregnant women, sixteen symptoms were reported by the patients with dyspnea being the most frequent. Cough, fever (P= 0.00), abdominal pain (P= 0.04), and chills (P= 0.03) were significantly more frequently observed among the ICU-admitted patients. The least common symptom was flank pain. Women with severe diseases who died were at significantly higher risk for fever, cough, and dyspnea. 116 (25.2%) cases had severe disease and were admitted to the ICU and 5.7% expired. Hospitalization in the ICU was the most important predictor of death. (B=-22.286, P=0.00).

    Conclusion

    The study indicates that pregnant women who experience symptoms such as fever, dyspnea, cough, chills, or abdominal pain are more susceptible to severe COVID-19.

    Keywords: COVID-19, Coronavirus, Pregnancy, Mortality
  • Gulbanu Ganikyzy Shaimerdenova, Gulzhan Narkenovna Abuova, Ardak Ayazbekov, Gulzhaukhar Taskynova, Dana Bekaryssova
    Background

    The coronavirus (COVID-19) pandemic has caused global uncertainty. Recent studies indicate an increased risk of spontaneous abortion, spontaneous preterm labor, and severe maternal and neonatal complications caused by COVID-19.

    Objectives

    The aim of our study is to investigate the impact of COVID-19 infection on maternal and neonatal perinatal outcomes.

    Methods

    This is a non-interventional, analytical clinical study. We conducted a retrospective analysis of 410 histories of pregnant women admitted to hospitals from 2020 to 2022 in the City Infectious Disease Centre and the City Infectious Disease Hospital of Shymkent.

    Results

    In the main group, there were 48 (21.0%) babies, while in the control group, there were 18 (10.5%) babies. A weight above 2500 g was recorded in 79% (182) of newborns in the main group. When comparing the weight of newborns between the groups, we did not find statistically significant differences (P = 0.051). Births of babies weighing more than 2500 g were 2.26 times more common in the control group than in the main group (95% CI: 0.984 - 5.228). A birth height of less than 48 cm was recorded in 1.7% (3) cases in the control group and 13.8% (32) of newborns in the main group (P = 0.002). A birth height greater than 48 cm was recorded in 86.2% (198) of neonates in the main group and 98.3% (84) in the control group.

    Conclusions

    A large systematic review (28 studies involving 790,954 pregnant women, among whom 15,524 were diagnosed with SARS-CoV-2 infection) aimed to investigate the relationship between SARS-CoV-2 infection during pregnancy and the risk of pre-eclampsia. It should also be noted that SARS-CoV-2 during pregnancy increases the likelihood of developing severe pre-eclampsia and HELLP syndrome. In our study, preeclampsia (54 - 13.1%) and HELLP syndrome (4 - 1.1%) were more frequent in the main group than in the comparison group. It should also be noted that frequent complications of COVID-19 in pregnant women included preterm labor (80 - 19.4%) and antenatal fetal death (8 - 2.0%).Analysis of perinatal outcomes revealed that women with COVID-19 infection are significantly more likely to give birth to infants with low growth, prematurity, and lower Apgar scores, and these infants are more likely to stay in the neonatal pathology department compared to those born to women without COVID-19 infection.

    Keywords: COVID-19, Pregnancy, Newborns
  • مینا ولی زاده، زهره محمودی، محمود بختیاری، مهدی موسویان، منصوره یزدخواستی*
    زمینه و هدف

    با شیوع ویروس نوپدید کووید19 نگرانی های  بسیاری درباره تاثیرات و عوارض ابتلای زنان باردار به این ویروس به وجود آمد. از آن جایی که زنان باردار به واسطه تغییرات فیزیولوژیک مرتبط با بارداری  در گروه آسیب پذیر قرار می گیرند، بنابراین هدف از این مطالعه تعیین و ارتباط ابتلا به عفونت کووید19 با تست های کبدی و پیامدهای بارداری بود.

    روش بررسی

    این پژوهش از نوع پژوهش های کوهورت آینده نگر می باشد که از مهر ماه 1399  تا شهریور ماه 1401 در مراکز آموزشی درمانی شهید اکبرآبادی و فیروزگر شهر تهران انجام شده است. در این مطالعه 191 نفر زن بیمار وارد مطالعه شدند و به دو گروه 1 زنان باردار مبتلا به کووید 19 (گروه مورد)، 2 زنان باردار غیرمبتلا به کووید 19 (گروه شاهد) تقسیم شدند. افراد واجد شرایط در ابتدا به روش در دسترس و سپس تخصیص تصادفی ساده وارد مطالعه شدند. جمع آوری داده ها به وسیله پرسشنامه های دموگرافیک و باروری,  درد (VAS) و چک لیست های مربوطه انجام شد. داده های جمع آوری شده با استفاده از آزمون های تی تست، من ویتنی، کای اسکوئر، آزمون دقیق فیشر، اسپیرمن، پیرسون  و رگرسیون لجستیک تجزیه و تحلیل شدند. 

    یافته ها

    میزان تست های کبدی (نسبت نرمال بین المللی (INR)، اسپارتات آمینو ترانسفراز AST، آلانین آمینو ترانسفراز((ALT، ALP آلکالین فسفاتاز (001/0>p) در بین دو گروه افزایش داشت. این افزایش در بین دو گروه دارای تفاوت آماری معنی داری بود (001/0>p)، ولی میانگین پلاکت، بیلی روبین غیرمستقیم و زمان ترومبوپلاستین نسبی در گروه مورد به ترتیب، به طور معنی داری کمتر از گروه شاهد بود (002/0p< ، 001/0>p، 041/0>p). هم چنین، زایمان زودرس و شدت انقباضات در گروه مورد و شاهد  تفاوت آماری معنی داری داشت (001/0>p). نوع زایمان در دو گروه مورد و شاهد تفاوت آماری معنی داری مشاهده نشد. ابتلا به کووید19 ریسک خطر آلکالین فسفاتاز ALP را 15 درصد و میزان خطر بیلی روبین غیر مستقیم را 58 درصد افزایش داد که از نظر آماری معنی دار گزارش شده است، ولی بر روی پلاکت  و نسبت نرمال بین المللی  INR تاثیری نداشته است.

    نتیجه گیری

      بر اساس یافته های مطالعه حاضر، ابتلا به عفونت کووید 19 باعث اختلال تست های کبدی گردید. اختلال تست های کبدی به دلیل عفونت کووید19 می تواند باعث همپوشانی  تغییرات ایجاد شده در جریان سندرم پره اکلامپسی و یا سندرم HELLP (همولیز، افزایش آنزیم های کبدی، کاهش پلاکت)گردد. هم چنین ابتلا به عفونت کووید 19 باعث افزایش شدت انقباضات و زایمان زودرس گردید.

    کلید واژگان: ویروس کوید 19, بارداری, تست های کبدی, پیامد حاملگی
    M. Valizadeh, Z. Mahmoodi, M .Bakhtiari, M .Moosavian, M .Yazdkhasti*
    Background & aim

    With the spread of the newly emerging virus, Covid-19, there were many concerns about the effects and complications of pregnant women contracting this virus. Since pregnant women are in a vulnerable group due to the physiological changes associated with pregnancy, the purpose of the present study was to determine and relate the infection of covid-19 with liver tests and pregnancy outcomes.

    Methods

    The present prospective cohort study was conducted from October 2019 to September 2021 at Shahid Akbarabadi and Firouzgar educational centers of Tehran, Iran. In this study, 191 female patients were included in the study and divided into two groups: 1- pregnant women infected with covid-19 (case group), 2- pregnant women not infected with covid-19 (control group). Eligible people were initially included in the study by available method and then by simple random allocation. Data collection was done by demographic and fertility questionnaires, pain (VAS) and relevant checklists. Collected data were analyzed using t-test, Mann-Whitney, chi-square, Fisher's exact test, Spearman, Pearson and logistic regression.

    Results

    The level of liver tests (International Normalized Ratio(INR), aspartate aminotransferase (AST), alanine aminotransferase (ALT, ALP, alkaline phosphatase) increased between the two groups. The increase between the two groups indicated a statistically significant difference (p<0.001), but the mean platelet, indirect bilirubin and relative thromboplastin time in the case group were significantly lower than the control group respectively (p<0.002, p<0.001, 041. Moreover, there was a significant difference in premature delivery and the intensity of contractions in the case and control groups (p<0.001). Phosphatase increased ALP by 15% and indirect bilirubin risk by 58%, which was reported to be statistically significant, but it had no effect on platelets and INR.

    Conclusion

    Based on the results of the present study, the infection of covid-19 caused liver test disorders. Disruption of liver tests due to covid-19 infection can overlap the changes made during preeclampsia syndrome or HELLP syndrome (hemolysis, increase of liver enzymes, decrease of platelets). Furthermore, the covid-19 infection increased the intensity of contractions and premature delivery.

    Keywords: COVID-19 Virus, Pregnancy, Liver Tests, Pregnancy Outcome
  • رنگین فتاح نیا، روناک شاهوی، ماریا مریم کلهر، بیژن نوری، فرزانه ظاهری*
    مقدمه

    دیابت بارداری از شایع ترین مشکلات دوران بارداری است. جهت کاهش عوارض این بیماری ضرورت دارد که بیماران در کنترل آن مداخله فعال داشته باشند. این مطالعه با هدف تعیین تاثیر برنامه خودمدیریتی مبتنی بر الگوی پنج آ بر خودکارآمدی زنان مبتلا به دیابت بارداری مراجعه کننده به مرکز دیابت بیمارستان توحید سنندج در سال 1401 انجام شد.

    روش ها

    این مطالعه ی نیمه تجربی بر روی 60 زن باردار واجد شرایط مراجعه کننده به مرکز دیابت بیمارستان توحید سنندج انجام شد. اطلاعات توسط فرم مشخصات دموگرافیک و مامایی و پرسشنامه ی خودکارآمدی در ارتباط با بیماران مبتلا به دیابت قبل و بعد از انجام مداخله، گردآوری شد. شرکت کنندگان بصورت تصادفی در دو گروه مداخله و شاهد قرار گرفتند. برای گروه مداخله، چهار جلسه آموزشی به مدت چهار هفته برگزار شد و گروه شاهد، مراقبت های معمول را دریافت کردند. آنالیز داده ها با نرم افزار STATA نسخه ی 12 و آزمون های مرتبط انجام شد. سطح معنی داری کمتر از 05/0 در نظر گرفته شد.

    یافته ها

    بر اساس نتایج، دو گروه از نظر متغیرهای دموگرافیک و مامایی تفاوت آماری معنی داری نداشتند (0/05 P >). قبل از مداخله، میانگین نمره ی خودکارآمدی در گروه مداخله و شاهد به ترتیب 7/0 ±33/4 و 4/0 ± 33/1 بود که تفاوت آماری معنی دار را نشان نداد (0/840 = P) اما در پایان مطالعه، میانگین نمره ی خودکارآمدی با اختلاف آماری معنی دار در گروه مداخله بیشتر بود (15/1 ± 52 در برابر 4/1 ± 33/9، 0/001 = P).

    نتیجه گیری

    نتایج مطالعه نشان داد که اجرای برنامه ی خودمدیریتی مبتنی بر الگوی پنج آ در زنان مبتلا به دیابت بارداری می تواند منجر به افزایش خودکارآمدی شود، بنابراین می توان در برنامه ی درمانی و پروتکل های مراقبت بارداری استفاده از این برنامه را پیشنهاد داد.

    کلید واژگان: بارداری, دیابت بارداری, خودمدیریتی, خودکارآمدی
    Rangin Fatahnia, Roonak Shahoie, Marya Maryam Kalhor, Bijan Nouri, Farzaneh Zaheri *
    Background

    Gestational diabetes is one of the most common problems during pregnancy. To reduce this disease, patients must intervene actively in its control. This study was conducted to determine the effect of the self-management program based on the five-A model on the self-efficacy of women with gestational diabetes referred to the diabetes center of Tohid Hospital in Sanandaj in 2022.

    Methods

    This semi-experimental study was conducted on 60 eligible pregnant women referred to the diabetes center of Tohid Hospital in Sanandaj. Information was collected using demographic and midwifery profile forms and a self-efficacy questionnaire related to diabetic patients before and after the intervention.  Participants were selected as available and were randomly divided into intervention and control groups. For the intervention group, four training sessions were held for four weeks, while the control group received usual care.

    Findings

    Based on the results, the two groups had no statistically significant differences in demographic and obstetric variables. Before the intervention, the average self-efficacy score in the intervention and control groups was 33.4 ± 0.7 and 33.1 ± 0.4, respectively (P = 0.840). Finally, the average self-efficacy score at the end of the study was significantly higher in the intervention group (52 ± 0.15 vs. 33.9 ± 4.1, P = 0.001).

    Conclusion

    The results of the study showed that the self-management program implementation based on the five-A model in pregnant women with gestational diabetes could lead to an increase in self-efficacy, so it can be suggested to use this program in the treatment plan and pregnancy care protocol for pregnant women.

    Keywords: Pregnancy, Gestational Diabetes, Self-Management, Self-Efficacy
  • Fatemeh Talebian, Leila Mahasti Jouybari
    Introduction

    Infertility, defined as a woman's inability to conceive and carry a pregnancy, is a significant health concern requiring careful attention and treatment. This study aims to describe the nursing process for a patient with infertility using King's goal attainment model.

    Case Presentation

    The case involves a patient with infertility who has undergone six unsuccessful in vitro fertilization (IVF) attempts and declined surrogate uterus transplantation. Following each IVF attempt, the patient experienced renal complications, resulting in three hospitalizations. Data were collected through observations, interviews with the patient and her family, and paraclinical tests and documents. The nursing process was customized according to the patient's preferences.

    Conclusions

    The results of the study indicated that the patient was able to interact with nurses but did not adhere to health-promoting behaviors and treatments. The analysis led to eight nursing diagnoses and 25 care goals, with the patient managing to act according to her prioritized goals through the nursing process utilizing King's goal attainment model. These findings underscore the importance of a systematic and structured approach, such as King's goal attainment model, in providing effective nursing care for patients with infertility.

    Keywords: Pregnancy, Female, Goals, Nursing Diagnosis, Infertility, Fertilization In Vitro, Patient Care Planning
  • Fariba Jandaghi, Mohammadreza Maleki, Sareh Shakerian
    Background

    The present study aimed to determine and compare the weight gain patterns of Iranian and Afghan pregnant women and investigate their relationship with neonatal anthropometric features.

    Methods

    In this descriptive-analytical study, the health profiles of randomly selected Iranian and Afghan pregnant women referred to health centers in Semnan city, Iran, were reviewed. Data were collected following the guidelines recommended by the Institute of Medicine (IOM). Neonatal anthropometric measures were evaluated based on the reference values issued by the Iranian Ministry of Health (MOH). A statistical significance level of P < 0.05 was considered.

    Results

    The average age of Afghan mothers was 27.36 ± 5.46 years, while that of Iranian mothers was 29.13 ± 5.44 years. The average weight gain during pregnancy was slightly lower in Afghan mothers (OR = -0.88, 95% CI: 0.82 - 0.94). Although the average weight gain in both groups and the percentiles of neonatal anthropometric measures were within permissible limits, a regression model indicated that weight gain during pregnancy significantly affected neonatal birth weight only in Iranian mothers (β = -0.313, P ≤ 0.001). Logistic regression analysis revealed no significant difference in the impact of maternal weight gain on neonatal anthropometric measures between the Iranian and Afghan mothers.

    Conclusions

    The findings of this study suggest that nationality (i.e., Iranian or Afghan) does not influence maternal weight gain or neonatal anthropometric measures. The establishment of guest houses and training programs, such as Behbakhsh initiatives for Afghan women, appears to have been effective in ensuring equitable access to health services for Afghan immigrants.

    Keywords: Pregnancy Weight Gain, Anthropometric Measures, Pregnancy, Immigrant, Afghan, Iran, Refugee, Neonatal Parameters
  • Sajede Aligoltabar, Fatemeh Nasiri-Amiri, Soraya Khafri, Hajar Adib-Rad, Shahnaz Barat, Zeinab Pahlavan, Seyedsina Taheriotaghsara, Mostafa Rayati, Mahbobeh Faramarzi
    Background

    There is a notable lack of empirical validation regarding the use of internet-based emotion-focused cognitive behavioral therapy (IECBT) for counseling pregnant women.

    Objectives

    This study examines the feasibility, acceptability, and effectiveness of IECBT in counseling women with suspected fetal anomalies.

    Methods

    In a quasi-experimental study, 130 pregnant women diagnosed with anxiety disorders were randomly assigned to either IECBT with spousal participation (65 participants) or IECBT alone (65 participants). All participants completed three pregnancy-specific stress questionnaires—the NuPDQ, Spielberger State Anxiety Inventory, and Edinburgh Depression Scale—both before and immediately after the intervention.

    Results

    Within-group analyses indicated that both counseling methods, with and without spousal involvement, led to significant reductions in pregnancy-specific stress, depression, and anxiety symptoms by the end of the intervention (P < 0.001). Between-group comparisons revealed that IECBT with spousal participation significantly reduced pregnancy-specific stress (effect size = 0.055, P = 0.007) and depressive symptoms (effect size = 0.480, P < 0.001) compared to IECBT without spousal involvement. However, neither intervention produced a significant reduction in anxiety symptoms (effect size = 0.001, P = 0.787).

    Conclusions

    Both IECBT approaches (with and without spousal participation) are feasible, reliable, and effective methods for alleviating depression and stress symptoms in pregnant women with suspected fetal anomalies.

    Keywords: Pregnancy, Counseling, Internet-Based Intervention, Cognitive Behavioral Therapy, Feasibility Studies, Anxiety
  • حانیه سلمانی ایزدی، سلماز حسنی*

    سندرم شیهان یکی از علل کم کاری هیپوفیز پس از زایمان است که از عوارض بسیار جدی خونریزی پس از زایمان شناخته می شود. این سندرم معمولا تا سال ها پس از زایمان تشخیص داده نمی شود؛ زیرا علائم آن معمولا خفیف است، به ویژه در کشورهای در حال توسعه به دلیل سطح پایین مراقبت های مامایی و رواج زایمان در خانه حائز اهمیت است. این گزارش موردی اهمیت شناخت تظاهرات غیر معمول این سندرم مانند حملات هیپوگلیسمی را در جهت کمک به تشخیص زودهنگام و مدیریت بهتر نشان می دهد. خانم 34 ساله ای با G4P2Ab2L2 با سطح هوشیاری پایین، دیافورز و هیپوگلیسمی شدید متعاقب عمل سزارین به سرویس غدد ارجاع داده شد. بعدا، در اخذ شرح حال دقیق تر، سابقه عدم توانایی شیردهی پس از اولین زایمان طبیعی، 8 سال پیش، مشخص شد. از آن زمان تاکنون بیمار چندین دوره حملات افت فشار خون، ضعف و بی حالی و هیپوگلیسمی را تجربه کرده است. بررسی های آزمایشگاهی با سطح پایین گلوکز خون در سطوح کاهش یافته کورتیزول، هورمون آدرنوکورتیکوتروپیک (ACTH) و پرولاکتین، نارسایی آدنوهیپوفیز در این بیمار را نشان داد. تشخیص سندرم شیهان در این بیمار با مشاهده سلای خالی در تصویربرداری رزونانس مغناطیسی (MRI) هیپوفیز تایید و مسجل گردید. این گزارش بر اهمیت شک بالینی زودهنگام به سندرم شیهان در بیمارانی که با علائم کمتر شناخته شده این سندرم مانند حملات مکرر هیپوگلیسمی در زنان با سوابق مامایی قابل توجه، تاکید دارد.

    کلید واژگان: گزارش موردی, سندرم شیهان, بارداری, هایپوگلایسمی, نارسایی ثانویه آدرنال
    Hanieh Salmani Izadi, Solmaz Hasani*

    Sheehan syndrome, also known as postpartum hypopituitarism, is a very serious complication of postpartum hemorrhage. It usually remains underdiagnosed years after delivery as symptoms may be subtle, especially in developing countries due to poor obstetric care and home deliveries. This case report highlights the importance of recognizing atypical presentations, such as hypoglycemic attacks, to help with early diagnosis and better management. A female 34-year-old, G4P2Ab2L2, presented with a low level of consciousness, diaphoresis, and severe hypoglycemia after C-section delivery. Adetailed history revealed a history of failure of lactation following her first vaginal delivery, 8 years ago, accompanied by no complication or history of postpartum hemorrhage. She has experienced a few episodes of hypotension, malaise, and hypoglycemia afterward. Laboratory examination displayed adenohypophyseal insufficiency as evident from low blood glucose level in the presence of low levels of cortisol, Adrenocorticotropic hormone (ACTH), and prolactin. Sheehan syndrome was confirmed with Magnetic resonance imaging (MRI) of the pituitary as an empty sella turcica consistent with the provisional diagnosis. This case report emphasizes the significance of early suspicion in cases presented with less known complications of Sheehan's syndrome as recurrent symptomatic episodes of hypoglycemia and management of this easily missed and treatable condition.

    Keywords: Case Report, Hypoglycemia, Pregnancy, Secondary Adrenal Insufficiency, Sheehan’S Syndrome
  • Parisa Samadi, Zahra Alipour *, Maryam Ghaedrahmati, Mostafa Vahedian
    Background
    Due to the high prevalence of COVID-19 and the prevention and control of adverse fetal and neonatal outcomes in pregnant women, including vertical transmission, this study was performed to describe the fetal and neonatal outcomes of pregnancy with a spectrum of COVID-19 disease during pregnancy in Iran.
    Materials and Methods
    In this cross-sectional study, we analyzed the medical records of 258 pregnant women admitted to the Forghani Hospital, Qom, Iran, from 18 February 2020, to May 10, 2021. PCR-RT or respiratory compromise in the presence of marked radiographic changes of COVID-19 in the lungs, or both COVID-19 disease confirmed COVID-19 disease. Then, we collected the disease spectrum of COVID-19 and fetal and neonatal outcomes from patient records.
    Results
    The findings of our study showed that out of 258 pregnant women who were hospitalized due to COVID-19, 79.8% had mild to moderate disease, 16.7% had severe COVID-19, and 3.5% were in the critical stage. After adjusting for the confounding variables, the severity of the disease was significantly associated with adverse fetal and neonatal outcomes such as fetal distress, Intra Uterine Growth Restriction (IUGR), preterm delivery, and Low Birth Weight (LBW), and low first minute Apgar score. However, the severity of COVID-19 was not a predictor of spontaneous preterm delivery, admission to NICU, low Apgar scores at 5 minutes, vertical transmission, stillbirth, and neonatal death.
    Conclusion
    Neonates of mothers with the severe and critical stage of COVID-19 are exposed to higher potential risks such as fetal distress, IUGR, preterm delivery, LBW, and low Apgar scores at 1 minute than women with mild to moderate disease.
    Keywords: Fetal, Neonatal, Outcomes, Pregnancy, Severity Of COVID-19
  • مقدمه

    با توجه به شواهد متناقضی که در مورد تاثیر بیماری کووید- 19 بر پیامدهای بارداری و نوزادی وجود دارد. انجام این تحقیق در سال اول کرونا در شمال ایران که یک مکان پربازدید و شلوغ می باشد ضروری است چون که احتمال ابتلا به ویروس کرونا و شدت عفونت افزایش می یابد.

    هدف

    مطالعه حاضر با هدف بررسی و مقایسه پیامدهای بارداری و نوزادی در زنان باردار مبتلا و غیرمبتلا به بیماری کووید-19 در بارداری انجام شد.

    مواد و روش ها

    در این مطالعه همگروهی گذشته نگر، اطلاعات 160 زن باردار مراجعه کننده به 3 بیمارستان مازندران از فروردین تا اسفند 1399 با استفاده از چک لیست از پرونده پزشکی آنها استخراج شد. شرکت کنندگان به 2 گروه تقسیم شدند. (گروه الف: 80 زن باردار مبتلا به کووید-19، گروه ب: 80 زن باردار غیرمبتلا). کلیه اطلاعات مربوط به پیامدهای مادری و نوزادی از پرونده دو گروه استخراج و مقایسه شد. نتایج به دست آمده از مقایسه 2 گروه از زنان باردار از نتیجه آزمون RT-PCR واکنش زنجیره ای پلیمراز رونویسی معکوس مورد تجزیه و تحلیل قرار گرفت.

    نتایج

    شایع ترین علامت در گروه کووید-19، تب و سرفه بود. عوارض بارداری مانند سقط (4/0 = p)، پره اکلامپسی (45/0 = p) و زایمان زودرس (45/0 = p) در 2 گروه معنی دار نشد. تفاوت آماری معنی داری بین 2 گروه در مورد پیامدهای بارداری و نوزادی وجود نداشت.

    نتیجه گیری

    علیرغم اوج و شدت بیماری کووید-19 در سال اول همه گیری، به نظر می رسد که آن تاثیری بر پیامدهای مادری و نوزادی در زنان مبتلا نداشت.

    کلید واژگان: بارداری, کووید-19, پیامد
    Malihe Nourollahpour Shiadeh, Ommolbanin Zare*, Mahmood Moosazadeh, Azadeh Kiapour, Sima Elyasi
    Background

    Considering the conflicting evidence that exists regarding the effect of the coronavirus disease 2019 (COVID-19) on pregnancy and newborn outcomes, it is necessary to conduct this research during the first year in the north of Iran, a highly visited and trafficked place, which increases the possibility of contracting the virus and severity of the infection.

    Objective

    This study aimed to compare maternal and neonatal outcomes in pregnant women with and without COVID-19.

    Materials and Methods

    In this retrospective cohort study, data from 160 pregnant women referred to 3 hospitals in Mazandaran, Iran from April 2020 to March 2021 were extracted from their medical records using checklists. Participants were divided into 2 groups: group A) 80 pregnant women with COVID-19, group B) 80 noninfected pregnant women. All information related to maternal and neonatal outcomes were extracted and compared from the files of the 2 groups. The results obtained from comparing 2 groups of pregnant women from the result of the reverse-transcription polymerase chain reaction test were analyzed.

    Results

    The most common symptoms in the COVID-19 group were fever and cough. Pregnancy complications such as abortion, pre-eclampsia, and premature birth were not significant between groups (p = 0.4, 0.45, 0.45, respectively). No statistically significant difference was observed between groups regarding maternal and neonatal outcomes.

    Conclusion

    Despite the peak and severity of the COVID-19 disease in the first year of the pandemic, it seems that it had no effect on maternal and neonatal outcomes in each trimester of pregnancy in affected women.

    Keywords: Pregnancy, COVID-19, Outcome
  • مقدمه

    شکست مکرر لانه گزینی را می توان عمدتا با تعامل نامناسب بین جنین و آندومتر توضیح داد. تعادل پروفایل T-helper1/T-helper2 بر لانه گزینی موثر جنین تاثیر می گذارد. تعدیل ایمنی آندومتر از طریق تزریق داخل رحمی سلول های تک هسته ای فعال شده ی خون محیطی (PBMCs) یا پلاسمای غنی از پلاکت اتولوگ (PRP) یک گزینه درمانی بالقوه کارآمد است.

    هدف

    هدف اصلی این مطالعه بررسی حاملگی های بیوشیمیایی و بالینی ناشی از تجویز داخل رحمی PBMCs فعال شده و PRP در زنان RIF بود.

    مواد و روش ها

    این مطالعه کارآزمایی بالینی تصادفی شده دوسوکور در مرکز درمان ناباروری رویا جهاد دانشگاهی استان قم، از نوامبر 2022 تا آپریل 2024 انجام شد. 96 زن با حداقل 2 مورد RIF پس از لقاح آزمایشگاهی بطور تصادفی در گروه های کنترل، PBMC و PRP قرار گرفتند. به طور خلاصه، 3 میلی لیتر نمونه خون جمع آوری شد و PBMC ها با استفاده از محلول جداسازی Ficoll جدا شده و به مدت 72 ساعت کشت داده شدند. PRP با استفاده از سانتریفیوژ و از 10 میلی لیتر خون محیطی جدا شد. دو روز قبل از انتقال جنین، PBMC ها یا PRP به داخل حفره آندومتر منتقل شدند.

    نتایج

    به جز مدت زمان ناباروری که در گروه PBMC بیشتر از گروه کنترل بود، سایر خصوصیات پایه از نظر آماری تفاوتی نداشتند. همچنین میزان حاملگی بیوشیمیایی در گروه PRP (32/10) وPBMC  (32/12) در مقایسه با گروه شاهد (32/3) به طور قابل توجهی بالاتر بود (027/0 = p)، در حالی که میزان حاملگی بالینی فقط در گروهPBMC  (32/10) به طور معنی داری بالاتر از گروه کنترل (32/2) بود (038/0 = p).

    نتیجه گیری

    نه مداخلات PBMC و نه PRP برتری قابل توجهی نسبت به یکدیگر در مورد میزان بارداری بیوشیمیایی و بالینی نشان ندادند.

    کلید واژگان: سلول های تک هسته ای خون محیطی, پلاسمای غنی از پلاکت, شکست مکرر لانه گزینی, حاملگی
    Hoda Fazaeli, Azar Sheikholeslami, Zahra Ebrahimi, Naser Kalhor, Leila Naserpour*
    Background

    Recurrent implantation failure (RIF) can be explained mainly by improper crosstalk between the embryo and endometrium. The T-helper1/T-helper2 profile balance influences effective embryo implantation. Endometrial immunomodulation via intrauterine injection of activated peripheral blood mononuclear cells (PBMCs) or autologous platelet-rich plasma (PRP) is a potentially efficient treatment option.

    Objective

    This study aims to examine the biochemical and clinical pregnancies resulting from the intrauterine administering of activated PBMCs and PRP in RIF women.

    Materials and Methods

    This randomized clinical trial study was done in the Rooya Infertility Treatment Center, Qom, Iran from November 2022 to April 2024. 96 women with at least 2 RIFs were randomized into control, PBMC, and PRP groups. Briefly, 3 ml of blood sample was collected and PBMCs were isolated using Ficoll separation solution, and cultured for 72 hr. PRP was separated from 10 ml of peripheral blood through centrifugation. 2 days before embryo transfer PBMCs or PRP were transferred into the endometrial cavity.

    Results

    Except for the duration of infertility, which was higher in the PBMC group, all other baseline characteristics were not statistically different. Moreover, a significantly higher rate of biochemical pregnancy was observed in the PRP (10/32) and PBMC (12/32) groups compared to the control (3/32) (p = 0.027), while the rate of clinical pregnancy was only significantly higher in the PBMC group (10/32) than in the control group (2/32) (p = 0.038).

    Conclusion

    Neither PBMC nor PRP interventions exhibited a substantial advantage over one another regarding biochemical and clinical pregnancy rates.

    Keywords: Peripheral Blood Mononuclear Cells, Platelet-Rich Plasma, Recurrent Implantation Failure, Pregnancy
  • الهام زارع، سیده هانیه علم الهدی*، اسما زال پور، آتنا حکیم زاده، راضیه محمدی چرمهینی، فاطمه وکیلی
    مقدمه

    تهوع و استفراغ در میان زنان باردار از شیوع بسیار بالایی برخوردار است. مطالعه سیستماتیک حاضر با هدف بررسی تاثیر داروهای گیاهی بر درمان تهوع و استفراغ مادران باردار صورت گرفت.

    روش کار

    در این مطالعه مروری نظام مند جهت یافتن مطالعات، کارآزمایی های بالینی دوسوکور و سه سوکور با گروه کنترل پلاسبو که به سایر درمان ها نظیر طب سوزنی نپرداخته اند، پایگاه های اطلاعاتی بین المللی google scholar، pubmed، web of science، Scopus، science direct، Cochran library و پایگاه های داخلی Iranmedex،Irandoc ،Magiran و SID با استفاده از کلمات کلیدی شامل: Morning sickness، nausea، vomiting، pregnancy، herbal treatment، herbal medicine و herbal remedy با عملگرهای بولین AND و OR مورد بررسی قرار گرفتند. در نهایت دو پژوهشگر به طور مستقل مقالات را جهت ارزیابی کیفیت به وسیله چک لیست ورهاگن و استخراج داده های اصلی آنها مورد بررسی قرار دادند.

    یافته ها

    در این مطالعه، 19 مقاله با حجم نمونه کلی 1593 نفر مورد ارزیابی قرار گرفت. سال انتشار مقالات تا آپریل 2023 بود و در تمامی آنها از گروه کنترل پلاسبو استفاده شده بود. به جز یک مطالعه که به صورت متقاطع انجام گرفته بود، طراحی سایر مطالعات به صورت موازی بود و به جز 2 مقاله، سایر مقالات نمره 3 یا بیشتر را از چک لیست ارزیابی کیفیت ورهاگن دریافت کردند. به طور کلی نتایج نشان داد که زنجبیل، لیمو، نعناع، هل و نیز ترکیب نعناع و لیمو در اکثر موارد می تواند در کاهش شدت و دفعات تهوع و استفراغ موثر واقع شود.

    نتیجه گیری

    بر اساس مطالعات انجام گرفته، گیاهان دارویی می توانند تاثیرات مثبتی بر کاهش تهوع و استفراغ صبحگاهی مادران باردار داشته باشند و با کمترین عوارض، استفاده شوند.

    کلید واژگان: استفراغ, بارداری, بیماری صبحگاهی, تهوع, داروی گیاهی
    Elham Zare, Seideh Hanieh Alamolhoda *, Asma Zalpoor, Atena Hakimzadeh, Razieh Mohammadi Chermahini, Fatemeh Vakili
    Introduction

    Nausea and vomiting are very common among pregnant women. The current systematic study was conducted with aim to investigate the effect of herbal medicines on the treatment of nausea and vomiting in pregnant mothers.

    Methods

    In this systematic review, to find double- and triple-blind clinical trial studies with a placebo control group that did not study other treatments such as acupuncture, the international databases of PubMed, Web of Science, Scopus, Science Direct, Cochran Library, Google Scholar, and internal databases of SID, Magiran, Irandoc, and Iranmedex were investigated using the keywords including: Morning sickness, nausea, vomiting, pregnancy, herbal treatment, herba medicine, herbal remedy with Boolean operators AND and OR. Finally, two researchers independently examined the articles to evaluate the quality using Verhagen's checklist and extract their main data.

    Results

    In this study, 19 articles with a total sample size of 1593 were evaluated. The year of publication of the articles was from 2001 to April 2023, and a placebo control group was used in all of them. Except for one study that was conducted as cross-sectional, the design of the other studies was parallel and except for 2 articles, the other articles received a score of 3 or more from Verhagen's quality assessment checklist. In general, the results showed that ginger, lemon, mint, cardamom and the combination of mint and lemon can be effective in reducing the intensity and frequency of nausea and vomiting in most cases.

    Conclusion

    According to the studies, medicinal plants can have a positive effect on reducing morning nausea and vomiting in pregnant mothers and can be used with minimal side effects.

    Keywords: Herbal Medicine, Morning Sickness, Nausea, Vomiting, Pregnancy
  • Aref Teimouri, Shima Mahmoudi, Atefeh Behkar, Keivan Sahebi, Hassan Foroozand, Gholamreza Hassanpour, Hossein Keshavarz

    Toxoplasma gondii is an intracellular parasite capable of crossing the placenta in pregnancy and infecting the developing fetus, leading to various congenital anomalies and even abortion. Acute Toxoplasma infection is responsible for almost all cases of congenital toxoplasmosis in immunocompetent pregnant women. Prenatal screening for acute toxoplasmosis primarily involves maternal serology and fetal ultrasound imaging. When serological or ultrasound findings suggest acute infection, further diagnostic tests are necessary to confirm fetal infection. Currently, molecular methods to detect the parasite’s DNA, including polymerase chain reaction-based methods, on amniotic fluid are the gold standard tests for the diagnosis of congenital toxoplasmosis. In this review, we aim to discuss various aspects of screening and diagnostic methods for toxoplasmosis in pregnancy, including (i) current serological assays, screening approaches, and future perspectives; (ii) the role of imaging techniques, with an emphasis on ultrasound; (iii) principles and recent advances in diagnostic molecular methods; (iv) emerging techniques, such as point-of-care-based tests and biosensors, and microRNAs as novel biomarkers of acute infection; and (v) an overview of screening programs in different countries, important epidemiological determinants, and recommendations for Toxoplasma screening health policies.

    Keywords: Toxoplasma Gondii, Pregnancy, Congenital Toxoplasmosis, Serological Assays, Molecular Diagnostics
  • Jessica Agada Jimmy *, Arunibebi Lamawal Lawrence, Maureen B Nkamare, Wonyinbarakemi Ladi Berefagha
    Background

     Pregnancy and childbirth are critical periods that require substantial support from husbands, especially in regions like Africa, where maternal and infant health outcomes remain a challenge. Insufficient support from husbands can contribute to increased maternal morbidity and mortality.

    Objectives

     This study evaluates the levels of perceived emotional, physical, and informational support provided by husbands to their wives during pregnancy and childbirth.

    Methods

     A cross-sectional study was conducted with 445 postpartum women selected through proportionate stratified random sampling from a population of 1057 attending health centers. Data were collected using a researcher-developed questionnaire and analyzed using SPSS version 25.0.

    Results

     The mean (SD) total score of perceived husband support was 2.86 (0.62), perceived emotional support was 3.18 (0.24), perceived physical support was 2.87 (0.40), and perceived informational support was 2.37 (0.49). There was a significant association between the level of support provided and husbands’ education (p< 0.001).

    Conclusion

     While emotional and physical support from husbands was generally sufficient, informational support was lacking. To improve maternal outcomes, targeted interventions such as including husbands in antenatal education programs should be implemented to enhance their involvement during pregnancy and childbirth.

    Keywords: Pregnancy, Social Support, Prenatal Care, Parturition, Maternal Health
نکته
  • نتایج بر اساس تاریخ انتشار مرتب شده‌اند.
  • کلیدواژه مورد نظر شما تنها در فیلد کلیدواژگان مقالات جستجو شده‌است. به منظور حذف نتایج غیر مرتبط، جستجو تنها در مقالات مجلاتی انجام شده که با مجله ماخذ هم موضوع هستند.
  • در صورتی که می‌خواهید جستجو را در همه موضوعات و با شرایط دیگر تکرار کنید به صفحه جستجوی پیشرفته مجلات مراجعه کنید.
درخواست پشتیبانی - گزارش اشکال