International Journal of Reproductive BioMedicine
Volume:17 Issue: 7, Jul 2019

One of the causes of maternal and fetal mortality and morbidity is pregnancy-induced hypertension, the most common form of which is preeclampsia that causes many complications for mother and fetus.

The aim of this systematic review and meta-analysis was to determine the relationship between body mass index (BMI) and preeclampsia in Iran.

Using valid keywords in the SID database, PubMed, Scopus,data obtained from all the articles, which were reviewed in Iran between 2000 and 2016, were combined using the meta-analysis method (random-effects model) and analyzed using STATA version 11.1.

A total number of 5,946 samples were enrolled in 16 studies with the mean BMI values of 25.13, 27.42, and 26.33 kg /m2 in the healthy, mild, and severe preeclamptic groups, respectively.

The results of this study revealed that there is a significant relationship between BMI and the risk of preeclampsia, so it can be said that BMI may be one of the ways to diagnose preeclampsia.

Recurrent spontaneous abortion (RSA) often remains unclear and can be burden for the patient and time consuming for clinician. RSA may initiates from a genetic or non-genetic factors. It is well known that the quality of placental circulation is critical for implantation and embryo development. Because of angiogenic effects of VEGF–KDR pathway on placenta, the genes involved in this pathway (the KDR or VEGFR genes) are thought to be linked with RSA.

The aim of this study was to investigate the relationship between Gln472His (A/T) polymorphism of the KDR gene with RSAs in southern Iran.

In this case-control study, 50 aborted embryonic tissue obtained from fetuses and 50 umbilical cord blood of newborn babies were studied.Fetal sample from mothers with history of at least two consecutive miscarriages and controls from mothers who had at least one full-term infants born were taken. Genomic DNA was extracted by using PureLink genomic DNA kit (Life Technologies, CA). The Rotor-Gene Q real-Time PCR machine and High-resolution melting curve analysis (HRM) technique were used for genotyping.

Based on the AA genotype as reference, it is shown that the T allele (OR =2.447, 95% CI = 1.095–5.468, p = 0.029) as well as AT heterozygote genotype was significantly associated with an increased risk of miscarriage (OR = 2.824, 95% CI = 1.210-6.673, p = 0.016).

A positive correlation between Q472H polymorphism of the KDR gene and RSA may be the cause in southern Iran.

Embryo transfer (ET) is the last and the most clinical process in assisted reproductive technology cycle. It has been suggested that cervical mucus interacts with an adequate embryo transfer in different ways. A few studies showed that catheter rotation could discharge mucus entrapped in the embryo to neutralize embryo displacement.

The aim of this present study was to compare the outcome of frozen embryo transfer (FET) based on catheter rotation during withdrawal.

In this case-control study, the clinical documents of 240 women who experienced frozen embryo transfer cycles were reviewd. The subjects were divided into two groups (n = 120/each), including A) the rotation treatment group (360°) that underwent ET using catheter rotation and B) the control group including the subjects who experienced ET with no catheter rotation. Clinical and chemical pregnancies and implantation rates were compared between two groups.

Results showed that there is no significant difference between the basic clinical and demographic features of both groups (p > 0.05). A significant difference was observed in terms of the rate of chemical pregnancy between groups (21.7% vs 43.3%, p = 0.001 respectively). In addition, the rate of clinical pregnancy was significantly higher in study group than the control (33.35% vs 14.2%, p = 0.002 respectively).

Our results demonstrated that catheter rotation during withdrawal increased the implantation rate and clinical pregnancy.

Higher Fetuin-A (FA) concentrations were found to be associated with obesity and there is an interest to the relation between maternal FA and pregnancy outcomes.

In this study, our aim was to evaluate the association of maternal plasma levels of FA with fetal growth restriction (FGR).

41 pregnant women with FGR and 40 controls were recruited in this case-control study between July and November 2015. At the diagnosis of FGR, venous blood samples (10 cc) were obtained for FA analysis.

Maternal plasma FA levels were significantly higher in fetal growth-restricted pregnant women compared with controls (19.3 ± 3.0 ng/ml vs 25.9 ± 6.8 ng/ml, p = 0.001). Area under receiver operating characteristic curve analysis of FA in FGR was 0.815 (95% confidence interval (CI): 0.718-0.912, p < 0.001). The maternal FA levels with values more than 22.5 ng/ml had a sensitivity of about 73.17% (95% CI: 56.79- 85.25) and a specificity of about 82.5% (95% CI: 66.64-92.11) with positive and negative predictive values of about 81.08% (95% CI: 64.29-91.45) and 75% (95% CI: 59.35-86.30), respectively. Therefore, the diagnostic accuracy was obtained about 77.78%.

The results of this study show higher maternal plasma levels of FA in FGR. Further studies are needed in order to demonstrate the long-term effects of FA in pregnancies complicated with FGR and early prediction of FFGR.

Oxidative stress plays an important role in the development of diabetic complications.

This study evaluated the impact of pre- and post-treatment with Lactobacillus acidophilus ATCC 4356 on the oxidant and anti-oxidant factors of testis and epididymis in streptozotocin-induced diabetic rats.

Thirty male Wistar rats (10 wk old) weighing 220-230 g. were divided into five groups (n = 6/ each): 1- normal group, 2- normal lactobacillus group,3- diabetic group, 4- diabetic + lactobacillus before (DLB) group, and 5- diabetic + lactobacillus after (DLA) group. The normal and diabetic groups received daily 1 mL normal saline for 6 wk. Normal lactobacillus group received daily L. acidophilus for 6 wk. Group DLB received daily L. acidophilus for 2 wk before diabetes and for 4 wk after diabetes. Group DLA received daily 1 mL normal saline for 2 wk before diabetes and L.
acidophilus for 4 wk after diabetes. The dose of L. acidophilus was 1 × 109 CFU/mL.

The administration of L. acidophilus worsened blood glucose level and reduced the levels of Malondialdehyde (p = ≤ 0.0001) and Hydrogen peroxide (p ≤ 0.0001) and, Catalase and Glutathione peroxidase activity increased in the testis. In epididymis, Glutathione peroxidase and Catalase (p = 0.013) activity increased and Hydrogen peroxide concentration reduced, while Malondialdehyde concentration did not show any changes compared to the diabetic rats. Also, there was no significant difference between DLB and DLA groups, in these markers.

Data obtained suggests that L. acidophilus has anti-oxidant effects on the testis and sometime in the epididymis in diabetic rats.

The prevalence of sexual problems is high during pregnancy. Despite this, there are limited data about the impact of physical and psychological factors such as body weight and body image on sexual function in pregnant women.

To investigate the relationship between body mass index, body image, and sexual function among pregnant women.

In this cross-sectional study, a total of 206 Iranian pregnant women (106 with normal weight and 100 overweight women) in their 2nd and 3rd trimesters of pregnancy were surveyed. Survey instruments included the Female Sexual Function Index and Multidimensional Body-Self Relations Questionnaire.

The prevalence of female sexual disorder was 72.3% in this survey. Diminished sexual desire/appetite was the most common problem reported by the participants (37.9%). The mean score of sexual problem and body image were not significantly different among overweight and normal weight women in the 2nd (p = 0.945 and  p = 0.800, respectively) and 3rd trimesters of pregnancy (p = 0.310 and p = 0.507, respectively). Further, there were no relationships between the body mass index plus body image and the total female sexual function score (p = 0.44 and p = 0.837, respectively). However, the relationship between the appearance evaluation with lubrication (p = 0.043) and subjective weight with two subscales of sexual satisfaction (p = 0.005) and orgasm (p = 0.019) were significant.

The findings from this study revealed that there were no relationships between body mass index plus body image score and the sexual function in pregnancy.
Therefore, a further research is recommended to study other potential factors affecting sexual function during pregnancy.

Delivery is the only definite cure for hypertensive disorders. Therefore, cervical ripening and labor induction are important to achieve favorable outcomes.

This Randomized Control Trial (RCT) is aimed to compare the effects of sublingual misoprostol and Foley catheter in cervical ripening and labor induction among patients with preeclampsia or gestational hypertension.

A total number of 144 women with preeclampsia or gestational hypertention with indication of pregnancy termination, who were referred to academic hospitals of the University of Medical Sciences in Mashhad, Iran, between March 2015 and December 2016, were randomly divided into two groups. In group one (n = 72), 25 μg of misoprostol tablet was administrated sublingually every 4 hr up to six doses. In group two (n = 72), a 16F Foley catheter was placed through the internal cervical os, inflated with 60 cc of sterile saline.

There were no significant differences between groups regarding the demographic characteristics, primary bishop score, and pregnancy termination indication.
The cervical ripening time (primary outcome) (8.2 vs 14.2 hr, p < 0.00), induction to delivery interval (15.5 vs 19.9 hr, p < 0.00), and vaginal delivery before 24 hr (63.9% vs 40%, p = 0.03) were significantly different between the two groups. There was no significant difference between groups in view of oxytocin requirement (p = 0.12), neonatal Apgar score (p = 0.84), or neonatal intensive care unit admission (p = 78).

This trial showed that the application of sublingual misoprostol, compared to the Foley catheter, can reduce cervical ripening period and other parameters related to the duration of vaginal delivery. This misoprostol regimen showed inconsiderable maternal complications.

Cervical ectopic pregnancy (CEP) is a rare and dangerous form of ectopic pregnancy in which the blastocyst is installed within the endo-cervical canal. CEP diagnosis requires special awareness to evaluate patient precisely. Individualizing controversial medical and surgical management strategies is of importance in medical practice.

A 35-year-old nulliparous woman on her 9th week of pregnancy was referred to our hospital with vaginal bleeding preliminary misdiagnosed as aborting intrauterine pregnancy. Transvaginal ultrasound revealed an empty uterus and a viable triplet pregnancy just below the level of internal os. Cervical curettage after cerclage suture placement procedure removed conception tissues completely. Consequently, in the next few hours vaginal bleeding decreased to minimal amount and vital signs remained within normal limits and there was no hematocrit change. On follow-up day 32, serum B-HCG became negative.

CEP diagnosis requires special attention and awareness to evaluate patient precisely along with skillful assessment of possible risk factors. Lifesaving treatment beside fertility preservation was successful with pre-curettage cerclage.