فهرست مطالب

  • Volume:13 Issue: 4, 2020
  • تاریخ انتشار: 1398/11/13
  • تعداد عناوین: 8
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  • Linda Larsson, Mona Landin Olsson, Charlotta Nilsson* Pages 176-180
    Objective

    More and more young obese women get pregnant after undergoing gastric bypass surgery (GBP) but little is known about weight development in their offspring. The first aim of this study was to investigate weight development of children whose mothers have undergone GBP before pregnancy and compare them to age specific reference values in Sweden. Second aim was to study the frequency of small for gestational age (SGA) in this population.

    Materials and methods

    Weight of offspring (38 male and 28 female) where the mother had undergone GBP before pregnancy were studied from birth up to 18 months of age and compared to age-specific reference values in Sweden.

    Results

    The boys to mothers who had undergone GBP before pregnancy weighed more than Swedish reference values at 6 months, 8.44 ± 1.18 kilogram (kg) (n = 35) vs. 7.98 ± 0.81 kg (n = 1388; p = 0.001), and less at 18 months, 11.54 ± 0.93 kg (n = 19) vs. 12.27 ± 1.19 kg (n = 862; p < 0.001). The girls to mothers who had undergone GBP before pregnancy weighed more than Swedish reference values at 6 months, 7.84 ± 1.00 kg (n = 28) vs. 7.50 ± 0.77 kg (n = 1375; p = 0.020). Frequency of SGA was 3.0%.

    Conclusion

    No clear pattern was found concerning the short-term weight development of the children. However, studies with larger material and more follow up time must be performed.

    Keywords: Child, Weight Development, Gastric Bypass
  • Akram Ahangarpour, AliAkbar Oroojan*, Soheila Alboghobeish, Layasadat Khorsandi, Mitra Moradi Pages 181-190
    Objective

    Obesity is associated with reproductive disorders. Arsenic disrupts male reproduction by direct effects on the male gonads or androgens secretion. So, the present study was conducted to evaluate the toxic effects of chronic concomitant administration of high-fat diet (HF) and arsenic on the reproductive system of the male mouse.

    Materials and methods

    In this experimental study, 72 adult male mice were randomly divided into 6 groups: low-fat diet (LF0), LF+arsenic 25 ppm, LF+arsenic 50ppm, HF0, HF+arsenic 25 ppm and, HF+arsenic 50 ppm. 24 hours after the last experimental day, plasma samples, the cauda of epididymis and testis were prepared and removed for hormonal, sperm count and histopathological assessments.

    Results

    Testis weight and volume increased in HF0 than other groups except for LF0. Plasma LH and testosterone levels decreased in LF50, HF0, HF25, and HF50 compared to LF0. A similar effect was observed in plasma FSH levels of HF0, HF25 and HF50 groups compared with LF0. Plasma level of estradiol increased in LF50 versus to other groups. Testosterone to estradiol ratio and sperm count decreased in all groups compared to LF0. Reduced interstitial cells and large numbers of vacuoles were observed in germinal epithelium of HF0 group, that these changes were more intense in both concentrations of arsenic-treated mice.

    Conclusion

    Present study indicated that chronic exposure to HF and arsenic-induced hypogonadotropic hypogonadism concomitant with sperm count reduction and testicular damage.

    Keywords: Arsenic, High Fat Diet, Gonadotropin, Sperm, Testis
  • Bestari Tyas, Pudji Lestari, Muhammad Ilham Aldika Akbar* Pages 191-200
    Objective

    This study aims to analyze the effect of advanced maternal age (>35 years old) in maternal and perinatal outcomes of preeclampsia women.

    Materials and methods

    This is a retrospective cross-sectional study involved all women who were diagnosed with preeclampsia at Universitas Airlangga Hospital (Surabaya, Indonesia) between January 2016 until May 2017. The participant was divided into two groups based on maternal ages: the first group was women older than 35 years old (advanced maternal age - AMA), and the other group was 20-34 years old (reproductive age - RA). The primary outcomes of this study were the maternal and perinatal outcome.

    Results

    There were a total of 43 AMA preeclampsia women and 105 RA preeclampsia women. The AMA preeclampsia group had a higher proportion of poor maternal outcome (the occurence of any complication:pulmonary edema, HELLP syndrome, visual impairment, post partum hemorrhage, and eclampsia) compared to RA preeclampsia group (60,5% vs 33,3%, p = 0,002; OR 3,059, CI 1,469-6,371). There was no significant difference in the other maternal complications such as HELLP syndrome, pulmonary oedema, and eclampsia. The only difference was the occurrence of postpartum haemorrhage which was higher in the AMA group (16,3% vs 4,8%, p = 0,02; OR 3,889, CI 1,161-13,031). The prevalence of cesarean delivery was more common in AMA group (53,3% vs 28,6%, p = 0,004; OR 2.825, CI 1.380-5.988). The AMA preeclampsia women also had poorer perinatal outcomes compared to the RA group (81,4% vs 59%, p = 0,009; OR 3.034 CI 1.283-7.177). AMA women had a higher risk of perinatal complication such as prematurity (OR 3.266 CI 1.269-8.406), IUGR (OR 4.474 CI 1.019-19.634), asphyxia (OR 4.263 CI 2.004-9.069), and infection (OR 2.138 CI 1.040-4.393).

    Conclusion

    Advanced maternal age increases the risk of poorer maternal and neonatal outcomes in preeclampsia patients. The addition of advanced maternal ages in preeclampsia should raise the awareness of the health provider, tighter monitoring, complete screening and early intervention if needed to minimize the risk of complications.

    Keywords: Advanced Maternal Age, Preeclampsia, Maternal Outcomes, Perinatal Outcomes
  • Farzaneh Golboni, Amir Jalali*, Mohammadreza Dinmohammadi, Ziba Taghizadeh, Paricher Nouri, MohammadReza Salahsoor Pages 201-208
    Objective

    Our study aimed to clarify of factors affecting decisions to use a surrogate mother can create broad knowledge of this concept.

    Materials and methods

    For This qualitative research, participants were selected through snowball sampling methods out of couples with a history of using surrogacy as an alternative treatment for having a child. As well, sampling continued until data saturation was reached. Finally, 23 persons participated in study (9 couples, 5 related persons). After selecting the participants and obtaining informed consent, in-depth and semi-structured interviews were conducted and most of them were recorded with participants’ consent. Then, all the interviews were analyzed using a conventional method.

    Results

    Content analysis of the statements condenced to 311 codes, 13 subcategories and 5 categories including the absence of parental role, perceived norm, hope for parenting role, mental challenge, and decision to use surrogacy were extracted.

    Conclusion

    The results indicated that numerous variables had an effect on decision-making process to use a surrogate mother, but the variable of hope for parenting role was an influential concept that not only interacted with other concepts but also caused optimism and motivation in families to decide in this respect.

    Keywords: Qualitative Research, Infertility, Decision-Making, Iranian Couples
  • Nasrin Soufizadeh, Fariba Farhadifar, Saghar Tamri, Sara Behafarid, Karim Sharifi, Sima Aslani*, Mobin Naqshbandi Pages 209-213
    Objective

    Having a rapid and low cost diagnostic approach in assessment of fetal wellbeing is an important goal for prenatal care process. The aim of this study was to determine the diagnostic value of rapid biophysical profile (rBPP) in comparison to biophysical profile (BPP).

    Materials and methods

    In this study 142 pregnant women with insulin-dependent diabetes referred to Besat Hospital (Sanandaj, Iran) were evaluated in terms of fetal health. Age, gestational age and non-stress test (NST) data of patients were collected. The fetuses were evaluated using the standard BPP and selected rBPP methods. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were calculated. The receiver operating characteristic (ROC) curve was plotted. The data were analyzed in Stata 14 software, using appropriate statistical analyses.

    Results

    The mean ± standard deviation (SD) of maternal age and gestational age of the studied subjects were 30.6 ± 6.3 and 35.6 ± 1.5 weeks, respectively. The frequency of normal cases were 126 (88.7%) in the BPP method and 121 (85.2%) in the rBPP method. The results showed that sensitivity, specificity, PPV and NPV of rBPP in this study were 56.2%, 90.5%, 42.8% and 94.2%, respectively. The area under the ROC curve was 73.3%. Pearson Test showed a significant correlation between scores obtained through BPP and rBPP methods (p < 0.001).

    Conclusion

    Considering the high profile of the sensitivity and PPV of the RBPP method compared to BPP, rBPP method has a better capacity to discriminate non-distressed fetuses from distress-exposed fetuses. It can also be used as a quick and easy method in crowded centers with limited evaluation tests, where not much skill is needed.

    Keywords: Rapid Biophysical Profile, Biophysical Profile, Embryo Health, Pregnant Women, Insulindependent Diabetes
  • Fatemeh Nayeri, Nahid Farrokhzad, Tahereh Esmaeilnia, Nikoo Niknafs, Hossein Dalili, Lida Atarod, Hasti Charousaei, Mamak Shariat* Pages 214-219
    Objective

    The practice of breastfeeding is considered a blessing since its effects on health are well recognized and applies to both mothers and infants. The objective of this study was to evaluate the effectiveness of peer support and training on breastfeeding initiation, duration and exclusivity.

    Materials and methods

    This community-based clinical trial, (IRCT No: 201504049568N12), was conducted during 2015 in the Municipality of Tehran 19 District. First, a total of 150 mothers with their infants from 4 to 20 months of age were asked to complete a questionnaire, which included the demographic characteristics, educational level, and the type of lactation, the initial age of infant for breastfeeding, and the duration of exclusive breastfeeding. Afterwards, 25 volunteer women were selected for lactation counseling. After 6 months, another sample of 116 nursing mothers in the region who had received peer counseling was selected and questioned through the previously mentioned questionnaire. Finally, the results, which were collected from the behavior of the target population before and after the intervention, were compared.

    Results

    The results of the present study indicated that the nursing mothers who received peer counseling proved to have longer durations of breastfeeding (P-value = 0.039), and higher frequency of first hour initiation of breastfeeding (P-value = 0.003) however, the volunteer counselors were mainly housewives who had lower levels of education (P-value = 0.009) and were younger (P-value = 0.009) than those of untrained control group.

    Conclusion

    The study demonstrated the significant effect of peer counseling on breastfeeding initiation and continuation. It is suggested that lactation training could be initiated during the prenatal period along with the conventional methods of training.

    Keywords: Lactation, Exclusive Breastfeeding, Counseling
  • Patsouras Grigorios, George Maroudias*, Saloum Ioannis, Patsouras Konstantinos Pages 220-222

    Jarcho-Levin Syndrome was first defined in 1938 by Saul Jarcho and Paul Levin. In the medical literature Jarcho-Levin Syndrome has a variety of synonyms such as Spondylocostal dysplasia/Dysostosis, Spondylocostal Dysostosis (SCD), Spondylothoracic dysplasia/Dysostosis and costovertebral dysplasia. For years the SCD and a similar disorder, spondylothoracic dysplasia, were considered the same disorder and referred as Jarcho-Levin Syndrome. Today we know that these two disorders are different clinical entities with different causes and that the term Jarcho-Levin Syndrome should be reserved for individuals with Spondylocostal dysplasia. Affected individuals with SCD have various abnormalities in the development of the spine and ribs. Due to these abnormalities they are more prone to develop thoracic insufficiency syndrome which may eventually lead to early neonatal death. In the current case report we describe two consecutive cases with SCD in the same family. In the case of a strong clinical suspicion from the findings of the ultrasound scan we should proceed to a molecular genetic diagnosis of a mutation in DLL3, MESP2, LFNG and HES7 gene by sequencing the entire coding area of the fetal Deoxyribonucleic acid (DNA).

    Keywords: Jarcho-Levin Syndrome, Spondylocostal Dysostosis )SCD), Growth Disorder, Genetic Testing
  • Monika Anant*, Anita Paswan, Chandra Jyoti Pages 223-227

    Cesarean scar pregnancy (CSP) is a potentially life threatening ectopic pregnancy where a missed diagnosis is commoner than an accurate diagnosis. Incidence of Ectopic pregnancy is 1 – 2 % and cesarean scar ectopic occurs in about (0.05%) 1 in 2000 of all pregnancies. With increasing cesarean section rates worldwide, CSP is bound to increase with its dreaded complications like uterine rupture and catastrophic hemorrhage. Three patients misdiagnosed as incomplete miscarriages in post cesarean pregnancies in other centers were found to be CSP in Gynaecology department of a tertiary level hospital. All three patients were managed successfully, two surgically and one medically.

    Keywords: : Ectopic Pregnancy, Scar Ectopic, Laparoscopy, Methotrexate