شمسی عباسعلیزاده

 Evaluation of amniotic fluid is one of the main variables of examining fetal health in the second and third trimesters of pregnancy. An increase in amniotic fluid can affect the health of the fetus. The aim of this study is to compare the severity of blood flow disorder in the umbilical artery and MCA of the fetus in idiopathic polyhydramnios (IP) and diabetic polyhydramnios (DP).

 In this study, singleton pregnancies with a calendar age of 31 to 40 weeks along with DP and IP were included in the study from June 2019 to June 2019, following the inclusion and exclusion criteria. First, the patients were divided into two groups, diabetic and non-diabetic, and then each group was divided into three groups with mild, moderate, and severe polyhydramnios. In all cases, the amniotic fluid index and after fetal Doppler cytometry, pulsation index, systolic to diastolic ratio of the umbilical artery, and pulsation index, maximum systolic velocity, systolic to diastolic ratio of the middle cerebral artery were measured.

In this study, 138 pregnant mothers with polyhydramnios in the third trimester (70 in the IP group and 68 in the DP group) were studied. Compared to the standard values, 14 (20%) of the patients in the IP group and 10 (14.7%) in the DP group had abnormal fetal Doppler indices.In the idiopathic group, Doppler indices of the umbilical artery differed significantly only in the severe subgroup compared to the other two subgroups. Doppler indices of the middle cerebral artery, except for maximum systolic velocity, differed significantly in the moderate and severe polyhydramnios subgroups compared to the other subgroups. The impairment of fetal umbilical and middle cerebral artery Doppler indices, except for the umbilical artery systolic-to-diastolic ratio, was not associated with whether the polyhydramnios was diabetic or idiopathic. There was no significant difference between the two groups for the other indices, and this impairment was only related to the severity of polyhydramnios.

 Disturbance in fetal Doppler indices in mothers with polyhydramnios is related to the severity of this complication and has no relation with its cause. Therefore, maintenance treatments can be useful to reduce the relative volume of amniotic fluid in both groups.

Labor pain is known as severe pain; Lack of pain control causes wide-ranging complications for mother and newborn baby; Therefore, pain management in childbirth is very important. Different methods for analgesia during childbirth have been studied and evaluated, which are divided into two categories: pharmacological and non-pharmacological. Non-pharmacological methods can be effective only when labor pains are low, but since labor pains are very high, non-pharmacological analgesia can not be relied on. Drug methods include intramuscular injection of drugs, spinal anesthesia, epidural anesthesia, spinal-epidural anesthesia, remifentanil infusion and intermittent epidural analgesia. The most commonly used method is persistent epidural analgesia, but in cases where epidural catheter insertion is contraindicated for medical reasons, remifentanil infusion can be used.

 Recurrent Pregnancy Loss (RPL) is a multifactorial disease that affects 1-3% of couples. Since Human Leukocyte Antigen-G (HLA-G) gene is involved in fetal maternal immune tolerance, mutations in the HLA-G gene can affect the success rate of pregnancy.

 The present study aims to investigate the haplotype effect of rs1736933 and rs2735022 polymorphisms found in the HLA-G gene on the RPL.Methods In this case-control study, participants were 100 women with RPL and 80 women with normal fertility in northwestern Iran. The HLA-G gene promoter was amplified by Polymerase Chain Reaction (PCR) method and sequenced. The genotype and allele frequencies of the two polymorphisms were compared between the two groups by using t-test in SPSS software version 22. Haplotype analysis was performed using PHASE 2.1 and Haploview 4.2 applications

 C allele and CC genotype in rs2735022 polymorphism and the G allele and GG genotype in rs1736933 polymorphism showed a significant association with the RPL (P<0.05). Frequency of haplotypes AA, AC, GA, GC were 0.72, 0.23, 0.01, 0.03 in patients and 0.39, 0.01, 0.02, 0.59 in the control group (P<0.05). The linkage disequilibrium score was 94.

 Analysis of GC haplotype in rs2735022 and rs1736933 polymorphisms of the HLA-G gene can be helpful in genetic studies of women with RPL.

Studies have suggested that HLA-G is involved in protecting the fetus against the motherchr('39')s immune system, and upstream polymorphisms of this gene may influence pregnancy success by effecting its expression. The aim of this study was to evaluate the association of upstream HLA-G gene polymorphism, rs1736933, with recurrent spontaneous abortion in East Azerbaijan women population.

This case-control study was performed on 80 women with at least one child and without any history of abortion, and 100 women with at least two recurrent spontaneous abortions which were diagnosed by gynecologist. 2 ml of blood was obtained from the participants and after DNA extraction, a segment of the HLA-G gene promoter was amplified by PCR and analyzed by agarose gel electrophoresis. PCR products were sequenced and genotyped. Allelic and genotypic frequencies of patient and control groups were compared.

Frequency of AA, CA, CC genotypes in the patient group were 8(8%), 37(37%), 55(55%) and in the control group were 16(20%), 33(41.25%), 31(38.75%) respectively. Comparison of genotypic frequencies between the two groups showed that CC homozygous genotype was associated with recurrent abortion (p= 0.015). Statistical analysis also showed a significant difference between the allelic frequencies of the two groups (p= 0.019).

The results of this study showed that the upstream HLA-G gene polymorphism, rs1736933, is associated with the recurrent abortion in East Azerbaijan women population.

Placenta accreta has very dangerous effects for mother and baby; timely diagnosis of this complication can decrease the maternal and neonatal health. Due to the lack of MRI use for timely diagnosis of placenta accreta in Iran, this study was performed with aim to evaluate the accuracy of MRI and ultrasound in the diagnosis of placenta accreta in susceptible women referred to gynecology hospitals in Tabriz.

This cross-sectional descriptive study was conducted in Tabriz gynecology hospitals during 2015-2016 with the participation of 38 susceptible women to placenta accreta. After examination, the patients were referred to the imaging center (ultrasound and MRI) and the results of imaging were compared with the results of after cesarean. Data were analyzed using SPSS software (version 20) and McNemar test. P< 0.05 was considered statistically significant.

MRI examinations showed that 17 patients (89.47%) had placenta accreta, while ultrasound examination showed that 12 (63.15%) had placenta accreta. Comparison of the specificity and sensitivity showed that Ultrasound sensitivity (70%) and specificity (93%) were significantly lower than MRI sensitivity (79%) (p=0.048) and specificity (100%) (p=0.039).

The accuracy, sensitivity, and predictive power of MRI technique in timely detection of this dangerous complication were very good compared to ultrasound and can be used in women susceptible to placenta accreta.

Lack of knowledge about the prevalence of placenta accreta causes unintended complications in susceptible women. Awareness of its prevalence can guarantee the diagnostic and therapeutic methods in susceptible women in future studies. This study was performed with aim to evaluate the prevalence rate of placenta accreta in women candidate for non-emergency cesarean section with previous cesarean section referred to Tabriz women's hospitals.

This descriptive-analytical study was performed during 2012-2016 at Tabriz two hospitals of Al-Zahra and Taleghani with the participation of 310 women candidate for non-emergency cesarean. The individual information including demographic characteristics and disease-related information was included in the researcher-made checklist. Data were analyzed using SPSS software (version 20) and Spearman correlation and regression tests. P

55 patients (17.74%) had placenta accreta; the variables such as age (P=0.001), BMI (P=0.003), number of previous cesarean section (P=0.002), cigarette smoking (P=0.036), number of previous pregnancies (P=0.002), history of myomectomy (P=0.001), third trimester hemorrhage (P=0.003), and number of baby during delivery (P=0.003) were significantly associated with placenta accreta.

The prevalence of placenta accreta was 17.74% in the present study, which necessitates doing precise diagnostic measures to be aware of this complication.

The clinical consequences of hypothyroidism and hypothyroxinemia during pregnancy such as preterm birth are not still clear.

The aim of this meta-analysis was to estimate the relation of clinical and subclinical hypothyroidism and hypothyroxinemia during pregnancy and preterm birth.

In this meta-analysis, Preferred Reporting Items for Systematic review and Meta-Analysis were utilized. Searching the 83Tcohort studies83T were done by two researchers independently without any restrictions on Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO and Google Scholar databases up to 2017. The heterogeneity of the studies was checked by the Cochran's Q test and IP2P index. Both random and fixed-effects models were used for combining the relative risk and 95% confidence intervals. Data were analyzed using Comprehensive Meta-Analysis software version 2.

Twenty-three studies were included in the meta-analysis. The relative risks of the clinical hypothyroidism, subclinical hypothyroidism and hypothyroxinemia during pregnancy on preterm birth was estimated 1.30 (95% CI: 1.05-1.61, p=0.013, involving 20079 cases and 2452817 controls), 1.36 (95% CI: 1.09-1.68, p=0.005, involving 3580 cases and 64885 controls) and 1.31 (95% CI: 1.04-1.66, p=0.020, involving 1078 cases and 44377 controls), respectively.

The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, 83Tgynecologists and endocrinologists83T should manage these patients to control the incidence of 83Tadverse pregnancy outcomes83T such as preterm birth.

Vitamin D deficiency (VDD) has been considered as an undiagnosed pandemic. In recent review articles the relationship between VDD and several disorders of mothers and their newborns were indicated. The present study was aimed in order to investigate the VDD prevalence in Iranian pregnant women.
This First meta-analysis study was performed based on PRISMA checklist for systematic review and meta-analysis studies. A comprehensive literature searches of national and international databases including Scopus, PubMed, Science Direct, Cochrane, Web of Science, Magiran, Iranmedex, SID, Medlib and Google Scholar engine by using MESH keywords up to 2016 was empolyed.Two reviewers independently were conducted the search, including selection of studies, quality assessment and data extraction.
Eighteen studies and 5,572 pregnant women were included in the analysis. The prevalence of VDD in Iranian pregnant women with cut-off point of 10, 20 and 30ng/ml were calculated 41.9% (95%CI: 30.4-54.3), 68.6% (95%CI: 50.3-82.5) and 84.4% (95%CI: 74.2-91.1), respectively. The highest prevalence of VDD in trimester of pregnancy term in cutoff 10, 20 and 30 ng/ml was obtained in the second trimester (95% CI: 61.9 (61.95-36.7)), first trimester (95% CI: 89.4(87.8-90.8)) and third trimester (86.7(95% CI: 74.5-93.6)).
The prevalence of VDD in Iranian pregnant women is very high. Therefore, addressing VDD in women during pregnancy should be a health priority in Iran. To avoid of related disorders and adverse effects of VDD in mothers, appropriate interventions among pregnant women should be considered.

Perinatal transmission is one of the most common routes of hepatitis B virus (HBV) transmission in the worldwide. In Iran, more than 50% of HBV carriers have received the infection in this route. Therefore, this review study was performed with aim to determine the prevalence and risk factors of HBV infection in pregnant women of Iran.
Current study was conducted based on PRISMA checklist for systematic review and meta-analysis studies. To access to the English and Persian documents, two independent authors searched Scopus, PubMed, ScienceDirect, Cochrane, Web of Science (ISI), Springer, Online Library Wiley, Magiran, Iranmedex, SID, Medlib, IranDoc and Google Scholar search engine up to January 2016 by using Mesh keywords including: Prevalence, Hepatitis B, Pregnant women, Pregnancy, Risk Factors, HBsAg and Iran. Data was analyzed using the random-effects model for HBV prevalence and fixed-effects model for risk factors of HBV via Stata software (Version 11.2).
A total of 36 eligible studies with sample size of 64,195 pregnant women in Iran, HBV prevalence was estimated 0.5%. Minimum and maximum of this range were related to the North (0.4%) and East (1.6%) of the Iran. HBV prevalence in urban and rural pregnant women was estimated 1.1 and 1.2%, respectively. HBV prevalence among housewife pregnant women was 1.7% and employee pregnant women was 0.1%. The frequency of HBsAb>10 mIU/ml in Iranian pregnant women were calculated 40%. Among the risk factors, illiteracy, occupation, blood transfusion, abortion and husband addiction were significant related with prevalence of HBV (P0.05).
The lowest prevalence of HBV in Iran was related to pregnant women and less than the general population. History of blood transfusions, husband addiction, illiteracy, occupation and abortion are associated with HBV in Iranian pregnant women.

Identification of prevalence and risk factors of hepatitis B (HBV) in pregnant women is very important as a major source of infection in HBV prevention program. Therefore, this review study was performed with aim to determine the prevalence and risk factors of hepatitis B (HBV) infection in pregnant women of Iran.
Current study was conducted based on PRISMA checklist for systematic review and meta-analysis studies. To access to the English and Persian documents, two independent authors searched Scopus, PubMed, ScienceDirect, Cochrane, Web of Science (ISI), Springer, Online Library Wiley, Magiran, Iranmedex, SID, Medlib, IranDoc and also Google Scholar search engine without any time limitation to January 2016 by using mesh keywords including: Prevalence, Hepatitis, Pregnant women, Pregnancy, Risk Factors, Hepatitis B Surface Antigens, HBsAg, and HBeAg. Data was analyzed using the fixed-effects model via Stata software (Version 11.1).
A total of 36 eligible studies with sample size of 64,193 pregnant women in Iran, HBV prevalence was estimated 0.5%. Minimum and maximum of this range were related to the North (0.4%) and East (1.6%) of the Iran. HBV prevalence in urban and rural pregnant women was estimated 1.1 and 1.2%, respectively. The prevalence of HBeAg, HBeAb, HBsAb in pregnant women of Iran were calculated 0.05, 0.05 and 40%, respectively. Among the risk factors, illiteracy, abortion, history of blood transfusion and husband addiction were significant related with prevalence of HBV (P0.05).
The lowest prevalence of HBV in Iran was related to pregnant women and less than the general population. History of blood transfusions, husband addiction, illiteracy and abortion are associated with HBV in Iranian pregnant women.

Helicobacter pylori is a well-known bacteria; it produces multiple and serious gastrointestinal diseases. Studies in Iran, The prevalence of Helicobacter pylori infection is Variable between 7. 7-80% in pregnant women. The present study aims at assessing the prevalence of Helicobacter pylori infection among Iranian pregnant women using a meta-analysis method.
According to purpose study, published articles in national and international journals were examined about prevalence of H. pylori infection among Iranian pregnant women. To achieve the related documentation, national and International databases include: Magiran, Iran medex, IranDoc, SID, Medlib, Embase, Scopus, Web of Science, Pubmed, Science Direct, Cochrane and the Google Scholar search engine no time limit to 2015 were searched by using standard keywords. Search, data extraction and quality assessment were independently carried out by two researchers. The data were combined using Random Effects Model through Meta-Analysis method by Stata software.
1605 subjects were studied in 22 studies. The prevalence of H. pylori infection among Iranian pregnant women was estimated as 45.9% (95% CI: 39.4- 52.5). Minimum and maximum of this range were related to the West (36.2%) and the South (61.5%).
The prevalence of H. pylori infection among Iranian pregnant women is high and similar Iranian general population, the preventive strategies should be carried out to control this infection.

Infertility is defined as the inability to achieve the pregnancy within a year of unprotected intercourse. Infertility is a complex issue and different factors such as stress oxidative can be involved in this problem. So, any attempt to neutralize oxidative stress would be helpful in the treatment of infertility. Melatonin is a known scavenger of free radicals.

The aim of our study was to evaluate the level of melatonin and its correlation with oxidative biomarkers in fertile and infertile women.

The participants including fertile and infertile women were divided into two groups of 30 people. Blood sampling was performed and sera were collected. The level of Malondialdehyde (MDA), total antioxidant capacity (TAC) and melatonin were detected. Data were analyzed using T-test and their correlation was assessed using Spearman test.

Serum melatonin from fertile women was higher than infertile women but the difference was not significant (p= 0.46). MDA level in fertile women was significantly lower than infertile women (p<0.001) and the level of TAC in fertile women was significantly higher than infertile women (p<0.001). Spearman test revealed a significant and direct correlation between melatonin and TAC in fertile and infertile women and a significant but reverse correlation between melatonin and MDA in infertile and fertile women.

Differences in the level of oxidative stress biomarkers in fertile and infertile individuals have been reported. This study revealed a significant correlation between melatonin and oxidative stress biomarkers, concluding that melatonin level could be involved in infertility.

Molar pregnancy along with a live fetus is not rare، and survival rate of the live fetus with mole is variable and dependent on mole fraction effects. The effects of molar pregnancy for mother include preeclampsia، bleeding، thyroid disorders، and persistent gestational trophoblastic disease. This study was performed with the aim to investigate the maternal and fetal effects of Molar pregnancy along with a live fetus in order to facilitate deciding about termination of pregnancy in spite of the presence of a live fetus or continue it accepting all future potential effects. to access the articles، all the articles published on this topic between 1980 and 2012 were extracted using a systematic search in Embase، Google scholar، science direct، Iranmedex، PubMed، SID، Magiran، medlib، irandoc and Medline databases، and after evaluation، finally، data of 29 articles was analyzed using the statistical software CMA2. The results of the statistical analysis indicated that the rate of the birth of the live fetus (event rate: 0. 204) is greater than the persistent gestational trophoblastic disease (event rate: 0. 186). The event rate of bleeding was 0. 258 and event rate of preeclampsia was 0. 211. In this study، the birth rate of the live fetus was greater than the persistent gestational trophoblastic disease. Bleeding was the most complication and then، preeclampsia had the highest prevalence.

Fetal movement counting is a method that used by the mother to quantify her baby''s movements. Since 1970s a variety of counting techniques with different alarm limits have been developed few of which have been evaluated for predictive values and hence the clinical value of the absolute number of fetal movements has not been established. This cross-sectional study was carried out in 2011 in Educational and Medical Center of Alzahra in Tabriz. Three hundred singleton pregnant women at 32-40 weeks’ gestation having inclusion criteria were selected randomly from among women with complaint of decreased fetal movement. To perform the counting of three fetal movements in one hour and their recording in related chart was instructed by the researcher in a face to face manner. After the counting، pregnant woman was referred to ultrasound unit in order to perform the test of biophysical profile، then the two test results were compared with each other. According to the test of fetal movement counting، 99. 7% of fetuses were active and 0. 3% of them were inactive. On the basis of the test of biophysical profile، 96. 3% of fetuses had score of 10 and 3. 7% had score less than 10. In this study، a significant relationship was found to exist between the result of maternal fetal movement counting and biophysical profile (p< 0. 001). The sensitivity، specificity، positive and negative predictive value of the test of fetal movement counting were 100%، 96%، 9% and 100% respectively. The result of this study suggests the usefulness of maternal fetal movement counting as an early simple screening and noninvasive method in assessment of fetal well-being.