نفیسه فقیه

Considering the high prevalence of cesarean section and the methods of conducting it, this study was performed with aim to determine the relationship between rectus ablation in cesarean section and postoperative pain, thickness and distance of abdominal wall muscles.

This randomized controlled clinical trial study was conducted in 2022 80 pregnant women candidates for caesarean section referred to the Ayatollah Taleghani hospital in Tehran. The subjects were randomly divided into two groups of intervention (n=40, rectus muscle repair) and control (n=40). Pain, thickness and distance of abdominal wall muscles were evaluated. Patients' pain in the first 72 hours after entering recovery (12, 24 and 72 hours after surgery) as well as pain when leaving the bed and pain in the interval of one week after surgery was measured using the visual pain index (VAS). Data were analyzed using SPSS software (version 23) and Shipro-Wilk, t-test, Mann-Whitney and Chi-square tests. P<0.05 was considered statistically significant.

The intensity of pain in the control group compared to the intervention, when getting out of bed (P<0.001) and at 12 hours (P<0.001), 24 hours (P<0.001), 72 hours (P<0.001) and one week later (P<0.001) was lower. In the intervention group compared to the control, the need for painkillers was more (P=0.001) and diastasis recti in the epigastric area (P<0.001) and hypogaster (P<0.001) were lower.

The re-approximation of rectus abdominis muscle during cesarean section reduces the thickness of the abdominal wall muscles and diastasis recti, but on the other hand, it increases the amount of pain and the need for painkillers.

Evidences suggest an association between the prevalence of thyroid peroxidase (anti-TPO) and infertility. About 5-10 percent of euthyroid women have anti-TPO antibodies.. The aim of this study was to obtain the prevalence of anti TPO antibodies in euthyroid women with unexplained infertility referred to IVF center in Afzalipour Hospital in 2013-2014.
Through convenience sampling 75 euthyroid women with unexplained infertility were selected for the experience group and 150 euthyroid fertile women with one successful pregnancy for the control group. Anti-TPO antibodies were measured and evaluated by Liaison method in serum of participant.
Serum anti-TPO antibodies were significantly higher in infertile euthyroid women comparing to the healthy group (infertile group:15/4±3/61,fertile group:5/68±0/65 p=0/013). In the fertile group, serum anti-TPO antibody levels were significantly different between women with positive aborted history and the negative ones. There was no significant relation between age, BMI, TSH level and abuse of opium in two groups. There was also no significant relation between serum anti TPO antibody in one side and TSH level ,BMI and gravidity on other side in each group.
The results of our study show for the first time that serum anti-TPO antibodies were significantly higher in infertile euthyroid women comparing to healthy group. We put in that anti TPO antibody measured in infertile women.