fatemeh mohsenpour

Gestational trophoblastic neoplasia (GTN) is a group of tumors highly responsive to chemotherapy. It has been suggested that cancer therapies have detrimental effects on female fertility. Anti-Müllerian hormone (AMH) is considered fertility potential and ovarian reserves in women. The aim of this study was to compare serum AMH levels between the patients with GTN treated with chemotherapy and the patients with hydatidiform mole who underwent suction curettage without receiving any chemotherapy.

In 35 patients with GTN, serum AMH levels were measured before suction curettage and after the administration of chemotherapy and compared with serum AMH levels measured in 35 patients with hydatidiform mole, who did not receive any chemotherapy as a control. In controls, serum levels of AMH were measured before suction curettage and at the time when beta human chorionic gonadotrophin (ß-hCG) levels approached zero concentration.

The mean serum AMH levels in the GTN group were significantly lower than those measured in the control group after chemotherapy. In addition, serum AMH levels measured after intervention in each group significantly decreased compared to the basal levels (p=0.034). Serum AMH levels showed significant differences between the patients who received chemotherapy regimens with methotrexate (MTX) alone, actinomycin-D (Act-D) alone, or the combination of MTX and Act-D (p=0.001).

Our study showed that fertility preservation is of great importance in patients with GTN treated with chemotherapy. Furthermore, both MTX and Act-D could have potential adverse effects on ovarian reserve.

Preeclampsia is a serious hypertensive condition of pregnancy associated with high maternal and fetal morbidity and mortality. In this study, the effect of selenium supplementation on the incidence and severity of preeclampsia in pregnant women was evaluated.

The present double-blind, placebo-controlled, parallel study was registered at Fatemieh Hospital of Hamadan, Iran. One hundred eighty women in the first trimesters of pregnancy were assigned to either selenium (SG, n = 90) or placebo (PG, n = 90) groups. SG and PG received 100 μg of selenium supplement or placebo per day, respectively.

In this study, no significant difference was observed between two groups in terms of age, body mass index, and serum selenium before the intervention (P > 0.05). The incidence of preeclampsia in the SG and PG was 9 and 5, respectively (P = 0.28). There was no statistically significant difference between sex and Apgar score of neonates in the two groups (P = 0.73). The mean birth weight, systolic and diastolic blood pressure in the SG was significantly higher than PG (P = 0.003, 0.01, and 0.007, respectively). The mean gestational age in the SG was insignificantly lower than the PG (P = 0.41). After the study, preeclampsia incidence was not significant between the groups (P = 0.28).

The administration of 100 μg of selenium supplementation in pregnant women, had no effect on decreasing preeclampsia, but it may reduce the severity of preeclampsia.

Invasive cervical cancer is one of the most fatal genital cancers of women which can be detected by having Pap smear in precancerous stage. Various approaches can be taken for treating or preventing the progress of these precancerous lesions. The aim of this study was to investigate the cytopathological and colposcopic response of precancerous lesions to multivitamin, mineral (multimineral), and coenzyme Q10 supplements.

The present randomized clinical trial was conducted on 120 participants with clinical complaints or abnormal Pap smear test results. The intervention and control groups received supplemental and placebo treatments, respectively, for 3 months after a primarily Pap smear test. The Pap smear test was also performed after the treatment and patients with abnormal results were screened by colposcopy. Data were analyzed by SPSS software and P-value less than 0.05 was considered significant.

The percentage of participants in the intervention and control groups were 40% and 28.3% in the age range of 20-29, 26.7% and 41.7% in the age range of 30–39, and finally 33.3% and 30% over 40 years of age, respectively (P=0.19). The percentage of normalization in Pap smear test result was 83.3% and 53.3% in the intervention and control groups, respectively (P<0.001).

It was found that short-term usage of multi-mineral and Q10 supplements may decrease the risk of cervical cancer in women with abnormal Pap smear. However, studies with larger population and longer trial period are needed for further investigation.

Women with polycystic ovary syndrome (PCOS) are at higher risk of developing pregnancy complications including gestational diabetes and preeclampsia. This study was performed with the aim of examining the impact of metformin on incidence of gestational diabetes and preeclampsia in pregnant women with PCOS.

In this clinical trial, 88 pregnant women with PCOS with a history of taking metformin referring to Fatemieh hospital in Hamedan, Iran in 2017-18 were randomly assigned into two groups: metformin consumption (1000-2000 mg/day) continuing throughout the pregnancy and control (stopping metformin consumption immediately after detection of pregnancy). The pregnancy and fetal consequences and complications were compared in both groups. The data were analyzed by STATA software version 14.0.

In both groups, no significant difference was observed in terms of mean age, duration of infertility, body mass index, and baseline variables (p>0.05). The relative risk (RR) of incidence of gestational diabetes (RR: 1.97, 95% CI: 1.63 -2.39), preeclampsia (RR: 2.65, 95% CI:  1.95- 3.59), and abortion (RR: 2.33, 95% CI: 1.69 -3.22) was higher in the control group who did not continue metformin consumption throughout the pregnancy (p<0.05). The frequency of C-section was lower in the intervention group than in the control group (p<0.05).

Based on the results of the present study, continuation of metformin consumption in women with PCOS during pregnancy may be associated with decreased adverse consequences of pregnancy including gestational diabetes and preeclampsia.

Background Small for gestational age (SGA) refers to newborns whose birth weight is less than the 10th percentile for gestational age. The aim of this study was to provide a comparative assessment of ultrasound placental findings in SGA and normal-weight fetuses in singleton pregnant women. Materials and Methods In this cross-sectional study, a total number of 112 singleton pregnant women who were in their second trimester and referred to Shariati and Imam Khomeini hospitals, Tehran, Iran, during 2016-17 were selected. Ultrasound placental findings were assessed in SGA and normal-weight fetuses. Fetal and maternal indices were also assessed. Data were analyzed using SPSS software (version 16.0). Results There was a significant relationship between maternal age and IUGR (0.026); while no significant relationship was found between gestational age and IUGR (p=0.185). No statistically significant difference existed between male and female fetuses in terms of IUGR (p=0.542). The highest artery Doppler systolic-diastolic pressure ratio was found in EFW90th percentile groups were the highest and lowest respectively with a statistically significant difference with other groups (p<0.01). Amniotic fluid index was the lowest in 5-10th percentile and Conclusion Based on the results, SGA incidence was significantly related to maternal pregnancy age, artery Doppler systolic-diastolic pressure ratio, UARI, AFI, and placental thickness. As such, ultrasound methods can be employed during pregnancy to detect SGA incidence.

Background Preterm birth with a prevalence of about 10% causes 75-95% of prenatal mortality, and one of the effective factors of it is hormonal factors. This study aimed to investigate the effect of oral medroxy progesterone on reducing preterm labor in women with a history of preterm labor. Materials and Methods This double-blinded clinical trial was performed on 214 pregnant women with the history of at least one preterm labor referred to midwifery clinic of Fatemieh Hospital, Shiraz, Iran, during 2017 to 2018. One hundred and seven women underwent treatment with oral medroxy progesterone (100 mg per day), and 107 individuals were prescribed placebo, and prenatal care was performed routinely. Recent pregnancy course and delivery time were compared in two groups. Data were analyzed by SPSS software version 16.0. Results Gestational age with a mean of 30 ± 3.89 and 36± 2.11 weeks, respectively in control and intervention groups differed significantly (P <0.05). The number of referrals to hospital due to preterm labor, the age of patients at first referral due to preterm labor, and age of delivery in both groups of receiving progesterone and placebo were significantly different (P <0.05). Conclusion Based on the results of the current study using 100 mg oral progesterone per day in weeks 16-36 of pregnancy was effective in reduction of preterm labor, and caused improved gestational age in mothers.

COPD is primarily the disease of the lungs; nevertheless, multiple systemic manifestations including poor sleep quality and sleep disturbances have been linked to this illness. Administration of sedative hypnotics is not recommended in COPD patients, as these drugs suppress the ventilatory response and exacerbate sleep-related disorders. Melatonin is an alternative medication that has been widely used to treat sleep disturbances caused by aging and other specific conditions. We aimed to investigate the efficacy of melatonin administration in improvement of sleep quality in COPD patients. A randomized, double-blind, placebo-controlled trial was conducted. A total of 54 patients were recruited and randomly assigned into either melatonin or placebo group. Sleep quality was evaluated by Pittsburgh Sleep Quality Index (PSQI); daytime sleepiness was assessed by Epworth Sleepiness Scale (ESS). For all patients, spirometry and pulse oximetry were preformed to evaluate lung function and oxygenation. Compared with placebo, melatonin administration significantly improved global PSQI score (p<0.001). Of PSQI individual components, sleep quality (p=0.001), sleep latency (p=0.001), sleep efficacy (p=0.003), and sleep duration (p=0.024) improved significantly. On the other hand, melatonin treatment did not significantly change indices of daytime sleepiness, lung function and oxygenation (p>0.05). Melatonin significantly improves sleep quality in COPD patients with sleep complaints. This improvement was in the absence of significant elevation in the indices of daytime sleepiness and lung function.