فهرست مطالب me parsanezhad

IMost women who report increased levels of physical activity are not at an increased risk of preterm delivery or reduced intrauterine growth. This study was conducted to look into the safety and effects of regularly timed aerobic exercises during pregnancy on both the mother and the neonate. A prospective, case-control study was done on 120 healthy pregnant women in their first trimester. The data were collected in the prenatal outpatient care, labor and delivery rooms of a university-based Obstetrics Department. After completing basic information forms, the pregnant women were educated on the specific exercises in 8 stages throughout the pregnancy. Sixty-three patients presenting for delivery without any history of physical exercise were selected as the control group. There was no significant difference between the two groups regarding their occupation. The exercising group experienced significantly decreased durations of labor. There was no significant difference in neonatal birth weight or apgar scores. There were a significant decreased number of assisted deliveries in the exercising group. Exercise during pregnancy shortens the duration of the second stage of labor and reduces the risk of assisted delivery while is safe for the neonate too.

Weight gain during pregnancy for women with normal Body Mass Index (BMI) before pregnancy has been reported to be 11.5–16.0 Kg/m2 by IOM and supported by several authors. This study was carried out to determine the relationship between pre-pregnancy BMI and gestational weight gain and pregnancy outcome. In 476 pregnant women, BMI was categorized and weight gain was divided into less than normal and higher than normal groups based on Institute of Medicine (IOM) recommendations. Women with normal weight gain had better pregnancy outcomes. The incidence of low birth weight was higher among underweight women and those with low gestational weight gain. Overweight women and those with high gestational weight gain had a higher rate of cesarean delivery and postpartum hemorrhage. There was also a significant difference between the BMI early postpartum hemorrhage, method of delivery, neonatal weight, nausea, vomiting and weight gain during pregnancy. Women gained weight according to recommendations had good pregnancy outcome in relation to weight, lengths and head chest circumferences of the neonate and methods of delivery and post partum hemorrhage. The findings presented here indicate that prenatal care providers should consider women with abnormal prepregnancy BMI and gestational weight gain at an increased risk unconditionally and that they need special care to avoid the pregnancy-associated complications forthwith.

In order to evaluate the effects of short course administration of dexamethasone (DEX) combined with clomiphene citrate (CC) in CC-resistant patients with polycystic ovary syndrome (PCaS) and normal DHEAS, a prospective, double blind, placebo controlled, randomized study was undertaken at referral university hospitals, Two-hundred and thirty women with PCOS and normal DHEAS who failed to ovulate with a routine protocol of CC received 200 mg of CC from day 5 to 9 and 2 mg of DEX from day 5 to 14 of the menstrual cycle. The control group received the same protocol of CC combined with placebo. Follicular development, hormonal status, ovulation rate, and pregnancy rate were evaluated. Mean follicular diameters were 18.4124±2.4314 mm and 13.8585±2.0722 mm (p<0.001) for treatment and placebo group respectively. Eighty-eight percent of treatment and 20% of the control group had evidence of ovulation. The difference of cumulative pregnancy rate in treatment and control groups was statistically significant (p<0.000l). Hormonal levels, follicular development and cumulative pregnancy rate improved with the addition of DEX to CC in CC-resistant patients with PCOS and normal DHEAS.This regimen is recommended before any gonadotropin therapy or surgical intervention.

The purpose of this study was to compare the effect of intraperitoneal bupivacaine and lidocaine administration on pain reduction after diagnostic laparoscopy. In this randomized, double blind, placebo controlled study, diagnostic laparoscopy was done for one-hundred and ninety-six infertile women with unexplained infertility. Patients were randomized to 4 groups (A, B,C, and D). At the end of the procedure, 30 mL of 0.125% bupivacaine, 30 mL of 5% lidocaine and 30 mL of normal saline was instilled in the pelvic cavity and 15 mL of the same solution over the diaphragmatic vault in group A, B and C, respectively. Group D received no intraperitoneal substance. The verbal pain scale questionnaire was used for assessment of postoperative pain. In conclusion, when instilled intraperitoneally after diagnostic laparoscopy, bupivacaine significantly decreases postoperative pain for a long period. It also reduces the rate of analgesic needed, increases the rate at which patients were discharged 2 hours after surgery, and decreases hospital stay. It is highly effective compared to lidocaine and placebo.

In order to determine outcome of pregnancy with lUI in patients with unexplained recurrent miscarriage whose husbands have low hypo-osmotic swelling test scores, a prospective clinical intervention was performed at a university referral clinic of recurrent abortion. Out of 56 patients whose husbands had abnormal hypo-osmotic swelling tests, 43 patients underwent lUI, from which only 14 patients became pregnant (treatment group) and 13 patients became spontaneously pregnant without lUI as control group. Our main outcome measure was successful pregnancy (continuation of pregnancy after 20 weeks). Among the 14 patients who became pregnant, 3 patients aborted below 20 weeks (21.4%), and 11 patients continued pregnancy after 20 weeks of gestation (78.6%). In the control group among the 13 patients with spontaneous pregnancy, 8 patients aborted below 20 weeks (61.5%) and 5 patients continued pregnancy over 20 weeks (36.4%), success rate ratio was 2.04% and the difference was statistically significant (d= 4.49, p<0.05). Treating the unexplained recurrent aborter whose male partner has a low hypo-osmotic swelling test score with lUI could be effective. This is the first study to present an ideal way for selection of recurrent aborters who benefit from lUI. The probable mechanism for this effect may be selection of the best quality sperms which will be discussed in detail.

The purpose of this study was to determine whether sectioning the cervical septum is associated with intraoperative bleeding, incompetent cervix, and secondary infertility. In this prospective observational study, fourteen women with complete septate uterus who had a history of repeated pregnancy loss and infertility were treated hysteroscopically. Preoperative history included 35 pregnancies of which abortion rate was 62.8% and premature delivery 37.2%. Three infants (8.5%) survived. The cerivcal portion of the septum was incised with Metzenbaum scissors and the corporeal portion with micro scissors under hysteroscopic guidance. Eleven patients achieved pregnancy (78.5%). There were ten term pregnancies (91 %). Mean±SD of operating time was 31.1±9.74 minutes with a mean±SD distending media deficit of 472±186 mL. No significant bleeding was encountered. At follow up hysterosalpingography, all cervices were competent. In conclusion, section of the cervical septum with scissors is simple, rapid and safe, facilitates corporeal hysteroscopic metroplasty, and may be considered a valid procedure to correct a complete septate uterus.

Congenital Mullerian abnormalities, particularly the septate uterus, may result in recurrent abortion, premature labor and infertility. The purpose of this study is to report the surgical and reproductive outcome in two groups of patients who underwent hysteroscopic metroplasty (HMP). Between Aug. 1993 and March 1998,76 women underwent HMP in Shiraz University of Medical Sciences' affiliated hospitals. They were divided into two groups. Group one received no postoperative (post-op) additional therapy. Group two received post-op estrogen, and an IUD was also placed to prevent post-op endometrial adhesion. They were analyzed with respect to post-op complications and reproductive outcome. Seven of these patients had a complete uterine septum which extended through the cervix and to the vagina. All of the seven cervical septums were incised with good obstetrical outcome. There were a total of 45 pregnancies during 6 months or more post-op in the two groups. Differences between the reproductive outcome of the two groups was not statistically significant (p=O.90066) and the general results were as follows: term delivery rate was 35 (72.7%),23 (51%) delivered vaginally, and 12 (26.5%) delivered by cesarean section (CIS) for obstetric indications,4 (8.8%) were spontaneous abortions and one immature delivery at 16 wks due to premature rupture of membranes (PROM). Intraoperative and post-op morbidity was negligible. We concluded that with HMP, septa can be incised successfully, post-op hormonal therapy and IUD placement are not needed, the cervical septum can be incised without any post-op complication, and a good reproductive outcome can be expected.