فهرست مطالب shideh ariana

Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would reduce perioperative blood loss.

In this double-blind randomized controlled parallel group study, a single dosage of fibrinogen concentrate or a placebo was given to 260 cesarean section patients at random (by G*Power software, Heinrich-Heine-Universität Düsseldorf, Germany) in a university-affiliated general hospital between November 11, 2022, to January 8, 2023. Individuals in the fibrinogen group received a dose of one gram of fibrinogen concentrate and those in the placebo group received normal saline solution with the same volume in the placebo group. Total blood loss was the primary outcome of this study.

A total of 280 cases were screened and 260 were randomized. With a P-value of 0.001, the median (IQR) volume of bleeding in the fibrinogen group was 660 (341.25) mL, as opposed to 790 (475.00) mL in the placebo group. Comparatively, only 10 (7.7%) of the fibrinogen group and 26 (20%) of the placebo group required blood transfusions (P=0.006). No adverse event related to fibrinogen was reported.

Empiric treatment with fibrinogen concentrate results in reduced blood loss.

 The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.

 In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.

 The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.

 In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.

The coronavirus, which is caused by acute respiratory syndrome, appeared in Wuhan, China, in December 2019 and gradually spread around the world until almost all countries became infected with the coronavirus. In Iran, the outbreak of coronavirus began on February 21, 2020, with the report of infection of two people in the city of Qom. The aim of this study is to evaluate the clinical findings of neonates born to pregnant women with corona disease.

During this case study (February 21 to November 30, 2020), out of 88 pregnant mothers who referred to the hospitals of Shahid Beheshti University of Medical Sciences, 44 live neonates were born from 42 pregnant women with COVID‑19, who were evaluated for clinical signs by studying their files and reported as a case series, due to limited samples, No statistical analysis of the study was performed.

In studies of clinical records of hospitalized mothers and infants, among the polymerase chain reactions (PCRs) provided for all infants, one PCR was reported positive 2 days after birth, whereas this infant 10 min after birth, immediately after routine procedures, due to positive mother’s PCR was isolated from the operating room. However, all of the infant’s clinical symptoms were normal during the 3‑day hospital stay for routine postpartum care. Twenty‑eight days after birth, the baby was reevaluated for clinical, laboratory, and chest X‑ray symptoms, all of which were normal. The PCR of other neonates was negative, and five intubated neonates, two twin, and two single died, and the other neonates were discharged. In evaluating the clinical records of mothers of these infants, the mean age is 30 years, and the average gestational age is 35 weeks, 32 cases of caesarean section, and 10 cases of normal delivery.

We describe epidemiological data, demographics, signs and symptoms on admission, laboratory results, comorbidities, infection COVID‑19 in the mothers and neonates, chest radiography and computed tomography findings, treatment received for COVID‑19, and clinical maternal, fetal, and neonatal outcomes. Due to the fact that the study population is small consist of 42 mothers with COVID‑19 infection, among all PCR samples from infants born to COVID‑19 positive mothers, the PCR result of one case was positive, and the rest of was negative. Therefore, vertical transmission of COVID‑19 through the placenta to the fetus cannot be confirmed or denied, nor can the COVID‑19 confirmed or denied the baby’s postnatal complication during pregnancy.

Müllerian anomalies are associated with infertility. Hysteroscopy as the gold standard for evaluating Müllerian anomalies is an invasive, expensive and risky procedure which requires enough experience. Transvaginal sonography (TVS) and hysterosalpingography (HSG) are less invasive procedures, but there is little known about the accuracy of these tests. The aim of this study was to evaluate the accuracy of the combination of TVS and HSG with hysteroscopy as the gold standard.
Medical records of infertile women who were undertaken all three diagnostic modalities were reviewed to analyze their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Ninety-nine infertile women were assessed with a mean±SD age of 29.1±6.47 years, mean±SD duration of themarriage of 8.9±10.28 years, and mean±SD duration of infertility of 5.6± 4.16 years. The sensitivity, specificity, PPV, and NPV of TVS were 98.55%, 30%, 76.4%, and 90%, respectively. HSG had a sensitivity of 95.6%, specificity of 60%, PPV of 84.62%, and NPV of 85.71%.When both modalities were combined, the sensitivity, specificity, PPV, and NPV were 94.2, 66.67, 86.67, and 83.33%, respectively. The diagnostic accuracy of single TVS, HSG or combined techniques was statistically similar that was equal to 77.7, 84.8 and 85.8 % respectively.
The accuracy of combination of two diagnostic modalities, 2D TVS and HSG is not higher than HSG alone for assessing uterine malformation in infertile women.