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Showing 7 results for Pourali

Nafiseh Saghafi, Atieh Mohammadzadeh Vatanchi, Fatemeh Tara, Leila Pourali, Salmeh Dadgar,
Volume 12, Issue 12 (12-2014)

Background: Preeclampsia is one of the common complications during pregnancy with considerable maternal and fetal mortality and morbidity. Hypercoagulability due to thrombophilic factors is discussed as the etiology involved in this disease.
Objective: The aim of this study was to evaluate selected thrombotic factors among pregnant women with preeclampsia and normal pregnant women.
Materials and Methods: This case-control study was performed on 200 pregnant women at third trimester of pregnancy between 2012 and 2013. 100 pregnant women admitted to Qaem and Imam Reza hospitals of Mashhad, due to preeclampsia, were selected as case group and 100 pregnant women without preeclampsia referred to OB/GYN clinic of these hospitals as control group. Blood samples were taken from two groups for evaluation of the coagulation factors including factor V Leiden, protein C, protein S, antithrombin III, anti-cardiolipin antibodies, and lupus anticoagulant antibodies.
Results: Two groups were not significantly different in terms of maternal age and parity (p>0.05). Levels of factor V Leiden, protein C, protein S, antithrombin III, anti-cardiolipin antibodies and lupus anticoagulant antibodies were compared between two groups. The number of patients with abnormal factor V Leiden and protein C was significantly higher in case group than in the control group (p<0.01 respectively), but other factors were not significant different between two groups. Thrombophilia disorders were significantly more in case group compared to control (p<0.001).
Conclusion: The risk of thrombophilia disorders is higher in preeclamptic patients than normal pregnant women.

Leila Pourali, Sedigheh Ayati, Shahrzad Jelodar, Ahmadreza Zarifian, Mohammad Sobhan Sheikh Andalibi,
Volume 14, Issue 5 (5-2016)

Introduction: Regarding to the recent advances in assisted reproductive techniques (ART), twin and multiple pregnancies have increased during past years.
Objective: This study was performed to compare obstetrics and perinatal outcomes of dichorionic twin pregnancy following ART with spontaneous pregnancy.
Materials and Methods: In this cross-sectional study which was performed in Ghaem Hospital, Mashhad University of Medical Sciences, 107 dichorionic twin pregnancy were enrolled in two groups: spontaneous group (n=96) and ART group (n=31). Basic criteria and obstetrics and neonatal outcomes information including demographic data, gestational age, mode of delivery, pregnancy complications (preeclampsia, gestational diabetes, preterm labor, and intrauterine growth retardation (IUGR), postpartum hemorrhage), neonatal outcomes (weight, first and fifth minute Apgar score, Neonatal Intensive Care Unit (NICU) admission, mortality, respiratory distress, and icterus) were recorded using a questionnaire.
Results: Preterm labor, gestational diabetes, and preeclampsia were significantly higher in ART group compared to spontaneous pregnancy group. However, other factors such as anemia, IUGR, postpartum hemorrhage, and intrauterine fetal death (IUFD) were not significantly different between groups. There were no significant differences between groups in terms of neonatal outcomes (weight, 1st and 5th min Apgar score <7, NICU hospitalization, mortality, respiratory distress, and icterus).
Conclusion: With regard of significantly higher poor outcomes such as preeclampsia, gestational diabetes and preterm labor in ART group, the couples should be aware of these potential risks before choosing ART.
Leila Pourali, Sedigheh Ayati, Shirin Tavakolizadeh, Hourieh Soleimani, Fatemeh Teimouri Sani,
Volume 15, Issue 1 (1-2017)

Background: Clomiphene citrate is one of the effective drugs for infertilitytreatment due to oligo-ovulation or anovulation. Intrauterine insemination (IUI) isone of more adherent methods for treatment of infertile cases which is followed bycontrolled ovarian hyperstimulation (COH).
Objective: the aim of this study was to evaluate Clomiphene citrate versus letrozolewith gonadotropins in IUI cycles.
Materials and Methods: In this prospective randomized trial, 180 infertile patientswho were referred to Milad Hospital were selected. The first group received 5mg/day letrozole on day 3-7 of menstrual cycle. The second group received 100mg/day Clomiphene in the same way as letrozole. In both groups, humanmenopausal gonadotropin was administered every day starting on day between 6-8of cycle. Ovulation was triggered with urinary Human Chorionic Gonadotropin(5000 IU) when have two follicles of ≥16 mm. IUI was performed 36 hr later.
Results: The number of matured follicles, cycle cancellation, and abortion were thesame in both groups. Endometrial thickness was higher at the time of humanmenopausal gonadotropin administration in letrozole group. Chemical and clinicalpregnancy rates were much higher in letrozole group. Ovarian hyperstimulation wassignificantly higher in clomiphene group.
Conclusion: Letrozole appears to be a good alternative to clomiphene citrate withfewer side effects.
Sedigheh Ayati, Leila Pourali, Masoud Pezeshkirad, Farokh Seilanian Toosi, Sirous Nekooei, Mohammad Taghi Shakeri, Mansoureh Sadat Golmohammadi,
Volume 15, Issue 4 (6-2017)

Background: Placenta adhesive disorder (PAD) is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities.
Objective: The purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of PADs.
Materials and Methods:In this is cross-sectional study, Eighty-two pregnant women who were high risk for PAD underwent color Doppler ultrasound and MRI after 18 weeks of gestation. The sonographic and MRI findings were compared with the final pathologic or clinical findings. P<0.05 was considered statistically significant.
Results: Mean maternal age was 31.42±4.2 years. The average gravidity was third pregnancy. 46% of patients had placenta previa. The history of the previous cesarean section was seen in 79 cases (96%). The diagnosis of placenta adhesive disorder was found in 17 cases (21%). Doppler sonography sensitivity was 87% and MRI sensitivity was 76% (p=0.37). Doppler sonography specificity was 63% and MRI specificity was 83% (p=0.01).
Conclusion: Women with high-risk factors for PAD should undergo Doppler ultrasonography at first. When results on Doppler sonography are equivocal for PAD, MRI can be performed due to its high specificity.
Nafiseh Saghafi, Leila Pourali, Vahid Ghavami Ghanbarabadi, Fatemeh Mirzamarjani, Masoumeh Mirteimouri,
Volume 16, Issue 1 (January 2018)

Background: Preeclampsia, a severe complication of human pregnancy is one of the main causes of maternal, fetal, and neonatal morbidity and mortality with unclear pathogenesis. Heat shock protein 70 (HSP70) is one of the factors that can mediate cytoprotective, antiapoptotic, and immune regulatory effects.
Objective: This meta-analysis was performed with aim to evaluate HSP70 in preeclampsia and normal pregnancy.
Materials and Methods: The original publications reporting the serum HSP70 levels in preeclampsia and normal pregnancies published before November 2015 were identified by searching PubMed Central, Scopus, and ISI Web of Knowledge databases by two researchers, separately. The keywords were” preeclampsia” and “HSP70” or “Heat shock protein 70” Statistical analyses were performed using STATA software (version 11).
Results: Out of 127 studies, seven eligible case-control studies were identified which consists of 350 preeclampsia and 429 normal pregnancies. Our pooled analysis of data from 7 studies which met the inclusion criteria, provides evidence that there is a significant association between HSP70 and preeclampsia. Cochranchr('39')s test results showed the heterogeneity of the studies (p<0.001) and the I2 index was 91%. The standardized mean differences (SMD) based on a random effect model with trim and fill method was 0.92 (95% CI: 0.33-1.51); also there was a significant association between HSP70 and preeclampsia (Z=3.07, p=0.002).
Conclusion: The results showed that serum HSP70 concentration was significantly higher in preeclamptic patients than the control group. Therefore HSP70 may be identified as a diagnostic factor.

Nafiseh Saghafi, Leila Pourali, Kiarash Ghazvini, Asieh Maleki, Mahdis Ghavidel, Mohsen Karbalaeizadeh Babaki ,
Volume 16, Issue 5 (May 2018)

Background: One of the most important etiologies in pretermpremature rupture of membranes (PPROM) is cervical bacterial colonization.
Objective: This study evaluated cervical bacterial colonization in women with PPROM and the pregnancy outcomes.
Materials and Methods: In this cohort study, 200 pregnant women with PPROM at 27-37 wk of gestation who were admitted in an academic hospital of Mashhad University of Medical Sciences from March 2015 to July 2016 were studied. samples were obtained from endocervical canal for detection of routine bacteria and Gram staining. Also, we obtained one blood culture from neonates. Maternal endocervical culture, chorioamnionitis, neonatal intensive care unit admission, neonatal positive blood culture, neonatal sepsis, and mortality were documented.
Results: Most common isolated microorganism of endocervical culture were Escherichia coli (24.2%), Coagulase negative Staphylococci (27.2%), Enterococcus and candida each one (11.7%). The prevalence of GBS was only 2.2%. Simultaneous positive blood cultures were seen in 3% of neonates. Among them, Gram-negative bacilli accounted for (66.6%), while Gram-positive cocci and candida made up only (16.7%). Endocervical colonization was associated with a higher admission rate (p=0.004), but there was no significant correlation between endocervical colonization and chorioamnionitis, positive blood culture and neonatal mortality rate.
Conclusion: With regard to low GBS colonization rate, appropriate antibiotic regimens should be considered in PPROM cases according to the most prevalent micro organisms of endocervical bacterial colonization. Maybe cervical bacterial colonization had some effects on neonatal outcomes. There was no significant association between endocervical bacterial colonization and chorioamnionitis, positive neonatal blood culture and neonatal mortality.
Sedigheh Ayati, Elahe Hasanzadeh, Leila Pourali, Mohammadtaghi Shakeri, Atiye Vatanchi,
Volume 17, Issue 7 (July 2019 2019)

Background: Delivery is the only definite cure for hypertensive disorders. Therefore, cervical ripening and labor induction are important to achieve favorable outcomes.
Objective: This Randomized Control Trial (RCT) is aimed to compare the effects of sublingual misoprostol and Foley catheter in cervical ripening and labor induction among patients with preeclampsia or gestational hypertension.
Materials and Methods: A total number of 144 women with preeclampsia or gestational hypertention with indication of pregnancy termination, who were referred to academic hospitals of the University of Medical Sciences in Mashhad, Iran, between March 2015 and December 2016, were randomly divided into two groups. In group one (n = 72), 25 μg of misoprostol tablet was administrated sublingually every 4 hr up to six doses. In group two (n = 72), a 16F Foley catheter was placed through the internal cervical os, inflated with 60 cc of sterile saline.
Results: There were no significant differences between groups regarding the demographic characteristics, primary bishop score, and pregnancy termination indication.
The cervical ripening time (primary outcome) (8.2 vs 14.2 hr, p < 0.00), induction to delivery interval (15.5 vs 19.9 hr, p < 0.00), and vaginal delivery before 24 hr (63.9% vs 40%, p = 0.03) were significantly different between the two groups. There was no significant difference between groups in view of oxytocin requirement (p = 0.12), neonatal Apgar score (p = 0.84), or neonatal intensive care unit admission (p = 78).
Conclusion: This trial showed that the application of sublingual misoprostol, compared to the Foley catheter, can reduce cervical ripening period and other parameters related to the duration of vaginal delivery. This misoprostol regimen showed inconsiderable maternal complications.

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