ABSTRACT: Pregnancy considerably increases iron needs in a mother and her fetus. The purpose of this study was to assess the relationship between maternal hemoglobin concentration in labor with neonatal birth weight.
A population-based study in Shahid Sadughi Hospital in Yazd, Iran, was performed by comparing 1842 singleton term pregnancies of patients with and without anemia and their newborns. Maternal characteristics, including hemoglobin values, were recorded at the labor visit. Maternal anemia was defined as hemoglobin concentration lower than 10 g/dl during pregnancy. Main outcome measures included birth weight and Apgar score. Linear and logistic regression models were used to analyze data.
Anemia (Hb < 10 g/dl) was associated with a significantly increased risk of low birth weight (< 2500 g). High hemoglobin (> 13 g/dl) increased the risk of low birth weight but it was not significant. The risk of a low Apgar score was significantly increased in women with anemia. The minimum incidence of low birth weight occurs in association with a hemoglobin concentration of 10-13 g/dl.
Maternal anemia was significantly associated with effect on birth weight. Also Hb > 13 g/dl was also associated with an increased risk of low birth weight.
Hematology (Amsterdam, Netherlands) 11/2011; 16(6):373-6. · 1.33 Impact Factor
ABSTRACT: To evaluate and compare the efficacy of microdose gonadotropin-releasing hormone (GnRH) agonist flare (MF) and GnRH antagonist/letrozole protocols in poor responders undergoing in vitro fertilization.
A total of 94 poorly responding patients were randomized in an ovarian stimulation protocol with a MF, or a letrozole and high dose follicle-stimulating hormone/human menopausal gonadotropin and flexible GnRH antagonist protocol.
There was no significant difference in mean age, body mass index, basal serum follicle stimulating hormone and estradiol levels, duration of infertility, distribution of etiology of infertility, and the number of previously failed in vitro fertilization cycles. The days of stimulation, mean gonadotropin dose, the number of mature follicles, and oocytes retrieved and metaphase II oocytes retrieved, serum estradiol level on the day of human chorionic gonadotropin administration, and the percentage of top and good quality embryos were significantly higher in the MF group. The endometrial thickness, fertilization rate, and the number of embryos transferred were similar in both groups. The implantation and clinical pregnancy rates were higher in the MF group and the total cancellation rate was higher in the GnRH antagonist/letrozole group, but these findings were not statistically significant.
The addition of letrozole to the GnRH antagonist for poor responders does not improve the outcome of assisted reproductive technology cycles. The MF protocol remains the most appropriate protocol in poor responders.
Taiwanese journal of obstetrics & gynecology 09/2010; 49(3):297-301.
ABSTRACT: This prospective study evaluated the efficacy of gonadotropin-releasing hormone (GnRH) antagonist protocol in comparison with the GnRH agonist protocol in the first cycle of assisted reproductive technique (ART).
We randomized 235 patients undergoing ART for the first time. The first group was stimulated with a standard long protocol and the second group stimulated with GnRH antagonis.
There was no statistically significant difference in the age, infertility cause, basal FSH, BMI, the number of oocytes retrieved, number of M2 oocytes, embryo obtained and endometrial thickness between the two groups. But Serum estradiol, consumption of gonadotropins and ovarian hyperstimulation syndrome were significantly lower in the antagonist protocol. Cancellation rate of embryo transfer due to poor-quality embryo in the antagonist protocol was higher, but it was not significant. There was no significant difference in the clinical pregnancy and ongoing pregnancy between the two groups.
GnRH-antagonist is an effective, safe, and well-tolerated alternative to agonist in the first cycle of ART.
Archives of Gynecology 05/2009; 281(1):81-5. · 0.91 Impact Factor
ABSTRACT: To assess whether immediate removal of an indwelling catheter after anterior colporrhaphy influences the rate of re-catheterisation and symptomatic urinary tract infections.
A prospective randomised study conducted on 90 women divided into two groups who underwent anterior repair. The indwelling catheter was removed immediately (early catheter removal), and at least 24 h after the operation in case and control groups, respectively. The association between clinical variables and the duration of catheterisation and continuous data were analysed by chi(2) test and two-tailed t-test, respectively. Excel and SPSS 15.0 software were used, and a P-value of 0.05 or less was considered to indicate statistically significant differences.
Symptomatic urinary tract infection was significantly lower in early catheter-removal group; also patients in this group reported significantly less pain and voiding disturbances. Only a few of women required re-catheterisation after failing to void and all were able to resume normal voiding, also had shorter ambulation time and hospital stay.
Early removal of an indwelling catheter immediately after anterior colporrhaphy was not associated with adverse events and increased rate of re-catheterisation. In this group, symptomatic urinary tract infection was significantly lower. Moreover, early removal of indwelling catheters immediately after operation seemed to decrease the ambulation time and hospital stay.
Australian and New Zealand Journal of Obstetrics and Gynaecology 07/2008; 48(3):348-52. · 1.24 Impact Factor