Publications by authors named "Vajihe Marsoosi"

3 Publications

  • Page 1 of 1

Prolonged second stage of labor and levator ani muscle injuries.

Glob J Health Sci 2014 Sep 28;7(1):267-73. Epub 2014 Sep 28.

Assistant Professor of Perinatology, Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

Objective: To determine the effect of pregnancy and vaginal delivery on the pelvic floor and levatorani morphology and function.

Methods: Design. Cross-sectional study. Setting. Tertiary care teaching hospital. Population. 75 primigravid women were recruited for assessment at 6 weeks postpartum compared with 25 nulliparous women. Hiatal morphology and levator ani muscle avulsion were assessed by 4-dimensional translabial ultrasound examination. The volume achievement obtained by ultrasound was performed in supine position with empty bladder at rest, on maximum Valsalva maneuver, and on maximum pelvic floor muscle contraction. Main Outcome Measures. Hiatal diameter and area were measured at the plane of minimal hiatal dimension as defined in the midsagittal plane and Levator avulsion was assessed.

Results: There were significant differences in hiatal area morphology at rest, on Valsalva maneuver and during contraction of muscles among the study groups, but there was no difference in pelvic diameter at rest, on Valsalva maneuver, and during contraction. There were 21 cases of puborectalis avulsion (42%) with no significant difference between non-progressive labor (8 cases) and Normal Vaginal Delivery (NVD) (13 cases) groups.

Conclusions: The results of the present study showed that non-progressive labor is the main risk factor for pelvic muscle injuries, indicating the necessity of a better management and timely cesareans in women with prolonged second stage of labor.
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September 2014

Effect of different maternal metabolic characteristics on fetal growth in women with gestational diabetes mellitus.

Iran J Reprod Med 2013 Apr;11(4):325-34

Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.

Background: Fetal growth in diabetic pregnancies is a complex process and probably abnormalities in other metabolic pathways such as protein and lipid, as well as carbohydrate are responsible for delivering of macrosomic newborn.

Objective: The purpose of this study was to investigate the association between fetal growth and different maternal metabolic parameters in women with gestational diabetes mellitus (GDM) in comparison to control group.

Materials And Methods: This was a prospective cohort study conducted between March 2011 and May 2012, on 112 pregnant women with GDM and 159 healthy pregnant women. In order to determine of lipids or lipoproteins changes during pregnancy and to investigate any possible effects on fetal growth, lipid components, glucose and insulin levels were obtained in maternal serum three times in third trimester.

Results: Maternal serum glucose, total cholesterol (TC), low and high density lipoprotein (LDL-c, HDL-c) levels did not show any significant difference between two groups. While insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and triglyceride (TG) values were detected to be significantly higher in the GDM cases especially after 32 weeks of gestation (p<0.001). After adjustment for confounding variables, maternal hypertriglyceridemia remained as a significant risk factor for delivering large for gestational age (LGA) newborns (p=0.04); and according to spearman test the increase of TG level was correlated with increase of insulin resistance and HOMA-IR (p<0.001, CI: 0.312).

Conclusion: Due to positive correlation of hypertriglyceridemia and hyperinsulinemia with newborn weight, it is possible to assume that elevated TGs levels in GDM cases is a reflection of variation in maternal insulin levels.
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April 2013

The role of Doppler indices in predicting intra ventricular hemorrhage and perinatal mortality in fetal growth restriction.

Med Ultrason 2012 Jun;14(2):125-32

Shariaty Hospital, Tehran Medical Sciences University, Tehran, Iran.

Objectives: The aim of this study is to determine whether Doppler indices predict intra-ventricular hemorrhage and perinatal mortality in fetal growth restricted pregnancies (FGR).

Material And Methods: In this cohort study, 43 FGR fetuses underwent multi-vessel Doppler ultrasounds weekly or twice weekly after admission. Blood gases of the umbilical cord were analyzed immediately after delivery. Ultrasonography of the neonatal brain was performed after birth. Intra ventricular hemorrhage (IVH) and perinatal mortality were studied as outcomes.

Results: The median gestational age at the diagnosis of fetal growth restriction was 31 weeks, and the median age at delivery was 33.4 weeks. Seven cases had IVH. The chance of IVH was about five times greater in cases of absent/reversed umbilical diastolic flow (AREDF). The predicting factors for IVH were gestational age at delivery, birth weight, and acidosis. Nine neonates died in the neonatal period. AREDF, the Resistance Index of middle cranial artery (MCA/RI) and umbilical artery (UA), and absent/reversed "a" waves in ductus venosus (DV) were the Doppler indices predicting perinatal mortality. The other prognostic factors for perinatal mortality were gestational age at diagnosis and delivery, final amniotic fluid, Apgar score, and acidosis.

Conclusion: Doppler indices, such as AREDF, can be predictors of IVH or perinatal death, and an absent or reversed "a" wave in the ductus venosus and the hypoxic index can be significant predictors of death in fetuses with fetal growth restriction. However, other important factors for IVH were gestational age at delivery and birth weight. The most important factors predicting perinatal mortality were gestational age, birth weight, acidosis, low AF, and low Apgar score.
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June 2012