A comparison of neonatal outcomes after taking progesterone pills and progesterone intramuscular injections in preterm labor: An RCT.

Background: Approximately two-thirds of infant mortality within the first year of life are caused by preterm labor (PL). Objective: This study aimed to investigate the effects of progesterone-based compounds to prevent PL. Materials and Methods: This randomized clinical trial study was conducted on 146 pregnant women admitted to Department of Obstetrics and Gynecology, Afzalipour hospital in Kerman University of Medical Sciences, Kerman, Iran in June 2019. The participants with PL received Tocolytic and 12 mg Betamethasone in 2 doses over 2 days to mature the fetus's lungs. Stopping PL was considered a 12-hr period without any contractions after finishing the Tocolytic. Following the successful cessation of PL, the participants were monitored for 48 hr. Subsequently, the participants were divided into 2 groups. Participants received 200 mg Lutogel capsules orally per day in group A while group B received a weekly dose of 250 mg Proluton in the form of intramuscular injection, respectively. Treatment in groups continued until the 36th wk of delivery. The participants were followed-up weekly, and if any signs of PL were detected, an obstetrician carried out a vaginal examination. Results: The incidence of PL was the same in both groups. There was no significant difference in the latent phase, average birth weight, and the neonatal intensive care unit admission frequency (p = 0.07, 0.17, 0.58, respectively) between groups. Conclusion: No difference in the results obtained from theneonataloutcomes evaluated in groups. Both medications similarly led to recovering pregnancy and neonatal outcomes caused by PL. Applying the oral form with similar beneficial effects were pointed out in this study, which can be a solution to the issues caused by numerous injections that are inevitable in the injected administration of this medicine.

Prevalence of single umbilical artery, clinical outcomes and its risk factors: A cross-sectional study.

BACKGROUND: Single umbilical artery (SUA) is found in 0.5-6% of all pregnancies worldwide. Although the association of SUA with some congenital malformations is mainly accepted, its effect on pregnancy/neonatal outcomes is still controversial. OBJECTIVE: This is the first study aimed to approximate the SUA prevalence in southern part of Iran. SUA epidemiologic features accompanied by some of its effects on pregnancy/neonatal outcomes are investigated as well. MATERIALS AND METHODS: In this cross-sectional study, data from two referral centers in Southern Iran were analyzed. In total, 1,469 pregnancies, fetuses, and neonates were examined for epidemiological features associated with SUA. SUA was confirmed by pathological examination, while congenital anomalies were diagnosed by clinical, ultrasound, and echocardiographical examinations. Data on pregnancy outcome were recorded based on the patients' medical records. RESULTS: The prevalence of SUA was 3.47% (95% CI: 2.6-4.6%). Fetal anomalies including renal, cardiac, and other congenital anomalies, intrauterine fetal death, early neonatal death, low birth weight, low placental weight, and preterm birth were significantly higher in the SUA group (OR = 68.02, 31.04, 16.03, 3.85, 11.31, 3.22, 2.70, and 2.47, respectively). However, the maternal multiparity was lower in the SUA group (OR = 0.65; 95% CI: 0.44-0.98). CONCLUSION: A significant association was observed between SUA and increased risk of intrauterine fetal death and early neonatal death, as well as low birth weight and preterm birth. Obstetrical history of the mother like parity was identified as an important predictor of SUA. Further investigations are suggested on risk stratification of neonates in this regard.

Sensitive and selective electrochemical detection of bisphenol A based on SBA-15 like Cu-PMO modified glassy carbon electrode.

This work reports the electrochemical detection of bisphenol A (BPA) using a novel and sensitive electrochemical sensor based on the Cu functionalized SBA-15 like periodic mesoporous organosilica-ionic liquid composite modified glassy carbon electrode (Cu@TU-PMO/IL/GCE). The structural morphology of Cu@TU-PMO is characterized by X-ray powder diffraction (XRD), energy dispersive X-ray analysis (EDX), Fourier transform infrared spectroscopy (FT-IR), transmission electron microscopy (TEM), Field emission scanning electron microscopy (FE-SEM), and Brunauer-Emmett-Teller (BET). The catalytic activity of the modified electrode toward oxidation of BPA was interrogated with cyclic voltammetry (CV) and differential pulse voltammetry (DPV) in phosphate buffer solution (pH 7.0) using the fabricated sensor. The electrochemical detection of the analyte was carried out at a neutral pH and the scan rate studies revealed that the sensor was stable. Under the optimal conditions, a linear range from 5.0 nM to 2.0 µM and 4.0 to 500 µM for detecting BPA was observed with a detection limit of 1.5 nM (S/N = 3). The sensor was applied to detect BPA in tap and seawater samples, and the accuracy of the results was validated by high-performance liquid chromatography (HPLC). The proposed method provides a powerful tool for the rapid and sensitive detection of BPA in environmental samples.

Euphorbia leaf extract-assisted sustainable synthesis of Au NPs supported on exfoliated GO for superior activity on water purification: reduction of 4-NP and MB.

In the present work, the effect of graphene oxide (GO) architecture and synthesis of gold nanoparticles (AuNPs) on the surface of GO by using Euphorbia leaf extract was investigated. The as-synthesized catalyst was utilized for reduction of 4-nitrophenol (4-NP) and methylene-blue (MB). The ethanol/water extract of the leaves of Euphorbia was found as a non-toxic, suitable, eco-friendly natural reducing agent in one-step generation of Au nanoparticles onto the GO. The catalyst was characterized by different analysis such as atomic force microscopy, powder X-ray diffraction, field emission scanning electron microscopy, energy dispersive X-ray spectroscopy, SEM-mapping, transmission electron microscopy, and atomic absorption spectrometry. The high catalytic performance of the surfactant exfoliated gold-GO (SE-AuNPs/GO) towards the reduction of 4-NP to 4-aminophenol (4-AP) and reduction of MB to leucomethylene blue (LMB) under mild conditions, in water and at room temperature, was exhibited. Graphical abstract.

Serum concentration of calcium, magnesium and zinc in normotensive versus preeclampsia pregnant women: A descriptive study in women of Kerman province of Iran.

BACKGROUND: Preeclampsia is a disorder of pregnancy without any specific reasons that characterized by high blood pressure and large amounts of protein in the urine. This disorder is caused by multiple factors and finding any factor related to this disorder can help on time prevention of this disease. OBJECTIVE: In this study, serum levels of calcium (Ca), magnesium (Mg) and zinc (Zn) were evaluated in preeclampsia women and compared to normotensive ones. MATERIALS AND METHODS: This was a case-control study on 40 normotensive pregnancies as controls, 20 mild and 20 severe preeclamptic pregnancies as case groups. The women were studied in their 28-40 weeks of pregnancy. Simple random sampling was done based on inclusion and exclusion criteria and data were collected by blood sampling. RESULTS: The serum Ca levels of 4.96±0.62, 4.89±0.34, 5.05±0.35 mg/dL, Mg levels of 0.83±0.08, 0.85±0.11, 0.84±0.11 mg/dL and Zn levels of 107.55±22.74, 108.00±22.40, 107.50±22.30 mg/dL was detected in normotensive, mild and severe preeclampsia, respectively. Statistical analysis revealed that there were no significant differences between three groups in serum levels of Ca (p=0.6), Mg (p=0.827) and Zn (p=0.997). CONCLUSION: The findings of this study showed that the assessment of serum Ca, Mg and Zn levels does not have any clinical values for predicting and/or managing of preeclampsia. However, based on the positive relationship between serum Ca and Mg concentration and the severity of preeclampsia in this study, we recommend assessment of serum levels of these two mineral elements as indices of the severity of preeclampsia.

Screening of preterm labor in Yazd city: transvaginal ultrasound assessment of the length of cervix in the second trimester.

BACKGROUND: Spontaneous preterm labor is one of the common obstetrics problems causing several physical, psychological and economical outcomes. Although due to these outcomes and the efficacy of cares for decreasing them, preterm labor screening is cost-effective and it is still one of the challenging issues in obstetrics. OBJECTIVE: In this study preterm labor screening by using cervical transvaginal sonography was evaluated. MATERIALS AND METHODS: This observational cohort study was performed in Yazd, Iran. Samples were selected from pregnant women at gestational age of 21-24 weeks who had single live fetus and referred to the obstetrics clinics of two selected hospitals in Yazd. Gestational age was estimated based on the sonography of the first trimester and cervical length measured by transvaginal sonography. Data analysis was done by using t and x(2) test as well as ANOVA. Statistical significant level was considered as p<0.05. RESULTS: From 450 participants, 47 cases had preterm labor and 6 cases had positive funneling. Mean age of women with term labor was 26.09±4.13 years and that of women with preterm labor was 26.7±3.51 years (p=0.334). Duration of pregnancy and cervical length significantly differed between women with and without funneling (p=0.001). The sensitivity and specificity of screening based on cervical length of 25mm were 55.5% (50.9-60.1%) and 93.6% (91.2-96%) respectively. CONCLUSION: Based on the results of the present study, transvaginal ultrasound assessment of cervical length in low risk women has an acceptable reliability for screening of preterm labor.

Efficacy of tranexamic acid in reducing blood loss after cesarean section.

AIM: To assess the efficacy and safety of tranexamic acid in reducing blood loss at caesarian section (CS). METHOD: A prospective randomised study conducted on 90 primiparas divided into two groups who underwent CS. The study group, 45 women, received tranexamic acid immediately before CS, whereas the control group, 45 women received placebo. Blood loss volume was measured from the end of CS to 2 h postpartum and compared between the two groups. Hemoglobin (Hb) and hematocrit (Hct) were tested 24 h after CS and compared between the two groups. RESULTS: Tranexamic acid significantly reduced the blood loss from the end of CS to 2 h postpartum; 28.02 +/- 5.53 mL in the tranexamic group versus 37.12 +/- 8.97 mL in the control group (p = 0.000). Hb 24 h after CS was significantly greater in tranexamic group than control group (12.57 +/- 1.33 in the tranexamic group and 11.74 +/- 1.14 in the control group, p = 0.002). No complications or side effects were reported in either group. CONCLUSIONS: Tranexamic acid statistically reduces blood loss from end to 2 h after CS and its use was not associated with any side effects or complications. Consequently, tranexamic acid can be used safely and effectively to reduce bleeding resulting from CS.