Homeira Vafaei

Placenta accreta spectrum (PAS) is a severe obstetric condition associated with substantial maternal and neonatal morbidity. This study aimed to evaluate a

Cognitive Behavioral Therapy (CBT) is a non-pharmacological intervention that may reduce anxiety during pregnancy. This study aimed to evaluate the effect

A short cervical length (CL) in placenta accreta spectrum (PAS) may be associated with adverse outcomes. This study aimed to evaluate the impact of CL on m

Pregnancy in women with a history of liver transplantation is considered high risk due to concerns about graft function, immunosuppressive therapy, and maternal‐fetal complications. We present the case of a young woman who underwent liver transplantation for fulminant hepatic failure in adolescence and subsequently achieved two successful pregnancies with favorable maternal and neonatal outcomes. Her pregnancies were carefully managed through close collaboration between transplant specialists and obstetricians, with regular monitoring of graft function, immunosuppressive levels, and maternal‐fetal well‐being. Both deliveries were uneventful, and long‐term follow‐up revealed stable graft function and healthy children. A review of previously reported cases demonstrates that while risks such as preterm delivery, low birth weight, and hypertensive disorders exist, favorable outcomes are increasingly achievable with meticulous multidisciplinary care. This case highlights the potential for successful pregnancies following liver transplantation and emphasizes the importance of individualized management, patient counseling, and long‐term follow‐up.

Placenta accreta is a serious condition during pregnancy often leading to cesarean hysterectomy. This study aimed to investigate a novel hysterectomy metho

Isolated fetal pleural effusion is typically caused by agenesis or atresia of the lymphatic duct and can lead to lung compression, pulmonary hypoplasia, polyhydramnios, mediastinal shift, cardiac dysfunction, and fetal hydrops. Medium‐chain triglycerides (MCTs), compared to long‐chain fatty acids (LCFAs), are absorbed directly into the portal venous system, bypassing the lymphatic system during digestion, which reduces chyle production. We present two cases of severe unilateral fetal pleural effusion that completely resolved after maternal intake of MCTs and a restricted LCFA diet.

Background: Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetuses. Methods: This prospective study was conducted on 35 FGR, 32 SGA, and 33 Appropriate for Gestational Age (AGA) fetuses. Demographic data, amniotic fluid index, neonatal outcome, and Doppler velocimetry, including Umbilical Artery Pulsatility Index (UMAPI), Uterine Artery Pulsatility Index (UTAPI), Middle Cerebral Artery Pulsatility Index (MCAPI), Ductus Venosus Pulsatility Index (DVPI), and FOPI were documented. Kolmogorov-Smirnov normality test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis, non-parametric pairwise comparisons adjusted for Bonferroni correction, Pearson correlation test, Chi square, Fisher's exact test, and Receiver Operating Characteristic Curve (ROC) analysis with Youden's Index (sensitivity+specificity-1) to estimate cut-off point were used to analyze the data at significance level <0.05 for all tests. Results: FOPI cut-off points were 2.24 (sensitivity=77%, specificity=94%) and 1.15 (sensitivity=90%, specificity=20%) to predict FGR and SGA, respectively. FOPI showed a positive correlation with UMAPI and UTAPI (r=0.52 and r=0.30, P<0.001 and P=0.006, respectively), but not with MCAPI and DVPI (r=0.08 and r=0.12, P=0.50 and P=0.30, respectively). Besides, UMAPI, UTAPI, and FOPI were altered among patients with stages I and II FGR. Umbilical cord potential hydrogen (umbilical cord pH), 1- and 5-min Apgar score significantly increased by Birth weight centile; however, UMAPI, FOPI, and UTAPI significantly decreased. Conclusion: UMAPI is recommended to predict short-term neonatal morbidities and demonstrate the early or late onset FGR. Besides, FOPI is suggested as the first-line Doppler study to detect abnormal growth velocity. More studies are warranted, especially considering long-term neonatal morbidities.

Background: Penile duplication or diphallia is a rare congenital anomaly with unclear pathophysiological cause. Most cases of diphallia are reported postnatally; however, today with the use of a high-resolution ultrasound device, in-uterine diagnosis of many congenital anomalies is possible. Case presentation: Herein we report a multiparous mother at 25 weeks of gestation who referred due to an abnormal cystic structure protruding from a large abdominal wall defect located below the umbilicus that was noted during a routine exam. Target scan revealed two penile-like protrusions with an empty scrotal sac and double bladder in an otherwise normal fetus, which was confirmed postnatally. Neonatal microarray study and karyotype were normal. Conclusion: Diphallia could be detected prenatally as an isolated anomaly, associated with caudal duplication syndrome, or as an exstrophy-epispadias complex. As this is a rare congenital anomaly, all sonographers should be familiar with prenatal ultrasound features and associated anomalies, an important issue in prenatal counseling with parents, delivery planning, psychological support of the family, and postnatal management.

Objective: beta-thalassemia is a prevalent disease in Iran. The adverse effects of anemia on placental and neonatal outcomes have previously been shown. Women require additional iron during pregnancy and the anemia of women with beta-thalassemia may adversely affect the neonatal outcome and increase placental abnormalities. In this study, we compared the placental histology and neonatal outcomes among pregnant women with and without beta-thalassemia. Material and methods: In this population-based cross-sectional study, 144 pregnant women with beta-thalassemia minor (case group) were compared to 142 women without beta-thalassemia (control group). Women with singleton pregnancies over 20 weeks of gestation without pregnancy complications, anemia, collagen vascular diseases, or other hemoglobinopathies, all referred to hospitals affiliated to Shiraz University of Medical Sciences from March 2014 to February 2016, were included and maternal and neonatal data were extracted from medical records. After child birth, the placenta was evaluated for macroscopic and microscopic changes. Results: The frequency of LBW was significantly higher in the case group than that in the control group (19.7 vs. 9.7%, respectively) (p = .019). Six in the case group had gross abnormalities of placenta, while none in the control group (p = .03) and the case group had a higher frequency of chorangiosis, calcification, syncytial knot, and umbilical cord position (p < .05). Conclusion: As beta-thalassemia increases the chance of placental abnormalities, it is recommended to pay more attention to patients with beta-thalassemia, especially during pregnancy, to prevent placental and neonatal adverse outcomes.