Shahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001Caffeine versus Aminophylline for Apnea of Prematurity: A Randomized Clinical Trial47537810.18502/wjpn.v2i2.4338ENMohamad HoseinLookzadehDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranElahaJafari AbeshooriMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranMahmoodNoorishadkamDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranSeyed RezaMirjaliliDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranHamid RezaMohammadiCardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranFatemehEmambakhshsaniMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20201003 <br /> <strong>Background:</strong> Apnea of prematurity is often found in preterm neonates with gestational age less than 34-37 weeks or birth weight (BW) less than 1000 grams. The American Academy of Pediatrics defines apnea as a respiratory halt lasting at least 20 seconds, with bradycardia or cyanosis. Methylxanthines reduce the incidence of apnea. The purpose of this study was to compare the effect of caffeine and aminophylline on the incidence of the apnea in premature infants.<br /> <strong>Methods:</strong> This randomized clinical trial study was conducted on 80 premature neonates at Shahid Sadoughi hospital in Yazd. The first group received the initial dose of 5 mg/kg aminophylline diluted in 5% dextrose with a maintenance dose of 2 mg/kg every 8 hours, while the second group received 30 mg/kg of caffeine diluted in 5% dextrose with a 24-hour maintenance dose of 10 mg/kg.<br /> <strong>Results: </strong>There was no significant difference infrequency of apnea between the two groups (<em>P </em>= 0.121). However there was a significant difference in respiratory status between the two groups so that in caffeine group, oxyhood was less necessary for neonates (<em>P </em>= 0.012) and using continuous positive airway pressure (CPAP) was significantly less in aminophylline group (<em>P </em>= 0.012).<br /> <strong>Conclusion:</strong> Our study showed that the frequency of apnea was less in the caffeine group, but there was no significant difference between the two groups. Aminophylline treatment in comparison with caffeine can reduce the need for CPAP in neonates with apnea.https://wjpn.ssu.ac.ir/article_78_b63827c2de9eaae2a94cd909d484ab78.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001Assessment of the Frequency and Molecular Identity of Mycoplasma Species in Women with a History of Idiopathic Recurrent Abortion: A Case Control Study54607910.18502/wjpn.v2i2.4339ENHamidHasheminasabMedical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Yazd, IranMahdiehYavariDepartment of Biology, Faculty of Science, Yazd University, Yazd, IranMohammad JavadKazemiMedical Biotechnology Research Center, Ashkezar Branch, Islamic Azad University, Yazd, IranJournal Article20201003<strong>Background:</strong> Abortion is the most common complication in the first trimester of pregnancy. Infections are reported as the etiology of abortions. Some species of Mycoplasmas are seen in the lower genital tract. The aim of this study was to investigate the frequency and the molecular identity of Mycoplasma species in women with a history of idiopathic recurrent abortion.
<strong>Methods:</strong> This study was carried out on 68 women with a history of recurrent abortion<strong>. </strong>Detecting 16S rRNA to identify the infection of Mycoplasma was done by polymerase chain reaction (PCR) on cervical samples. Furthermore, the sequencing of positive samples was performed to identify the species of Mycoplasma.
<strong>Results: </strong>The results showed that only one woman with history of three times abortions was infected by Mycoplasma. Her gestational age was six weeks and she had apparent signs of infection. After sequencing, <em>Mycoplasma genitalium</em> was diagnosed as the infectious agent. The prevalence rate of Mycoplasma was 1.47% and 0% in the case and control groups, respectively. There was no significant association betweenabortion and Mycoplasma infection.
<strong>Conclusion:</strong> It seems more studies are necessary to evaluate the relationship between Mycoplasma infection and abortion. Moreover the increase in the level of public health due to better education and the improvement of contraceptive methods compared to the past has created a significant reduction in Mycoplasma infection.https://wjpn.ssu.ac.ir/article_79_ad179c53534762c3cc0006f27fef38d8.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001A Survey on Leading Indications of Fetomaternal Therapeutic Abortions in Yazd: A Cross Sectional Study61668010.18502/wjpn.v2i2.4340ENSamiraAsadollahiDiabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranMahtaMazaheriDepartment of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences,Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranRazieh SadatTabatabaeeDepartment of Obstetrics and Gynecology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd,IranSahelKhajehnooriDepartment of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences,Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran0000-0003-3750-140XMahmoodNoorishadkamMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMehdiMirjaliliLegal Medicine of Research Center, Forensic Medicine Organization, Yazd, IranMahdiGhazanfari-NasrabadLegal Medicine of Research Center, Forensic Medicine Organization, Yazd, IranJournal Article20201004<strong>Background:</strong> Congenital abnormalities are diseases that occur during fertilization of the egg or development of the fetus and lead to disability, illness or mortality. This study aimed to investigate the prevalence and the factors associated with fetomaternal abnormalities in therapeutic abortions.
<strong>Methods:</strong> This cross-sectional study was performed on 391 mothers referred to Yazd Legal Medicine Organization for pregnancy termination from March 2017 to March 2020. The data about mothers and their fetuses were extracted and recorded.
<strong>Results: </strong>The most common fetal abnormalities observed in this study were central nervous system abnormalities (21.1%), subsequently chromosomal disorder (16.8%), hydrops fetalis, cystic hygroma (15.9%), syndromic disorders (10.1%), single-gene disorders (8.1%), dysmorphology (8.1%), musculoskeletal disorders (7.8%), and cardiovascular disorders (7.2%).
<strong>Conclusion:</strong> The main maternal causes for therapeutic abortion were cardiovascular disease, kidney diseases and cancers, while the most common fetal disorders leading to therapeutic abortion were central nervous system disorders such as anencephaly.https://wjpn.ssu.ac.ir/article_80_01e5a9009c27c3258be0d0aca179f361.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001Coronavirus Disease 2019 (COVID-19) and late Pregnancy Loss in Infected Pregnant Women: A Mini Review67708110.18502/wjpn.v2i2.4342ENMahmoodNoorishadkamDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranMohamad HoseinLookzadehDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranMahtaMazaheriMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranSeyed RezaMirjaliliDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranRezaBahramiNeonatal Research Center, Shiraz University of Medical Sciences, Shiraz, IranFatemehAsadianDepartment of Medical Laboratory Sciences, School of Paramedical Science, Shiraz University of Medical Sciences, Shiraz, IranHosseinNeamatzadehMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMaryamSaeida ArdekaniMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20201004<strong>Background:</strong> One of the main issues for health care systems during the coronavirus disease 2019 (COVID‑19) was whether infected pregnant women would have pregnancy complications compared with healthy pregnant women during the pandemic. There was no sufficient data about the risk and rate of late pregnancy loss in pregnant women infected with COVID-19. In this study we reviewed the late pregnancy loss in infected pregnant women with COVID-19.
<strong>Methods:</strong> A comprehensive bibliographic search was conducted in PubMed, Google Scholar, SciELO, Springer Link, China National Knowledge Infrastructure (CNKI) platforms, and Wan Fang database to identify relevant studies published up to September 10, 2020.
<strong>Results: </strong>A total of seven cohort studies exclusively on late pregnancy loss and infected women with COVID-19 were included.
<strong>Conclusion:</strong> No evidence supported higher risk of late pregnancy loss in pregnant women with COVID-19. We suggested that the pandemic rapidly unfolds, it is critical that medical health care staffs keep up to date and caution should be undertaken to further study and monitor possible infection in the late pregnant mothers.https://wjpn.ssu.ac.ir/article_81_924a206a2acde98597b3131cb5fcf4b7.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001Investigation of Some Modifiable Risk Factors That Lead to Congenital Anomalies: A Review Article71798210.18502/wjpn.v2i2.4343ENFatemehAbdiDepartment of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMahdiehMehrvar.pDepartment of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranSimaValizadehMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMahtaMazaheriDepartment of Medical Genetics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20201004 Congenital anomalies are inborn errors of development. Genetic and environmental factors are known causes of congenital anomalies. Environmental factors are modifiable risk factors.<br /> This review focuses on modifiable risk factors for birth defects. There is a strong link between alcohol use and an increased risk of congenital anomalies. Marijuana can be expected to cause fetal growth restriction; smoking before conception, even with cessation in the first trimester, may also pose a risk for gastroschisis. Benzodiazepines during the first trimester were associated with Dandy–Walker malformation , anophthalmia or microphthalmia and esophageal atresia. While oral retinoids are absolutely contraindicated, topical retinoids, should conservatively be avoided during pregnancy but if were used by accident, the existing data can reduce the anxiety of happening adverse pregnancy outcomes. Antihypertensives such as labetalol, methyldopa and extended release nifedipine are relatively safe choices. Antiemetics such as doxylamine-pyridoxine and metoclopramide may have potential teratogenicity in first trimester. Ondansetron use was not significantly associated with major congenital anomalies but recent meta-analysis suggested more concern. An antiepileptic such as valproate poses the highest risk among antiepileptic drugs, whereas the prevalence of congenital anomalies is the lowest with lamotrigine, levetiracetam, and oxcarbazepine.<br /> Education and counseling to women who are planning to become pregnant can reduce the risk of congenital anolamies. https://wjpn.ssu.ac.ir/article_82_6b6684234fc8a1d2df9c8153e43486f1.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001Six Patients with Methylmalonic Acidemia and Their Outcome: Literature Review and Case Series80838310.18502/wjpn.v2i2.4344ENNaser AliMirhosseiniDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranSanaTaghiyarDepartment of Clinical Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranMahdiehSaatchiDepartment of Pediatrics, Shahid sadoughi University of Medical Sciences, Yazd, IranJournal Article20201004<strong>Background: </strong>Methylmalonic acidemia (MMA) is a congenital disorder due to the defects in the propionate pathway. It results from a deficiency in methylmalonyl coenzyme A mutase or one of the steps of the synthesis of the cobalamin (B12) cofactors for the enzyme. There is deficiency of methylmalonyl coA mutase (MCM) in the classic MMA.It presents with severe metabolic acidosis in the first month of life, progressive failure to thrive, feeding problems, recurrent vomiting, dehydration, hepatomegaly, lethargy, seizures, and developmental delay. Quantitative analysis of urinary organic acid patterns by GC-MS is used in MMA diagnosis. Treatment with large doses of hydroxocobalamin is helpful in some cases of MMA.<br /> <strong>Case Presentation: </strong>We Reported 6 patients with MMA with a variety of clinical manifestations and outcomes.<br /> <strong>Conclusion: </strong>The overall prognosis of classic MMA remains doubtful, whereas vitamin B12 responsive MMA has a reasonable outcome.https://wjpn.ssu.ac.ir/article_83_9e5287540e676e0eb515e6dab5822d4b.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001Jejuno-Jejunal Intussusception Caused by Meckel’s Diverticulum in a Neonate: A Case Report84868410.18502/wjpn.v2i2.4345ENMohamad HoseinLookzadehDepartment of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, IranMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranFatemehBaghalsafaMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranAbdolhamidAmooeeDepartment of Surgery, Shahid Sadoughi University of Medical Sciences, Yazd, IranSimaValizadehMother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IranDepartment of Emergency Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20201004<strong>Background:</strong> Intussusception is very rare in neonatal ages. It's one of differential diagnosis in gastrointestinal obstructions.<br /> <strong>Case </strong><strong>Presentation</strong><strong>:</strong> We reported a 5-day old baby who had bilious vomiting after every feeds. The baby had no bloody stool. She was admitted in NICU to rule out gastrointestinal obstruction. There was neither abdominal distension nor palpable abdominal mass. Abdominal ultrasonography was normal. Abdominal plain x-ray showed cut off sign and gray abdomen, intestinal loops were full of fluids. The patient underwent laparotomy. Jejuno-Jejunal intussusception was diagnosed. There was a diverticulum next to invagination area which was resected.<br /> <strong>Conclusion:</strong> Intussusception has to be in differential diagnosis of gastrointestinal obstruction and NEC. Abdominal ultrasonography and x-ray can be helpful in diagnosis. It might have high mortality and morbidity rates in case of late diagnosis and management.https://wjpn.ssu.ac.ir/article_84_c5a36402d213813e52933d5b0636b0e2.pdfShahid Sadoughi University of Medical SciencesJournal of Integrated Maternal and Pediatric Care3134-07922220191001A Rare Case of Central Diabetes Incipidus Due to Post Pituitary Gland Agenesis: A Case Report87908510.18502/wjpn.v2i2.4346ENNaser AliMirhosseiniDepartment of Pediatrics, Shahid Sadoughi University of Medical sciences, Yazd, IranFatemehTahghighiDepartment of Pediatrics, Shahid Sadoughi University of Medical sciences, Yazd, IranRezaNafisi MoghadamDepartment of Radiology, Shahid Sadoughi University of Medical Science, Yazd, IranJournal Article20201004<strong>Background:</strong> Diabetes insipidus is a syndrome that begins with polyuria and is often associated with polydipsia. Three significant differential diagnosis are important to consider in evaluating the causes of polyuria, including primary polydipsia, diabetes mellitus, and diabetes insipidus. In diabetes incipidus, ADH hormone is not synthesized and secreted in central DI or the hormone has lost its function in the renal tubules in nephrogenic DI type.<br /> <strong>Case </strong><strong>Presentation</strong><strong>:</strong> The present case was about 5.5 year-old-boy with polyurea and polydipsia from the beginning of the infancy. The patient had the serum osmolality of 277 mOsm/kg with the 24 hours urine volume of 4500 cc and urine osmolality of 200 mOsm/kg. The patient underwent water deprivation test for 12 hours. After administration of 20 μg of desmopressin spray, the urine osmolality increased to 720 mOsm/kg. Central diabetes insipidus was diagnosed. There was posterior hypophyseal agenesis in the brain MRI.<br /> <strong>Conclusion:</strong> The above patient seemed to be one of the rare cases of autosomal recessive central DI that became symptomatic with polyuria and polydipsia from the early days of life. This rare and interesting case had isolated posterior pituitary agenesis. Desmopressin treatment resolved the patient's complaints. The patient was asymptomatic, and had normal growth in one year follow up.https://wjpn.ssu.ac.ir/article_85_5df5132dc86265b99b85131b3909c5ee.pdf