No abstract

SARS-CoV-2, the leading cause of COVID-19 pandemic, was detected for the first time in Wuhan. In this study, we investigated the potential undesirable maternal and feto-neonatal consequences of COVID-19, and the related pathophysiological alterations in mother, neonate, and especially in the placenta as a vital organ, were reviewed. Also, the possibility of vertical transmission of virus and placental abnormalities were evaluated. The pregnant women were a vulnerable population for COVID-19, and several obstetric consequences were reported following SARS-CoV-2 infection. The higher risk of abruption, preterm labor, maternal death, stillbirth, intrauterine growth restriction, and newborns with fetal distress were adverse pregnancy and perinatal outcomes of COVID-19. Despite the ACE2 expression on placental components was confirmed, there is no agreement on the mother–child vertical transmission of this virus. Therefore, feto-neonatal consequences might be associated with placental abnormalities. The placental abnormalities are characterized by feto-maternal vascular malperfusion. Additionally, these adverse consequences lead to early termination of pregnancy in some cases, mostly via cesarean section. The pregnant women screening, coordination between healthcare personnel and neonatal unit, and infected women quarantine may decrease the risk of maternal and neonatal death after delivery.

Gabapentin at a dose of 300 mg/day is more effective for treatment of VMS among postmenopausal women than is 20 mg/day fluoxetine. Iranian Registry of Clinical Trials:IRCT2014092711019N3.

Objectives:Recent studies have shown that vitamin D deficiency is more common in women with uterine leiomyomas than in healthy women. Molecular investigations have also confirmed the role of vitamin D in the pathogenesis of uterine leiomyoma. The aim of the present study was to evaluate whether vitamin D administration is effective in the treatment of leiomyoma in patients suffering from vitamin D deficiency. Methods: This is a double-blind clinical trial (registration No. IRCT2014121511019N4). Fifty one women diagnosed with uterine leiomyomas who were also suffering from vitamin D deficiency were randomly divided into two groups: the intervention group (n = 26) and the control group (n = 25). The intervention group received vitamin D3 following the guidelines provided by an endocrinologist, while the control group received placebo. For each group, changes in the size of leiomyoma were measured. Furthermore, before the start of treatment and two and four months into the treatment, menstrual blood loss volume was assessed using the pictorial blood loss assessment chart (PBAC), pelvic pain was assessed by visual analogue scale (VAS), and serum hemoglobin level was also determined. These measurements were compared between the two groups. Results: At the baseline, the median of the total volume of leiomyoma in the intervention and control groups was 731.8 and 440.5 cm 3 , respectively. After four months of treatment, the aforementioned values were 691.1 and 404.9 cm 3 , indicating a significantly greater decrease in the volume of leiomyoma in the intervention group than in the control group (P = 0.014). The intervention group showed a significantly greater decrease in PBAC than the control group (P = 0.02). However, there were no significant differences between the two groups in the pain or menstrual blood loss indices. Conclusions: We conclude that the treatment of vitamin D deficiency in patients with uterine leiomyoma may reduce the size of leiomyoma.