Background: The purpose of the present study is the comparison between the effect of oxytocin alone or in combination with propranolol on the labor.

Materials & Methods : A double blind randomized controlled trial was performed on 150 nuliparas with gestational age of 39-41 weeks of pregnancy and Bishop score of ≤5, singleton, and cephalic presentation. The patients were randomly assigned in two groups. In the first group (oxytocin group=75), oxytocin was started at the rate of 2 mIu/ml and increased to a dose of 2 mIu/ml every 15 minutes until desired contractions were obtained Then it was continued at this rate for 8 hours. If the patients entered the active phase of labor, induction would be continued until delivery otherwise, the induction would be discontinued and patients would be transferred to the pre-labor ward, and on the next day, the protocol was performed again, unless patients were entered the active phase and deliver, cesarean would be performed. In the second group (propranolol group=75 cases), before the beginning of oxytoicn, 2mg propranolol was slowly injected intravenously then the oxytocin was initiated similar to the previous group and, in the second day of induction, before beginning of oxytocin, a 2mg propranolol was injected intravenously again and inductions were performed completely like the other group.

Results: There were no statistically significant difference between the two groups according to maternal and gestational age, primary Bishop score and neonatal birth weight. The number of patients who delivered at the first day did not show statistically significant difference between the two groups. [54 (72%) patients in Oxytocin group vs 62(82.6%) patients in propranolol group]. The mean duration for obtaining good contractions was shorter in propranolol group in the both first and second day of induction (2.59±0.87 h vs 3.7±2 h, p=0.000 for the first day and 1.8±1 h vs 3.9±0.89 h, p<0.002 for the second day). The mean interval between the beginning of induction until the beginning of active phase (3-4 cm dilatation of cervix) at the first day of induction was significantly shorter in propranolol group (3.6±1.6 h vs 5.6±2.4 h, p=0.000). The mean interval between the beginning of induction until delivery at the first day of induction was significantly shorter in propranolol group (7.67±2.5 h vs 10.18±4.1 h, p=0.000). The amount of necessary oxytocin for the first day of induction was less in propranolol group (14372.8±8209 mIu vs 11362±4013 mIu, p<0.005). The other variables did not show statistically significant difference between the two groups according to the neonatal Apgar scores of minute 1 and 5. The cesarean rate in oxytocin only group was 9 cases (12%) and in propranolol group was 7 cases (9.2%), without any significant difference.

Conclusion: Propranolol may shorten the induction duration and labor and reduce the amount of necessary oxytocin.

Background: Preterm delivery is one of the important problems in obstetrics and finding a way for its prediction and prevention has always been under investigation.

Materials and Methods: This study carried out to determine whether human chorionic gonadotropin (HCG) detected in cervicovaginal secretion of patients with symptoms suggestive of preterm labor is a predictor of preterm birth, and to determine the cut-off values for HCG in prediction of delivery before 37 weeks of pregnancy. 150 pregnant women with gestational age 24-34 weeks and diagnosis of preterm labor and intact membrane were enrolled to the study. The patients were allocated in two groups and HCG in cervicovaginal secretion was measured in all of them. The patients were followed until their delivery and were divided in two groups. Seventy one cases delivered after 37 weeks of pregnancy (term) and 79 before 37 weeks (preterm). The amount of HCG in cervicovaginal secretion of the two groups was compared.

Results: Mean concentration of HCG in cervicovaginal secretion in term group was 7.9 ± 34.1 miu/ml and in preterm group 61.12 ± 66.84 miu/ml which was statistically significant (p<0.001). A significant positive correlation was found between the cervical HCG concentration, gestational age at the time of sampling (p<0.01, r=0.2), cervical dilatation (p<0.001, r=0.54) and cervical effacement (p<0.001, r=0.43), and a significant negative correlation between the cervical HCG concentration, gestational age at the time of delivery (p<0.001, r=-0.4). The cut-off value for cervical HCG concentration, its sensitivity, specificity, positive and negative predictive values and accuracy for determination of delivery before 37 weeks of pregnancy were 9.5 miu/ml, 92.4% (95%CI= 83.6-96.9), 87.3% (95%CI= 76.8-93.7), 89%, 91.27% and 90%, respectively. However, these characteristics for HCG concentration of 10.5 miu/ml were 79.7% (95%CI =68.9-87.6), 93% (95%CI =83.7-97.4), 92.6%, 80.5% and 86% respectively, and for HCG concentration of 13.5 miu/ml were 73.4% (95%CI= 62.1-82.4), 98.6%(95%CI =93.1-99.9), 98.3%, 76.9% and 85.3% respectively.

Conclusion: Quantitative HCG concentration measurement from cervicovaginal secretions may be a useful predictor of preterm birth in symptomatic patients. This test has the advantage of low cost and wide availability.

Background: The epidemiological studies have shown that the excessive iodine intake leads to autoimmune thyroid diseases with an unknown mechanism. Moreover, previous studies have shown that the disturbance in the circulating cytokines can lead to the autoimmune diseases. To determine the role of iodine in cytokine production and development of thyroid autoimmune diseases, whole blood was stimulated with NaI (10 mM) and I2 (0.5 mM).

Materials and Methods: After evaluation of the laboratory results of the 25 healthy females (aged 40-45 years), 10 subjects with the matched results were selected. Ten ml of the sterile heparinized peripheral blood was taken from each subject and immediately were divided into the 6 groups: control, NaI stimulated, I2 stimulated and matching groups in presence of the standard stimulators (LPS 1μg/ml & PHA 10μg/ml). Three identical groups were setup to investigate the cytokine production at 24, 48, and 72 hours. All samples were incubated in cell culture incubator (95% O2 and 5% CO2) and after elapse of the appropriate time, plasma separated from each well were kept at -70 ºC till the time of cytokines (IL-4, IL-10, INF- and TGF-1) analysis.

Results: NaI significantly decreased the production of TGF-1 at all time points (P<0.02), while it did not affect the level of other cytokines. On the other hand, I2 significantly decreased the level of IL-4 and IL- 10 (P<0.01). In the presence of LPS/PHA, NaI also reduced the production of IL-10 (P<0.02), while I2 decreased the level of IL-4 as well as IL-10 (P<0.01).

Conclusion: Results of this study indicate that the high levels of NaI and I2 may reduce the level of the protective cytokines in circulation. Finally, since neither thyroid hormones nor thyroid glands had role in this process, it may be concluded that thyroid autoimmunity is initiated from high consumption of iodine leading to the imbalance in cytokine production.