fa اختلالات فشار خون ناشی از حاملگی های IVF: یک گزارش از کوزوو Original Article Original Article <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">مقدمه: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">در برخی مطالعات، ارتباط بین لقاح آزمایشگاهی (</span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">)، فشارخون بارداری و نتایج بارداری نشان داده شده است. با این حال، هنوز اینکه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> یا &nbsp;&nbsp;&nbsp;ویژگی&shy;های خاص بیماران نابارور مسئول نتایج بدتر حاملگی و اثر بر روی نوزادان باشد مورد بحث می&shy;باشد.</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف از انجام این مطالعه بررسی خصوصیات مادران مرتبط با اختلالات فشارخون (</span></span><span dir="LTR"><span style="font-size:10.0pt;">HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) در بارداری&shy;های </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> و ارزیابی نتایج حاملگی و نوزادان بود</span></span>.<span dir="LTR"></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">موارد و روش&shy;ها: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">این مطالعه توصیفی مقطعی با رویکرد </span></span><span dir="LTR"><span style="font-size:10.0pt;">STROBE</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> گزارش شده است. این مطالعه در مرکز بالینی دانشگاه کوزوو، دانشکده پزشکی دانشگاه پریشتینا انجام شد</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">.</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 207 زن باردار تحت درمان </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">به دو گروه تقسیم شدند: گروه بدون </span></span><span dir="LTR"><span style="font-size:10.0pt;">HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در طول بارداری (گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) و گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در دوران بارداری (گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF+HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">). داده</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">های مربوط به مادر، ماما و نوزاد در دو گروه مقایسه شد. مقادیر 0/05</span></span><span dir="LTR"><span style="font-size:10.0pt;">p<</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> معنی دار و 0/001</span></span><span dir="LTR"><span style="font-size:10.0pt;">p<</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> به عنوان بسیار معنی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">دار نظر گرفته شد.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">برخی از خصوصیات مادر در </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF+HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> نسبت به گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> به طور معنی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">داری بیشتر بود (مانند: سن بالاتر (0/0001</span></span><span style="font-size:10.0pt;">=</span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">)، تک اولادی (0/038</span></span><span dir="LTR"><span style="font-size:10.0pt;">p=</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">)، چاقی (0/0001</span></span><span style="font-size:10.0pt;">=</span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) و مصرف سیگار (0/0001</span></span><span style="font-size:10.0pt;">=</span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">). اختلاف معنی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">داری بین گروه</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">ها در مورد پیامدهای بارداری وجود نداشت همچنین زمان </span></span><span dir="LTR"><span style="font-size:10.0pt;">PROM</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF+HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> نسبت به گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> به طور معنی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">داری بیشتر بود (0/036</span></span><span style="font-size:10.0pt;">=</span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">). با توجه به نتایج نوزاد، تنها تفاوت آماری معنی&shy;داری در نمره 5 دقیقه آپگار بود که در گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF+HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> نسبت به گروه </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">بدون </span></span><span dir="LTR"><span style="font-size:10.0pt;">HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> بالاتر بود (0/002</span></span><span style="font-size:10.0pt;">=</span><span dir="LTR"><span style="font-size:10.0pt;">p</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">).</span></span><strong><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتیجه &shy;گیری: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">با توجه به تفاوت معنی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">داری در ویژگی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">های مادران </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> حاملگی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">ها با </span></span><span dir="LTR"><span style="font-size:10.0pt;">HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در مقایسه با حاملگی&shy;های بدون عوارض، پیشگیری از </span></span><span dir="LTR"><span style="font-size:10.0pt;">HD</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در&nbsp; &nbsp;حاملگی&shy;های به دنبال </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> در کوزوو به شدت پیشنهاد می&shy;شود. علاوه بر این، ایجاد یک ثبت ملی برای ارزیابی نتایج حاصل از درمان </span></span><span dir="LTR"><span style="font-size:10.0pt;">IVF</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> توصیه می&shy;شود.</span></span><strong><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;"></span></span></span></strong> <strong>Background:</strong> Relationships between in-vitro fertilization (IVF), gestational hypertension, and pregnancy outcomes are demonstrated in a number of studies. However, it is still debated if IVF treatment or specific characteristics of infertile patients are responsible for worse obstetrical and neonatal outcomes.<br> <strong>Objective: </strong>The aim of this study was to investigate maternal characteristics associated with hypertensive disorders (HD) in IVF conceived pregnancies and to assess the obstetrical and neonatal outcomes.<br> <strong>Materials and Methods:</strong> In this observational, cross-sectional study, 207 pregnant women who underwent IVF treatment were consecutively divided into two groups: a group that had no HD during pregnancy (IVF group) and a group that had HD during pregnancy (IVF+HD group). Maternal, obstetrical and neonatal data of the two groups were compared.<br> <strong>Results: </strong>Some maternal characteristics were significantly higher in IVF+HD compared to IVF group such as: older age (p=0.0001), primiparity (p=0.038), obesity (p=0.0001), and cigarette smoking (p=0.0001). There were no significant differences between the groups in regard to obstetrical outcomes besides premature rupture of membranes time that was significantly higher in IVF+HD group compared to IVF group (p=0.036). In regard to neonatal outcomes, the only statistically significant difference was in the 5th min Apgar score, which was higher in IVF+HD group compared to IVF group without HD (p=0.002).<br> <strong>Conclusion: </strong>With regard to significantly higher differences in maternal characteristics of IVF conceived pregnancies complicated with HD, compared to uncomplicated ones, development of a specific national prevention measure for HD of IVF conceived pregnancies in Kosovo is strongly suggested. In addition, setting up of a national registry is recommended in order to evaluate the outcomes of IVF treatments properly. لقاح آزمایشگاهی, فشار خون حاملگی, نتایج, کوزوو. In vitro fertilization, Gestational hypertension, Outcomes, Kosovo 77 82 http://ijrm.ir/browse.php?a_code=A-10-1-503&slc_lang=fa&sid=1 Merita Vuniqi-Krasniqi No Department of Gynecology, University Clinical Center of Kosova, Medical Faculty, University of Pristine, Prishtine, Kosovo Myrvete Paçarada No Department of Gynecology, University Clinical Center of Kosova, Medical Faculty, University of Pristine, Prishtine, Kosovo Qëndresë Daka qendrese.daka@uni-pr.edu Yes Department of Pathophysiology, University Clinical Center of Kosova, Medical Faculty, University of Pristine, Pristine, Kosovo Zeqir Dervishi No Department of Gynecology, University Clinical Center of Kosova, Medical Faculty, University of Pristine, Prishtine, Kosovo Astrit Bimbashi No University Hospital of Obstetrics and Gynecology Koço Gliozheni, University of Medicine, Tirana, Albania Kushtrim Dakaj No Dentistry School, Medical Faculty, University of Pristine, Pristine, Kosovo