zinat ghanbari; leila pourali; Tahereh Eftekhar; maryam deldar pesikhani; soudabeh darvish; zahra lotfi; elnaz ayati
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Defecatory dysfunction is a common problem among women who referred for urogynecological care. Pelvic organ prolapse (POP) which is a downward displacement of pelvic organs is one of the common condition among patients with defecatory problems . This study was planned to evaluate the correlation ...
Read More
Introduction: Defecatory dysfunction is a common problem among women who referred for urogynecological care. Pelvic organ prolapse (POP) which is a downward displacement of pelvic organs is one of the common condition among patients with defecatory problems . This study was planned to evaluate the correlation of obstructive defecatory symptoms with the site and severity of pelvic organ prolapse and the anorectal manometry results.Methods: This cross-sectional study was performed between Dec 2018 and Nov 2019. About 150 women with symptoms of defecatory problems were enrolled. Patients were classified in two groups according to each compartment prolapse staging and severity; stage ≤2 and stage >2. The correlation between defecatory symptoms and pelvic organ prolapse examination, anorectal examination and anal manometry were evaluated.Results: A total of 150women were evaluated. There was a significant correlation between higher stage of anterior compartment prolapse (cystocele stage>2) and constipation (P=0.035). Although all the defecatory symptoms were more frequent in anterior prolapse stage>2, but the difference was not significant (P>0.05).There was no significant correlation between defecatory symptoms and severity of posterior compartment prolapse. There was a significant correlation between stage>2 of apical prolapse and all the defecatory symptoms (P≤0.05). The abnormal anal resting and squeeze pressure and also abnormal balloon expulsion test were more frequent in stage >2 of all compartment prolapse, but the difference was not significant (P>0.05).Conclusion:Obstructive defecatory symptoms were more frequent in patients with higher stage of anterior and apical prolapse. Abnormal manometry results were more frequent in patients with defecatory dysfunction with advanced vaginal prolapse.
Obstetrics and Gynecology
Soheila Dabiran; Shahla Khosravi; Leila Pourali; Sedigheh Ayati; Zahra Mohaddes Ardebili; Shamim Delavari
Volume 8, Issue 1 , November and December 2022, , Pages 35-40
Abstract
Background & Objective: Delayed childbearing has become a worldwide phenomenon, yet the association between advanced maternal age (AMA ≥35 years) and pregnancy outcomes remains unclear. This issue has also been inadequately explored in Iran. To assess the relationship between pregnancy complications ...
Read More
Background & Objective: Delayed childbearing has become a worldwide phenomenon, yet the association between advanced maternal age (AMA ≥35 years) and pregnancy outcomes remains unclear. This issue has also been inadequately explored in Iran. To assess the relationship between pregnancy complications and AMA in the Iranian context.Materials & Methods: This cross-sectional study involved 891 women who had consecutive pregnancies and were referred for delivery to an academic hospital at Mashhad university of medical sciences, Mashhad , Iran, from March 2015 to March 2019 for The women were considered into the two age groups, namely, a 20 to 34year group and an AMA group, who were then assessed in terms of complications of late childbearing, such as preeclampsia, gestational hypertension, and gestational diabetes mellitus (GDM); mode of delivery; and five-minute Apgar score. The data were analyzed using the chi-square test and the Mann–Whitney U test in SPSS version 9. The P<0.05 was considered statistically significant.Results: The AMA group exhibited lower five-minute Apgar scores and a significantly higher prevalence of preeclampsia, gestational hypertension, and GDM (p < 0.05). The two groups also substantially differed concerningquality of prenatal care (p < 0.001). Regarding the mode of delivery, cesarean section was more prevalent in the AMA group, whereas vaginal delivery was more common in the younger group (p < 0.001).Conclusion: With regard to trend to pregnancy in higher maternal age and higher pregnancy complication in this population, precise preconception counseling is crucial to educating couples for early childbearing at younger age.
Obstetrics and Gynecology
Tahereh Eftekhar; Marzieh Hajibabaei; Leila Pourali; Maryam Vizheh; Ali Montazeri
Volume 6, Issue 3 , June 2021, , Pages 128-133
Abstract
Background & Objective: Vaginal laxity is a prevalent disorder that influences woman’s sexual satisfaction and quality of life. This study aimed to evaluate the impact of Higgs radiofrequency on pelvic organ prolapse and sexual function among women suffering from vaginal laxity.Materials & ...
Read More
Background & Objective: Vaginal laxity is a prevalent disorder that influences woman’s sexual satisfaction and quality of life. This study aimed to evaluate the impact of Higgs radiofrequency on pelvic organ prolapse and sexual function among women suffering from vaginal laxity.Materials & Methods: This was a pre- and post-intervention study. Twenty-two subjects who suffered from vaginal laxity referring to a pelvic floor clinic affiliated with Tehran University of Medical Sciences were studied. Higgs radiofrequency was administered at six sessions with a two-week interval. Women were evaluated by an urogynecologist for pelvic organ prolapse quantification (POP-Q) twice: before and three months after intervention. Also, women responded to the Female Sexual Function Index (FSFI-19) at baseline and three months follow-up assessment. Data were analyzed by descriptive statistics and paired samples t-test.Results: The mean age of participants was 40.30 (SD = 8.01) years. The mean number of gravidities was 2.45 (SD = 1.29). Seventeen women (77.3 %) suffered from severe or moderate vaginal laxity. After intervention, the point Ba (P < /em>=0.02), perineal body-point PB (P < /em>=0.058) and total vaginal length (0.014) significantly improved. Also, female sexual function and its six domains improved (P < /em><0.001).Conclusion: The findings indicated that Higgs radiofrequency was a safe and noninvasive technique that improved some pelvic organ prolapse quantification and sexual function among women suffering from vaginal laxity.
Leila Pourali; Sedigheh Ayati; Atiyeh Vatanchi; Anis Darvish
Volume 4, Issue 1 , March and April 2019, , Pages 42-44
Abstract
Introduction: Postpartum hemorrhage has different etiologies. One of the rare causes is inner myometrial laceration that makes the diagnosis more difficult. This report aimed to introduce a case of massive postpartum hemorrhage following an inner myometrial laceration.
Case Report: A 24-year-old primigravid ...
Read More
Introduction: Postpartum hemorrhage has different etiologies. One of the rare causes is inner myometrial laceration that makes the diagnosis more difficult. This report aimed to introduce a case of massive postpartum hemorrhage following an inner myometrial laceration.
Case Report: A 24-year-old primigravid woman referred to an academic Hospital due to hypertension of 140/90 and diagnosis of preeclampsia. Her pregnancy was terminated at 39th gestational week. She received two doses of 25 μg misoprostol sublingually. Subsequently, an induction was performed and normal vaginal delivery occurred. A 2800 gr infant was born. After the delivery, the patient suffered from massive postpartum hemorrhage which continued in spite of all medical treatments. With regard of unstable vital signs, laparotomy was done. By transverse uterine incision, a longitudinal inner myometrial laceration was found in the lower uterine segment, which was repaired, thus, hemorrhage was controlled.
Conclusion: An inner myometrial laceration is one of the differential diagnoses of postpartum hemorrhage which should be taken into consideration. Laparotomy and hysterotomy for repairing the inner myometrial laceration would control postpartum hemorrhage and could avoid hysterectomy.
Sedigheh Ayati; Leila Pourali; Atiyeh Vatanchi; Lida Jedi; Zahra Mohades Ardebili
Volume 3, Issue 4 , November and December 2018, , Pages 173-176
Abstract
Background & Objective: HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelet count; it probably shows a severe form of preeclampsia. This syndrome usually occurs in third trimester of pregnancy and may be associated with severe complications, including subcapsular ...
Read More
Background & Objective: HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelet count; it probably shows a severe form of preeclampsia. This syndrome usually occurs in third trimester of pregnancy and may be associated with severe complications, including subcapsular liver hematoma, eclampsia, pulmonary edema, liver or renal dysfunction, and even maternal death. This study aimed to report a case of maternal death misdiagnosis of HELLP syndrome.
Case Report: A 28-year-old pregnant woman with gestational age of 28 weeks referred to an emergency ward because of epigastric pain, nausea, and vomiting. She was discharged after receiving outpatient treatment. The next day, she was referred to the hospital because of seizure, decreased level of consciousness, and hypertension. A cesarean section was performed immediately. Unfortunately, some hours after the surgery, cardiac arrest occurred and she died in intensive care unit (ICU).
Conclusion: Nausea, vomiting, and epigastric pain in the late second or third trimester of pregnancy are among the significant symptoms which should be seriously taken into consideration. Therefore, it is recommended that a patient be hospitalized and precise evaluation be performed to rule out the life-threatening differential diagnoses, like HELLP syndrome, and to prevent dangerous complications which can lead to maternal death.
Sedighe Ayati; Leila Pourali; Atiyeh Vatanchi; Sara Mirzaeian; Elnaz Ayati; Zahra Mohaddes Ardebili
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: Myoma is the most common benign tumor of the female genital tract. The incidence of myoma increases with age. It mostly presents in the fifth decade of life. Since myoma is often asymptomatic and incidentally diagnosed, the true prevalence is unknown. This tumor may also become symptomatic ...
Read More
Introduction: Myoma is the most common benign tumor of the female genital tract. The incidence of myoma increases with age. It mostly presents in the fifth decade of life. Since myoma is often asymptomatic and incidentally diagnosed, the true prevalence is unknown. This tumor may also become symptomatic and affect women’s quality of life. This study was performed to report a rare case of vaginal myomectomy in post-partum severe hemorrhage caused by a submucosal myoma.
Case Report: A 39-year-old G2P1 woman with previous cesarean section and decreased fetal movement at 38th week of gestation was hospitalized. In sonography and biophysical profile, due to fetal compromised, pregnancy was terminated. After delivery of fetus, a submucosal myoma (12 × 12 cm) was protruded through cervical canal. Massive hemorrhage occurred and then vaginal myomectomy was done and the bed of myoma was packed with two long gauzes that removed after one day.
Conclusions: Vaginal myomectomy after natural vaginal delivery or possibly during cesarean section is a safe and reliable method to remove submucosal myomas especially large myomas and decrease the risk of complications and costs of re-surgery. Due to the increased risk of hemorrhage, it is better to conduct this surgery in third-level referral hospitals.
