Obstetrics and Gynecology
maryam dehghan; tajosadat alameh; Zahra Allameh; zahra Seyed-Hoseini
Volume 8, Issue 2 , March and April 2023, , Pages 113-119
Abstract
Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly ...
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Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter or misoprostol modes. Cervical ripening in Foley catheter group was done with transcervical Foley catheter 18, and in misoprostol group with 25 μg single dose vaginal misoprostol (The maximum allowed dose for patients was 6 doses.). Bishop score, Apgar score, active phase duration, stage 2 duration and insertion to delivery interval were the main outcomes.Results: The mean time of ripening and the active phase in vaginal misoprostol group was significantly shorter than in Foley catheter group (2.32 versus 5.11 hours respectively, P-value = 0.0001). After intervention, Bishop score in vaginal misoprostol group was significantly more than Foley catheter group (8.70 versus 6.68 respectively, P-value = 0.0001). Insertion to delivery interval in vaginal misoprostol group was 9.54 hours and in Foley catheter group was 12.88 hours (P-value = 0.0001). The hospitalization time in Foley catheter group was significantly more than vaginal misoprostol group (P-value = 0.0001). The other outcomes were similar between groups.Conclusion: By the decreasing in the total time from insertion to birth, vaginal misoprostol was more effective than Foley catheter, as a cervical ripening method in our study.
Maternal Fetal Medicine
Tajossadat Allameh; Zahra Allameh; Zahra Javanmardi; Elham Moazam; Maryam Dehghan
Volume 8, Issue 2 , March and April 2023, , Pages 131-136
Abstract
Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean ...
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Background & Objective: Due to the uncertainties of maternal and neonatal complications after delivery and the lack of similar studies in this regard, this study aimed to compare the maternal and fetal complications of vaginal birth after C-Section (VBAC), natural delivery and repeat Cesarean section in Isfahan province.Materials & Methods: In this one-year descriptive cross-sectional study, 49889 pregnant women who had the natural childbirth (29631 deliveries), elective repeat Cesarean section (20148 deliveries) and VBAC delivery (110 deliveries) were enrolled, then maternal and neonatal complications were compared in three groups.Results: There was a significant difference between the three groups based on the maternal and neonatal outcome, Apgar scores in the first and fifth minutes after delivery and the need for resuscitation at birth (P <0.05). Neonatal outcome was better in natural delivery and then VBAC compared to repeat C-section, respectively. Maternal outcome was better in VBAC and then repeat C-section than the natural childbirth. Apgar scores in the first and fifth minute were better in VBAC, and later natural delivery than repeat C-section. Resuscitation at birth demonstrated better results for natural delivery and then VBAC than repeat C-section.Conclusion: Utilizing VBAC and natural delivery have better maternal and fetal outcomes compared to C-section, along with being more satisfactory and safer.
Gynecology Oncology
Fariba Behnamfar; Fatemeh Ahmadi Solush; Tajossadat Allameh
Volume 8, Issue 1 , January and February 2023, , Pages 11-16
Abstract
Background & Objective: Cervical Cancer (CC) is a common cancer which is associated with HPV-infection. The aim of this study is to investigate the risk factors which affects HPV-clearance.Materials & Methods: This study was carried out on women with high risk HPV infection. All the patients ...
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Background & Objective: Cervical Cancer (CC) is a common cancer which is associated with HPV-infection. The aim of this study is to investigate the risk factors which affects HPV-clearance.Materials & Methods: This study was carried out on women with high risk HPV infection. All the patients underwent pap smears and cervical biopsy. Demographic data, marital status, vaccination history and consumption of tobacco, alcohol, opium and oral contraceptive pills were asked through a questionnaire. Results: The results showed that in one year follow-up, 142 (67.1%) patients showed HPV clearance. The HPV clearance decreased by increasing age (P=0.028) or higher CIN grades (P=0.017). In case of parity, there was no significant difference in univariate analysis (P=0.147), but it was significant in multiple logistic regression analysis (95% CI: 0.413-0.941, OR=0624, P= 0.024).Conclusion: It seems that age and cervical histology at the start of HPV infection are the most important factors for HPV clearance.
Pathology
Tajossadat Allameh; Behnoosh Mohamadi
Volume 8, Issue 1 , January and February 2023, , Pages 76-80
Abstract
Signet ring stromal tumor is a rare benign ovarian neoplasm, of which only about 17 cases have been reported since 1996. The signet ring appearance of this tumor may mimic a Krukenberg tumor and result in a diagnostic challenge in some cases. The previous cases occurred in adult or in old patients. We ...
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Signet ring stromal tumor is a rare benign ovarian neoplasm, of which only about 17 cases have been reported since 1996. The signet ring appearance of this tumor may mimic a Krukenberg tumor and result in a diagnostic challenge in some cases. The previous cases occurred in adult or in old patients. We have reporteda Signet ring stromal tumor in a 13-year-old girl.
Gynecology Oncology
Tajossadat Alameh; Leila Mousavi Seresht; Noshin Afshar; Behnoosh Mohamadi Jazi
Volume 7, Issue 5 , July and August 2022, , Pages 452-457
Abstract
Background & Objective: Primary lymphoma of the cervix is rare and can be misdiagnosed most of the time. On the other hand, there is no consensus on the best treatment and follow-up strategy for this type of cervical malignancy. The present study aimed to present a misdiagnosed primary cervical lymphoma ...
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Background & Objective: Primary lymphoma of the cervix is rare and can be misdiagnosed most of the time. On the other hand, there is no consensus on the best treatment and follow-up strategy for this type of cervical malignancy. The present study aimed to present a misdiagnosed primary cervical lymphoma due to its confusing presentation and rarity.Case Report: A 41-year-old woman presented with abnormal vaginal discharge and dyspareunia complaints. Unfortunately, the patient was not examined, and cervicitis was reported on biopsy. Therefore, the patient was treated for vaginitis for a long time. Due to a lack of response to antibiotic therapy, an ultrasound was performed, which showed a huge mass in the cervix. Patient was referred to the oncology department of obstetrics and gynecology center, Beheshti Hospital, Isphahan, Iran, in July 2013. Diffuse large B-cell lymphomas was diagnosed on a CT-guided biopsy of the presacral mass. Fortunately, despite the delay in diagnosis, 5 years after the last R-CHOP chemotherapic session (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient has good quality of life with no sign of recurrences.Conclusion: Due to the rarity of uterine cervix lymphoma, the diagnosis of genital lymphoma could be missed if the clinician does not consider this malignancy. High suspicion, rapid diagnosis and proper communication between clinician and pathologist lead to an excellent prognosis.
Obstetrics and Gynecology
Tajossadat Allameh; Maryam Kalatehjari
Volume 7, Issue 4 , March and April 2022, , Pages 279-285
Abstract
Background & Objective: Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes ...
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Background & Objective: Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes of colposcopy in contrast to Pap smear. The current study aims to assess the values of colposcopy for cervical cancer diagnosis.Materials & Methods: This is a cross-sectional study conducted on 94 patients diagnosed with high-grade squamous intraepithelial lesion (HSIL). After that, colposcopy was performed for all patients, and findings were presented as normal, chronic cervicitis, the thin acetowhite lesion (AWL), dense/thick AWL, AVP, pilling, and cauliflower-like mass. The biopsies were taken and pathological studies, as the gold standard was interpreted as normal, cervicitis, atypical squamous cells of undetermined significance (ASCUS), cervical intraepithelial neoplasia-1, -2 or -3 (CIN-1, -2 or -3), carcinoma-in-situ (CIS), adenocarcinoma and invasive squamous cell carcinoma (SCC).Results: The pap-smear results were significantly associated with the biopsy reports (P < /em><0.001; kappa=0.225). Besides, significant concordance was found between colposcopy and biopsy (P < /em><0.001; kappa=0.247). The total sensitivity and specificity of colposcopy were based on the biopsy findings as the gold standard was 97% and 41%, respectively (P < /em><0.001).Conclusion: Colposcopy was significantly sensitive and specific for diagnosing both non-malignant CIN-1 and malignant cervical lesions, but not for CIN-2, -3, and CIS lesions. Further evaluations are strongly recommended.
Gynecology Oncology
Tajossadat Allameh; Maryam Nazemi; Leila Mousavi Seresht; Behnoosh Mohamadi
Volume 7, Issue 2 , September and October 2021, , Pages 126-130
Abstract
This case report aimed to describe the clinical symptoms, pathological features, treatment, and prognosis of two cases of vulvar dermatofibrosarcoma protuberans (DFSP). Two Iranian women aged 37 and 35 presented with a nodular mass lesion in labia major and were initially diagnosed with DFSP in the vulva. ...
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This case report aimed to describe the clinical symptoms, pathological features, treatment, and prognosis of two cases of vulvar dermatofibrosarcoma protuberans (DFSP). Two Iranian women aged 37 and 35 presented with a nodular mass lesion in labia major and were initially diagnosed with DFSP in the vulva. Magnetic resonance imaging of the abdominopelvic region showed a small round lesion in the right side of the vulva vaginal region. The excisional procedure was performed under general anesthesia, and postoperative recovery was uneventful. Histopathology reported DFSP, which is a rare vulvar tumor. The patients were further investigated by computed tomography scan for metastasis, showing that the chest, abdomen, and pelvis were normal. The outcome was favorable. The DFSP is a rare tumor, constituting only 0.1% of all malignancies. Vulvar DFSP is exceptionally rare.
Gynecology Oncology
Fariba Behnamfar; Safoura Rouholamin; Taj Sadat Allameh; Fahimeh Sabet; Leila Mousavi Seresht; Maryam Nazemi
Volume 7, Issue 1 , September and October 2021, , Pages 32-37
Abstract
Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated ...
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Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated with Isfahan University of Medical Sciences (IUMS) during 2020 and 2021. The laparoscopic predictive index value (PIV) score (range: 0-14) was calculated for all patients. In patients with PIV scores <8, primary cytoreductive surgery (PCS) was performed, and patients with scores ≥8 were candidates for neoadjuvant chemotherapy (NACT). In the PCS group, laparotomy scoring and surgical findings for each anatomical area were registered for all patients, and concordance between laparoscopy and laparotomy findings was compared. Residual disease following PCS was documented for all patients.Results: A total of 27 patients underwent laparoscopic scoring surgery; 25 patients (92/5%) had a PIV score <8, and two patients (7/5%) had a PIV score ≥8. There was 92% agreement between PIV scores at laparoscopy and laparotomy. Agreements in different anatomical regions in laparoscopy and laparotomy were as follows: involvement of the bowel 76%, mesenteric 92%, liver 96%, omental 92%, diaphragm 96%, stomach 100%, peritoneal carcinomatosis 96%. A laparoscopic PIV score of <8 had a PPV of 84% at predicting R0 at PCS.Conclusion: Laparoscopic scoring is a precise approach in the management of patients with advanced ovarian cancer. Laparoscopic scoring is a screening method of selecting patients for primary surgery or NACT and improved R0 resection at PCS. The present study was designed to assess patients who would gain the maximum benefits from primary surgery.
Obstetrics and Gynecology
Tajossadat Allameh; Maryam Dehghan
Volume 6, Issue 4 , August 2021, , Pages 202-208
Abstract
Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical ...
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Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical glandular cells (AGCs) referred to gynecology clinics in Isfahan, Iran, and seventy women were selected to undergo Pap smear test, colposcopic examination and ECC. EMC was performed in women older than 35. Pap smear test results were classified as normal, inflammation, AGCs and necrosis. Colposcopy, ECC and EMC findings were classified as normal, benign and malignant pathologic lesions.Results: Repetitive Pap smears findings were as follows: 15.7% were normal, 77.2% had inflammation, 4% had AGC and 3.1% had necrosis. Based on colposcopy findings, 61.2%, 7.5%, and 31.3% of the samples were classified as normal, benign and malignant, respectively. ECC findings in 95.5% of women was indicative of benign lesions and malignant lesions in 4.5%. EMC findings showed that 79.7% were normal, 8.5% had benign lesions and 11.9% had malignant lesions. Pap smears with several AGCs were associated with benign lesions in 24.2% of the cases and premalignant and malignant lesions in 14.2% of the cases.Conclusion: According to our study, due to the significant association between AGC cytology and pathologic cervical and endometrial lesions, intensive assessment is necessary in women with AGC Pap smears, especially in older and post-menopausal women, in order to reduce mortality.