Monireh Rahimkhani; Alireza Mordadi; Mohammad Zayandeh; Laya Sam
Volume 3, Issue 3 , September and October 2018, , Pages 111-114
Abstract
Aims: Preterm labors and abortions are among dangers that threaten mothers’ and infants’ lives. Several bacterial, viral, and parasitic agents can cause preterm labor and abortion. Among these bacterial agents, Chlamydia trachomatis plays a very key role. The aim of this study was to detect ...
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Aims: Preterm labors and abortions are among dangers that threaten mothers’ and infants’ lives. Several bacterial, viral, and parasitic agents can cause preterm labor and abortion. Among these bacterial agents, Chlamydia trachomatis plays a very key role. The aim of this study was to detect and isolate Chlamydia trachomatis from urine and its role in preterm labor.
Materials & Methods: This cross sectional study was carried out from 2016 to 2017 in AlMahdi Clinic under the supervision of Tehran University of Medical Sciences. 119 pregnant women who were in the first trimester of pregnancy (between 12 and 14 weeks) referred to a health center for screening tests were selected using available sampling method and were collected their urine samples. The obtained samples were centrifuged and the DNA was extracted from urine sediment. Using specific PCR kits for detecting Chlamydia trachomatis, the presence or absence of this bacteria was investigated in the urine sediment. The data were analyzed using Chi square test.
Findings: The rate of isolating Chlamydia trachomatis from the urine of these pregnant women was 6.72%. There was no significant relationship between chlamydia infection and history of abortion (p=0.93).
Conclusion: The level of the isolation of Chlamydia trachomatis from the urine of pregnant women is twice more than the level of its isolation from samples taken from vaginal and cervical discharge in pregnant women. Therefore, urine is an appropriate sample for the diagnosis of Chlamydia trachomatis since the sampling method is non-invasive and has more positive cases
Soheila Aminimoghaddam; Nastaran Abolghasem; Tahereh Ashraf- Ganjooie
Volume 3, Issue 3 , September and October 2018, , Pages 123-128
Abstract
Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients ...
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Introduction: Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients have metastatic disease when Gestational trophoblastic neoplasia (GTN) is diagnosed. GTN is unique in women malignancies because it arises from trophoblast but not from genital organs. It is curable with chemotherapy, low-risk GTN completely response to single-agent chemotherapy and does not require histological confirmation. In persistent GTN, clinical staging and workup of metastasis should be performed. The aim of the present study was to review the new management of GTD.
Conclusion In the case of brain, liver, or renal metastases, any woman of reproductive age who presents with an apparent metastatic malignancy of unknown primary site should be screened for the possibility of GTN with a serum HCG level. Excisional biopsy is not indicated to histologically confirm the diagnosis of malignant GTN if the patient is not pregnant and has a high HCG value. Given the vascular nature of these lesions, a biopsy can have significant morbidity. In every woman with abnormal bleeding or neurologic symptom without documented reason, the probability of malignant GTN should be in mind and determination of HCG titer is recommended. In selected cases with low-risk GTN, repeat curettage is done to reduce the need for chemotherapy courses. In recent years personalized medicine is encouraged for treatment of GTN.
Setareh Akhavan; Jila Agah; Abbas Alipour
Volume 3, Issue 2 , May and June 2018, , Pages 59-63
Abstract
Aims: Ovarian cancer is the 4th cause of women’s mortality occurring due to cancer. Malignant germ cell tumors (GCTs) account for 5% of malignant ovarian tumors and 70% of ovarian tumors in women between the ages of 10-30 years old. The aim of the present study was to detect the frequency of malignant ...
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Aims: Ovarian cancer is the 4th cause of women’s mortality occurring due to cancer. Malignant germ cell tumors (GCTs) account for 5% of malignant ovarian tumors and 70% of ovarian tumors in women between the ages of 10-30 years old. The aim of the present study was to detect the frequency of malignant ovarian germ cell tumor and distribution of demographic features in the most crowded gynecology oncology clinic.
Materials and Methods: This cohort descriptive-analytical study was conducted on cases with malignant ovarian tumor managed in Vali-Asr hospital, Tehran, Iran, from 2001 to 2018 (n=1540). The malignant germ cell tumors cases were extracted (n=128) and evaluated in point of epidemiologic and demographic data via the software SPSS 24.
Findings: 128 patients (8.3%) had GCTs. The average age was 23.88±7.85 years. 79.7% lived in the city, 76.6% had medium economic status and 53.6% had normal body mass index. Premature puberty was revealed in one person. Karyotype XY was detected in 5 persons. About 70.3% of the patients had no parity. In parous women, the highest percentage was related to a childbirth (55.0%). A history of infertility was detected at 6.1%. In 10 patients, the tumor was detected during pregnancy.
Conclusion: The highest frequency is related to the early young women with no considerable association with socioeconomic and weight status. It is possible that parity would be a protective factor for this tumor. In the case of adnexal mass during pregnancy, Malignant Germ cell tumors should be rolled out.
Azadeh Joulaee; Nasibeh Khaleghnejad-Tabari
Volume 2, Issue 4 , November and December 2017, , Pages 1-3
Abstract
The majority of cases are very young, less than 40 years old, which means they are out of the screening age range. For older pregnant women, screening is not done both due to possible radiation exposure of fetus and low accuracy of mammographyin pregnancy-induced highly dense breasts. Therefore, all ...
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The majority of cases are very young, less than 40 years old, which means they are out of the screening age range. For older pregnant women, screening is not done both due to possible radiation exposure of fetus and low accuracy of mammographyin pregnancy-induced highly dense breasts. Therefore, all the patients are symptomatic at presentation. Mass or ulcer in the breast, nipple or axilla; skin or nipple retraction, nipple scaling, unilateral uniduct spontaneous nipple discharge with any color, unilateral breast edema without or with redness (Peaud’orange) are the symptoms that bring the patient to her obstetrician. Thus, all pregnant women must be informed by their obstetricians about the possibility of breast cancer occurrence during pregnancy as well as all signs and symptoms of breast cancer. It should be noted that, stage by stage, the prognosis is the same as that of non-pregnant patients. Among the three breast imaging modalities, sonography is the first imaging procedure used for symptomatic pregnant women. It can safely be done during all trimesters of pregnancy. As always, sonography can differentiate solid tumors from cysts. Simple cysts are always benign, although they may present as large masses. Since there is no possibility for malignancy in these simple cysts, there would be no need for further follow-up because during the follow-up, their size and number can change or they may disappear spontaneously. These findings do not change our approach. In the case of large painful cysts, they can be aspirated using a needle either by surgeons or under the guide of sonography by a radiologist. On the other hand, if any solid mass is seen in the wall of a cyst, it is no longer a simple cyst and is considered as suspicious, thus classified as at least breast imaging reporting and data system (BIRADS) 4 needing immediate tissue diagnosis. Sonography, also, gives important information about solid tumors. By the evaluation of margins, vascularity, and elasticity, it can differentiate possibly benign tumor defined as BIRADS 3 from suspicious ones defined as BIRADS 4 or 5 that, again, need immediate tissue diagnosis. Well defined round or oval masses with fine margins without vascularity by Doppler evaluation and elastic, not rigid in elastography, are considered as possibly benign tumors or BIRADS 3 and can be followed by sonography instead of tissue diagnosis because the possibility of malignancy though not zero, is less than 2%. Sonography can, also, evaluate the lymp nodes in the breast and axilla; and diagnose the suspicious ones (thick cortex, round rather than kidney shape). If an LN is suspicious, tissue diagnosis is needed by needle biopsy which is usually done at the same time as the breast biopsy.
Masoumeh Mirteimouri; Seyedeh Azam Pourhoseini; Fahimeh Ghaneie Motlagh
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: HELLP syndrome is a life-threatening complication of preeclampsia. We report a young pregnant woman with HELLP syndrome who was diagnosed, managed, and delivered in a timely manner.
Case Presentation: A 23-year-old second gravida twin pregnant woman was referred to our clinic due to high ...
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Introduction: HELLP syndrome is a life-threatening complication of preeclampsia. We report a young pregnant woman with HELLP syndrome who was diagnosed, managed, and delivered in a timely manner.
Case Presentation: A 23-year-old second gravida twin pregnant woman was referred to our clinic due to high blood pressure. After delivery, she experienced a hemolytic condition with elevated liver enzymes and thrombocytopenia, defined as HELLP syndrome. After confirmation of HELLP syndrome by laboratory tests, the patient underwent hemodialysis and plasmapheresis. 10 days later, she was discharged under good general condition.
Conclusions: Women with a history of HELLP syndrome are considered to have an increased risk of death. Therefore, this life threatening condition should be closely monitored and treated in a timely manner.
Malihe Hasanzadeh; Mina Baradaran Khalkhale; Akram Behroznia
Volume 2, Issue 2 , May and June 2017
Abstract
Introduction: The prevalence of ectopic pregnancy is 1 to 2% and a previous cesarean section scar ectopic pregnancy or hysterectomy occurs as rare as 1 per 2000 pregnancies. In the current case report, the authors introduced ectopic pregnancy in cesarean scar with unstable hemodynamic condition and surgical ...
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Introduction: The prevalence of ectopic pregnancy is 1 to 2% and a previous cesarean section scar ectopic pregnancy or hysterectomy occurs as rare as 1 per 2000 pregnancies. In the current case report, the authors introduced ectopic pregnancy in cesarean scar with unstable hemodynamic condition and surgical management to preserve uterus.
Case Presentation: A 31-year-old pregnant female in the 9th week of pregnancy was admitted with vaginal bleeding and slight pain in the hypogastrium. The cesarean scar pregnancy was confirmed by sonography. In the course of hospitalization, due to the patient’s hemodynamic instability, the emergency laparotomy was performed. In the previous cesarean section scar, a 3 × 4 cm mass with a massive hematoma was found. It was removed and placental bed was sutured. Since the vaginal bleeding continued, the uterine artery ligation was carried out and due to severe bleeding, Foley catheters were packed inside the uterus. Two days later, the patient was discharged from the hospital in good general condition.
Conclusions: Despite the rarity of ectopic pregnancies in the previous cesarean section scars, paying attention and having this kind of pregnancy in mind can aid its early diagnosis and reduce possible morbidity and mortality including uterine rupture and severe bleeding, which can be considered as its irreversible complications.
Soheila Aminimoghaddam
Volume 2, Issue 2 , May and June 2017
Abstract
Combined oral contraceptive pills (OCPs) contain estrogen (ethinylestradiol) and progesterone (first-generation levonorgestrel and fourth-generation drospirenone). Progesterone has peripheral effects on the endometrium, fallopian tubes, and cervix and can promote contraception. These pills are used to ...
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Combined oral contraceptive pills (OCPs) contain estrogen (ethinylestradiol) and progesterone (first-generation levonorgestrel and fourth-generation drospirenone). Progesterone has peripheral effects on the endometrium, fallopian tubes, and cervix and can promote contraception. These pills are used to prevent pain caused by Mittelschmerz syndrome and endometriosis and to treat hyperandrogenism. To prescribe contraceptives, it is adequate to take the patient’s medical history and blood pressure. In the absence of risk factors, patients should be followed-up by history-taking, blood pressure measurement, urinalysis, Pap smear test, and examination of breasts, pelvis, and liver. The risk of venous thrombosis in new OCPs is twice higher than that of older generations and usually occurs in the first year of consumption. The only absolute contraindications for the use of new OCPs include chronic and acute cholestatic liver diseases. In fact, use of new OCPs increases the risk of liver adenoma, but not hepatocellular carcinoma. On the other hand, in female patients with genital tract cancers, risk of endometrial and ovarian epithelial cancers decreases following the use of OCPs. However, the risk of cervical adenocarcinoma increases after 5 years of consumption due to cervical eversion and impaired vitamin metabolism. These pills are contraindicated in women above 35 years who smoke more than 15 cigarettes daily or have uncontrolled hypertension, venous thromboembolism, migraine aura, severe hyperglycemia, breast cancer (diagnosed or suspected), or diabetes mellitus associated with cardiovascular diseases.
Maryam Moshfeghi; Mohammad Hossein Eftekhari
Volume 2, Issue 1 , March and April 2017
Abstract
Introduction: When a mother is contaminated with the parasitic protozoan Toxoplasma gondii as a primary infection in pregnancy, the golden test to confirm fetus infection is polymerase chain reaction (PCR), for the parasite DNA in amniotic fluid that may reach fetus and cause congenital toxoplasmosis. ...
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Introduction: When a mother is contaminated with the parasitic protozoan Toxoplasma gondii as a primary infection in pregnancy, the golden test to confirm fetus infection is polymerase chain reaction (PCR), for the parasite DNA in amniotic fluid that may reach fetus and cause congenital toxoplasmosis. Toxoplasmosis sometimes appears with very rare presentations that should be considered and treated to save mother and her baby.
Case Presentation: A 28-year-old pregnant mother was referred to the perinatology clinic of Shariati hospital, Tehran, Iran, for the diagnosis of her fetus problem. She was a rare case of congenital toxoplasmosis.
Conclusions: Diagnosis of toxoplasmosis in pregnancy is based on seroconversion of antibodies; based on many studies in the literature, the best method to confirm fetus is PCR for Toxoplasma gondii DNA in amniotic fluid.
Hamid Zahedi
Volume 1, Issue 3 , November and December 2016
Mahboobeh Shirazi; Fatemeh Shahbazi; Setareh Akhavan; Mohadeseh Sharifi Taskooh; Fatemah Azadi
Volume 1, Issue 3 , November and December 2016
Abstract
Backgroung: Given the importance of natural childbirth and emphasis on the normal vaginal delivery, and since important causes of having a C-section are lack of response to induction of labor with Syntocinon® injection and the fact that the cervix is unfavorable for labor.
Objective: The present ...
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Backgroung: Given the importance of natural childbirth and emphasis on the normal vaginal delivery, and since important causes of having a C-section are lack of response to induction of labor with Syntocinon® injection and the fact that the cervix is unfavorable for labor.
Objective: The present study aims at achieving the best method of cervical ripening for pregnancy termination to reduce the C-section rate, labor duration, economic burden, and labor pain.
Methods: In this regard, the current study examined the effect of hyoscine-N-butylbromide (HBB) on the progression of cervical ripening in normal vaginal delivery. In the current prospective double-blind controlled clinical trial, 60 pregnant females referred to Valiasr hospital (with the mean age of 27.2 years) were randomly divided into 2 groups of experimental and control; HBB and normal saline (placebo) were intravenously administered in the active phase of labor.
Results: The pain reduction in the patients, the duration of drug action until the cervical dilatation, the number of drug use for the full cervical dilatation, the time of the onset of the first, second, and third stages of labor, the length of hospitalization until the delivery, the drug effect on the fetus and mother, and the delivery method were evaluated in both groups. HBB significantly reduced the duration of the first stage of labor; however, it did not affect the second and third stages. Moreover, no negative effects were observed on the mother and fetus health.
Conclusion: According to the obtained results, it can be concluded that the intravenous injection of HBB can be applied as an effective drug for labor progress; however, further clinical studies with larger sample sizes are required to confirm these findings.
