Obstetrics and Gynecology
Khor Chun Kit; Christine Na Sin Ee; Jackie Wong Kee Hung; Aiswaryaa Devi A/P Tambi Selvam; Chan Sue Vern; Lee Lionel; Hussein Akl; KAVITHA NAGANDLA
Volume 8, Issue 2 , January and February 2023, , Pages 105-112
Abstract
Background and Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy, however medical treatment is an option for those who wish to preserve fertility. ...
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Background and Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy, however medical treatment is an option for those who wish to preserve fertility. This systematic review aims to assess the efficacy of levonorgestrel-releasing intrauterine device as medical management in women who have adenomyosis.Methods: We searched PubMed, Cochrane and Scopus databases from 2000 to November 2019 for relevant studies containing the use of levonorgestrel-releasing intrauterine device (LNG-IUD) in managing patients with ultrasonographic diagnosed adenomyosis. Main outcomes measures in the study are menstrual blood loss (milliliters), pain score measured in 10cm-visual analogue scale, and uterine volume. Results: Pooled results from meta-analysis showed that after LNG-IUD treatment for adenomyosis, there is significant reduction in dysmenorrhoea measured using Visual Analogue Scale after six months Standardized Mean Difference (SMD), ( 3.68; CI: 2.11-5.25), twelve months (SMD: 4.23; CI: 2.99-5.48), 24 months (SMD: 4.69; CI: 3.40-5.97) and 36 months (SMD: 4.01; CI: 3.57-4.45); significant reduction in menstrual bleeding after six months (SMD: 2.52; CI: 1.15-3.89), twelve months (SMD: 3.43; CI: 1.64-5.22) and 24 months (SMD: 3.57; CI: 1.88-5.26); significant reduction in uterine volume after six months (SMD: 0.49; CI: 0.04-0.93), twelve months (SMD: 0.80; CI: 0.11-1.48) and 24 months (SMD: 0.86; CI: 0.15-1.58). Conclusion LNG-IUS is an effective method in alleviating the symptoms of adenomyosis. It is a valuable long-term alternative for the treatment of adenomyosis for young and perimenopausal women in terms of dysmenorrhoea and heavy menstrual bleeding.
Obstetrics and Gynecology
maryam dehghan; tajosadat alameh; Zahra Allameh; zahra Seyed-Hoseini
Volume 8, Issue 2 , January and February 2023, , Pages 113-119
Abstract
Background: 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.Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter ...
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Background: 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.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 birth time were the main outcomes.Results: The mean of time between ripening and the active phase in vaginal misoprostol group was significantly shorter than in Foley catheter group (2.32 versus 5.11 hour 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). Time from insertion to birth 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). 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.
Obstetrics and Gynecology
Shahla Mirgaloybayat; Sharareh Saneei; Marziyeh Ajdary; Saeedeh Sarhadi; Neda Eslahi; Foroogh Sadat Mousavi; farahnaz farzaneh
Volume 8, Issue 2 , January and February 2023, , Pages 120-124
Abstract
Introduction: Determining the correct date of pregnancy and fetal age has a very important role in the management of pregnancy from the first trimester to delivery, which makes it necessary to know the exact method in this field. Therefore, this study aimed to compare the accuracy of ultrasound ...
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Introduction: Determining the correct date of pregnancy and fetal age has a very important role in the management of pregnancy from the first trimester to delivery, which makes it necessary to know the exact method in this field. Therefore, this study aimed to compare the accuracy of ultrasound at 8-16 weeks with Naegele’s Revised Rule of the delivery date.Methods: This study was performed on 50 pregnant women. After recording demographic information and age of delivery, sonography of weeks 8-16 and Naegel’s Revised Rule were also recorded. A Paired t-test was used to compare data.Results: The results of our study showed that the average difference between the Naegele’s Revised Rule and real age was 3.52 days, which is a significant difference. However, the average difference between the estimated date by ultrasound and real age is 0.58 days, which is not a significant difference. Ultrasound is more accurate than the Naegele’s Revised Rule, which still did not differ significantly from the actual date of delivery by grouping by age, sex of the fetus, number of pregnancies, and deliveries.Conclusion: Ultrasound has more accuracy in accurately estimating the date of delivery, and therefore using this method and relying on it has more reliability than the Naegele’s Revised Rule.
Obstetrics and Gynecology
Mahsa Naemi; Maasoumeh Saleh; Mahboubeh Saleh
Volume 8, Issue 2 , January and February 2023, , Pages 125-130
Abstract
Preeclampsia (PE) is a major complication of pregnancy worldwide. Doppler ultrasound of maternal arteries, including uterine and ophthalmic arteries (OA), plays an important role in determining individuals progressing PE. The aim of this study is to compare OA indices in pregnant women with a diagnosis ...
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Preeclampsia (PE) is a major complication of pregnancy worldwide. Doppler ultrasound of maternal arteries, including uterine and ophthalmic arteries (OA), plays an important role in determining individuals progressing PE. The aim of this study is to compare OA indices in pregnant women with a diagnosis of PE and women without it. Out of 148 included participants, 48 cases progressed to PE at 35 to 37 weeks of gestation and 100 cases did not have PE at the same gestational age. All OA parameters including (First and second peak systolic velocities (PSV), Second to first PSV Ratio (PR) and Pulsatility Index (PI) in each eye; as well as, the average of these indices in both eyes) were assessed. PR and PI between the two eyes were statistically different in those with PE.
Obstetrics and Gynecology
Zena M. Al Hindawi
Volume 8, Issue 2 , January and February 2023, , Pages 137-142
Abstract
Background and Objective: Infertility in women can be attributed to a wide variety of factors, including inherited and acquired abnormalities of the uterus. Ultrasonography is used for determining the thickness of the endometrium during various phases of the menstrual cycle. The purpose of this study ...
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Background and Objective: Infertility in women can be attributed to a wide variety of factors, including inherited and acquired abnormalities of the uterus. Ultrasonography is used for determining the thickness of the endometrium during various phases of the menstrual cycle. The purpose of this study is to determine the thickness of the endometrium in women who are unable to conceive using ultrasound imaging during the secretory phase.Methods: A total of 134 adult females between the ages of 22 and 45 were examined by means of an endo-vaginal and transabdominal approach with EVN 4-9 MHZ and CA1-7AD probes, respectively, during the course of this research project, which took place in Imam Al-Hujjah Charitable Hospital, Karbala, Iraq, between February 2021 and April 2022.Results: The findings showed that primary infertility accounted for 69.4% of cases, which was significantly higher than women with secondary infertility, which accounted for 30.6% of cases. There were 68.8% of women who presented with primary infertility who had endometrial thickness between 9-12 mm, and there were 31.1% of women who presented with secondary infertility who had this thickness. 65.8% of women who are experiencing primary infertility and 34.1% of women who are experiencing secondary infertility have an endometrial thickness of 14-18 mm. Our study showed that 40% of women who suffer from primary infertility and 60% of those who have secondary infertility have an endometrial thickness of 19-23 mm.Conclusion: When it comes to diagnosing and treating infertility, ultrasound is a crucial tool for measuring the thickness of the endometrium in women.
Obstetrics and Gynecology
Roshan Nikbakht; mahvash zargar; farideh morammezi; asma motaharifard; Maryam Seyedtabib
Volume 8, Issue 2 , January and February 2023, , Pages 143-149
Abstract
Background: Frozen embryo replacement (FER) cycle is a procedure that assists in vitro fertilization (IVF) outcome by using the storage and transfer of excess embryos. This study evaluated the success of FER using spinnbarkeit and endometrial thickness.Materials and Methods: This cross-sectional study ...
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Background: Frozen embryo replacement (FER) cycle is a procedure that assists in vitro fertilization (IVF) outcome by using the storage and transfer of excess embryos. This study evaluated the success of FER using spinnbarkeit and endometrial thickness.Materials and Methods: This cross-sectional study was performed on 97 infertile women at the Imam Khomeini hospital of Ahvaz, from March 2019 to March 2020. Endometrium was prepared with Estradiol valerate from the third day of menstruation and followed by serial vaginal ultrasound till the thickness of the endometrium attain 7 millimeter to 8 millimeter. The cervical secretions were collected from the external os and were estimated based on centimeters. Also, endometrial thickness was recorded.Results: no substantial difference between endometrial thickness and spinnbarkeit in the FER cycles with pregnancy outcomes was observed (P>0.05).Conclusion: Some variables such as endometrial thickness, spinnbarkiet, estradiol dose intake, and quality of embryos have no relationship with the success of FER cycles.
Obstetrics and Gynecology
Hamideh Gholami; Sahar Farahmand; Fatemeh Moradiha
Volume 8, Issue 2 , January and February 2023, , Pages 150-156
Abstract
Background: Labor pain is one of the most severe pains that a woman may experience, so it is important to research the methods to reduce this pain. Paracetamol infusion is an efficient and available remedy to alleviate labor pain in an active phase. This study was conducted to assess the efficacy of ...
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Background: Labor pain is one of the most severe pains that a woman may experience, so it is important to research the methods to reduce this pain. Paracetamol infusion is an efficient and available remedy to alleviate labor pain in an active phase. This study was conducted to assess the efficacy of intravenous paracetamol injection on reducing labor pain.Methods: In this double-blind randomized clinical trial study, the number of 110 nulliparous pregnant women who were candidates for vaginal delivery were included in the study. After the onset of the active phase of labor, the control group received only 300 cc normal saline and the intervention group received 300 cc normal saline plus one gram of paracetamol. The maternal pain score, duration of the first and second stages of labor, delivery type and Apgar score were compared between two groups. Repeated measure ANOVA was used for comparison of means of the VAS score between groups based on repeated observations.Results: The mean age of the patients was 25.09 ± 4.2 years (18-35 years). The mean length of the first stage (2.85 vs. 3.52 hours, P = 0.001) and second stage (38.77 vs. 43.44 minutes, P = 037) in the intervention group was significantly lower than the control group. Moreover, the mean score of pain was significantly lower in the paracetamol group at all times than the control group (P <0.05).Conclusion: The prescription of intravenous paracetamol not only reduces pain during labor in women but also reduces the duration of different stages of labor, increases patients’ satisfaction with natural childbirth, and reduces the demand for Cesarean.
Obstetrics and Gynecology
Zinah hammad; Ban J. Edan
Volume 8, Issue 2 , January and February 2023, , Pages 167-172
Abstract
Background: One of the worldwide healthcare problems is Diabetes mellitus (DM), and the prevalence of this disease increases steadily, particularly in pregnancy. The several metabolic disorders in the pregnancy were revealed by the placenta. The pathogenesis of diabetes mellitus is associated with hyperglycemia, ...
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Background: One of the worldwide healthcare problems is Diabetes mellitus (DM), and the prevalence of this disease increases steadily, particularly in pregnancy. The several metabolic disorders in the pregnancy were revealed by the placenta. The pathogenesis of diabetes mellitus is associated with hyperglycemia, insulin resistance, and oxidative stress, and it negatively impacts the mother-placenta-fetus system. This research aims to compare the amount of leptin expression, as well as its score and intensity, in the placentas of women with diabetes with those of healthy controls.Materials and methods: In this work, we used a case-control methodology. Thirty women were diagnosed with diabetes and were placed in one group, while the other 40 served as a comparison. Primary monoclonal antibodies were used for the immunohistochemical analysis of leptin (Abcam, UK).Results: The patients group showed the greatest percentage (23%) of placental expression of leptin. The expression of leptin was high in around 53% of the patient population. The intensity of leptin expression was significantly higher in DM patient than control groups (P>0.05). About 77% of patients group had moderate intensity of leptin expression, while 37.5% of control group had no leptin expression.Conclusion: Diabetes mellitus was related with alterations in expressions of leptin as metabolic placental factor. Leptin may affect the pregnancy diverse disorders and pregnancy outcome.
Obstetrics and Gynecology
Saeedeh Shahali; Farnaz Sahhaf Ebrahimi; Simin Taghavi; Elnaz Afsari
Volume 8, Issue 1 , November and December 2022, , Pages 1-10
Abstract
Background & Objective: Diabetes mellitus and gestational diabetes are complications that may be associated with preterm premature rupture of the membrane (i.e. PPROM) during pregnancy. We have investigate the impact of gestational and overt diabetes on PPROM through a statistical campaign. Materials ...
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Background & Objective: Diabetes mellitus and gestational diabetes are complications that may be associated with preterm premature rupture of the membrane (i.e. PPROM) during pregnancy. We have investigate the impact of gestational and overt diabetes on PPROM through a statistical campaign. Materials & Methods: This study was conducted in two parts: In the first part, the PPROM patients (211 cases) were classified into three groups, without diabetes (W/ODM=126 cases), gestational diabetes (GDM=69 cases consist of 44 cases under insulin therapy and 25 cases of diet controlled), and diabetes mellitus (ODM=16 cases). PPROM complications were studied and compared between these three groups. In the second part, GDM patients under insulin therapy or diet control were compared to W/ODM patients in terms of PPROM complications. Results: There were no significant statistical differences between the groups regarding pregnancy outcomes, except, for mean gestational age at rupture of membrane and delivery. For maternal outcomes, there were significant changes between groups in terms of labor duration, hospital stay after childbirth, and severe preeclampsia. Fetus and neonatal outcomes suggested that the newborn weight, neonatal hyperglycemia, Apgar score, revive need, infant death, and umbilical cord blood gas test results (except BE) were significantly different between the three groups. Results of the second part of the study, in terms of statistically significant differences between insulin therapy, diet control, and W/ODM are consistent with the first part, for all discussed factors. Conclusion: Results revealed that PPROM protocol management on PPROM cases who have gestational or overt diabetes is applicable and does not have any further risk.
Obstetrics and Gynecology
Mahnaz Ashrafi; Sahar Golmohammadi
Volume 8, Issue 1 , November and December 2022, , Pages 23-28
Abstract
Background & Objective: Clomiphene resistance is an important problem among women with Polycystic Ovarian Disease (PCOD) suffering from infertility. Recognition of the causes would result in better prognosis in these patients. This study was performed to determine different PCOD phenotypes and ...
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Background & Objective: Clomiphene resistance is an important problem among women with Polycystic Ovarian Disease (PCOD) suffering from infertility. Recognition of the causes would result in better prognosis in these patients. This study was performed to determine different PCOD phenotypes and their effects on clomiphene resistance in infertile women.Materials & Methods: In this descriptive-comparative cross-sectional study, 200 consecutive PCOD women with infertility taking clomiphene who were reffered to Akbarabadi hospital in 2017 and 2018 were enrolled. Different PCOD phenotypes and their effects on clomiphene resistance among these women were assessed.Results: The results showed that A, B, C, and D phenotypes were observed in 79 (39.5%), 13 (6.5%), 51 (25.5%), and 57 (28.5%) patients, respectively. Sixty-one patients (30.5%) had resistance. Despite no significant difference between phenotypes (P=0.064), the most common PCOD phenotype was A (HA+OA+PCO) found in 39.2% and D (OA+PCO) was seen in 29.8% of the patients.Conclusion: According to the results, there was no significant association between PCOD phenotypes and clomiphene resistance. Finally, A and D phenotypes were frequent types with clomiphene resistance.
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 ...
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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
Zahra Soleimani; Mansoor Nourmohammadi; Neda Hashemi; Maryam Aghaei
Volume 8, Issue 1 , November and December 2022, , Pages 41-46
Abstract
Background & Objective: Considering the importance of good sleep quality during pregnancy and the adverse effects of poor sleep quality on mother before and after childbirth and also its adverse effects on the fetus and newborn, identifying the related factors to sleep disturbance is important. ...
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Background & Objective: Considering the importance of good sleep quality during pregnancy and the adverse effects of poor sleep quality on mother before and after childbirth and also its adverse effects on the fetus and newborn, identifying the related factors to sleep disturbance is important. Therefore, this study was conducted to evaluate the relationship between prenatal and sleep quality in pregnant women.Materials & Methods: The present cross-sectional study was done on 150 pregnant women who were referred to Baqiyatallah Hospital, Tehran, Iran. Convenience sampling method was used for choosing participants. Pittsburgh Sleep Quality Index (PSQI) and Prenatal Distress Questionnaire (PDQ) were used for gathering information.Results: The prevalence rates of poor sleep quality in first, second and third trimesters were 36%, 54% and 62%, respectively. In all three trimesters, the newborn health parameter had the highest score and relationship score had the lowest score. There was a statistically significant relationship between prenatal concerns and sleep quality of pregnant women in all three trimesters of pregnancy (P<0.05).Conclusion: We found the significant relationship between pregnancy concerns and sleep quality of pregnant women in all three trimesters of pregnancy, and this finding indicates the direct effect of pregnancy concerns on sleep quality during pregnancy. Therefore, it is necessary to plan and perform the necessary interventions to minimize the concerns of pregnant women.
Obstetrics and Gynecology
Fadhil Hussam; Shaymaa Abdulhameed Khudair; Waleed K. Alkhafaje; Yasir S. Alnassar; Rashad M. Kaoud; Ahmed Najm Abed; Haneen Saad Jabbar; Hiba Ali Numan
Volume 8, Issue 1 , November and December 2022, , Pages 47-52
Abstract
Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to ...
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Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to female infertility. About 10-12% of couples struggle with infertility, a multifaceted issue with ramifications for society, the economy, and culture. The majority of female infertility cases are caused by issues with egg production. By analyzing samples from infertility clinics, the current study aims to investigate the degree of female infertility in Erbil, Iraq, while covering all facets of the condition.Materials & Methods: 595 infertile females receiving medical counseling from three infertile institutions between February 2020 to December 2021 were screened for the current study. In addition to anthropometric measurements, information about the etiology, duration, and lifestyle, factors of infertility has been gathered using a standardized questionnaire. Additionally, the sample was subjected to clinical examinations. Five groups of reproductive abnormalities were identified. Around 61.79% of women in the infertile group for the first two years had tubal obstruction, and 49.92% had hormonal deficiencies. Ovulation defects (4.62%) and undersized uteri (4.82%) predominated in the >10-year infertile group. Both weight and body mass index have shown a favorable association with infertility duration.Results: Our findings demonstrated a significant correlation between body mass index and infertility. Most academic and wealthy groups pursued medical advice to resolve issues related to infertility.Conclusion: Finally, it is suggested that female infertility can be managed and cured with hormone therapy, laparoscopic procedures, minor surgical procedures, and medicine.
Obstetrics and Gynecology
Minoo Gharouni; Abolfazl Mehdizadeh Kashi; Shahla Chaichian; Zahra Azizian; Kobra Tahermanesh; Samaneh Rokhgireh
Volume 8, Issue 1 , November and December 2022, , Pages 57-62
Abstract
Background & Objective: Fast-track surgery (FTS) consists of different pathways to decrease surgical complications and improve outcomes and patient satisfaction. FTS in an elective gynecologic laparoscopic surgery has not been well assessed. No consensus guidelines have been developed for gynecologic ...
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Background & Objective: Fast-track surgery (FTS) consists of different pathways to decrease surgical complications and improve outcomes and patient satisfaction. FTS in an elective gynecologic laparoscopic surgery has not been well assessed. No consensus guidelines have been developed for gynecologic laparoscopic surgeries. The purpose of this study is to evaluate enhanced recovery after surgery (ERAS) for total laparoscopic hysterectomy.Materials & Methods: 260 patients underwent for laparoscopic hysterectomy surgery. All patients were divided into two groups as follows: one group received traditional laparoscopic hysterectomy surgery and the intervention group was treated under ERAS protocol. ERAS protocol includes not receiving preoperative mechanical bowel preparation and laxatives as well as fasting 6 h and not drinking liquids 2h before surgery. The patients were allowed to resume the ordinary diet 6h post-operation. Ondansetron 4 mg were prescribed after surgery for nausea and vomiting, pain was controlled with non-narcotic analgesics diclofenac suppository 100 mg/q12 h and paracetamol 1000 mg/q6 h until discharge. Urinary catheter was removed whenever possible and early ambulation occurred 6h after the surgery.Results: A total of 260 patients were studied. Regarding the length of hospitalization, significant differences were shown between the groups (P<0.001). Return to daily functions was occurred earlier in the fast-track surgery group than another group. Complications and VAS pain scores showed no significant differences between the groups.Conclusion: Our results show that ERAS surgery has fewer side effects and better outcomes which make it more suitable for patients undergoing laparoscopic hysterectomy.
Obstetrics and Gynecology
Sedigheh Ghasemian Dizajmehr; Afshin Mohammadi; Sara Malekshahi Nejad
Volume 8, Issue 1 , November and December 2022, , Pages 63-67
Abstract
Background & Objective: Postpartum hemorrhage is the most common cause of maternal morbidity, especially in developing countries, and a major cause of direct maternal death worldwide. Considering the importance of timely postpartum hemorrhage management and access to low-risk methods, assessing ...
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Background & Objective: Postpartum hemorrhage is the most common cause of maternal morbidity, especially in developing countries, and a major cause of direct maternal death worldwide. Considering the importance of timely postpartum hemorrhage management and access to low-risk methods, assessing the efficacy of uterine artery embolization (UAE) is essential. Therefore, the present study was conducted to evaluate the success rate and outcomes of UAE in the treatment of delayed postpartum hemorrhage.Materials & Methods: This cross-sectional study was performed on women with delayed postpartum hemorrhage who were referred to the gynecology and obstetrics clinic of a referral hospital in Urmia city under treatment of UAE. The census method was used for choosing the patients and all women with delayed postpartum hemorrhage between April 2019 and March 2020 were entered into the study.Results: During the study period, he number of 22 women with delayed postpartum hemorrhage were entered into the study. The mean age of the women was 29.36±5.09 years. The success rate of UAE was 95.6%. The number of 20 (90.9%) cases did not report complications. For one case, UAE complication was associated with amenorrhea and for the other one with vaginal bleeding.Conclusion: The results showed that the UAE method as an effective method with high efficacy and low complications can be considered a suitable choice for the treatment of delayed postpartum hemorrhage.
Obstetrics and Gynecology
Fahimeh Ghotbizadeh; Zahra Panahi; Azam Tarafdari Manshadi; Saeed Soltani; Razieh Akbari; Mahdieh Parsapur
Volume 8, Issue 1 , November and December 2022, , Pages 68-75
Abstract
Background & Objective: Social factors which are integrated with health status are considered crucial in pregnancy morbidity. Mothers with a developed level of health literacy (HL) experience a lower risk of preterm delivery. This study aimed to evaluate the relationship between maternal HL ...
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Background & Objective: Social factors which are integrated with health status are considered crucial in pregnancy morbidity. Mothers with a developed level of health literacy (HL) experience a lower risk of preterm delivery. This study aimed to evaluate the relationship between maternal HL and prenatal care and pregnancy outcome.Materials & Methods: The research was a cohort study. A total of 323 participants were selected from prenatal clinics. The women were followed until delivery. Women who had gestational diabetes or preeclampsia or gestational hypertension during pregnancy were omitted. Data were collected with a survey.Results: The result found 34.1%, 33.1%, 23.8%, and 9% were categorized as having inadequate, problematic, sufficient, and excellent maternal HL. Women with sufficient and excellent literacy were meaningfully better in having earlier and more frequent antenatal care, earlier folic acid consumption, and exercise before and during pregnancy, pregnancy alarm sign awareness, neonatal birth weight, and breastfeeding.Conclusion: The results proposed that sufficient and excellent HL among women is related to good pregnancy outcomes and poor HL causes a poor chance to gain a positive pregnancy outcome. A cooperative work to grow maternal HL by considering HL levels, revision of educational materials into plain language, and provision of pregnant women with verbal and video instruction in addition to written materials are highly recommended.
Obstetrics and Gynecology
Mohammad Reza Zeraati; Hojjat Torkmandi; Mohammad Abdi; Mohammad Reza Jamshidi; Alireza Safaie
Volume 8, Issue 1 , November and December 2022, , Pages 86-94
Abstract
Pyrexia and shivering are the most popular side effects of postpartum administration of misoprostol, but other side effects of this drug are very rare. A 27-year-old pregnant female patient was admitted to Ayatollah Mousavi hospital (Zanjan, Iran), complaining about severe headache and the primary diagnosis ...
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Pyrexia and shivering are the most popular side effects of postpartum administration of misoprostol, but other side effects of this drug are very rare. A 27-year-old pregnant female patient was admitted to Ayatollah Mousavi hospital (Zanjan, Iran), complaining about severe headache and the primary diagnosis of cerebral venous thrombosis. Treatment was successful after primary investigations and planed therapy for Cerebral Venous Thrombosis (CVT). Following the decision on terminating the pregnancy, five tablets of Sublingual misoprostol (200 mg) was used once evacuation of pregnancy remnants was done. About thirty minutes after the administration of misoprostol, onset of severe shivering and tachycardia (201/min) with high fever (about 41°C) and hypertension (182/123 mmHg) was observed. National Adverse Drug Reaction (ADR) form was completed. All of symptoms were alleviated 30 minutes after administration of Paracetamol 1gram (Intravenous infusion) followed by Metoprolol 50 mg (orally). According to the literature, we listed the various side effects of misoprostol. Even though the side effects of misoprostol are diverse and rare, the simultaneous occurrence of these side effects is not cited till date. These incidents are reported to the authorities as per ADR policy; nonetheless, no preventive measures are implemented. This necessitates medical educational policies to be taken into consideration to educate healthcare providers throughout their professional career as well as research.
Obstetrics and Gynecology
Maryam Moradi; Azin Niazi; Melissa Parker; Anne Sneddon; Violeta Lopez; David Ellwood
Volume 7, Issue 6 , September and October 2022, , Pages 479-488
Abstract
Background & Objective: The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey.Materials & Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed ...
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Background & Objective: The aim of this study was to determine the endometriosis-associated symptoms and diagnostic delay through an online survey.Materials & Methods: A cross-sectional study was conducted in Australia using an online web-based survey. All data were entered into and analyzed using the STATA software (version 14.1). A total of 903 respondents completed an online survey from September 2013 to October 2015.Results: Out of 903, 71.10% were Australians and 28.90% were Non-Australian, with a self-reported diagnosis of endometriosis confirmed by surgery. Out of the participants, 86.5% completed the online survey. Delay in diagnosis was 8.1±6.2 years. There was no difference in the age range (P < /i> = 0.35), mean age of onset of the first symptoms (P < /i> = 0.93), and delay in diagnosis (P < /i> = 0.11) between both groups. Most common endometriosis-related symptoms that all respondents had experienced in their lifetime were period pain (98.1%), fatigue (94%), bloating (90.7%), ovulation pain (88.7%), pelvic pain (87.3%), pain during and before/after sexual activity (82.7%), and heavy bleeding (82.2%). Treatments used by affected women included: pain killers (96%), hormonal medication (84.7%), surgical treatments (84.5%), and delayed fertility (37.1%). Conclusion: Vast similarities in demographics and endometriosis-associated symptoms among the Australian and non-Australian women with endometriosis support the universality of the disease characteristics. Delay in diagnosis of endometriosis is a problem and the reasons for delayed diagnosis must be understood to try to shorten this delay. Besides pain, patients with endometriosis suffer from a variety of other symptoms; hence, any treatment must take into account the most prominent symptoms.
Obstetrics and Gynecology
Farzaneh Abedini; Mahdis Mohammadian Amiri; Mahsa Danaei; Nooshin Eshraghi
Volume 7, Issue 6 , September and October 2022, , Pages 489-496
Abstract
Background & Objective: Premature rupture of membranes (PROM) and preterm delivery are the most important problems observed in pregnancies that can cause many consequences. The present study investigated the relationship between amniotic fluid index (AFI) and uterocervical angle in patients with ...
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Background & Objective: Premature rupture of membranes (PROM) and preterm delivery are the most important problems observed in pregnancies that can cause many consequences. The present study investigated the relationship between amniotic fluid index (AFI) and uterocervical angle in patients with PROM between 24 and 34 weeks of gestation.Materials & Methods: This study was a cohort study carried out on 50 pregnant women with PROM. Inclusion criteria were 24 to 34 weeks of gestation and singleton deliveries. Demographic characteristics and pregnancy history of the subjects were determined through interviews and examinations. Moreover, AFI and uterocervical angle were determined based on ultrasound results. Subjects were followed up until delivery.Results: Mean age of the patients was 25.14±5.32 years; 23 patients (46%) had delivery latency less than 7 days. The mean uterocervical angle in the delivery latency group ≤7 was significantly higher than that in the group more than 7 days (P < /i> <0.001). Moreover, the mean AFI in the delivery latency group ≤7 was significantly higher (P < /i> <0.001). The uterocervical angle above 107.7 with a sensitivity of 87% and a specificity of 88.9% had a predictive power and its area under curve (AUC) was 0.912 (P < /i> <0.001). The mean AFI below 5.4 with a sensitivity of 81.5% and a specificity of 65.5% had a predictive power (AUC: 0.866, P < /i> <0.001). Conclusion: Uteroservical angle and AFI can be good predictors for assessing delivery latency in women with PROM. Furthermore, the mean uterocervical angle in the delivery latency group ≤7 days is significantly higher than that in the group more than 7 days, but conversely AFI is less.
Obstetrics and Gynecology
Awgichew Behaile Teklemariam; Endriyas Kelta Wabalo; Tesfaye Adugna Leta; Semira Shimeles Assefa; Endeshaw Chekol Abebe
Volume 7, Issue 6 , September and October 2022, , Pages 497-506
Abstract
Background & Objective: Pregnancy-induced hypertensive disorders (PIHD) are the main reasons for maternal and perinatal mortality, as they complicate 10% of pregnancies worldwide. Serum lactic acid dehydrogenase (LDH) and gamma-glutamyl transferase (GGT) are possible markers reflecting the occurrence ...
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Background & Objective: Pregnancy-induced hypertensive disorders (PIHD) are the main reasons for maternal and perinatal mortality, as they complicate 10% of pregnancies worldwide. Serum lactic acid dehydrogenase (LDH) and gamma-glutamyl transferase (GGT) are possible markers reflecting the occurrence of pregnancy-associated complications like preeclampsia and eclampsia. There is a paucity of data with conflicting results showing serum LDH and GGT on PIHD in Ethiopia. This investigation aimed to assess the serum LDH and GGT levels in pregnant women with PIHD along with their correlation with the severity of the disease at Jimma Medical Center (JMC), Ethiopia.Materials & Methods: This hospital-based comparative cross-sectional study was undertaken from August 03 to September 27, 2020, in JMC. A total of 97 study participants were recruited. Serum GGT and LDH levels were determined using a fully automated Roche Cobas 6000 chemistry analyzer. The data were analyzed using SPSS 25.0. One-way ANOVA and independent samples t-test were employed to compare serum GGT and LDH levels with categories of PIHD.Results: The significantly highest mean serum levels of LDH (580.9±193.8 U/L) and GGT (86.1±29.2 U/L) were observed in eclamptic women compared to gestational hypertensive (276.7±60.7 and 38.3±16.9 U/L) and preeclamptic patients (353±132.8 and 48.8±29.9 U/L), respectively. Both serum GGT and LDH levels were found to correlate with the severity of preeclampsia, respectively significantly.Conclusion: Serum LDH and GGT were found to be at the highest levels in eclamptic than preeclamptic and gestational hypertensive women. Blood pressure, gestational age, and severity of hypertensive disorders of pregnancy were predictor variables associated with serum GGT and LDH.
Obstetrics and Gynecology
Neda Hashemi; Zahra Soleimani
Volume 7, Issue 6 , September and October 2022, , Pages 513-517
Abstract
Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis ...
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Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis infection and risk of female infertility.Materials & Methods: Web of Science, PubMed and Scopus were searched using appropriate keywords as major international electronic bibliographic databases up to January 2020. Q-test and I2 statistic were used for evaluating heterogeneity between studies as well as Begg's and Egger's tests for exploring publication. Results were reported by pooled odds ratio (OR) estimate from individual studies by choosing random-effects model.Results: In total, 650 articles were obtained by initial search until January 2020 with 9779 women. Results of the pooled OR estimates showed a significant association between T. vaginalis and infertility in adjusted studies (OR=1.95; 95% CI: 1.46, 2.43). Based on Begg's and Egger's tests, there was no evidence of publication bias (P < /i>=0.532 and P < /i>=0.896, respectively).Conclusion: There was a significant association between T. vaginalis and female infertility. However, more evidence is necessary to prove the potential association of T. vaginalis with an increased risk of female infertility.
Obstetrics and Gynecology
Farzaneh Boroumand; Shiva Ghayur; Rasoul Gharaaghaji; Shabnam Vazifekhah
Volume 7, Issue 6 , September and October 2022, , Pages 524-529
Abstract
Background & Objective: Maternal obesity can increases pregnancy consequences like postpartum hemorrhage, preeclampsia, need for cesarean section, neonatal death, and fetal macrosomia. In this study, the efficacy of prophylactic use of metformin to prevent gestational diabetes mellitus in nondiabetic ...
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Background & Objective: Maternal obesity can increases pregnancy consequences like postpartum hemorrhage, preeclampsia, need for cesarean section, neonatal death, and fetal macrosomia. In this study, the efficacy of prophylactic use of metformin to prevent gestational diabetes mellitus in nondiabetic pregnant women with obesity was examined.Materials & Methods: This study was a clinical trial. Totally, 340 pregnant women who were in the first trimester were referred to the gynecology clinic of Motahhari hospital in Urmia after ensuring the absence of underlying diseases such as diabetes, hypertension, kidney, liver, and cardiovascular disease, without a history of allergy to metformin, in case of a singleton pregnancy, and Body Mass Index (BMI) above 30 were allocated to two equal groups. The intervention group was given 1000 mg of metformin, and the control group was given a placebo. Demographic information, including age, gravity, parity, live birth, birth, and maternal weight, previous delivery method, abortion, delivery method with its cause, polyhydramnios, NICU hospitalization, gestational age, mortality, and neonatal anomalies was also recorded. The results were analyzed using SPSS version 26.Results: In the control group, 15 mothers (9.4%) out of 160 people, and in the intervention group, 13 mothers (8.1%) had gestational diabetes (P < /i>=0.692). In the intervention group, the mean insulin dose was 10.8 ±3 units; in the control group, the mean insulin dose was 21.2±15.7 units (P=0.048). Twenty patients (6.7%) out of 297 obese patients and 8 patients (34.8%) in the morbid obesity group had diabetes (P < /i><0.001). In the control group, the mean weight of mothers was 8.04±2.5 kg; in the intervention group, it was 5.2±2.3 kg during pregnancy (P < /i><0.001). Gestational diabetes, delivery method, death one week after birth, preterm birth, polyhydramnios, and intensive care unit were similar in the two groups. Conclusion: Metformin in pregnant women with a BMI>30 deals with low maternal weight, reduced birth weight, and reduced insulin dose in diabetic mothers.
Obstetrics and Gynecology
Mitra Modares Gilani; Azam Sadat Mousavi; Setareh Akhavan; Shahrzad Sheikhhasani
Volume 7, Issue 6 , September and October 2022, , Pages 530-535
Abstract
Background & Objective: Cervical cancer is one of the most common cancers in women. One of the most important indicators that deal with all aspects of the patients' health is the Health-related quality of life (QOL). In this study, the QOL of women with cervical cancer in Iran was investigated.Materials ...
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Background & Objective: Cervical cancer is one of the most common cancers in women. One of the most important indicators that deal with all aspects of the patients' health is the Health-related quality of life (QOL). In this study, the QOL of women with cervical cancer in Iran was investigated.Materials & Methods: The present cross-sectional study examined the QOL of 139 patients with cervical cancer referred to Imam Khomeini hospital, affiliated with the Tehran University of Medical Sciences. For this study, a specific questionnaire of QOL in patients with cervical cancer was used. To determine the predictors of cervical cancer patients, the QOL linear regression model was used.Results: Findings of this study showed that the total score of QOL of patients was 20.97±1.29. Moreover, in the regression model, a significant relationship was observed between the type of treatment and patients' QOL scores and those patients who had neoadjuvant therapy plus surgery (β=-17.45, P < /i>=0.02) and those who received brachytherapy (β=- 14.86 and P < /i>=0.09) had a significantly lower QOL score.Conclusion: Overall, the QOL of people with cervical cancer was moderate. Implementing educational programs for service providers and choosing the appropriate type of treatment according to the stage of the disease and the patient's age can help control this type of disease and its complications and improve the QOL of patients.
Obstetrics and Gynecology
Misa Naghdipour Mirsadeghi; Zahra Hamidi Madani; Aynaz Boostan; Ali Massoudifar
Volume 7, Issue 6 , September and October 2022, , Pages 543-547
Abstract
Background & Objective: Although giving birth is quite a natural process in a woman's life; it is very painful. Different people, however, experience this pain on different levels. In fact, one's perception of labor pain is determined by physiological, cultural, social, mental, and psychological ...
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Background & Objective: Although giving birth is quite a natural process in a woman's life; it is very painful. Different people, however, experience this pain on different levels. In fact, one's perception of labor pain is determined by physiological, cultural, social, mental, and psychological factors. The present study aims to investigate the relationship between personality traits and one's perception of labor pain.Materials & Methods: This study is a descriptive-analytical correlational study. Two questionnaires were used for Gathering information: one on personality traits and the other on labor pain. One hundred participants were chosen according to their demographic information from a pool of pregnant women at the Persian Gulf Hospital maternity ward in Bandar Abbas City. The data was analyzed using descriptive and analytical measures such as the Pearson Factor.Results: Meaningful positive relationship between labor pain and Neuroticism (P < /i>=0.000, r=0.448), Openness (P < /i>=0.000, r=0.517) and Agreeableness (P < /i>=0.003, r=0.296). While Consciousness (P < /i>=0.047, r=-0.199) is found to have a meaningful negative relationship, extraversion shows no correlation with labor pain. Conclusion: Good Childbirth Counseling and proper training, based explicitly on a mother's personality traits, could significantly help provide an enjoyable childbirth experience and reduce the unnecessary demand for C-section operations.
Obstetrics and Gynecology
Roshan Nikbakht; Raziye Mohammad Jafari; Mojgan Barati; Masume Jafari Nezhad; Maziar Shamsaei
Volume 7, Issue 6 , September and October 2022, , Pages 548-553
Abstract
Background & Objective: The objective of this study was to determine the association between the maternal serum concentration of PAPP-A and free B-HCG at 11-13(+6) weeks and the uterine artery pulsatility index (PI) at 30-34 weeks with the prediction of preeclampsia.Materials & Methods: This ...
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Background & Objective: The objective of this study was to determine the association between the maternal serum concentration of PAPP-A and free B-HCG at 11-13(+6) weeks and the uterine artery pulsatility index (PI) at 30-34 weeks with the prediction of preeclampsia.Materials & Methods: This cohort study was performed on 882 women with singleton pregnancies from March 2018 to November 2020 at the university hospital (referred center) in Ahvaz/Khuzestan. Maternal serum PAPP-A and free B-HCG at 11-13(+6) weeks and uterine artery PI at 30-34 weeks were measured and compared between women with and without PE. MOM PAPP-A<0.4, MOM-free B-HCG>3, and uterine artery pulsatility index >1 (>95%) were considered abnormal. Then The effect of each of the indicators on preeclampsia was determined by overlaying the layers and performing logical calculations in ARC GIS software. The distribution of PE in different cities of Khuzestan province was investigated.Results: The mean MOM PAPP-A was significantly lower (1.05 vs. 1.21 P < /i>=0.03), and uterine artery PI was significantly upper (0.93 vs. 0.88 P < /i><0.01) in preeclamptic women compared to women without PE. No significant differences were observed in the mean MOM-free B-HCG between women with and without PE (1.33 vs. 1.2 P < /i>=0.667). The highest percentage of PE was in two regions of Ahvaz (80%), but concerning women referred from different cities was in Andimeshk (75%). Conclusion: A low level of maternal serum PAPP-A and increased uterine artery PI promoted the chance of developing PE. The highest prevalence of PE was in two regions of the center of Khuzestan province, and the most preferred due to PE in different cities was in Andimeshk.
