Obstetrics and Gynecology
Behnaz Nouri; Maliheh Arab; Mohammad Nasiri
Volume 8, Issue 5 , September and October 2023, , Pages 481-487
Abstract
Background & Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis ...
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Background & Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis who are candidates for laparoscopic surgery.Materials & Methods: This cross-sectional study was performed on 433 patients with endometriosis who were candidates for laparoscopic surgery referred to Shohada-Tajrish Hospital in Tehran, Iran, between January 2016 and December 2021. A questionnaire including demographic and clinical information, MRI, and pathology reports were collected from participants. The MRI lesions were segmented and the results were compared with pathology and clinical examination. For statistical analysis SPSS software, version 22 was used.Results: A total of 433 participated in this study with a mean age of 34.18±7.99. The average estimated duration of disease symptoms (months) was 40.58±42.33. The predictive value of clinical symptoms is weak compared to MRI. However, the probability that the disease is not present when the clinical signs are negative is acceptable in most of the endometriosis sites. MRI considerably shows the true negative rate, but its sensitivity is only relatively acceptable for the diagnosis of ascites (67.66%). Calculating the accuracy of MRI reports probably shows the overall classification of the patients via MRI test.Conclusion: despite extensive research, there are no suitable and accurate non-invasive methods for diagnosing endometriosis. MRI and clinical examination alone are not useful for definitive diagnosis and it is better to examine biomarkers and artificial intelligence for non-invasive and accurate diagnosis of this disease.
Obstetrics and Gynecology
Farima Rahimi Mansour; Farah Farzaneh; Mohammad Mahdi Dabbagh; Amirreza Keyvanfar
Volume 8, Issue 5 , September and October 2023, , Pages 488-493
Abstract
Background & Objective: Aluminum (Al) is used in different industries to produce cosmetics, supplements, drugs, food packaging, toothpaste, kitchen utensils, and antiperspirants. Uterine fibroid (UF) is women's most prevalent benign tumor during the reproductive ages. Since Al can accumulate ...
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Background & Objective: Aluminum (Al) is used in different industries to produce cosmetics, supplements, drugs, food packaging, toothpaste, kitchen utensils, and antiperspirants. Uterine fibroid (UF) is women's most prevalent benign tumor during the reproductive ages. Since Al can accumulate in the body's organs, it may play a role in the pathogenesis of UF. This study aimed to measure Al levels in serum and uterine samples (normal uterine tissue of control and UF patients, and leiomyoma of UF patients).Materials & Methods: In this descriptive study, we included ten women who underwent hysterectomy (five women due to UF and five women for a reason other than UF). Samples were obtained from serum, normal uterine tissue, and leiomyoma. Tissue and serum samples were digested with nitric acid (HNO3) and hydrogen peroxide (H2O2). Eventually, the Al levels in samples were analyzed by inductively coupled plasma atomic emission spectroscopy (ICP-AES).Results: Al level was higher in the serum of the control group compared with UF patients (326.8 ± 360.8 µg/L vs. 211.2 ± 56.4 µg/L, P =0.310). Al level was higher in the control group compared with the normal tissue of UF patients (410.2 ± 244.7 µg/L vs. 300 ± 138.0 µg/L, P=0.465). Besides, leiomyoma had a higher Al level compared with the normal tissue of UF patients (1482.2 ± 2062.9 µg/L vs. 300 ± 138.0 µg/L, P=0.138).Conclusion: The results showed that Al levels of tissue and serum samples in various groups differed, but these differences were not statistically significant.
Obstetrics and Gynecology
Omarov Nazarbek Bakytbeko; Thaiba Abdulrazzaq; Entsar Hachim Muhammad; Sundus Mohammed Ali Al Bazi; Mazin A. A. Najm; Talib Kh. Hussein; Zahraa Hamzaa Abd Alzahraa; Sarah A. Hamood
Volume 8, Issue 5 , September and October 2023, , Pages 501-508
Abstract
Background & Objective: The birth of a baby with a low birth-weight (LBW), which has numerous consequences, is one of the most significant problems associated with childbirth. By evaluating the factors influencing LBW in infants, therapeutic interventions can be improved to mitigate its effects. ...
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Background & Objective: The birth of a baby with a low birth-weight (LBW), which has numerous consequences, is one of the most significant problems associated with childbirth. By evaluating the factors influencing LBW in infants, therapeutic interventions can be improved to mitigate its effects. In this regard, the present study aims to identify the causes of LBW in infants and assess these causes' impact.Materials & Methods: In the current retrospective observational study, the required data regarding demographic variables and history of pregnancy and childbirth was extracted from 730 electronic records of deliveries performed from Alwiyah Hospital for Obstetrics and Gynecology in Baghdad in 2021 involving infants with LBW. The SPSS.23 software,the t-test, independent t-test, and multiple logistic regression were used to analyze the data. The results' significance level was deemed to be less than 0.05.Results: The multiple logistic regression analysis model included variables with a significance level of less than 0.05. The results show that the variables of mother's age at delivery, the number of babies born in the current delivery, history of infertility, and iron deficiency anemia increase the chances of LBW by 0.48, 3.12, 0.38, and 0.56, respectively, and had a significant relationship with LBW infants (P<0.001).Conclusion: Paying particular attention to the treatment and improvement of the practical factors in LBW before birth in pregnant women is crucial.
Obstetrics and Gynecology
Minthami Sharon
Volume 8, Issue 5 , September and October 2023, , Pages 514-519
Abstract
Background & Objective: Obstructive sleep apnoea (OSA) is characterised by repeated episodes of upper airway obstruction resulting in hypoxemia, hypercapnia and sleep fragmentation. It is intriguing to consider the consequences of these events on pregnancy outcomes. This study was conducted ...
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Background & Objective: Obstructive sleep apnoea (OSA) is characterised by repeated episodes of upper airway obstruction resulting in hypoxemia, hypercapnia and sleep fragmentation. It is intriguing to consider the consequences of these events on pregnancy outcomes. This study was conducted to determine the prevalence of obstructive sleep apnoea among pregnant women and its association with pregnancy outcomes.Materials & Methods: It has been found that subjects belonging to the age group 21-25 years had increased sleep disturbances and reduced quality of sleep. Also, pregnant women in the first trimester were found to have poor quality sleep.Results: Pregnancy outcomes associated with OSA were found as high chance of caesarean section, gestational diabetes mellitus, Gestational hypertension, low birth weight and APGAR<7.Conclusion: Hence, early detection and its prevention can improve the pregnancy outcomes.
Obstetrics and Gynecology
Rakhmanova Nodira Khodjayazovna; Thaiba Abdulrazzaq; Mazin A. A. Najm; Sadiq M. Al-shaikh; Khulood Majid Alsaraf; Mariam Alaa Toama; Mahmood Hasen Shuhata Alubiady; Shaymaa Abdulhameed Khudair
Volume 8, Issue 5 , September and October 2023, , Pages 520-527
Abstract
Background & Objective: One of the most prevalent musculoskeletal issues during pregnancy is pelvic pain, which most pregnant women may experience to varying degrees. The current research aims to identify and evaluate the risk factors contributing to pelvic pain in pregnant women.Materials & ...
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Background & Objective: One of the most prevalent musculoskeletal issues during pregnancy is pelvic pain, which most pregnant women may experience to varying degrees. The current research aims to identify and evaluate the risk factors contributing to pelvic pain in pregnant women.Materials & Methods: The present case-control research was conducted on 180 pregnant women at Baghdad's Alwiyah Hospital for Obstetrics and Gynecology in 2022. For data collection, two questionnaires and a checklist were utilized. The questionnaires included demographic information about women and questions about risk factors, and the checklist included the results of women's examinations to identify risk factors. Using SPSS.23 software, the data were analyzed, and the statistical significance level of the results was considered less than 0.05.Results: The results showed that from the demographic variables, only the age variable showed a statistically significant difference between the two groups (P<0.05). Also, evaluating the risk factors indicated a significant difference between the two groups for the baby's weight, back pain before pregnancy, and back pain in the previous pregnancy (P<0.001). Other demographic variables and risk factors did not significant difference between the two groups (P>0.05).Conclusion: The results demonstrated that identifying the risk factors could aid in managing aggravating pelvic pain factors during pregnancy and preventing movement restrictions in postpartum women.
Obstetrics and Gynecology
Eighty Mardiyan Kurniawati; Gatut Hardianto; Hari Paraton; Tri Hastono Setyo Hadi; Anis Widyasari; Anisah Nur Rahmawati
Volume 8, Issue 5 , September and October 2023, , Pages 538-541
Abstract
Vaginismus is a medical condition characterized by involuntary tightening of the muscles around the vagina. This situation disrupts sexual relations and impacts the chances of pregnancy. This study explores the occurrence of pregnancy in women with vaginismus after treatment in 2022 in East Java Indonesia. ...
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Vaginismus is a medical condition characterized by involuntary tightening of the muscles around the vagina. This situation disrupts sexual relations and impacts the chances of pregnancy. This study explores the occurrence of pregnancy in women with vaginismus after treatment in 2022 in East Java Indonesia. There were 60 patients with a diagnosis of vaginismus in 2022. Married less than 1 year as many as 6 people (10%), 1-5 years as many as 49 people (82%), and more than 5 years as many as 5 people (8%). Management is carried out independently and collaboratively. The management is independent dilatation with the help of dilators, Botox injection, hymenectomy, and collaboration with psychiatrists and andrologists. Of the 60 patients who underwent anamnesis and physical examination, five patients successfully obtained pregnancy treated with Botox injections, independent dilatation or independent dilatation, and andrology consultation. Proper management of vaginismus can increase the chances of pregnancy.
Obstetrics and Gynecology
Poorya Davoodi; Delaram J. Ghadimi; Malihe Rezaei; Mohammad Amin Khazei Tabari; Aryan Shirani; Behnaz Nouri; Noosha Samieefar; Meisam Akhlaghdoust
Volume 8, Issue 4 , July and August 2023, , Pages 315-326
Abstract
Background & Objective: Endometriosis, a common disease of the female reproductive system, could affect many aspects of women’s lives. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate ...
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Background & Objective: Endometriosis, a common disease of the female reproductive system, could affect many aspects of women’s lives. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate COVID-19 in endometriosis patients in terms of prognosis, diagnosis, treatment, and quality of life during the pandemic.Materials & Methods: Relevant studies were identified through searching for endometriosis and COVID-19 in different databases, including PubMed, Medline, Scopus, and Web of Science, on 17 January 2022. Peer-reviewed published articles evaluating COVID-19 and endometriosis written in English were included.Results: Out of 115 articles, 9 manuscripts met our criteria. Endometriosis does not intensify the risk of COVID-19 infection. However, COVID-19 has changed the health care of endometriosis patients.Conclusion: COVID-19 has affected endometriosis patients’ life in many aspects, including their job, lifestyle, and health care. Further studies are recommended to evaluate how the pandemic has affected endometriosis patients.
Obstetrics and Gynecology
Fatemeh Bahadori; Zahra Sahebazzamani; Somayeh Ghasemzadeh; Zahra Kousehlou; Leila Zarei; Marjan Hoseinpour
Volume 8, Issue 4 , July and August 2023, , Pages 327-334
Abstract
Background & Objective: Menarche is an important stage in the development of girls which can predict the adolescent’s puberty process and fertility onset. The changes in menstrual cycle have health consequences not only in adolescence but also over the life-course. Childhood obesity as ...
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Background & Objective: Menarche is an important stage in the development of girls which can predict the adolescent’s puberty process and fertility onset. The changes in menstrual cycle have health consequences not only in adolescence but also over the life-course. Childhood obesity as a common health problem has been observed in both developed and developing countries, and its prevalence is continuing to increase. The aim of this study was to identify menstrual patterns and related disorders and also to investigate the relationship between menarche age, menstrual disorders, and (BMI) in high school girls in Urmia.Materials & Methods: In this cross-sectional study, 716 adolescent girls aged 14-18 years were selected with multistage sampling from high schools of Urmia (Sept 2012 to Dec 2013). Participants completed the questionnaire of menstrual pattern characteristics including age at menarche, menstrual cycle length, dysmenorrhea, and the need for pain relief. BMI percentile was calculated and obesity was determined using the CDC’s 2000 BMI-for-age growth charts.Results: The results showed that the average of age, BMI, and menarche age were: 15.66±1.019 year, 22.05±3.91 kg/m2 and 12.87±0.98 year, respectively. The prevalence of overweight and obesity were 13.7% and 8.4%, respectively. A large majority of the subjects (76.1%) had a normal, healthy weight. There was a significant association between BMI and the duration of flow, menarche age, menstruation flow, and pain severity (P<0.05).Conclusion: Based on the results, planning and intervention for decreasing the BMI in high school girls can help reduce menstrual disorders. Future studies are required to confirm and complete our results.
Obstetrics and Gynecology
Roya Kaboodmehri; Seyedeh Hajar Sharami; Sodabeh Kazemi; Mandana Mansour Ghanaei; Seyedeh Fatemeh Dalil Heirati; Zahra Pourhabibi; Sina Montazeri
Volume 8, Issue 4 , July and August 2023, , Pages 350-356
Abstract
Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this ...
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Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this cross-sectional study, conducted in Al-Zahra hospital Rasht in the north of Iran, 234 patients, 18-45 years old, were enrolled. The demographic parameters (e.g. age, education, habitat and etc.) and AMH levels were recorded for each patient. The patients were divided into two groups based on their AMH levels [group 1: less than 1.1 (ng/ml) vs. group 2: more than (1.1 ng/ml)]. The data was analyzed by SPSS-21 software.Results: The mean AMH level was 2.66 ng/ml. Age, education status and habitat showed significant differences among subjects with AMH levels, so that with aging the AMH levels decreased. Patients living in villages or the ones with low educational degrees and those with higher parities also revealed lower levels of AMH (p<0.05).Conclusion: There was a significant relationship between age, educational status and habitat with AMH values. Similar to other studies, we believe that with aging the AMH levels decrease. Furthermore, the other two aforementioned demographic features could affect a woman’s ovarian reserve and fertility status, too.
Obstetrics and Gynecology
Hadeel Ali Mahamda; Reem Ali Haddad; Ameen Abdulhasan Al Alwany; Noora M. Hameed; Thulfeqar Ahmed Hamza
Volume 8, Issue 4 , July and August 2023, , Pages 366-373
Abstract
Background & Objective: An essential issue in obstetrics is the prevalence of maternal and fetal complications in pregnant women with polycystic ovary syndrome (PCOS). The purpose of the present study was to investigate the prevalence of pregnancy complications among various phenotypes of pregnant ...
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Background & Objective: An essential issue in obstetrics is the prevalence of maternal and fetal complications in pregnant women with polycystic ovary syndrome (PCOS). The purpose of the present study was to investigate the prevalence of pregnancy complications among various phenotypes of pregnant women with PCOS.Materials & Methods: In the current study, the pregnancy period of 143 women with PCOS who were referred to the Babylon teaching hospital in Iraq in 2021 was analyzed based on their medical records. These women were separated into two groups based on their PCOS-related clinical symptoms. People in the first group possessed a severe phenotype, while those in the second group possessed a mild phenotype. SPSS version 23 was utilized for comparing maternal and fetal complications during pregnancy and for data analysis.Results: Regarding maternal and fetal complications, there was a significant difference between the two groups regarding low birth weight (LBW) (P<0.05). In this study, there was no statistically significant difference between PCOS phenotypes and the incidence of gestational diabetes, preterm birth, or spontaneous abortion (P>0.05). In conclusion, women with a more severe phenotype are more likely to give birth to babies with low birth weight (LBW) (approximately 1.9 times).Conclusion: In clinical considerations of pregnant women with PCOS, it appears necessary to consider the disease's phenotype as one of the factors influencing fetal outcomes.
Obstetrics and Gynecology
Ali Abdulhussain Fadhil; Ghazi Mohamad Ramadan; Zahraa A. Al-Ajeeli; Noora M. Hameed; Wael Dheaa Kadhim; Ahmed S. Abed; Iman Hazim Jirjees; Anwar Sabbah Hussen
Volume 8, Issue 4 , July and August 2023, , Pages 374-381
Abstract
Background & Objective: Low and high hemoglobin concentration is one of the main concerns of women during pregnancy due to its high prevalence and adverse effects. The present study aimed to examine the correlation between maternal hemoglobin concentration and the baby's birth weight and height ...
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Background & Objective: Low and high hemoglobin concentration is one of the main concerns of women during pregnancy due to its high prevalence and adverse effects. The present study aimed to examine the correlation between maternal hemoglobin concentration and the baby's birth weight and height in 326 pregnant women referred to the Alwiyah hospital for obstetrics and gynecology in Baghdad, Iraq, in 2019.Materials & Methods: In the current descriptive-analytical study, pregnant women were classified into two groups: anemia and normal; four groups of moderate to severe anemia, mild, regular, and high hemoglobin; and eight groups with intervals of 12 g/L from severe anemia to high hemoglobin. This study's variables included infants' age, number of children, education level, socioeconomic status, weight, and height. The data was analyzed using SPSS version 19, descriptive statistics, t-test, and logistic regression. In this study, the level of statistical significance was deemed to be 0.001.Results: The results showed that the probability of low birth weight and abnormal height increases 4.96 times and 4.13 times, respectively, in mothers with high hemoglobin concentrations versus mothers with low hemoglobin concentrations; these ratios are statistically significant (P<0.001). Also, hemoglobin concentrations ranging from 104 to 115 g/L have the lowest probability. Furthermore, hemoglobin concentrations greater than 125 g/L are statistically significant (P<0.001).Conclusion: The current study revealed that high maternal hemoglobin concentrations during pregnancy could significantly impact the baby's weight and height.
Obstetrics and Gynecology
Tyurina Natalya Alexandrovna; Fomicheva Tatyana Vladimirovna; Laksaev Vladislav Petrovich; Naumova Irina Sergeevna; Goryachkina Daria Valerievna; Minashkina Alina Sergeevna; Shukshina Olga Ivanovna; Kanunova Tatyana Andreevna
Volume 8, Issue 4 , July and August 2023, , Pages 382-388
Abstract
Background & Objective: There is a well-established link between multiple pregnancies and assisted reproductive techniques (ARTs). Increased maternal and perinatal morbidity and mortality are directly related to multiple pregnancies. The purpose of the current study is to examine the effects ...
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Background & Objective: There is a well-established link between multiple pregnancies and assisted reproductive techniques (ARTs). Increased maternal and perinatal morbidity and mortality are directly related to multiple pregnancies. The purpose of the current study is to examine the effects of multiple pregnancies on women using various reproductive techniques.Materials & Methods: This study used a comparative-analytical approach. We assessed a cohort of 130 pregnant women of which 120 had twins and 10 had triplets. In vitro fertilization and embryo transfer (IVF-ET) were performed on 62.0% of women, while 6.0% had ovulation induction. Using ultrasound examination, twin and triplet pregnancies were found in 92% and 8%, respectively.Results: Our results show that 11% of women experience the physiological course of pregnancy with multiple pregnancies. Pregnancy concludes in the delivery of twins only in 50% of patients with multiple pregnancies diagnosed by ultrasound examination before 10 weeks. It was found that 46% of births in women carrying multiple pregnancies happened prematurely after studying more than 100 births. Of these, 6% occurred before 28 weeks, 20% between 29 and 34 weeks, and 20% between 35 and 37 weeks.Conclusion: Preeclampsia and placental insufficiency are more likely to occur in multiple pregnancies than in single pregnancies. As a result, at the beginning of the second trimester, all preventative measures should be implemented. Although abdominal delivery is not the preferred option for multiple pregnancies, there is a need to increase the indications for surgical delivery for the benefit of the fetuses.
Obstetrics and Gynecology
Berikuly Duman; Ali Abdulhussain Fadhil; Samah Sajad Kadim; Ayad Abas Hasan; Naseer Mehdi Mohammed; Ebtihal Sattar Qasim; Tamara Muayad Abdullah
Volume 8, Issue 4 , July and August 2023, , Pages 389-395
Abstract
Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications ...
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Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications in pregnant patients with preeclampsia, the present study was conducted.Materials & Methods: In 2020, in Alwiyah Hospital for Obstetrics and Gynecology, Al-Jadiriah Private Hospital, Al-Karama Teaching Hospital, and Yarmouk Teaching Hospital in Baghdad, 87 pregnant women with preeclampsia and 160 healthy pregnant women participated in the present prospective study. The Doppler signal of the uterine arteries was evaluated during a supine abdominal Doppler ultrasound examination between 26 and 36 weeks of pregnancy. The survey form was updated with information about the birth of the children following the termination of the pregnancy. The data were evaluated using SPSS software (version 19) and independent t, Mann-Whitney, and chi-square tests.Results: The mean uterine artery pulsatility index of mothers with preeclampsia had the greatest sensitivity, specificity, and positive predictive amount of predicting a baby's low birth weight at 54.8%, 87.3%, and 91.6%, respectively. In addition, the sensitivity, specificity, and positive predictive amount of the mean uterine artery resistance index for predicting a baby's low birth weight were 65.2%, 96.4%, and 95.4%, respectively.Conclusion: Although uterine artery indices in Doppler ultrasound do not have a high sensitivity for predicting neonatal complications, abnormal indices can predict low birth weight with high confidence.
Obstetrics and Gynecology
Maliheh Arab; Nafiseh Poorzad; Giti Noghabaei; Ghazaleh Fazli; Behnaz Ghavami; Tayebeh Jahed Bozorgan
Volume 8, Issue 3 , May and June 2023, , Pages 204-209
Abstract
Background & Objective: Gynecological cancer survivors have been growing, as a result of advancements in national cancer screening strategies, resulting in early-stage diagnosis, and cancer treatments developments. Lack of a valid documented assessment tool to measure their requirements for ...
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Background & Objective: Gynecological cancer survivors have been growing, as a result of advancements in national cancer screening strategies, resulting in early-stage diagnosis, and cancer treatments developments. Lack of a valid documented assessment tool to measure their requirements for supportive care is detected. The aim was to develop a comprehensive scale that comprises all features of gynecologic cancer survivors` requirements in Iranian population.Materials & Methods: The Cancer Survivors Assessment Questionnaire NCCN2.2020 (National comprehensive cancer network) was translated including the instructions, and the answer choices by two native translators, including one fluent translator and one linguist. For qualitative face validity of the questionnaire at the disposal of 10 specialists were delegated to make the necessary changes. Content validity and content validity index were evaluated in terms of qualitative face validity and quantitative face validity. Necessary changes were applied.Results: The original Cancer Survivors Assessment Questionnaire NCCN2.2020 (National comprehensive cancer network) was condensed from 27 to 24 questions during the customization process. Questions related to lymphedema, and immunization were eliminated from the survey, as a result of low content validity index and scores. According to the panel of experts, ten questions including number 3, 5, 6, 9, 10, 13, 17, 18, 19, and 25 of the questionnaires were changed to a more suitable and comprehensible ones in Persian language.Conclusion: We suggest that the Persian version of cancer survivors’ assessment questionnaire be applied in populations with Persian language and that its sensitivity to variation be measured.
Obstetrics and Gynecology
Fariba Almassinokiani; Mahzad Alimian; Parinaz Hamednasimi
Volume 8, Issue 3 , May and June 2023, , Pages 210-216
Abstract
Background & Objective: Hysterectomy is the most common gynecological surgery. Every year, numerous women around the world undergo this type of surgery for various reasons. Regardless of the type of surgery, bleeding during surgery and after surgery is the most common consequence? Tranexamic ...
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Background & Objective: Hysterectomy is the most common gynecological surgery. Every year, numerous women around the world undergo this type of surgery for various reasons. Regardless of the type of surgery, bleeding during surgery and after surgery is the most common consequence? Tranexamic acid is a cheap, available and low-complication drug that has been considered in recent years to control bleeding. The present study investigated the effectiveness of Tranexamic acid on the bleeding during laparotomy hysterectomy in women aged 35 to 55 years.Materials & Methods: This study was a randomized, double-blind clinical trial performed on 80 patients undergoing laparotomy hysterectomy. Using a random number table, patients were divided into two groups A (receiving Transid) and the other group receiving drug B (not receiving Transid), both of which received 100 ml of normal saline prepared to reduce bias in the prepared syringe.Results: Mean age of the patients was 46.24 ± 5.21 years. Based on the results of mean hemoglobin before surgery, the rate of infection, infusion and induction in the control and intervention groups were not statistically different (P > 0.05). Also, the mean hemoglobin variables before and after hemorrhage were estimated by the surgeon and hemorrhage estimated according to Hernandez formula were not statistically different in the two groups (P > 0.05).Conclusion: Tranexamic acid administration has no effect on the amount of bleeding during hysterectomy laparotomy.
Obstetrics and Gynecology
Fereshteh Fakour; Roya Kaboodmehri; Amirhossein Hajizadeh Fallah; Maryam Dourandeesh; Fatemeh Gholamalipour; Seyedeh Maryam Attari; Forozan Milani; Zahra Pourhabibi
Volume 8, Issue 3 , May and June 2023, , Pages 217-222
Abstract
Background & Objective: Most pain relief methods are associated with some side effects and limitations. Magnesium sulfate, due to its osmotic properties and absorption of cervical water (moisture) can shorten labor duration and decrease labor pain via improving effacement and cervical edema. ...
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Background & Objective: Most pain relief methods are associated with some side effects and limitations. Magnesium sulfate, due to its osmotic properties and absorption of cervical water (moisture) can shorten labor duration and decrease labor pain via improving effacement and cervical edema. The aim of our study was to evaluate the effect of intravaginal magnesium sulfate on pain severity and duration of the first and second stages of labor.Materials & Methods: In this double-blind randomized clinical trial study, 70 nulliparous women were allocated into two groups after the beginning of the active phase of labor. In group 1, 10 ccs of magnesium sulfate 50% was poured on the whole cervix during the vaginal examination. In group 2, a placebo (sterile water) in a similar way and amount was used. Then the two groups were compared in variables of demographic, obstetrics, clinical, pain severity, duration of the first and second stages of labor, and maternal and neonatal outcomes.Results: In different dilatations, pain severity in group 1 was significantly lower (P=0.0001). The duration of the first and second stages of labor was shorter in group 1 (P =0.0001). The two groups were similar in neonatal outcomes, drug side effects, and treatment satisfaction (P >0.05).Conclusion: Intravaginal magnesium sulfate improves the condition of the cervix, reduces the duration and the severity of labor pain, and has no medical or neonatal side effects.
Obstetrics and Gynecology
Leila Asadi; Zahra Behboodi-Moghadam; Mahboobeh Shirazi; Fateme Moshirenia; Behjat Khorsandi
Volume 8, Issue 3 , May and June 2023, , Pages 223-232
Abstract
Background & Objective: Understanding the reproductive and sexual needs of pregnant women seems to be crucial in increasing the effectiveness of services and addressing their needs and expectations. Therefore, the aim of this study was to explain the needs and concerns of reproductive and sexual ...
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Background & Objective: Understanding the reproductive and sexual needs of pregnant women seems to be crucial in increasing the effectiveness of services and addressing their needs and expectations. Therefore, the aim of this study was to explain the needs and concerns of reproductive and sexual health of pregnant women during the COVID-19 pandemic.Materials & Methods: This is a qualitative study with a content analysis approach. In this probe, 16 interviews were accomplished with 15 pregnant women who had been referred to pregnancy care centers. Data analysis was performed predicated on the content analysis approach using MAXQDA software version 12.Results: Based on 17 interviews conducted with pregnant women during the COVID-19 pandemic, pregnant women were found to be suffering from mental disorders, fears, disrupting prenatal care, and sexual problems.Conclusion: Reproductive and sexual health of pregnant women in the Covid-19 epidemic should not be neglected and considered in health planning.
Obstetrics and Gynecology
Dhai Abdulalazize Rashid; Fadia Jassim Alizzi
Volume 8, Issue 3 , May and June 2023, , Pages 233-239
Abstract
Background & Objective: Infertility that cannot be explained by anovulation, poor sperm quality, tubal disease, or any other recognized cause of infertility is referred to as unexplained infertility. The aim of this study is to assess the correlation between integrin alpha-v beta-3 expression, ...
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Background & Objective: Infertility that cannot be explained by anovulation, poor sperm quality, tubal disease, or any other recognized cause of infertility is referred to as unexplained infertility. The aim of this study is to assess the correlation between integrin alpha-v beta-3 expression, endometrial thickness and subendometrial blood flow resistance index in unexplained infertility.Materials & Methods: The study carried out on Kamal – Al-Samurai fertility center in the period from October 2020 - September 2021. Six days after detecting urinary Luteinizing Hormone (LH) surge, all the women were asked to come to do two-dimensional (2D) transvaginal ultrasound to assess endometrial thickness and subendometrial blood flow color Doppler resistance index and endometrial samples was taken and examined immunohistochemically to detect alpha-v beta-3 integrin. The cut-off value of integrin and subendometrial blood flow resistance index, sensitivity and specificity were calculated by applying Receiver Operative Characteristics (ROC) curve.Results: The endometrial thickness was lower and resistance index was higher in case group (P < 0.001). The expression of integrin alpha-v beta-3 in infertile group was significantly low (P < 0.001) with significant positive correlation between integrin score and endometrial thickness (r= -0.708 & P < 0.001) and significant negative correlation between integrin score and subendometrial resistance index (r= -0.786 & P <0.001).Conclusion: Alpha-v beta-3 integrin expressions and endometrial thickness are reduced significantly in mid-luteal phase while the subendometrial blood flow color Doppler resistant index significantly increased, and using them together can possibly be used as a diagnostic predictor of unexplained infertility.
Obstetrics and Gynecology
Melad Alias Alsanity; Chiman Younus Hasan
Volume 8, Issue 3 , May and June 2023, , Pages 240-248
Abstract
Background & Objective: Fertility control has been used for thousands of years in a variety of ways. Women need to use contraceptive methods correctly to reduce unintended pregnancies and maternal mortality. The purpose of this research was to determine the factors that have an impact on the ...
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Background & Objective: Fertility control has been used for thousands of years in a variety of ways. Women need to use contraceptive methods correctly to reduce unintended pregnancies and maternal mortality. The purpose of this research was to determine the factors that have an impact on the use of contraception in our community.Materials & Methods: During the time period of December 2021 to April 2022, a descriptive cross-sectional study was conducted in primary healthcare centers in the city of Duhok, which is located in the Kurdistan Region of Iraq. A total of 400 married women between the ages of 18-45 years were studied. Information on sociodemographic characteristics, obstetrical history, contraceptive methods used, deciding factors, and discontinuation were obtained from respondents. The statistical calculations were performed in John's Macintosh Project (JMP project, version 14.3.0, Apple Macintosh. USA).Results: Out of 400 women, 269 (67.25%) were aged 18-34, 106 (26.50%) completed primary education, and 204 (51.00%) desired to conceive. The most frequently used method was withdrawal 257 (64.25%), followed by oral contraceptive pills 43 (10.75%), Intrauterine contraceptive devices 39 (9.75%), and male condoms 35 (8.75%). For the purpose of becoming pregnant, 256 (64.00%) women stopped using contraceptives. Most of the failure rates were seen among withdrawal users, which recorded 77 (19.25%), and those who experienced side effects were 42 (10.50%).Conclusion: In every district of Dohuk, there is a need for comprehensive, easily accessible, client-centered, and modern family planning services. Educational program is requested to improve the behavior and attitude toward family control.
Obstetrics and Gynecology
Hamza Radhi; Shaymaa Abdulhameed Khudair; Miaad Adnan; Muntaha Kadhem Mejbel; Ahmed S. Abed; Nizar Awish Jassem
Volume 8, Issue 3 , May and June 2023, , Pages 249-254
Abstract
Background & Objective: The fetal head's persistent posterior position, which ranges from 1 to 5% during birth, has long been acknowledged as a significant challenge of intrapartum treatment. 10% to 20% of fetuses are found to be in the occiput posterior (OP) position at the beginning of labor; ...
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Background & Objective: The fetal head's persistent posterior position, which ranges from 1 to 5% during birth, has long been acknowledged as a significant challenge of intrapartum treatment. 10% to 20% of fetuses are found to be in the occiput posterior (OP) position at the beginning of labor; 90% of them rotate to the occiput anterior. This research aims to analyze the rate of delivery in the OP position (also called sunny-side-up) concerning the outcome of manual rotation carried out contingent upon the OP position remains persistent. Perinatal outcomes were the secondary goals.Materials & Methods: This prospective cohort study was carried out in Obstetrics & Gynecology Clinic (OGC) at Faruk Medical City, Iraq. The study included all women who experienced a singleton pregnancy after 36 weeks, had an effort to rotate the fetus manually and had the fetus remain in the persistent OP position. The primary result was the delivery's occiput position. Perineal injuries, labor length, and the method of delivery have been the secondary outcomes. According to the outcome of manual rotation, two groups were contrasted.Results: The overall number of women participating was 250, and the manual rotation success rate was 59.1%. The success was strongly correlated with a reduction in the OP position during vaginal, cesarean, operative vaginal delivery, episiotomy, and obstetric anal sphincter injury.Conclusion: Reduced incidence of OP position at anal sphincter injury during operative vaginal delivery is linked to attempts at manual rotation in the case of persistent OP position.
Obstetrics and Gynecology
Sahar Hassan; Nassrin Malik Aubead
Volume 8, Issue 3 , May and June 2023, , Pages 255-267
Abstract
Background & Objective: Congenital anomalies are a global issue and the primary reason of death in both developed and advanced countries. Congenital anomalies occur at varying rates in various populations. The purpose of this research was to determine the prevalence and pattern of ...
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Background & Objective: Congenital anomalies are a global issue and the primary reason of death in both developed and advanced countries. Congenital anomalies occur at varying rates in various populations. The purpose of this research was to determine the prevalence and pattern of congenital anomalies in newborns, as well as the associated maternal and environmental factors in newborns, presented at the Babylon teaching hospital for motherhood and pediatrics in AL-Hilla city, between 2017 and 2021.Materials & Methods: This study follows a descriptive design, and was based on population data from the statistic registry covering the AL-Hilla city, Iraq, 2017 to 2021. The registry covers live and still births. Also, maternal and neonatal information regarding sex, birth weight, parental consanguinity, and maternal age, were recorded.Results: There were 214 congenitally deformed newborns among the 46,777 births in AL-Hilla city. There were 109 males (50.69 percent) and 103 females (47.90 percent). The most common congenital malformations discovered were those relating to the neurological system, followed by those relating to the musculoskeletal system.Conclusion: Anomalies in the central nervous system were most apparent, however, this research can help to determine the approximate distribution of the prevalence of congenital anomalies in AL-Hilla city in Iraq. Also, by identifying their main types, information can be applied to improve the clinical performance and public policies of Iraq.
Obstetrics and Gynecology
Soudabeh Kazemi Aski; Seyedeh Hajar Sharami; Morvarid Ghasab Shirazi; Ezat Hesni; Seyedeh Fatemeh Dalil Heirati; Misa Naghdipour; Alireza Forozan; Maryam Ghalandari; Forozan Milani
Volume 8, Issue 3 , May and June 2023, , Pages 268-276
Abstract
Background & Objective: The Covid-19 pandemic can cause complications for pregnant women and more serious maternal, fetal and neonatal care related to this disease should be considered in health systems. The aim of the present study was to investigate the maternal, fetal, and neonatal outcomes ...
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Background & Objective: The Covid-19 pandemic can cause complications for pregnant women and more serious maternal, fetal and neonatal care related to this disease should be considered in health systems. The aim of the present study was to investigate the maternal, fetal, and neonatal outcomes of pregnant women with COVID-19 disease.Materials & Methods: We performed a prospective study with a longitudinal design of all pregnant women hospitalized due to moderate and severe COVID-19 referred to Al-Zahra hospital, Rasht, Iran. After patient discharge, patients were followed until delivery, maternal, fetal, and neonatal outcomes were assessed by a 4-part researcher-made questionnaire.Results: In total, 166 pregnant women with Covid-19 were included in the study. The median gestational age in patients was 35.5 weeks and the median delivery age was 38 weeks. Delivery in 137 (82.5%) women were cesarean section and 29 (17.5%) had a vaginal delivery. The most common clinical symptoms among patients were fever, cough, and dyspnea with 50.9%, 38.5%, and 31.5% frequency, respectively, 9.6% had poor prenatal outcomes, 15 patients (9%) were admitted to ICU and 4 patients died (2.4%). Poor maternal outcomes were reported in 61.5% of patients with severe clinical symptoms, (p <0.001). There was no significant relationship between the severity of the disease and the type of delivery (p = 0.41).Conclusion: In our study we observed an increase in poor maternal, fetal and neonatal outcomes particularly in pregnant women with severe symptoms, although careful care is still recommended for affected pregnant women to reduce fetal, neonatal, and maternal complications. Further research will be needed to devise plan for pregnancy care and future health care crises.
Obstetrics and Gynecology
Omarov Nazarbek Bakytbekovich; Ahmed Al-Hili; Duaa Hamid Ali; Aisha Kamal Mahmoud; Entsar Hachim Muhammad; Ahmed S. Abed; Marwa Jabbar Saiwan; Haider Hussain Jlood
Volume 8, Issue 3 , May and June 2023, , Pages 277-284
Abstract
Background & Objective: Cervical cancer screening is crucial for the early detection and prevention of this disease in women. Due to the prevalence of cervical cancer in Iraq, the current study aimed to improve Pap smear screening practices.Materials & Methods: The present semi-experimental ...
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Background & Objective: Cervical cancer screening is crucial for the early detection and prevention of this disease in women. Due to the prevalence of cervical cancer in Iraq, the current study aimed to improve Pap smear screening practices.Materials & Methods: The present semi-experimental study was conducted in 2019 on 192 Baghdad-based women aged 20 to 60 with active medical records. Two groups of 96 people, intervention and control, were created. The intervention group received training based on the constructs of health belief and stages of change models to enhance Pap smear screening behavior. The control group participated in routine training on Pap smear screening behavior in health centers from health professionals. The participants completed a questionnaire created by the researchers in the pre-test and post-test stages. For data analysis, version 19 of SPSS statistical software and independent t-tests, paired t-tests, chi-square, and Fisher's exact test were utilized.Results: A p-value of less than 0.05 was deemed statistically significant. Before the educational intervention, there was no significant difference between the two groups in the stages of behavior change (P>0.05). However, after the educational intervention, the intervention group significantly differed from the control group in the Pap smear screening change (P<0.01). Also, based on the paired t-test, the mean scores of the intervention group's knowledge, susceptibility, severity, barriers, and self-efficacy were significant before and after the intervention (P<0.05). After the intervention, the intervention group demonstrated significantly higher Pap smear screening behavior than the control group (P<0.01).Conclusion: The utilization of educational intervention of the stages of change and health beliefs models has proven to be highly effective in bringing individuals to the action stage.
Obstetrics and Gynecology
Maral Hosseinzadeh; Ebtehaj Heshmatkhah; Dariush Abtahi
Volume 8, Issue 3 , May and June 2023, , Pages 285-294
Abstract
Background & Objective: Globally, postpartum hemorrhage (PPH) remains a leading cause of maternal deaths. However, in many low and middle-income countries, information on the magnitude of and risk factors for PPH is scarce. Understanding the relative contributions of different risk factors for ...
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Background & Objective: Globally, postpartum hemorrhage (PPH) remains a leading cause of maternal deaths. However, in many low and middle-income countries, information on the magnitude of and risk factors for PPH is scarce. Understanding the relative contributions of different risk factors for PPH is important. We assessed the incidence of and risk factors for postpartum hemorrhage among women who had a cesarean section in Iran.Materials & Methods: Between March 2021 and March 2022, a prospective cohort study was conducted at a university-affiliated general hospital for women who had a cesarean section in Iran. We used Spearman’s correlation for the variables associated with PPH.Results: Among the 300 women, the overall incidence of postpartum hemorrhage was 15.7%. Risk factors for postpartum hemorrhage among deliveries by cesarean section were: body-mass index, previous PPH, preoperative anemia, and preoperative hypofibrinogenemia.Conclusion: The incidence of postpartum hemorrhage in the cesarean section was high. Extra vigilance in all women with cesarean section could address the risk factors identified.
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 , March and April 2023, , Pages 105-112
Abstract
Background & 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 & 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.Materials & Methods: We searched PubMed, Cochrane and Scopus databases from January 2000 to November 2019 for relevant studies containing the use of levonorgestrel-releasing intrauterine device (LNG-IUD) in managing patients with ultrasonographic diagnosis of adenomyosis. Main outcome measures in the study are menstrual blood loss (milliliters), pain score measured in 10 cm-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 6 months (Standardized Mean Difference (SMD): 3.68; Cl: 2.11-5.25) , 12 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 6 months (SMD: 2.52; CI: 1.15-3.89), 12 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 6 months (SMD: 0.49; CI: 0.04-0.93), 12 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.
