Obstetrics and Gynecology
Mohammed Ubaid Hamza; Noora M. Hameed; Sura Hasan Al-Zubaidi; Roua Abulkassim; Zahraa Basim Mohamed; Safaa Saad Mahmood; Dhuha Mohsin Al-Dhalemi; Heba Takleef al Salami; Nathera Hussin Alwan; Doaa A. Hamad
Volume 7, Issue 6 , September and October 2022, , Pages 563-568
Abstract
Background & Objective: Toxoplasmosis is a zoonotic infection caused by Toxoplasma gondii, a parasite that causes a variety of clinical symptoms in humans. It is a facultatively heteroxenous, polyxenous protozoon that has evolved several potential transmission routes within and between the host species. ...
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Background & Objective: Toxoplasmosis is a zoonotic infection caused by Toxoplasma gondii, a parasite that causes a variety of clinical symptoms in humans. It is a facultatively heteroxenous, polyxenous protozoon that has evolved several potential transmission routes within and between the host species. Infections caused by Toxoplasma gondii are more frequently seen in immunocompetent patients. The infection acquired by the mother during pregnancy puts the fetus at risk of congenital infection due to the parasite transmission across the placenta. The severity and frequency of infection are determined by the gestational age of the mother at the time of infection. The objective of this research was to study the toxoplasmosis infection in women, and to estimate the relationship between T. gondii infection and parameters including abortion time, chronic diseases, and age.Materials & Methods: The case-control study was conducted on 50 healthy women (pregnant and non-pregnant) as control group and 135 women with abortion experience as case group at the Women's and Children's Hospital in Baghdad, Iraq from December 2021 until March 2022. The questionnaire was used to gather information from the women. The participant's name, age, gestational age, address, medications taken, medical history, previous abortions, and the date the sample was taken were all included. Under sterile conditions, five milliliters of the venous blood were drawn from each woman. The ELISA test was used to determine the level of anti-T. gondii IgM and IgG antibodies in serum samples.Results: The anti-Toxoplasma IgM and IgG antibodies were found to be positive in 51% and 8% of the cases, respectively. However, the anti-T. gondii antibodies seroprevalence was 59% in women who had abortion. The healthy women had 0% for all antibodies. Conclusion: Despite reporting the high rates of infection among women who had single abortions, the current study found no significant association between the percentage of infection and the number of abortions. The cause of high incidence among women who had abortion could be due to decrease in the immune system function.
Obstetrics and Gynecology
Fatemeh Golshahi; Behnaz Moradi; Forough Jabbari; Marjan Ahmadi
Volume 7, Issue 6 , September and October 2022, , Pages 574-577
Abstract
Fraser syndrome is a rare genetic disorder characterized by multiple structural abnormalities, above all of which are cryptophthalmos and syndactyly. According to reviews of reported cases, diagnostic criteria have been established. Here, we report a case of 18 weeks pregnancy diagnosed with Fraser syndrome ...
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Fraser syndrome is a rare genetic disorder characterized by multiple structural abnormalities, above all of which are cryptophthalmos and syndactyly. According to reviews of reported cases, diagnostic criteria have been established. Here, we report a case of 18 weeks pregnancy diagnosed with Fraser syndrome presenting with cryptophthalmos, syndactyly, kidney agenesis, and hyper-echogenic lungs during an ultrasound examination. The pregnancy was terminated, and diagnostic features of the syndrome were confirmed afterward. Since the imaging characteristics are unique, it is of value that clinicians become familiar with the appearance of the syndrome to provide families with the opportunity to make timely decisions regarding pregnancy termination and use the prenatal diagnostic tools to have healthy children in subsequent pregnancies.
Obstetrics and Gynecology
Behnaz Moradi; Sara Naybandi Atashi; Elham Shirali
Volume 7, Issue 6 , September and October 2022, , Pages 587-588
Abstract
Adnexal masses characterization is a really challenging issue and is essential for appropriate patient management. Ovarian Adnexal Reporting and Data System (O-RADS) is tone excellent standardized lexicons to provide practical uniform terms, definitions and measurements for describing and classifying ...
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Adnexal masses characterization is a really challenging issue and is essential for appropriate patient management. Ovarian Adnexal Reporting and Data System (O-RADS) is tone excellent standardized lexicons to provide practical uniform terms, definitions and measurements for describing and classifying ovarian masses.In the first publication of O-RADS system, they noted that cystic lesions with maximum diameter of solid component of ≥7 mm, are at higher risk for malignancy. On the other hand, the number of papillary projections had nearly similar positive LR (2.2). Despite this and inclusion of the number of papillary projections in the final risk stratification system, the maximal size of solid part was not included and no cystic lesion with solid component could be categorized in O-RADS 3 category, and size of papillary projection make no change in malignancy risk stratification.In conclusion, we propose that in O-RADS lexicon the use of maximal diameter of solid components (with 7 mm cut off point) along with number of papillary projections is helpful to categorize cystic ovarian mass lesions as auxiliary item for classifying risk of malignancy less than 10% to higher than 50% (O-RADS 3 to ORADS 5).
Obstetrics and Gynecology
Shahnaz Ahmadi; Elnaz Salarifar; Kambiz Ahmadi; Maryam Rahimi; Mahshid Bahraini
Volume 7, Issue 5 , July and August 2022, , Pages 399-404
Abstract
Background & Objective: Preeclampsia is associated with the release of soluble endoglin (sENG) into the maternal circulation. It inhibits sENG secretion, inhibiting the complex I of the mitochondrial electron transport chain. Therefore, using metformin may be helpful in the prevention of preeclampsia. ...
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Background & Objective: Preeclampsia is associated with the release of soluble endoglin (sENG) into the maternal circulation. It inhibits sENG secretion, inhibiting the complex I of the mitochondrial electron transport chain. Therefore, using metformin may be helpful in the prevention of preeclampsia. The aim of this study was to evaluate the effect of metformin in preventing superimposed preeclampsia.Materials & Methods: This single-blind randomized clinical trial was conducted on 60 pregnant women 25-40 years old with chronic hypertension before the 20th week of pregnancy. The patients were randomized and divided into two groups (n=30). The first group received 1000 mg metformin (tablet metformin 500 mg bid), and the second group received a placebo (2 tablets daily). Then the incidence of preeclampsia and intrauterine retardation growth of the fetus were compared in the two groups.Results: The metformin consumption significantly reduced the incidence of preeclampsia (P < /i>=0.04) and intrauterine growth restriction (P < /i>=0.035) compared to the control group. Conclusion: Metformin effectively reduced the incidence of superimposed preeclampsia and related factors in a pregnant patient with chronic hypertension.
Obstetrics and Gynecology
Zinatossadat Bouzari; Tara Mohammadi; Mohammad Ranaei; Karimollah Hajian-Taliki; Azita Ghanbarpour
Volume 7, Issue 5 , July and August 2022, , Pages 414-421
Abstract
Background & Objective: Gestational diabetes mellitus (GDM) is also defined as a metabolic disease associated with relative insulin resistance during pregnancy, and elevated circulating insulin may increase the risk of EH and EC development. This study aimed to investigate the association between ...
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Background & Objective: Gestational diabetes mellitus (GDM) is also defined as a metabolic disease associated with relative insulin resistance during pregnancy, and elevated circulating insulin may increase the risk of EH and EC development. This study aimed to investigate the association between GDM and the incidence of EH and EC.Materials & Methods: We conducted a retrospective case-control study, including 300 women with abnormal uterine bleeding (AUB) referred to Ayatollah Rouhani Hospital in Babol. Cases (n=152) were patients with HC and EC based on medical records, and the controls (n=148) were individuals without HC and EC. The groups were compared according to demographic information, GDM or diabetes mellitus (DM) history, and body mass index (BMI). The Chi-square, independent t-test, and logistic regression analyses were performed to compare groups.Results: Of 300 women studied, 72 people (24.1%) had a GDM history, and 64 people had a diabetes mellitus history. There was a significant difference between the incidence of EC and EH with GDM (P < /i>=0.001). Both GDM and DM were associated with the increased EC (OR: 17.98, 95% CI: 6.73-48.08, and OR: 1.84, 95% CI: 1.26-2.68, respectively). GDM was also associated with the increased risk of EH (OR: 6.68, 95% CI: 2.77-16.10), whereas diabetes mellitus had not a significant role in the increased risk of EH (P < /i>=0.14). Conclusion: This study indicated that a GDM history is significantly associated with HC and EC. Therefore, to prevent and control these two complications in the future, management and monitoring of diabetes during pregnancy should be considered.
Obstetrics and Gynecology
Ivanna Beru Brahmana; Inayati Inayati
Volume 7, Issue 5 , July and August 2022, , Pages 422-428
Abstract
Background & Objective: Vaginal discharge caused by infection and inflammation could lead to premature rupture of the membranes, which increases the risk of premature labor. If not handled properly, preterm delivery elevates the neonatal mortality risk and morbidity rate. This study aims to know ...
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Background & Objective: Vaginal discharge caused by infection and inflammation could lead to premature rupture of the membranes, which increases the risk of premature labor. If not handled properly, preterm delivery elevates the neonatal mortality risk and morbidity rate. This study aims to know the relationship between uterine contractions with preterm.Materials & Methods: Observational research and cross-sectional design on pregnant women with vaginal discharge and without vaginal discharge based on criteria inclusion was gestational age 16–37 weeks, and exclusion criteria were pregnant women with a history of sexually transmitted diseases.Results: The results showed that there were 130 pregnant women, of whom 77 (59.23%) have vaginal discharge complaints, and 53 (40.77%) do not have vaginal discharge complaints. Most pregnant women were in their first pregnancy (primigravida) and with 29–36 weeks gestational age. Uterine contractions (his) occurred in 68.8% (P < /i>=0.000) of pregnant women with vaginal discharge complaints but did not occur in pregnant women without vaginal discharge complaints. Conclusion: Vaginal discharge in pregnancy carries the risk of uterine contractions, which may increase the incidence of preterm birth. To conclude, vaginal discharge in pregnancy has a relationship with preterm birth.
Obstetrics and Gynecology
Nooshin Amjadi; Nasrin Mansori; Leili Rezaie Kahkha; Mojtaba Ashrafi; Saeedeh Chalaki; Khadije Rezaie Keikhaie
Volume 7, Issue 5 , July and August 2022, , Pages 445-451
Abstract
Background & Objective: Diabetes Mellitus refers to a group of specific metabolic diseases with a hyperglycemic phenotype. The present study compares pregnancy outcomes and nonstress tests (NST) in insulin-treated diabetic women with healthy pregnant women.Materials & Methods: In this cross-sectional ...
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Background & Objective: Diabetes Mellitus refers to a group of specific metabolic diseases with a hyperglycemic phenotype. The present study compares pregnancy outcomes and nonstress tests (NST) in insulin-treated diabetic women with healthy pregnant women.Materials & Methods: In this cross-sectional study, pregnancy outcomes and NST results were evaluated in 45 diabetic pregnant women who had received insulin therapy and 90 healthy pregnant women. The NST tracings of all women were applied and evaluated regarding reactive and non-reactive parameters. Data were analyzed using SPSS software version 20 and Fisher's exact test.Results: Our results demonstrated that NST was reactive in 75.6%and was non-reactive in 24.4% of diabetic mothers. There was a significant increase in macrosomia in diabetic mothers with non-reactive NST, while there was no statistical significance between NST results in the two groups. Conclusion: Pregnant women with diabetes are more prone to complications than healthy women. The main complication is the fetal size which leads to difficulties in delivery and increased incidence of cesarean section.
Obstetrics and Gynecology
Fariba Yarandi; Sara Ramhormozian; Behzad Asanjarani; Elham Shirali
Volume 7, Issue 5 , July and August 2022, , Pages 458-462
Abstract
GTN (Gestational trophoblastic neoplasm) complications such as uterine rupture or massive bleeding can be life-threatening and usually need a hysterectomy. In young patients who want to preserve fertility, hysterectomy is not suitable. Under specific circumstances, some physicians choose conservative ...
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GTN (Gestational trophoblastic neoplasm) complications such as uterine rupture or massive bleeding can be life-threatening and usually need a hysterectomy. In young patients who want to preserve fertility, hysterectomy is not suitable. Under specific circumstances, some physicians choose conservative management. Uterine preservation after complicated GTN is rare by itself. In conclusion, conservative management of GTN patients who develop high-risk complications and desire for future pregnancies must be considered an option. In published case reports, outcomes of conservative surgical management have been very good if managed properly.
Obstetrics and Gynecology
Marzieh Talebian; Niloofar Mehri; Maryam Mousavi Shirazi
Volume 7, Issue 5 , July and August 2022, , Pages 462-465
Abstract
Severe injury to the nervous system in pregnancy needs advanced critical care support to the mother and consideration of fetal effects. Managing persistent vegetative state (PSV) cases in pregnant patients is complex due to the lack of clear guidelines for medical and ethical reasons. This reports a ...
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Severe injury to the nervous system in pregnancy needs advanced critical care support to the mother and consideration of fetal effects. Managing persistent vegetative state (PSV) cases in pregnant patients is complex due to the lack of clear guidelines for medical and ethical reasons. This reports a gravida 4, maternal persistent vegetative state case due to a car accident for a 25-year-old woman at 20 pregnancy weeks. Aggressive support enabled the continuation of pregnancy toward 3th trimester without any impediment to the infant's development. A fetal scan for growth monitoring showed an estimated fetal weight near the 75th centile. Intervention in the pregnancy of a patient suffering PSV is not required if both mother and fetus are stable. Maternal malnutrition may adversely affect the fetus and neonate. In this case, high caloric nutrition with partial parenteral nutrition was employed. We monitored both the mother and her child in an attempt to gather data pertinent to the appropriate care of pregnancy in a persistent vegetative state and the potential sequel for offspring.
Obstetrics and Gynecology
Sedigheh Ghasemian; Somayeh Ghasemzadeh; Ali Soleimany
Volume 7, Issue 5 , July and August 2022, , Pages 466-470
Abstract
Clindamycin, IVIg, and corticosteroids are widely used in medicine. In this study, we represent an unusual case of sinus bradycardia following the administration of these drugs. The patient was a 31-year-old woman who presented a complaint of vaginal bleeding at Shahid Motahhari Hospital, Urmia, Iran. ...
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Clindamycin, IVIg, and corticosteroids are widely used in medicine. In this study, we represent an unusual case of sinus bradycardia following the administration of these drugs. The patient was a 31-year-old woman who presented a complaint of vaginal bleeding at Shahid Motahhari Hospital, Urmia, Iran. Vaginal examination revealed active bleeding. Laboratory tests reported a positive HCG level. Ultrasonography was performed, and the results showed the presence of retained products of conception. The patient became a candidate for curettage. The initial pulse rate was tachycardia. Laboratory data were reported, platelet count of 16000. corticosteroids and IVIgs were started. Due to the possibility of infectious abortion, Clindamycin and Gentamicin was started. About 24 hours after curettage and 4 hours after starting clindamycin, the patient felt dizziness. Vital signs were obtained that PR: 38-40. We concluded that clindamycin and IVIg can result in severe bradycardia, even in patients with no previous cardiac history, especially when combined with corticosteroids. As a result, we recommend physicians be more cautious when administrating these medications.
Obstetrics and Gynecology
Tajossadat Allameh; Maryam Kalatehjari
Volume 7, Issue 4 , March and April 2022, , Pages 279-285
Abstract
Background & Objective: Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes ...
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Background & Objective: Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes of colposcopy in contrast to Pap smear. The current study aims to assess the values of colposcopy for cervical cancer diagnosis.Materials & Methods: This is a cross-sectional study conducted on 94 patients diagnosed with high-grade squamous intraepithelial lesion (HSIL). After that, colposcopy was performed for all patients, and findings were presented as normal, chronic cervicitis, the thin acetowhite lesion (AWL), dense/thick AWL, AVP, pilling, and cauliflower-like mass. The biopsies were taken and pathological studies, as the gold standard was interpreted as normal, cervicitis, atypical squamous cells of undetermined significance (ASCUS), cervical intraepithelial neoplasia-1, -2 or -3 (CIN-1, -2 or -3), carcinoma-in-situ (CIS), adenocarcinoma and invasive squamous cell carcinoma (SCC).Results: The pap-smear results were significantly associated with the biopsy reports (P < /em><0.001; kappa=0.225). Besides, significant concordance was found between colposcopy and biopsy (P < /em><0.001; kappa=0.247). The total sensitivity and specificity of colposcopy were based on the biopsy findings as the gold standard was 97% and 41%, respectively (P < /em><0.001).Conclusion: Colposcopy was significantly sensitive and specific for diagnosing both non-malignant CIN-1 and malignant cervical lesions, but not for CIN-2, -3, and CIS lesions. Further evaluations are strongly recommended.
Obstetrics and Gynecology
Maryamsadat Hosseini; Farah Farzaneh; Mahsa Mirhadi; Seyed Ali Akbar Mahdavi Anari; Ladan Ajori; Saghar Salehpour; Tayebeh Jahed Bozorgan; Parichehr Pooransari; Shideh Ariana; Minoo Yaghmaei; Behnaz Nouri; Shahrzad Zadehmodarres; Sedighe Hosseini; Mehrdad Haghighi; Mir Mohammad Miri; Seyedpouzhia Shojaei; Ali Reza Mirkheshti; Dariush Abtahi; Tannaz Valadbeigi
Volume 7, Issue 4 , March and April 2022, , Pages 286-295
Abstract
Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation ...
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Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.Materials & Methods: In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.Results: The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.Conclusion: In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.
Obstetrics and Gynecology
Atefeh Mousavi; Sharareh Jannesari; Sepideh Hajian; Mahnaz Solhi; Mehdi Khabaz Khoob; Malihe Nasiri; Aryan Sadeghyan
Volume 7, Issue 4 , March and April 2022, , Pages 304-313
Abstract
Background & Objective: Breast cancer is the most common type of cancer and about one-third of all cancers in women. Within the case of early detection, more than 90% of the patients are treated. However, most women do not perform breast self-examination as a simple, effective, and inexpensive way ...
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Background & Objective: Breast cancer is the most common type of cancer and about one-third of all cancers in women. Within the case of early detection, more than 90% of the patients are treated. However, most women do not perform breast self-examination as a simple, effective, and inexpensive way to prevent cancer deaths. Therefore, this study aimed to inform and educate women to promote self-efficacy and encourage individuals to self-care.Materials & Methods: This study is quantitative research and was conducted on 80 women aged 20-60 years old in health centers of the city of Some Sara. The data collection tool was a researcher-made questionnaire designed based on the Extended Parallel Process Model. The educational intervention was conducted using lecture, question and answer, movie screening, and practical presentation using Moulage. The health behaviors and performance of the participants before and immediately after the intervention, and two months later, were compared within the intervention and control groups. Data were analyzed by repeated-measures test, chi-square, Mann -Whitney, Exact Fisher's test.Results: The study results showed that educational intervention based on the Extended Parallel Process Model had increased self-efficacy within the intervention group compared with the control group. The intervention increased the average score of individuals from model structures. So that before the educational intervention, the average perceived susceptibility and severity score, perceived self-efficacy and response efficacy, perceived threat, and perceived efficacy was moderate. After the intervention, the average score of all model components increased (P < /em><0/05). The mean score of the performance checklist was 14 before the intervention, which was upgraded to 20 after the intervention (P < /em><0/05).Conclusion: The results of this study supported the effectiveness of the Extended Parallel Process Model in preventing breast cancer.
Obstetrics and Gynecology
Hamideh Gholami; Sanaz Fayazi; Maryam Shirshekan; Nima Motamed; Shabnam Tofighi
Volume 7, Issue 4 , March and April 2022, , Pages 335-340
Abstract
Background & Objective: Conflicting results have been reported about the association between vitamin D and preeclampsia. The aim of the current study is to compare the serum levels of vitamin D in preeclamptic, and non-preeclamptic pregnant women admitted to the Ayatollah Mousavi Hospital in Zanjan.Materials ...
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Background & Objective: Conflicting results have been reported about the association between vitamin D and preeclampsia. The aim of the current study is to compare the serum levels of vitamin D in preeclamptic, and non-preeclamptic pregnant women admitted to the Ayatollah Mousavi Hospital in Zanjan.Materials & Methods: In this case-control study, 120 pregnant women were selected using convenience sampling in Zanjan in 2018-2019. Then they were divided into two groups, preeclampsia and non- preeclampsia. Both groups were matched one by one. The data were collected using a demographic information questionnaire and a researcher-made checklist. After obtaining consent from participants, blood samples were collected using the peripheral venous catheter. Then the ELISA test was used to measure vitamin D in participants. Data were analyzed by SPSS version 16 using, independent t-test, and Chi-square test (P < /em>≤0.05).Results: Of the participants, 64 (53.4 %) were between 20-35 years old, 48 (40%) were older than 35 years, and 8 (6%) were younger than 20 years. Most of the participants' gestational age was between 34 and 39 weeks (89.1%). The Mean (SD) of serum level of vitamin D was significantly higher in healthy pregnant women (19.06 (7.48)) than women with preeclampsia (16.60 (5.87)) (P < /em><0.01). Among those with preeclampsia, the highest vitamin D level (17.17) was observed at 37-39 weeks of gestation. The lowest level (10.8) was for those with less than 34 weeks gestational age.Conclusion: This study demonstrated that vitamin D could be a protective factor for preeclampsia in pregnant women. However, further studies are recommended.
Obstetrics and Gynecology
Tahereh Behrouzi lak; Somayeh Ghasemzadeh
Volume 7, Issue 4 , March and April 2022, , Pages 351-353
Abstract
The most common form of structural uterine anomaly is the septate uterus, which has the highest rate of reproductive failure. An uncommon type of development is a septate uterus with cervical duplication and a complete longitudinal vaginal septum. We report a 26-year-old woman with infertility complaints. ...
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The most common form of structural uterine anomaly is the septate uterus, which has the highest rate of reproductive failure. An uncommon type of development is a septate uterus with cervical duplication and a complete longitudinal vaginal septum. We report a 26-year-old woman with infertility complaints. We performed diagnostic procedures and noticed that the patient had a septate uterus and cervical duplication with a longitudinal vaginal septum. It is an uncommon Mullerian anomaly that does not fit into the current assortment system of Mullerian anomalies by the American Fertility Society (AFS).
Obstetrics and Gynecology
Reda Hemida
Volume 7, Issue 4 , March and April 2022, , Pages 356-357
Abstract
Dear Editor- in –Chief of Journal of Obstetrics, Gynecology and Cancer Research (JOGCR),I write to you regarding the published article in The Journal of Obstetrics, Gynecology, and Oncology research titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered ...
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Dear Editor- in –Chief of Journal of Obstetrics, Gynecology and Cancer Research (JOGCR),I write to you regarding the published article in The Journal of Obstetrics, Gynecology, and Oncology research titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy” by Aminimoghaddam et al that was published on 27th of September, 2019 [1]. The article was revised with interest and raised for me some serious concerns.
Obstetrics and Gynecology
Soheila Aminimoghaddam
Volume 7, Issue 4 , March and April 2022, , Pages 358-360
Abstract
Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered ...
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Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy,” published in 2019 in your journal.I want to first thank Professor Hemida for reading my paper carefully and sharing his comments. I highly believe that sharing comments and raising scientific questions could benefit our society. I hope that the responses that the co-authors have provided be helpful and to the point. As he suggested, I am willing to let the journal publish the responses in the next issue.
Obstetrics and Gynecology
Nasibeh Roozbeh; Sepideh Hajian; Soodabeh Darvish; Zahra Kiani
Volume 7, Issue 3 , January and February 2022, , Pages 131-143
Abstract
Background & Objective: Given the significant role of low birth weight (LBW) in infant death and disability and relevant childhood diseases, the present systematic review was conducted to determine the factors affecting newborns’ birth weight in Iran.Materials & Methods: This study ...
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Background & Objective: Given the significant role of low birth weight (LBW) in infant death and disability and relevant childhood diseases, the present systematic review was conducted to determine the factors affecting newborns’ birth weight in Iran.Materials & Methods: This study systematically reviewed all the observational studies carried out in Iran between 1990 and 2021 (retrieval date: April 28, 2021) in four steps and through searches in Persian databases (including Magiran, SID, and IranDoc) and English databases (including Embase, Cochrane Library, Web of Sciences, Google Scholar, PubMed, and Scopus). All the relevant articles were searched by two researchers separately and collected using research keywords, Boolean operators, and a combination of relevant tags depending on the type of database. The quality of the articles was evaluated with 22-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and Ottawa checklists, respectively.Results: Of the 251 articles collected, 31 met the study inclusion criteria. Variables such as the mother’s age (35%), body mass index (BMI) (25%), preterm childbirth, and diagnosis with a maternal chronic disease (25%) were found to be the most common causes of LBW in the reviewed studies, by order of prevalence.Conclusion: Based on the results of this review study and given that many of the known risk factors of LBW are preventable, the timely diagnosis, proper treatment, and follow-up of women at risk can prevent the birth of LBW infants.
Obstetrics and Gynecology
Khadijeh Elmizadeh; Misa Naghdipour; Fatemeh Lalooha; Seyedeh Masoomeh Hosseini Valmi; Ali Massoudifar; Marzieh Sarafraz
Volume 7, Issue 3 , January and February 2022, , Pages 158-164
Abstract
Background & Objective: Hysterectomy is one of the major gynecologic operations. This procedure can be performed by different methods including abdominal, vaginal, and laparoscopic hysterectomy. In fast-track hysterectomy (FTH), patients do not receive opioids during surgery and there is no ...
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Background & Objective: Hysterectomy is one of the major gynecologic operations. This procedure can be performed by different methods including abdominal, vaginal, and laparoscopic hysterectomy. In fast-track hysterectomy (FTH), patients do not receive opioids during surgery and there is no need for a 12-hour pre-surgery hospitalization. Patients are encouraged to eat and move at most 6 hours after operation. This study was performed to compare the outcomes of FTH with those of routine abdominal hysterectomy (RAH).Materials & Methods: This case-control pilot study was carried out on 82 candidates for hysterectomy at Kowsar Training Hospital in Qazvin, Iran, during 2016. Patients were divided into two randomized groups of FTH and RAH. Parameters such as pain visual analogue scale (VAS) after 3, 6, 12, and 24 hours, diet tolerance, analgesic dose, postoperative nausea and vomiting, hospital stay, postoperative adverse effects, gas passing time, and readmission were investigated and compared between two groups.Results: Analgesic use, gas passing time, and hospital stay were significantly lower in the FTH group (P < /em>=0.0001). While postoperative nausea and vomiting, adverse effects, food tolerance, and readmission rate were the same in both groups (P < /em>>0.05). Moreover, diet tolerance was observed in all patients. In general, pain VAS was lower in FTH with significant difference at 3rd (P < /em>=0.002) and 12th (P < /em>=0.001) hours, and at suture removal time (P < /em>=0.026).Conclusion: It can be concluded that FTH may result in reduced pain, analgesic use, gas passing time, and hospital stay in comparison with RAH.
Obstetrics and Gynecology
Nahid Zirak; Leila Mashhadi; Elaheh Jajarmi; Negar Morovatdar; Parisa Mohebbi; Nahid Javdani Haji; Shahrzad Maraghehmoghaddam; Leili Hafizi
Volume 7, Issue 3 , January and February 2022, , Pages 171-176
Abstract
Background & Objective: This study aimed to investigate the relationship between the level of high-sensitivity C-reactive protein (hs-CRP; as an indicator of inflammatory response) and shoulder tip pain (STP) following cesarean section (C-section).Materials & Methods: In this cohort study, a ...
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Background & Objective: This study aimed to investigate the relationship between the level of high-sensitivity C-reactive protein (hs-CRP; as an indicator of inflammatory response) and shoulder tip pain (STP) following cesarean section (C-section).Materials & Methods: In this cohort study, a total of 120 pregnant women who were candidates for elective C-section at Imam Reza Hospital were included. The level of hs-CRP was measured perioperatively. STP was measured after the operation.Results: Mean hs-CRP was significantly higher in females with STP compared to counterparts (19±13.1 vs. 7.2±4.5; P < /em><0.001). There was a positive and strong correlation between STP and postoperative hs-CRP (P < /em><0.001).Conclusion: The release of acute-phase proteins (such as hs-CRP) plays a significant role in STP after C-section; the intensity of STP is associated with the level of hs-CRP.
Obstetrics and Gynecology
Mandana Mansour Ghanaei; Sude Amir Afzali; Ali Morady; Roxana Mansour Ghanaie; Seyed Mohammah Asghari Ghalebin; Elahe Rafiei; Roya Kabodmehri
Volume 7, Issue 3 , January and February 2022, , Pages 177-185
Abstract
Background & Objective: Accordingly, this study aimed to assess pregnancy outcomes and pathological findings of the placenta caused by intrauterine growth restriction (IUGR) with or without pre-eclampsia (PE).Materials & Methods: This cohort study was conducted on two groups: Group I was ...
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Background & Objective: Accordingly, this study aimed to assess pregnancy outcomes and pathological findings of the placenta caused by intrauterine growth restriction (IUGR) with or without pre-eclampsia (PE).Materials & Methods: This cohort study was conducted on two groups: Group I was PE-induced IUGR (PE-IUGR), and group II was idiopathic IUGR (I-IUGR). Pregnancy and neonatal outcomes were evaluated in both groups. The placental assessment was also performed based on pathological findings. Data were compiled and analyzed by SPSS 21. An analytical study was conducted on the groups based on t (or non-parametric Mann-Whitney), chi-square, and Fisher’s exact tests.Results: The findings of this study showed that maternal age, body mass index (BMI), the incidence of preterm delivery, and low birth weight were higher in the PE-IUGR group (P < /em><0.001 in all) than in the I-IUGR group, and the difference was statistically significant. Additionally, circulatory disorders and impaired anomalies were higher in the PE-IUGR group (P < /em>>0.001) than in the I-IUGR group.Conclusion: Placental disorders and reduced blood flow to the fetus due to placental disorders might lead to low birth weight and preterm delivery.
Obstetrics and Gynecology
Shahnaz Ahmadi; Katayoon Farahani; Majid Aklamli; Kambiz Ahmadi; Niloufar Beheshti
Volume 7, Issue 3 , January and February 2022, , Pages 186-191
Abstract
Background & Objective: Spinal analgesia and Entonox analgesia are used as pain relief methods during labor. This cross-sectional study was conducted to determine the effect of spinal analgesia and Entonox analgesia on the duration of the first, second, and third stages of labor, Apgar score, and ...
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Background & Objective: Spinal analgesia and Entonox analgesia are used as pain relief methods during labor. This cross-sectional study was conducted to determine the effect of spinal analgesia and Entonox analgesia on the duration of the first, second, and third stages of labor, Apgar score, and maternal and fetal outcomes.Materials & Methods: Clinical information of 1,000 patients who delivered at Shahid Akbarabadi Hospital and underwent painless delivery with Entonox gas and spinal anesthesia was assessed; then, according to the inclusion criteria, 280 cases were divided into two groups: the spinal analgesia group (n=140) and Entonox analgesia group (n=140). In the spinal analgesia group, 25 μg of fentanyl and 1-2 mg of bupivacaine were administered. For the Entonox group, Entonox inhalation was administered via a face mask at the initiation of pain at each contraction. The duration of labor, mode of delivery, side effects, and maternal satisfaction were also compared in the two groups.Results: The duration of the first stage was significantly shorter in the spinal analgesia group than in the Entonox analgesia group (P < /em><0.001), but the duration of the second stage in the spinal analgesia group was longer (P < /em><0.001). There were no significant differences in the cesarean section rates, Apgar score, weight, and acidity (PH) and the partial pressure of carbon dioxide (pCO2) between the two groups. Measured pain was significantly lower in the spinal analgesia group (P < /em>=0.01) than in the Entonox analgesia group regarding visual analog scale (VAS) scores.Conclusion: Spinal analgesia is a safe, suitable, and effective method for pain reduction with no adverse effects on the outcome of labor compared to Entonox analgesia.
Obstetrics and Gynecology
Haleh Ayatollahi; Somayeh Ghasemzadeh; Sedigheh Ghasemiyan Dizaj Mehr
Volume 7, Issue 3 , January and February 2022, , Pages 192-199
Abstract
Background & Objective: At the beginning of the pandemic COVID-19, most health facilities suspended non-emergency surgeries to ensure emergency care capacity. Due to the need for surgery, and insufficient information about the complications of surgery in these patients, the present study aimed to ...
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Background & Objective: At the beginning of the pandemic COVID-19, most health facilities suspended non-emergency surgeries to ensure emergency care capacity. Due to the need for surgery, and insufficient information about the complications of surgery in these patients, the present study aimed to investigate the outcome of surgeries in patients with COVID-19 in Motahari Hospital in Urmia.Materials & Methods: This cross-sectional study was performed on 112 patients diagnosed with COVID-19 who underwent surgery. A Checklist including the following data was extracted from the patients' medical records, symptoms, laboratory tests, and any complications related to surgery up to one month after separate surgery.Results: A total of 6.3% of patients had limited complications due to the incision site after the surgery. The results did not show a significant relationship between age, type of anesthesia, and the type of operation with complications. However, the highest percentage of complications was seen in less than 40 years and emergency surgeries. It was found that patients with a history of diabetes had the highest rate of complications (57.1%), although there was no significant relationship between the underlying disease and complications (P = 0.40). In our study, none of the patients experienced complications such as vascular thrombosis or embolism, respiratory failure, and heart failure, or the need for cardiopulmonary resuscitation. Overall, 17.9% of patients needed ICU admission (mean 2.16 ± 1.50 days), indicating a higher ICU hospitalization demand. Also, in terms of in-ward hospitalization, patients with complications had a longer hospital stay than uncomplicated patients (7.85 ± 3.36 days) vs. (5.13 ± 1.66), which was not statistically significant (P = 0.88).Conclusion: The results show that surgery is not directly associated with an increased risk of mortality and complications in patients with COVID-19. On the other hand, Underlying diseases, age, and the urgency of surgery are associated with a higher risk for complications than COVID-19.
Obstetrics and Gynecology
Tipnaree Charoonwatana; Charuai Suwanbamrung; Udomsak Saengow
Volume 7, Issue 3 , January and February 2022, , Pages 213-220
Abstract
Background and Objective: Cesarean section (CS) rates have increased continuously worldwide in the past decades while not being associated with significant benefits for mothers and newborns. According to Robson's classification, the present research aimed to analyze the associating factor to cesarean ...
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Background and Objective: Cesarean section (CS) rates have increased continuously worldwide in the past decades while not being associated with significant benefits for mothers and newborns. According to Robson's classification, the present research aimed to analyze the associating factor to cesarean section to set the practice system and decrease the cesarean section rate in the near future.Methods: This is a retrospective cross-sectional analytic study of the medical record of pregnant women who delivered in 2019 at MNST Hospital. The logistic regression model carried out the adjusted odds ratio (OR) of cesarean section rate and 95% confidence intervals.Results: A total of 5,360 medical records were recruited. Of all birth, 55.4% occurred by cesarean section, most of whom were categorized in R1 to R4 of Robson classification (23.3%), followed by R5 (21.1%) and R10 (5.4%). The subgroup R1-R4 analysis demonstrated that obesity, Bachelor’s education, and private obstetrician were significantly related to the cesarean section in the group of spontaneous labor (R1, R3) and Bachelor’s education and private obstetrician were significantly related to the cesarean section in the group without spontaneous labor (R2, R4) (adjust OR 13.50, P < /em><0.001 and adjust OR 2.11, P < /em><0.001, respectively).Conclusion: Private obstetrician and education level were factors related to the obstetric indication of unnecessary cesarean section.
Obstetrics and Gynecology
Esmat Barooti; Farzaneh Rashidi Fakari; Soodabeh Darvish; Narges Tavakoly
Volume 7, Issue 3 , January and February 2022, , Pages 226-229
Abstract
Background & Objective: In pregnancy, the serum level of cancer antigen-125 (CA-125) increases in the first trimester and abortion. However, different studies reported conflicting results about the use of serum CA-125 to determine the prognosis of threatened abortion. In the present study, we try ...
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Background & Objective: In pregnancy, the serum level of cancer antigen-125 (CA-125) increases in the first trimester and abortion. However, different studies reported conflicting results about the use of serum CA-125 to determine the prognosis of threatened abortion. In the present study, we try to determine if the measurement of CA-125 level could be used as a predictor of outcome in women with threatened abortion.Materials & Methods: This prospective case-control study was performed on 58 patients with threatened abortion and 58 healthy pregnant women with a gestational age of fewer than 20 weeks (as the control group). In both groups, serum CA-125 level was measured. The patients were followed to determine who completed the pregnancy period and who eventually miscarried. Finally, the levels of CA-125 in these groups were compared.Results: The mean age of patients was 28.47 and 27.84 in the case and control groups, respectively; there was no significant statistical difference between the two groups (95% CI: -1.94 to 3.18, P < /em>=0.632). Also, there was no significant difference between them for BMI (95% CI: -1.09 to 1.38, P < /em>=0.813), gestational age (95% CI: -1.31 to 1.04, P < /em>=0.816), and parity (P < /em>=0.51). The mean serum level of CA-125 in the control group was 22.51 ± 6.82 IU/mL, and in the threatened abortion group was 27.70 ± 7.50 IU/mL. This difference was statistically significant (P<0.001). Of the patients, 51.72% with threatened abortion continued their pregnancy, and 48.28% eventually miscarried. The mean serum levels of CA-125 were 25.30±6.63 IU/mL and 30.28±7.63 IU/ml in patients who continued the pregnancy and miscarried, respectively (P < /em>=0.01).Conclusion: A single measurement of the maternal CA-125 may be used as an available, inexpensive prognostic test to determine the outcome of threatened abortion. However, a small number of patients is the main limitation of the present study. More studies with a larger sample size are required to accept the role of maternal CA-125 in predicting the outcome of threatened miscarriage.
