Obstetrics and Gynecology
Soudabeh Kazemi Aski; Shiva Alizadeh; Saghi Ghafourian Abadi; Fereshteh Yaseri Gilvaei; Seyedeh Marzieh Kiai
Volume 7, Issue 3 , January and February 2022, , Pages 235-242
Abstract
Background and Objective: With the outbreak of the new coronavirus, some sections of society are more vulnerable, including pregnant women. Today, with the pandemic of COVID-19, anxiety, and worries about pregnancy and fetal health have increased and will be associated with adverse consequences ...
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Background and Objective: With the outbreak of the new coronavirus, some sections of society are more vulnerable, including pregnant women. Today, with the pandemic of COVID-19, anxiety, and worries about pregnancy and fetal health have increased and will be associated with adverse consequences for the health of mothers and infants. There is also insufficient information on the effects of coronary heart disease and COVID-19 on the fetus and pregnancy. Therefore, this study aimed to examine the level of awareness of pregnant women about coronavirus disease (COVID-19) and its correlation with observed stress in pregnant women.Methods: This cross-sectional analytical research was conducted on 384 pregnant women who were referred To Al-Zahra Medical Center at Rasht, Iran in 2020 and were selected through simple random sampling. Data collection tools were a demographic questionnaire, standard perceived stress questionnaire, and a researcher-made questionnaire on COVID-19 disease. Using statistical tests, the collected information was analyzed using SPSS 23 at an importance level of less than 0.05.Results: The average scores of pregnant women's knowledge about the signs, symptoms, and ways of transmitting coronavirus are lower than the scores of mothers' awareness about the cause of the disease and how to prevent it. However, in general, the average score of pregnant women' knowledge about COVID-19 is high. Also, the mean scores of concern about COVID-19 and perceived stress of pregnant women about this disease in this reading are high. The present study's findings showed that the amount of knowledge of pregnant women about COVID-19 has a statistically significant relationship with anxiety and perceived stress about this disease and has a positive correlation.Conclusion: This study's results showed that the more pregnant women are aware of COVID-19, the more anxious and stressed they are. As a result, to provide psychological support to pregnant women during pregnancy, medical staff training, the help of social media, and psychiatric experts can minimize harm to them and their fetuses.
Obstetrics and Gynecology
Fatemeh Keikha; Mahshid Shooshtari; Narges Zamani
Volume 7, Issue 3 , January and February 2022, , Pages 243-246
Abstract
Intravaginal misoprostol is used worldwide with excellent results for second-trimester pregnancy termination. However, it has a rare but serious complication of uterine rupture, both in previously scarred and unscarred uteri. In this report, we present a case of this rare complication in an unscarred ...
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Intravaginal misoprostol is used worldwide with excellent results for second-trimester pregnancy termination. However, it has a rare but serious complication of uterine rupture, both in previously scarred and unscarred uteri. In this report, we present a case of this rare complication in an unscarred uterus during termination with misoprostol. Uterine rupture was found on laparotomy after the patient showed signs of shock during termination. A 2- to 3-cm laceration was detected in the uterine wall along with the left cornea. The placenta was attached to the uterus on the other side. We found an unusual pregnancy in the cornea and successfully repaired it. Although using misoprostol for termination is safe, a regimen protocol should be established. However, uterine structure and implantation safety should be confirmed before administrating misoprostol. This case highlights a difficult diagnosis of abnormal placentation, especially cornual ectopic pregnancy.
Obstetrics and Gynecology
Geeta Bhardwaj; Alfisha Siddiqui; Lily Podder
Volume 7, Issue 2 , September and October 2021, , Pages 63-68
Abstract
Coronavirus disease 2019 (COVID-19) is a major public health concern, highly contagious in nature and/or causing high mortalities. This review paper reveals comprehensive interpretations of current COVID-19 reports and their impact on pregnancy in conjunction with antenatal visits, mental health, and ...
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Coronavirus disease 2019 (COVID-19) is a major public health concern, highly contagious in nature and/or causing high mortalities. This review paper reveals comprehensive interpretations of current COVID-19 reports and their impact on pregnancy in conjunction with antenatal visits, mental health, and mode of delivery. We further review recent guidelines of distinct leading organizations, which intend to serve as assistance in managing pregnant women with suspected or confirmed COVID-19. Pregnancy amid the COVID-19 pandemic necessitates marked importance deliberating high-risk status and vulnerability to severe COVID-19 related illnesses. The risk of vertical transmission is low; however, neonatal illness varies from asymptomatic to mildly symptomatic. Healthcare providers should consider proper guidance and obvious illustration of preventive strategies to limit the further spread of COVID-19. We also discuss the safety and efficacy of COVID-19 vaccines in pregnant women, besides benefiting both mother and baby.
Obstetrics and Gynecology
Mahbod Kaveh; Venus Hajaliakbari; Fateme Davari-Tanha; Shokoh Varaei; Mahsa Ghajarzadeh; Elham Feizabad; Mohammad Ali Ashraf; Zahra Kaveh
Volume 7, Issue 2 , September and October 2021, , Pages 69-76
Abstract
Background & Objective: The recent surge in coronavirus disease 2019 (COVID-19) cases has exposed health care workers (HCWs) to a wide range of psychological stressors and predisposed them to anxiety-related disorders. In this study, we observed the anxiety level in this population.Materials & ...
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Background & Objective: The recent surge in coronavirus disease 2019 (COVID-19) cases has exposed health care workers (HCWs) to a wide range of psychological stressors and predisposed them to anxiety-related disorders. In this study, we observed the anxiety level in this population.Materials & Methods: This multicenter, cross-sectional study was performed on 1,038 HCWs in 14 hospitals of Tehran during the COVID-19 pandemic. In May 2020, Beck Anxiety Inventory (BAI) was used to measure the level of anxiety in this population.Results: The mean±SD age of participants was 36.30±8.23 years old. Most participants were 31 to 40 years old (43.2), female (87.6%), and nurses (49.5%). The BAI scores of the participants were in a positive skew distribution, with a score range of 0-63, a median of 12, and a mean value of 15.30±11.43. Out of 1,038 hospital staff, 411 (39.6%) had moderate to severe anxiety. The anxiety level was significantly higher in HCWs ≤40 years old, women, and nurses. However, there was no significant relationship between stress levels among frontline workers compared to second-line workers (P < /em>=0.82).Conclusion: It seems that HCWs experienced a high level of anxiety in the COVID-19 outbreak. One of the critical measures in every epidemic is to provide supportive care to maintain the mental well-being of HCWs, especially in high-risk groups, including younger HCWs, women, and nurses.
Obstetrics and Gynecology
Mitra Modares Gilani; Fariba Yarandi; Narges Zamani; Shaghayegh Nowroozi; Sara Ramhormozian; Elham Shirali
Volume 7, Issue 2 , September and October 2021, , Pages 77-82
Abstract
Background & Objective: Estradiol and misoprostol have been used for the enhancement of transformation zone (TZ) visibility in vaginal colposcopy. However, no consensus has been reached on the superiority of one medication over the other. This study aimed to compare the efficacy of estradiol and ...
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Background & Objective: Estradiol and misoprostol have been used for the enhancement of transformation zone (TZ) visibility in vaginal colposcopy. However, no consensus has been reached on the superiority of one medication over the other. This study aimed to compare the efficacy of estradiol and misoprostol for the enhancement of TZ visibility in vaginal colposcopy of premenopausal and postmenopausal women.Materials & Methods: In this clinical trial, 78 patients with unsatisfactory colposcopy were randomly divided into three groups. Group 1 (n=25) received 25 µg of vaginal estradiol for 14 days prior to colposcopy. Group 2 (n=27) received 400 µg of misoprostol 12 h prior to colposcopy. Group 3 (n=26) served as the control group and did not receive any medication. Visibility of the TZ, age, body mass index (BMI), history of vaginal delivery, history of sexually transmitted diseases, history of human papillomavirus (HPV), the reason for colposcopy, and drug-related side effects were compared among the three groups and also between premenopausal and postmenopausal women. Data were analyzed using analysis of variance (ANOVA), Kruskal-Wallis, Chi-square, and Fisher’s exact tests.Results: The percentage of TZ visibility was 72%, 55.6%, and 26.9% in the estradiol, misoprostol, and control groups, respectively (P < /em>=0.005). These values were 70%, 33.3%, and 0%, respectively, in postmenopausal women (P < /em>=0.043) and 60%, 72.7%, and 33.3%, respectively, in premenopausal women (P < /em>=0.152). Regarding drug-related side effects, there was no statistically significant difference between the three groups (P < /em>=0.374).Conclusion: Estradiol was significantly superior to misoprostol for the enhancement of TZ visibility, particularly in postmenopausal women, with no difference regarding side effects.
Obstetrics and Gynecology
Mandana Mansour Ghanaei; Effat Ebadollahi Nodeh; Seyed Mohammah Asghari Ghalebin; Seyedeh Hajar Sharami; Katayoun Haryalchi
Volume 7, Issue 2 , September and October 2021, , Pages 83-88
Abstract
Background & Objective: Opioids that are used during anesthesia may prolongate intestinal peristalsis. This study aimed to examine the effect of oral methylnaltrexone (OMNTX) on ileus after hysterectomy.Materials & Methods: This study was performed as a randomized, double-blind screening for ...
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Background & Objective: Opioids that are used during anesthesia may prolongate intestinal peristalsis. This study aimed to examine the effect of oral methylnaltrexone (OMNTX) on ileus after hysterectomy.Materials & Methods: This study was performed as a randomized, double-blind screening for an elective abdominal hysterectomy at Alzahra Hospital in Rasht, Iran; 33 patients were assigned to the OMNTX group (25 mg) and 33 to the placebo group using the random block method. Patients were asked and recorded about gas passing, constipation, vomiting, itching, and urinary retention.Results: There was a significant difference in the meantime of initiation of intestinal sound (P < /em>=0.039) and constipation (P < /em>=0.62) between the two groups. There was a positive correlation coefficient in the placebo group (P < /em>=0.02) between the hours of surgery and the time of initiation of bowel movements after the surgery. Still, there was not in the OMNTX group (P < /em>=0.0001). The mean onset of bowel sounds after the surgery was not related to age (P < /em>=0.599) and the duration of surgery significantly (P < /em>=0.926).Conclusion: It is possible that OMNTX before the surgery can trigger bowel sounds sooner after the surgery and prevent ileus.
Obstetrics and Gynecology
Zinat Ghanbari; Marzieh Hajibabaei; Elaheh Miri Ashtiani; Azita Ghanbarpour; Ali Montazeri
Volume 7, Issue 2 , September and October 2021, , Pages 114-120
Abstract
Background & Objective: Pelvic floor disorders (PFDs) are common devastating situations among women globally. The present study aimed to evaluate the clinical efficacy of radiofrequency (RF) on pelvic floor distress, restoration, and sexual function among women with PFDs.Materials & Methods: This ...
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Background & Objective: Pelvic floor disorders (PFDs) are common devastating situations among women globally. The present study aimed to evaluate the clinical efficacy of radiofrequency (RF) on pelvic floor distress, restoration, and sexual function among women with PFDs.Materials & Methods: This pre-post intervention study was performed on forty-three women with PFDs, who referred to a teaching pelvic floor clinic. Patients underwent RF three times fortnightly. Women were examined at three time points of baseline, one month post-intervention, and in a three months follow-up. In addition, a biofeedback evaluation was performed by a physiotherapist at the first session and follow-up. All women were asked to complete the Female Sexual Function Index and Pelvic Floor Distress Inventory questionnaires at the first session and in follow-up assessments. Descriptive statistics, the paired samples t-test, and the Friedman test were used to analyze the data.Results: The mean and standard deviation of the age and gravidity of participants were 40.3±8.01 years and 2.65±1.3, respectively. We observed that 81.4% of women had a history of vaginal delivery. A significant improvement was found in the levator muscle tonicity by manual examination in the three-month follow-up (P < /em><0.001). Moreover, maximal pelvic floor contraction measured by biofeedback improved (P < /em>=0.075). There were significant improvements in female sexual function and pelvic floor distress, including pelvic organ prolapse, colorectal-anal distress, and urinary distress after RF therapy (P < /em><0.001).Conclusion: The findings of the current investigation showed that RF could be applied for pelvic floor restoration and is likely to improve sexual function and pelvic floor distress.
Obstetrics and Gynecology
Fatemeh Golshahi; Fariba Yarandi; Sara Ramhormozian; Elham Shirali
Volume 7, Issue 2 , September and October 2021, , Pages 121-125
Abstract
With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive ...
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With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive cesarean section history while some others have no report of such effect. This complication cannot be predicted and can occur under various circumstances with different misoprostol regimens. Hereby, we reported three cases with positive cesarean section history undergoing second-trimester pregnancy termination due to preterm premature rupture of the membranes (PPROM) who developed uterine rupture with similar misoprostol dosages. Finally, we conclude that more cautions should be undertaken in the setting of PPROM with previous history of cesarean section or gestational age >20 weeks about uterine rupture risk and full recommended misoprostol dose must not be administered to prevent life-threatening events.
Obstetrics and Gynecology
Amirreza Naseri; Sepideh Seyedi Sahebari; Mohammad-Salar Hosseini
Volume 7, Issue 1 , September and October 2021, , Pages 1-6
Abstract
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a chief concern of the international community. As of May 2021, more than 150 million cases and 3.2 million deaths have been recorded. Considering the early struggle in treating COVID-19 ...
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The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a chief concern of the international community. As of May 2021, more than 150 million cases and 3.2 million deaths have been recorded. Considering the early struggle in treating COVID-19 patients, the researchers and clinicians have decided to try the previously available drugs according to their mechanisms of action. This article aims to review the potential drugs for COVID-19 patients during pregnancy and breastfeeding and their safety. PubMed and Scopus databases and Google Scholar engine were searched with the proper combination of the free keywords and MeSH Terms of COVID-19, SARS-CoV-2, Pregnancy, Breastfeeding, Treatment, Pharmacotherapy, Drug Therapy, and Drug Safety. All relevant clinical studies published until the end of 2020 were included in this review. Many antivirals, antibiotics, antiparasitics, and antipyretics have been proposed, but most of them are not registered for COVID-19 or have demonstrated little effect on the disease. Since there is still a long way to find an effective drug for the treatment of COVID-19, prevention is currently the most effective way. Also, prescribing drugs to these two groups of patients should be done according to the safety recommendations.
Obstetrics and Gynecology
Tahereh Behrouzi lak; Behrouz Ilkhanizadeh; Somayeh Ghasemzadeh; Sahel Khalilzadeh
Volume 7, Issue 1 , September and October 2021, , Pages 15-19
Abstract
Background and Objective: One of the most common causes of maternal mortality in the first trimester of pregnancy is ectopic pregnancy (EP). Adenosine deaminase (ADA) plays an essential role in production, maturation and function of lymphoid cells, which is produced in all tissues of the body. Total ...
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Background and Objective: One of the most common causes of maternal mortality in the first trimester of pregnancy is ectopic pregnancy (EP). Adenosine deaminase (ADA) plays an essential role in production, maturation and function of lymphoid cells, which is produced in all tissues of the body. Total serum adenosine deaminase levels decrease during normal pregnancy. Considering the importance of early detection of EP, this study aimed to investigate the relationship between adenosine deaminase and EP in pregnant women referred to Motahari Hospital in Urmia from 2017 to 2018.Material and Methods: This study consisted of two groups of patients including patients with EP as a case group and patients with normal pregnancy confirmed by sonography as a control group. The level of βHCG and serum ADA levels were compared in the two groups. P-values less than 0.05 were considered as significant.Results: In this study, 94 pregnant women were enrolled, including 47 patients as control group with normal pregnancy and 47 patients as case group with EP. The mean ADA level in patients with EP and the control group were 12.21±8.17 IU/L and 8.44±6.21 IU/L (P < /em>=0.01), respectively. The mean βHCG level in women with EP was 3215.60±1400.71 mIU/mL. In women with normal pregnancy, it was 11926.96±3408.23 mIU/mL (P < /em>=0.001).Conclusion: High levels of ADA can be helpful in the early diagnosis of EP.
Obstetrics and Gynecology
Mahboobeh Shirazi; Mehnoosh Torkzaban; Samira Fallah; Marjan Ghaemi
Volume 7, Issue 1 , September and October 2021, , Pages 20-24
Abstract
Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management ...
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Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion. Materials and Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was either simultaneously with the first dose of misoprostol or after beginning of the pain. Pain severity, induction-to-abortion time interval, total misoprostol dosage, Hemoglobin concentration, length of hospitalization, and size of retained pregnancy products by ultrasound, and the cumulative dose of opioid usage were compared between the groups.Results: The severity of pain which was measured by a visual analog scale (VAS), residual of conceived products, hospitalization days, and the total misoprostol dosage were significantly lower (P < /em><0.05) in the prophylaxis compared to the treatment group.Conclusion: Simultaneous administration of diclofenac with misoprostol as prophylactic method of pain management may be an optimal method in induced medical abortion in the second trimester.
Obstetrics and Gynecology
Zahra Akbarian Rad; Shahla Yazdani; Mina Galeshi; Neda Eftekhari; Fatemeh Shafizadeh
Volume 7, Issue 1 , September and October 2021, , Pages 45-51
Abstract
Background & Objective: Premature preterm rupture of membranes (PPROM) occurs in about 2-5% of singleton pregnancies and is known to cause one-third of preterm births. Our primary aim was to determine the maternal and neonatal outcomes in PPROM cases in mothers with a gestational age of less than ...
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Background & Objective: Premature preterm rupture of membranes (PPROM) occurs in about 2-5% of singleton pregnancies and is known to cause one-third of preterm births. Our primary aim was to determine the maternal and neonatal outcomes in PPROM cases in mothers with a gestational age of less than 37 weeks.Methods: In this prospective cross-sectional study, eligible singleton women between 24+0-37+6 weeks of gestation with the PPROM enrolled who had referred to Ayatollah Rouhani Hospital in Babol, Iran, during the years 2019-2020. Maternal and neonatal outcomes were obtained by the checklist.Results: The mean age of the studied mothers was 29.3± 6.19 years, and their mean body mass index was 30.6 ±5. The incidence of chorioamnionitis at the gestational age of >32 weeks was more than that in women at gestational age equal to or over 32 weeks (P < /em>≤0.0001). Vaginal bleeding was almost more than twice as high in women with a gestational age of less than 32 weeks compared to those with a gestational age equal to or over 32 weeks (P < /em>≤0.0001). Neonatal morbidity was higher in all cases at less than 32 weeks of gestation (P < /em>≤0.0001). The neonatal mortality rate was 5.35%, but it was 25% at less than 32 weeks of gestation (P < /em>≤0.0001). The latency period greater than 7 days had more odds ratio for neonatal morbidity.Conclusion: Due to the high incidence of maternal and neonatal outcomes in gestational age less than 32 weeks, it is suggested that appropriate instructional materials and proper proceeding should be taken to prevent preterm labor and preterm rupture of the membranes.
Obstetrics and Gynecology
M. Madhubala; Mansi Shukul; C. Kasthuri
Volume 6, Issue 4 , August 2021, , Pages 167-173
Abstract
Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained ...
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Background & Objective: Uterine fibroids (UF) in pregnancy is a condition, where symptomatic or asymptomatic fibroids in the uterine cavity may cause complications in pregnancies. Placental abruption and preterm labor, occurs in late pregnancy, postpartum hemorrhage, caesarean section and retained placenta in perinatal period. This study aimed to reckon whether the surgical Caesarean myomectomy is still a gold standard in myoma removal in pregnant women.Materials & Methods: This study was retrospectively conducted in pregnant women deliveries with uterine fibroids who underwent Myomectomy with lower segment caesarean section (LSCS). The caesarean myomectomy cases were compared with LSCS alone controls in 1:2 ratio. The primary outcome is to minimize blood loss and need for blood transfusion. The secondary outcome is the length of surgery duration and hospital stay.Results: The outcome of case and control compared was 43 caesarean myomectomy with LSCS as case group and 86 LSCS Alone as control group. The incidence of hemorrhage in case group was 10 out of 43 while control was 2 out of 86 (2.32%) with P-value of 0.0017. The secondary outcome was the length of surgery duration and hospital stay which were found statistically significant between the case and control groups, with P-value = 0.0001 and 0.0072, respectively.Conclusion: Caesarean Myomectomy can be the effective surgical option to enucleate uterine myoma, and preserve uterus and jettison from eventful or symptomatic uterine fibroids. To have the chances for prevention of immediate or interval - myomectomy / hysterectomy and control of post-partum menstrual over bleeding.
Obstetrics and Gynecology
Fatemeh Keikha; Mahnaz Veisian
Volume 6, Issue 4 , August 2021, , Pages 174-180
Abstract
Background & Objective: Some studies have suggested the association between the risk of osteoporosis and atherosclerosis. So, we aimed to compare the serum lipid levels of postmenopausal women with reduced bone density to serum lipid levels of those with normal bone density.Materials & Methods: In ...
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Background & Objective: Some studies have suggested the association between the risk of osteoporosis and atherosclerosis. So, we aimed to compare the serum lipid levels of postmenopausal women with reduced bone density to serum lipid levels of those with normal bone density.Materials & Methods: In this cross-sectional study, all 48-65 year-old women, menopause for more than 1 year prior to the study, who referred to Akbarabadi Hospital, Tehran, Iran, during September 2011-March 2013 were recruited. They underwent bone densitometry using the Dual-Energy X-Ray Absorptiometry Method and were divided into two groups: normal density (control group) and low density (case group). Body mass index (BMI) and waist circumference were measured. After 14 hours, fasting serum levels of lipid, fasting blood sugar (FBS), and HbA1C were checked. Hypercholesterolemia, as low high density lipoprotein (HDL) (<35 mg/dL) and high cholesterol levels (>200 mg/dL), were compared between the groups in addition to low density lipoprotein (LDL) levels.Results: The data of 241 women were analyzed. The mean±SD levels of serum TC were 192±24.7 and 185±19 mg/dL, in the case and control groups, respectively (P < /em>=0.009), and that of serum LDL levels were 112±20.2 and 105±17 g/dL, respectively (P < /em>=0.005). There was a significant and negative correlation between the women’s Z-score and their cholesterol level (r=-0.162, P < /em>=0.012). Regression results revealed that the following factors significantly affected Z-score: BMI, LDL, TC, and duration of menopause.Conclusion: Serum LDL and TC levels were higher in menopausal women with reduced bone density, which indicates the relationship between hypercholesterolemia and reduced bone density.
Obstetrics and Gynecology
Khadije Rezaie keikhaie; Leili Rezaie Kahkha; Zahra Shahraki; Sairo Esbati; Mahdi Afshari; Atefeh Kamali; Mahboobeh Shirazi; Maryam Moshfeghi
Volume 6, Issue 4 , August 2021, , Pages 181-187
Abstract
Background & Objective: Spontaneous preterm birth (SPB) occurs in about 10 to 12 percentage of pregnancies and causes many complications and mortality during pregnancy periods (1). The aim of this study was to determine the evaluation of uterocervical angle compared to cervical length as a sonographic ...
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Background & Objective: Spontaneous preterm birth (SPB) occurs in about 10 to 12 percentage of pregnancies and causes many complications and mortality during pregnancy periods (1). The aim of this study was to determine the evaluation of uterocervical angle compared to cervical length as a sonographic method in predicting preterm delivery for patients who were undergoing the transvaginal cerclage.Materials & Methods: The present study was performed on 91 pregnant women who were candidates for cerclage in 2019-2020. In this study, about 16.48 percentage of births were preterm and 27.47 percentage were post-term. During the study, routine cervical evaluation was performed by post-cerclage ultrasound and transvaginal ultrasound was performed in all patients one week after cerclage. Additional evaluation with transvaginal ultrasound was performed at intervals determined by the treating physicians with final ultrasound evaluation of the cervix up to 28 weeks of gestation. Finally, the obtained data were entered into SPSS 22 and statistically analyzed using t-test, Chi-square and Fisher's exact test.Results: The results of the present study showed that considering the existing thresholds (95 and 105) for the anterior uterosacral angle and the threshold 25 for the cervical length index, all these indices were included 100% sensitive.Conclusion: This sensitivity in the case of UCA higher than 95°C was about 80%, but the disadvantage of these indicators was their low specificity, so that these indicators were different ranging from 30% in the case of (UCA 105) to 7.15% in the case of (UCA 95).
Obstetrics and Gynecology
Zahra Naeiji; Saleheh Heydari; Melina Bahaar; Masoomeh Mirzamoradi; Atefeh Moridi; Marzieh Fathi
Volume 6, Issue 4 , August 2021, , Pages 195-201
Abstract
Background & Objective: Pessary is a silicone, rubber or plastic device, available in different shapes and sizes, which may prevent preterm labor in some pregnant women.Materials & Methods: We enrolled >18-year-old women with gestational age between 24 weeks and 0 days to 34 weeks ...
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Background & Objective: Pessary is a silicone, rubber or plastic device, available in different shapes and sizes, which may prevent preterm labor in some pregnant women.Materials & Methods: We enrolled >18-year-old women with gestational age between 24 weeks and 0 days to 34 weeks and 0 days, admitted to hospital with signs/symptoms of preterm labor (threatened preterm labor) and shortened cervical length (<25 mm in ultrasound measurement). Included subjects were randomly allocated to 2 groups. In first group a cervical pessary was placed for patient in lithotomy position. In second group no pessary was inserted and patients received only the routine standard institutional treatments.Results: Demographic characteristics, Body Mass Index, mean cervical length, parity status, fertilization type (natural, assisted) and route of delivery had no statistically significant difference in 2 studied groups. Although gestational age at which patient had experienced her first preterm labor episode was similar in 2 groups, gestational age at delivery was higher in pessary group compared with expectant management group (38.64 weeks versus 35.80 weeks which was statistically significant). Neonatal outcome measures (like rate of respiratory distress, orotracheal intubation, low birth weight, NICU admission, fetal death, etc.) were better (statistically significant) in pessary group.Conclusion: Using cervical pessary after successful control of a threatened preterm labor episode in women with short cervix can postpone the labor significantly, leading to increased gestational age and improved neonatal outcome.
Obstetrics and Gynecology
Tajossadat Allameh; Maryam Dehghan
Volume 6, Issue 4 , August 2021, , Pages 202-208
Abstract
Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical ...
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Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical glandular cells (AGCs) referred to gynecology clinics in Isfahan, Iran, and seventy women were selected to undergo Pap smear test, colposcopic examination and ECC. EMC was performed in women older than 35. Pap smear test results were classified as normal, inflammation, AGCs and necrosis. Colposcopy, ECC and EMC findings were classified as normal, benign and malignant pathologic lesions.Results: Repetitive Pap smears findings were as follows: 15.7% were normal, 77.2% had inflammation, 4% had AGC and 3.1% had necrosis. Based on colposcopy findings, 61.2%, 7.5%, and 31.3% of the samples were classified as normal, benign and malignant, respectively. ECC findings in 95.5% of women was indicative of benign lesions and malignant lesions in 4.5%. EMC findings showed that 79.7% were normal, 8.5% had benign lesions and 11.9% had malignant lesions. Pap smears with several AGCs were associated with benign lesions in 24.2% of the cases and premalignant and malignant lesions in 14.2% of the cases.Conclusion: According to our study, due to the significant association between AGC cytology and pathologic cervical and endometrial lesions, intensive assessment is necessary in women with AGC Pap smears, especially in older and post-menopausal women, in order to reduce mortality.
Obstetrics and Gynecology
Shiva Hadadianpour; Nasim Sanjari; Masoumeh Fallahian
Volume 6, Issue 4 , August 2021, , Pages 209-216
Abstract
Background & Objective: To determine the factors affecting Iranian obstetricians and gynecologists’ (OB/GYNs’) decision about performing a cesarean section on maternal request.Materials & Methods: A four-part questionnaire was designed and distributed between 150 randomly ...
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Background & Objective: To determine the factors affecting Iranian obstetricians and gynecologists’ (OB/GYNs’) decision about performing a cesarean section on maternal request.Materials & Methods: A four-part questionnaire was designed and distributed between 150 randomly selected OB/GYNs in Iran during a national conference. One hundred questionnaires were sent back by the participants. The data were analyzed using SPSS 25. The influential factors on OB/GYNs’ decision about the mode of delivery, as well as the correlations between their knowledge, attitude, practice, gender, and years of work experience, were assessed.Results: A positive correlation was found between OB/GYNs’ knowledge and attitude about the benefits of cesarean section and performing a cesarean section on maternal request in public and private hospitals. We did not find any correlation between age, gender, and years of practice with the practice of cesarean section on demand. Approximately 52.8% of female participants and 38.5% of male participants recommend cesarean section to their immediate families, and 81% of participants accepted the pregnant mother’s request for cesarean section. The stress of the potential impact of vaginal delivery on the pelvic floor and sexual function is the leading reason behind this decision. Conclusion: Since the views and concerns of OB/GYNs have a significant role in guiding pregnant women to decide the mode of delivery, and the fear of future sexual dysfunction is an important issue affecting obstetricians’ perspective, it should be taken into consideration.
Obstetrics and Gynecology
Tahereh Ashrafganjoei; Atyeh Bahman; Somayyeh Noei Teymoordash; Soheila Aminimoghaddam; Abdolali Ebrahimi; Maryam Talayeh
Volume 6, Issue 3 , June 2021, , Pages 105-109
Abstract
Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, ...
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Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, a complete surgical staging in endometrial cancer includes oophorectomy since 1988. There has been some research to assess whether an oophorectomy should be performed and in which cases, ovaries can be preserved.Materials & Methods: Aim of this study was to evaluate the coexistence of ovarian involvement in endometrioid endometrial carcinoma. In this study, we evaluated 180 patients with endometrioid endometrial cancer patients who were surgically staged at Imam Hossein Hospital between 2004 and 2017.Results: Mean age of subjects of the study was 56.78 ±10.59. Forty-six of patients (25.6 %) were less than 50 years old and 74.4 % (134) were older than 50. Twenty out of 180 (11.1 %) of them had ovarian involvement (one of them had simultaneous ovarian tumor) and 11 (55%) of these cases were less than 50 years old. In 55 % (11) patients, the involved ovaries were less than 5 cm with grossly normal appearance, lymph nodes metastases were detected in 3 out of 20 (15 %) of them although their ovarian size were 4, 4.5 and 6.5 cm. In 10 (50 %) of them, deep myometrial invasion was detected.Conclusion: In endometrial cancer staging, ovarian preservation could be a challenging decision and a real controversy which needs more researches.
Obstetrics and Gynecology
Khadije Rezaie Keikhaie; Mania Kaveh; Fatemeh Bahrami; Kambiz Sadegi; Atefeh Kamali; Mahdi Afshari
Volume 6, Issue 3 , June 2021, , Pages 110-115
Abstract
Background & Objective: Anti-mullerian hormone indicates ovarian reserve. The objective of this study was to compare the changes of AMH level following two methods of laparoscopic cystectomy in order to evaluate ovarian reserve in patients with endometrioma.Materials & Methods: To this end, ...
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Background & Objective: Anti-mullerian hormone indicates ovarian reserve. The objective of this study was to compare the changes of AMH level following two methods of laparoscopic cystectomy in order to evaluate ovarian reserve in patients with endometrioma.Materials & Methods: To this end, 86 patients with endometrioma were selected on the basis of inclusion and exclusion criteria, divided into two groups, and subjected to laparoscopic cystectomy. The mean hormone levels were measured before and after surgery and the changes were compared between the two groups using the repeated measures tests. The data were also analyzed using the SPSS 22.Results: The mean number of childbirth was 2.06 in patients with a standard deviation of 1.64. Out of 86, 42 patients (48.8%) were treated with complete removal of cysts and the rest underwent partial removal. The length of cysts in patients undergoing complete removal was significantly larger than that in patients with partial removal (P < /em>=0.011), while the width of cysts was not significantly different between the two groups of patients (P < /em>=0.084). The AMH levels in patients undergoing complete removal significantly decreased from 2.22 before surgery to 1.96 after surgery (P < /em><0.001). The AMH levels in patients undergoing partial removal was also decreased from 2.47 before surgery to 2.14 after surgery, representing a statistically significant difference (P < /em><0.001).Conclusion: Regarding the results of the study, the type of ovarian cyst removal has not any effect on after-surgery consequences.
Obstetrics and Gynecology
Robabeh MohammadBeigi; Ayda Fathollahpour; Asadolah Fathollahpour; Maryam Kashanian; Narges Sheikhansari
Volume 6, Issue 3 , June 2021, , Pages 116-121
Abstract
Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials ...
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Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials & Methods: The study was performed as a descriptive cross-sectional study on pregnant women who were admitted to the labor ward for delivery. Serum level of 25-hydroxyvitamin D [25(OH) D], was measured and compared in women and the umbilical cord blood. The relationship between 25(OH) D levels and anthropometric neonatal factors including birth weight, birth length and head circumference was evaluated.Results: A total of 106 pregnant women (53 Iranians and 53 Afghan refugees’ women) were evaluated. There was a significant correlation between maternal serum level of 25(OH) D and that of their neonates, both in Iranians and Afghans considering gestational age as a confounding factor (R=0.62, P < /em>=0.000). Maternal and neonatal 25(OH) D levels were significantly higher in Iranians than Afghans (27.2±11.5 ng/mL VS 21.9±12.7 ng/mL, P < /em>=0.026 and 26.5±11.2 VS 17.3±11.4, P < /em>=0.000) respectively. However, neonatal weight and head circumference (HC), were not different in Iranians and Afghans except for neonatal height which was higher in Afghans (P < /em>=0.015) irrespective of lower amount of neonatal 25(OH) D levels.The mean cord levels of vitamin D in boys and girls did not show a significant difference. There was no significant correlation between 25(OH) D serum level and pregnant women’s level of education, pre-labor rupture of membranes (PROM), past medical history (PMH), taking supplements and smoking.Conclusion: Maternal and neonatal 25(OH) D levels did not influence neonatal anthropometry.
Obstetrics and Gynecology
Farah Farzaneh; Sama Mohammadi; Elnaz Ghaffari; Afsaneh Hosseini; Sarang Younesi; Mohammad Mahdi Taheri Amin; Payam Balvayeh; Fariba Navid Pour; Shahla Noori Ardebili
Volume 6, Issue 3 , June 2021, , Pages 122-127
Abstract
Background & Objective: Cervical cancer is the second most common cancer and the fourth leading cause of death in women. Among the risk factors for cervical cancer, human papillomavirus (HPV) is the most important one.Materials & Methods: In this cross-sectional and retrospective study conducted ...
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Background & Objective: Cervical cancer is the second most common cancer and the fourth leading cause of death in women. Among the risk factors for cervical cancer, human papillomavirus (HPV) is the most important one.Materials & Methods: In this cross-sectional and retrospective study conducted from 2016 to 2020, 261 women with cervical intra-epithelial neoplasia (CIN) grade two and three referred to one of the gynecological oncology clinics of Shahid Beheshti University of Medical Sciences, who were eligible to enter the study and were evaluated by the research unit of the relevant university after receiving an ethics code. During the study, patients whose cervical cancer was confirmed by colposcopic diagnostic method, HPV screening was performed by COBAS method and lesions were sampled to determine the type of HPV.Results: Evaluation of the frequency distribution of colposcopic results compared to HPV, indicated that HPV-16 is the most common type of HPV in high grade CIN lesions. After HPV-16, other types of HPV are next in terms of frequency indicating the importance of other types of HPV. HPV-18 was also observed in people with CIN.Conclusion: Performing a similar study with a larger number of samples at the national level is suggested. If the results of a larger study are consistent with this study, it would be for the best to highlight the role of other types of HPV in cervical cancer screening in women.
Obstetrics and Gynecology
Tahereh Eftekhar; Marzieh Hajibabaei; Leila Pourali; Maryam Vizheh; Ali Montazeri
Volume 6, Issue 3 , June 2021, , Pages 128-133
Abstract
Background & Objective: Vaginal laxity is a prevalent disorder that influences woman’s sexual satisfaction and quality of life. This study aimed to evaluate the impact of Higgs radiofrequency on pelvic organ prolapse and sexual function among women suffering from vaginal laxity.Materials & ...
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Background & Objective: Vaginal laxity is a prevalent disorder that influences woman’s sexual satisfaction and quality of life. This study aimed to evaluate the impact of Higgs radiofrequency on pelvic organ prolapse and sexual function among women suffering from vaginal laxity.Materials & Methods: This was a pre- and post-intervention study. Twenty-two subjects who suffered from vaginal laxity referring to a pelvic floor clinic affiliated with Tehran University of Medical Sciences were studied. Higgs radiofrequency was administered at six sessions with a two-week interval. Women were evaluated by an urogynecologist for pelvic organ prolapse quantification (POP-Q) twice: before and three months after intervention. Also, women responded to the Female Sexual Function Index (FSFI-19) at baseline and three months follow-up assessment. Data were analyzed by descriptive statistics and paired samples t-test.Results: The mean age of participants was 40.30 (SD = 8.01) years. The mean number of gravidities was 2.45 (SD = 1.29). Seventeen women (77.3 %) suffered from severe or moderate vaginal laxity. After intervention, the point Ba (P < /em>=0.02), perineal body-point PB (P < /em>=0.058) and total vaginal length (0.014) significantly improved. Also, female sexual function and its six domains improved (P < /em><0.001).Conclusion: The findings indicated that Higgs radiofrequency was a safe and noninvasive technique that improved some pelvic organ prolapse quantification and sexual function among women suffering from vaginal laxity.
Obstetrics and Gynecology
Majid Zare-Bidaki; Mohammad Nadjafi Semnani; Ali Nadjafi Semnani; Nahid Ghanbarzadeh
Volume 6, Issue 3 , June 2021, , Pages 134-142
Abstract
Background & Objective: Urinary incontinence (UI) is a common disease that affects millions of people throughout their lives. It is reported that UI has a considerable economic burden on patients and communities. The aim of this study was to find out the prevalence of urinary incontinence (UI) and ...
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Background & Objective: Urinary incontinence (UI) is a common disease that affects millions of people throughout their lives. It is reported that UI has a considerable economic burden on patients and communities. The aim of this study was to find out the prevalence of urinary incontinence (UI) and its related factors among women living in Birjand city, Iran.Materials & Methods: A cross-sectional study from September 2020 to December 2020 was conducted on women 15 to 70 years living in nine areas of Birjand city. Data were gathered by researcher-made questionnaire and in-person interviews about demographic, obstetrics, and UI (stress, urge, and overflow UI) characteristics. Chi-square test was applied to analyze differences between women with and without UI about risk factors.Results: Of 3028 women (mean age 32.70±11.49 years), 828 (27.3%) reported to have UI. The rate of stress, urge, and mixed UI was 18.1%, 3.4%, and 5.9%, respectively. All types of UI were associated with age, education, BMI, chronic cough / dyspnea, constipation, diabetes mellitus, and smoking.Conclusion: Women should be continuously educated by health care providers on the risk factors and activities which can reduce their risk for UI. Further studies on women across the country may help decision makers to measure the regional burden of disease and to plan population-level interventions.
Obstetrics and Gynecology
Farzaneh Rashidi Fakari; Zahra Kiani
Volume 6, Issue 3 , June 2021, , Pages 143-146
Abstract
COVID‐19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general ...
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COVID‐19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general population. On the other hand, given the previous experiences with SARS and MERS, pregnant women are likely to be at high risk for COVID-19 and its complications. Comparing the results of studies on COVID-19 during pregnancy and that of the general population, it can be concluded that pregnant women develop COVID-19 at a younger age than the general population. The results showed that due to changes during pregnancy, pregnant women have a higher risk for COVID-19 than other people, perhaps due to the lower mean age of COVID-19 in pregnant women, this leads to less COVID-19 on the adverse pregnancy outcomes.
