Obstetrics and Gynecology
Khadijeh Elmizadeh; Marziyeh khezri; Hamideh Pakniat; vahideh pandamuz; nezal Azh; Simindokht Molaverdikhani
Articles in Press, Accepted Manuscript, Available Online from 02 October 2023
Abstract
Background: Cooling the uterus during cesarean section has emerged as one of the non-pharmacological management for blood loss during cesarean section. The aim of this study was to evaluate the effect of uterine cooling during the cesarean section on decreasing postpartum hemorrhage.
Methods: In this ...
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Background: Cooling the uterus during cesarean section has emerged as one of the non-pharmacological management for blood loss during cesarean section. The aim of this study was to evaluate the effect of uterine cooling during the cesarean section on decreasing postpartum hemorrhage.
Methods: In this single-blinded randomized clinical trial, a sample of 300 women with a singleton pregnancy, at 37 to 40 weeks gestation, who were scheduled for cesarean section was divided into two groups of 150 participants. In the intervention group after placental delivery, the uterus was covered with cold saline-soaked surgical sponges at 0-4°C at the time of hysterotomy repair, and the control group received standard cesarean section. The volume of blood loss, the hemoglobin level before surgery and 24 h after surgery, the need for additional oxytocic therapy, and the incidence of adverse effects were recorded.
Results: The bleeding volume and hemoglobin concentration reduction were significantly lower in the intervention group than in the control group (260.86± 150.25 Vs 214.35± 83.51, P<0.0001 and 1.24±0.75 Vs 1.54±0.92, P = 0.007 respectively). There were no statistically significant differences between the two groups in the frequency of need for additional uterotonic drugs. (18% vs. 21.33%, P = 0.475.)
Conclusion: The use of uterine cooling during cesarean section reduced the volume of blood loss and the rate of decline in hemoglobin concentration.
Obstetrics and Gynecology
Hoora Amoozegar; Nayereh Rahmati; Zahra Naseri; samira Shah-Hamzehi; mostafa vahedian; enayatollah Noori; alireza moradi
Articles in Press, Accepted Manuscript, Available Online from 15 July 2023
Abstract
Background: To evaluate the risk of uterine rupture during pregnancy, researchers use two-dimensional (2D) transvaginal ultrasound to assess lower uterine segment (LUS) thickness in the third trimester of pregnancy. This study aimed to compare the thickness of the LUS provided in a 2D transvaginal ultrasound ...
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Background: To evaluate the risk of uterine rupture during pregnancy, researchers use two-dimensional (2D) transvaginal ultrasound to assess lower uterine segment (LUS) thickness in the third trimester of pregnancy. This study aimed to compare the thickness of the LUS provided in a 2D transvaginal ultrasound with the findings during a cesarean section (C/S) of pregnant women with a history of previous C/S.
Materials and Method: This cross-sectional study was performed on 40 pregnant women referred to Izadi Obstetrics and Gynecology Hospital in Qom. All the women underwent transvaginal ultrasound followed by C/S within a maximum of one week later. Also, an expert gynecologist classified LUS thickness into four grades in the operation room.
Results: The mean age of women was 31.58 ± 4.56 years, and the mean thickness of the LUS was 2.17 ± 0.51 cm. Moreover, 57.5% of the women have grade I of LUS based on intraoperative findings. Results indicated that the mean thickness of the LUS measured by ultrasound significantly differed between the three grades detected by the gynecologist (P=0.04). However, there were no significant differences between maternal age, gestational age, parity, and time of last C/S among women with different LUS grades (P˃0.05). Transvaginal ultrasound could be helpful in evaluating the risk of scar dehiscence and uterine rupture among women with LUS grades I and II with a history of previous C/S.
Obstetrics and Gynecology
Mahsa Akbari Oryani; Mohaddeseh Shahraki; Marjaneh Farazestanian
Articles in Press, Accepted Manuscript, Available Online from 23 July 2023
Abstract
Disorders of sex development (DSD) result from intrauterine defects in sex discrimination. The clinical phenotype differs based on the disease type. Cases with ambiguous external genitalia are diagnosed at birth. However, diagnosis of cases with normal-appearing external genitalia may be delayed until ...
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Disorders of sex development (DSD) result from intrauterine defects in sex discrimination. The clinical phenotype differs based on the disease type. Cases with ambiguous external genitalia are diagnosed at birth. However, diagnosis of cases with normal-appearing external genitalia may be delayed until puberty. Here, we report a patient with a pelvic mass and a small uterus that was diagnosed by abdominal ultrasound, in addition to the history of primary amenorrhea and physical examination suggested Swyer syndrome, confirmed by genetic karyotyping. Pathological examination of the surgically removed mass revealed dysgerminoma. Until the age of 19, the patient did not have any idea about 46, XY karyotype, and assumed to be a female. The development of dysgerminoma (as a result of the simultaneous presence of gonadal dysgenesis and Y-chromosome) was another challenge that the patient had to deal with. The diagnosis of this patient at an earlier age could have prevented the development of gonadoblastoma, by removal of the streak gonads. By the presentation of this case, we intend to increase the physician’s awareness about DSDs; earlier diagnosis may help the patient deal with her disease better and reduce the risk of further complications.
Obstetrics and Gynecology
fatemeh davari tanha; Mojgan Asadi; Faeze Mirbagheri; Elham Feizabad; Zahra kaveh; Kazem Mousavizadeh
Articles in Press, Accepted Manuscript, Available Online from 01 August 2023
Abstract
Background and Objective: Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age. Chronic pelvic pain is a common symptom of endometriosis and can have a significant impact on a woman's quality of life, including sexual satisfaction. Botulinum toxin ...
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Background and Objective: Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age. Chronic pelvic pain is a common symptom of endometriosis and can have a significant impact on a woman's quality of life, including sexual satisfaction. Botulinum toxin injection has been used as a treatment for chronic pelvic pain in endometriosis, but its effect on sexual satisfaction is not well understood.Methods: A randomized controlled trial was conducted to evaluate the effect of botulinum toxin injection on chronic pelvic pain and sexual satisfaction in women with endometriosis. The study included 32 women with endometriosis who were randomly assigned to receive either botulinum toxin injection or placebo. The primary outcome measure was change in chronic pelvic pain assessed using the visual analog scale (VAS) at one month after treatment. Secondary outcome measures included changes in sexual satisfaction assessed using the Female Sexual Function Index (FSFI) at one month after treatment.Results: The results showed that botulinum toxin injection significantly reduced chronic pelvic pain compared to placebo at one month after treatment (p<0.001). There was also a significant improvement in sexual satisfaction in the botulinum toxin group compared to placebo at one month after treatment (p=0.001). Conclusion: Botulinum toxin injection may be an effective treatment option for women with endometriosis, chronic pelvic pain and sexual dysfunction.This research was also registered with the code IRCT20091012002576N20 in the Clinical Trial Registration Center of Iran. Date of registration performed between July2021and July 2022
Obstetrics and Gynecology
Najmiatul Fitria; Nauratul Ikramah; Ade Sukma; Hansen Nasif
Articles in Press, Accepted Manuscript, Available Online from 05 August 2023
Abstract
Background and Objective: Pregnant women need more nutritional intake than before pregnancy. If this nutritional intake is insufficient for the mother, it will result in Chronic Energy Deficiency (CED). To determine if pregnant women are experiencing malnutrition or cannot be known by measuring the Mid-Upper ...
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Background and Objective: Pregnant women need more nutritional intake than before pregnancy. If this nutritional intake is insufficient for the mother, it will result in Chronic Energy Deficiency (CED). To determine if pregnant women are experiencing malnutrition or cannot be known by measuring the Mid-Upper Arm Circumference (MUAC). Based on service regulations for pregnant women in Indonesia, the minimum number of Iron-Folic Acid (IFA) tablets pregnant women get is 120. Regarding this condition, a study was conducted to analyze the relationship between the amount of IFA consumption on MUAC and several other therapeutic outcomes
Methods: This study used a cross-sectional method by examining the patient's medical records. Patients who received IFA as many as 120 tablets or more will become the exposure group. Data will be analyzed descriptively using chi-square
Results: The MUAC size significantly differed at the end of pregnancy (p=0.01). However, overall there was no significant difference between the two groups
Conclusion: The IFA administration generally gives good results, but the optimal number of IFA doses still needs further study.
Obstetrics and Gynecology
Alfonsus Zeus Suryawan; Amillia Siddiq
Articles in Press, Accepted Manuscript, Available Online from 09 November 2023
Abstract
Background: Uncertainities exist about the diagnostic and prognostic role of hemocytometry values in patients with COVID-19 especially in pregnancy. This study aims to investigate hemostatic changes in pregnant woman with coronavirus disease (COVID-19) and their relationship to disease severity.Methods: ...
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Background: Uncertainities exist about the diagnostic and prognostic role of hemocytometry values in patients with COVID-19 especially in pregnancy. This study aims to investigate hemostatic changes in pregnant woman with coronavirus disease (COVID-19) and their relationship to disease severity.Methods: This research is an analytic observational study with case control design. Subject was gathered from Hasan Sadikin General Hospital patients medical records from June 2021 – March 2022. Inclusion criteria on this study is all pregnant COVID-19 patient with Prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer examination. The exclusion of this study all pregnant COVID-19 patient without required examination. PT, aPTT, and D-dimer were measured by Stago kits on a Stago automated coagulation analyzer (STA Compact Max®). Data was then analyzed by Kruskal Wallis with IBM SPSS Statistic 26th with α=0.05.Results: Statistical analysis shows there’s corelation between different severity levels with D-Dimer. This study shows mean of D-Dimer of each severity levels; asymptomatic 4.85 mg/L, mild 2.86 mg/L, moderate 5.47 mg/L and severe 14.51 mg/L (p <0.000). Changes seen after mild group which increase to 5,47 mg/dL in moderate COVID-19 and furthermore increase in severe become 14,51 mg/L. No changes in PT and aPTT was found.Conclusion: In conclusion, our findings demonstrate that coagulopathy is associated with the severity of COVID-19 illness. D-dimer is important parameter for evaluating the COVID-19 severity in pregnancy. This further could serve as diagnostic category to differ the severity of COVID-19 in pregnancy.
Obstetrics and Gynecology
Fariba Seyedoshohadaei; Masomeh Rezaie; Nasrin Sofizadeh; farnaz zandvakili; Khaled Rahmani; Hosna liravi
Articles in Press, Accepted Manuscript, Available Online from 29 November 2023
Abstract
Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with ...
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Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with complaints of infertility due to lack of ovulation were randomly divided into four groups using clomiphene citrate + placebo, letrozole + placebo, clomiphene citrate + Aspirin, and letrozole + aspirin divided by block randomizes. Follicometry was performed with the help of transvaginal ultrasound on the 14th day of the cycle. In the case of a positive pregnancy, the patients underwent transvaginal ultrasound in the 6th week of pregnancy to observe the gestational sac. Patients were followed up until the 12th week of pregnancy in terms of the abortion rate.
Results: This study showed that there was no significant difference in the number of follicles of 14 to 18 mm, follicles larger than 18 mm, and the thickness of the endometrium of the studied women in the four investigated groups (p>0.05). The pregnancy test results showed that the clomiphene citrate + aspirin group and the letrozole + aspirin group each had the highest pregnancy rate with 13 people (36.1%) having a positive test.
conclusion: Although the addition of aspirin to letrozole or clomiphene citrate does not affect the number of mature follicles and the thickness of the endometrium, it can increase the probability of pregnancy.
Obstetrics and Gynecology
Seyed Mojtaba Alavi; Mohammad Hosein Arjmandnia; meysam feizollahjani; enayatollah Noori; Maryam Yousefi
Articles in Press, Accepted Manuscript, Available Online from 12 December 2023
Abstract
Background: Placenta Accreta Spectrum is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean deliveries, which have been increasing without medical indication. This study ...
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Background: Placenta Accreta Spectrum is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean deliveries, which have been increasing without medical indication. This study aims to explore the risk factors of PAS, clinical outcomes, and strategies to minimize maternal morbidity and mortality.
Materials and Methods: A total of 142 women who had undergone at least one cesarean delivery in the past were included in our evaluation. Among them, 85 women had placenta accreta spectrum (PAS) in their current pregnancy (group 1) while the remaining 57 did not have PAS (group 2). We gathered information about their demographics and previous gynecological history, including placenta previa.
Results: The risk of placenta accreta spectrum (PAS) is significantly higher in cases where there has been a previous cesarean delivery or placenta previa (p-value<0.05). There were no significant differences between past elective or emergent CD (p-value>0.05). PAS was associated with more emergent cesarean deliveries (p-value<0.001) and hysterectomies (p-value<0.001). 97% of patients with history of placenta previa developed PAS (p-value<0.001). Most of the patients who underwent hysterectomy had PAS and placenta previa (p-value<0.001). There was no significant correlation found between previous hysteroscopies and curettages and a higher risk of PAS. (p-value>0.05)
Conclusion: Women with previous cesarean delivery are significantly at risk of placenta accreta in their future pregnancies. Pregnant women should avoid insisting on elective cesarean delivery without medical indication. Planned cesarean delivery could reduce the maternal complications
Obstetrics and Gynecology
Tiarma Uli Pardede; Heronimus Hansen Kaware; Leni Suhartini
Articles in Press, Accepted Manuscript, Available Online from 13 December 2023
Abstract
Background and Objective: Degenerated Uterine Leiomyomas (ULs) is one of the most common complications of UL in pregnancy and may cause severe maternal symptoms. In this study we present the rare case of UL permagna with cystic degeneration managed with Caesarean Section (CS) and Myomectomy with uterus ...
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Background and Objective: Degenerated Uterine Leiomyomas (ULs) is one of the most common complications of UL in pregnancy and may cause severe maternal symptoms. In this study we present the rare case of UL permagna with cystic degeneration managed with Caesarean Section (CS) and Myomectomy with uterus preservation.
Methods: A 37-year-old primigravid woman was referred to the clinic with the chief complaint of huge abdominal mass that coincides with the pregnancy. Physical examination showed that the abdomen was overdistended and upon palpation a mass at processus xiphoideus height was felt. Ultrasound examination showed that the foetus had IUGR (Estimated Fetal Weight below the 10th precentile of the fetal growth curve with oligohidramnion) and also a cystic mass with a clear border. The patient was diagnosed with cystic degeneration of UL premagna and IUGR. The first-line management given was CS and myomectomy as an effort to maintain the uterus because this is a case of pregnancy with 15 years primary infertility.
Result: The overall outcome was satisfactory. The neonate came out alive, Ballard score equivalent to 32 weeks, and weighing around 1480g. The degenerated UL was successfully extracted. The patient was discharged 4 days post-operatively. The baby was treated in the NICU for prematurity and went home after the baby's weight reached 1800 grams.
Conclusion : Degenerated UL permagna in pregnancy is a very rare and serious condition. It needs to be studied further as there are no global consensus on how to manage the case.
Obstetrics and Gynecology
Aida Mohamadi; Mahsa Ghajarzadeh; Fatemeh Davari Tanha; Amirreza Azimi
Articles in Press, Accepted Manuscript, Available Online from 21 December 2023
Abstract
Background: Women with multiple sclerosis (MS) suffer from a wide range of complications. The goal of this study was to compare sexual dysfunction (SD), depression, and sexual quality of life in women with MS with these problems in women without MS.
Methods: Fifty-four women with MS and 108 women without ...
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Background: Women with multiple sclerosis (MS) suffer from a wide range of complications. The goal of this study was to compare sexual dysfunction (SD), depression, and sexual quality of life in women with MS with these problems in women without MS.
Methods: Fifty-four women with MS and 108 women without MS were enrolled. All participants were asked to fill valid and reliable versions of BDI (Beck Depression Inventory), FSFI (Female Sexual Function Index), and SQOL (sexual quality of life) questionnaires.
Results: Mean scores for BDI, SQOL, and orgasm and satisfaction domains of FSFI were significantly different between case and control groups. Sexual quality of life (SQOL) had a significant positive correlation with FSFI (r=0.568, p<0.001) and a significant negative correlation with BDI scores (r=-0.528, p<0.001). A significant negative correlation was also found between FSFI and BDI scores (r=-0.325, p<0.001). According to the total FSFI cut-off point, 53.7% of cases and 44.4% of controls had SD (p=0.168).
Considering SQOL as a dependent variable and age, education level, marriage duration, husband’s age, and BDI and FSFI scores as independent variables, linear regression analysis showed that education level, BDI score, and FSFI score were independent predictors of SQOL in all participants, while among MS patients, only BDI and FSFI were significant predictors of SQOL.
Conclusion: Sexual quality of life and sexual function should be considered in women with MS, and depression should be assessed and treated as a possible risk factor.
Obstetrics and Gynecology
shereef elshwaikh; Ahmed Ossman; muhammad el-masry; ahmed swelam; yasmin elmasry
Articles in Press, Accepted Manuscript, Available Online from 24 December 2023
Abstract
Aim: To evaluate changes in serum AMH levels, fertility and metabolic conditions in reproductive-age severely obese women, after bariatric surgery.
Design: prospective cohort study.
Methods: This study had been conducted on marked obese women who were referred to BS in Tanta university hospital. the ...
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Aim: To evaluate changes in serum AMH levels, fertility and metabolic conditions in reproductive-age severely obese women, after bariatric surgery.
Design: prospective cohort study.
Methods: This study had been conducted on marked obese women who were referred to BS in Tanta university hospital. the AMH and other hormones (FSH- LH- free Testosterone- SHBG- fasting Insulin) levels had been measured as part of their evaluation will be reviewed before and after (6) months the surgery. The involved women were in reproductive age between 18 and 40 years old. With BMI > 36 kg/m2 and < 42 kg/m2.
Results: From 64 female who had been enrolled, 50 patients only completed the 6 months follow up , and it was found there was a significant difference as regard the weight and the BMI , fasting insulin level and regular menstrual pattern after 6 month follow but other fertility factors including were improved but had no significant difference .
Also 20 cases (40%) had a spontaneous ovulation after 6 moth follow up after BS , and by comparing them to those who had no spontaneous ovulation ,there was a significant effect on weight reduction on occurrence of spontaneous ovulation , BMI parameter, and the level of change of BMI, regular menstrual cycle, while the other fertility related parameters although improved but failed to show any significant relationship .
Conclusion: BS and reduction of the weight had a positive effect on the reproductive performance of obese female.
Obstetrics and Gynecology
Dina Hyari; Duha Arabiat; Ayman A. Qatawneh; Murad Rabadi; Katea Albawalsah; Rula Barham; Layan Budair; Omar Ahmed Abdelwahab
Articles in Press, Accepted Manuscript, Available Online from 17 January 2024
Abstract
Background: Menstrual irregularities after COVID-19 vaccines have been widely reported. This study aims to evaluate Jordanian women's menstrual changes after receiving the COVID-19 vaccine.
Methods: This study is an analytical cross-sectional study conducted through an online self-administered questionnaire ...
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Background: Menstrual irregularities after COVID-19 vaccines have been widely reported. This study aims to evaluate Jordanian women's menstrual changes after receiving the COVID-19 vaccine.
Methods: This study is an analytical cross-sectional study conducted through an online self-administered questionnaire distributed through social media during June and July 2022. It involved 384 women between the ages of 20 and 35 who took the vaccine and did not suffer from gynaecological or medical conditions that affect menstruation, were not pregnant or lactating, were not utilising hormonal or intrauterine contraceptives, and had normal menstrual cycle length and regularity prior to vaccination.
Results: The results of this study showed a statistically significant increase in menstrual cycle length with a mean difference of 2 days (p=<0.001), but not in menstrual duration (p=0.824). 55.4% had their first period after vaccination on time. Eight participants reported new-onset intermenstrual bleeding. Additionally, 41.3% experienced changes in menstrual volume, and their first period came on time. Around one-third of women reported increased or new-onset dysmenorrhea. As for premenstrual symptoms, 30% reported increased or new-onset mood disturbances, 20.6% had changes in their sleeping patterns, 17% had increased headaches.
Conclusion: The study revealed that COVID-19 vaccination might cause changes in menstrual cycle length and new or increased menstruation problems in some women, including dysmenorrhea, premenstrual symptoms, and intermenstrual bleeding. These results emphasize the need for additional longitudinal research to understand the effect of COVID-19 vaccination on menstrual health and to provide support and education to women who experience menstrual abnormalities after vaccination.
Obstetrics and Gynecology
KAVITHA NAGANDLA; Keeran Rajandram; Khaisro Ali Shah; Kathy Anne Rani A/P Arulraj; Lee Huang Ming; Joanne Wong Mei Jye
Articles in Press, Accepted Manuscript, Available Online from 23 January 2024
Abstract
Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant ...
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Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant concern during the pandemic. This systematic review aims to synthesise the current scientific evidence on the impact of the COVID-19 pandemic on perinatal mental health and its associated risk factors.
Materials & Methods: The review used a structured process based on JBI and PICOS strategy and searched three databases for studies published between July 2020 to December 2022 that measured specific mental health outcomes using validated measures. The PRISMA guideline was followed for the study selection process.
Results: Among the total 45 articles that have been included, the prevalence of depression and anxiety was found to be moderate to severe in pregnant and/or postpartum women during the pandemic, with a significantly higher level compared to prior to the pandemic. Additionally, pregnant and/or postpartum who tested positive for COVID-19 were more vulnerable to anxiety and depression. Furthermore, perinatal women with pre-existing mental illness showed further deterioration during the pandemic, and lastly, pregnant and/or postpartum women had higher levels of anxiety and depression compared to non-pregnant women.
Conclusions: This systematic review finds a significant increase in depression and anxiety among pregnant women during the COVID-19 pandemic, with risk factors such as unemployment and poor social support. Healthcare professionals should establish treatment plans to prevent adverse mental outcomes for this vulnerable population.
Obstetrics and Gynecology
Arti Sharma; Yashika Pehal; Namrata Saxena; Swati Agrawal
Articles in Press, Accepted Manuscript, Available Online from 31 January 2024
Abstract
Background and Objective: Iron deficiency anemia is a major public health problem worldwide. Oral iron intake is preferred, but parenteral administration of iron is necessary under certain circumstances. The objective of the present study is to compare the efficacy and safety of parenteral Iron Sucrose ...
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Background and Objective: Iron deficiency anemia is a major public health problem worldwide. Oral iron intake is preferred, but parenteral administration of iron is necessary under certain circumstances. The objective of the present study is to compare the efficacy and safety of parenteral Iron Sucrose to Ferric Carboxymaltose (FCM) in improving the hematological indices in anemic pregnant women.
Methods: The study was a comparative, observational study conducted at the Department of Obstetrics and Gynecology, SGRR Institute of Health and Medical Sciences, Dehradun from September 2018 to May 2020. The sample size was 120 pregnant women with iron deficiency anemia in each group. One group was treated with intravenous Iron Sucrose and the other group was treated with intravenous FCM. The outcome measures were improvement in hematological parameters and experienced side effects. Data was analyzed by using appropriate statistical tests.
Results: Both groups were comparable in terms of baseline parameters. Hemoglobin rise was rapid in the group treated with FCM (8.7 ± 0.47 g/dl to 11.6 ± 0.77 g/dl) than the iron sucrose (8.24 ± 0.57 g/dl to 10.60 ± 0.87g/dl) group. Rise in serum ferritin and MCV of RBC were also higher in FCM group than the iron sucrose group. Both groups have only mild side effects.
Conclusion: Hence we can conclude from our study that parenteral therapy with iron sucrose and FCM, both can successfully treat iron deficiency anemia in pregnancy but the improvement is faster, safer, and more convenient with the use of FCM than iron sucrose.
Obstetrics and Gynecology
Malihe Afiat; Nayere Khadem; Behnaz Ansari; Fedyeh Haghollahi; Mohadese Dashtkoohi; Mohammad Sadeq Najafi; Mohammad Dashtkoohi; MirFarbod Hojati Bagheri; Seyede Houra Mousavi Vahed
Articles in Press, Accepted Manuscript, Available Online from 05 February 2024
Abstract
Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact ...
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Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact of enoxaparin, an LMWH, and its outcomes in women with URPL.
Methods: This study presents a single-blinded randomized clinical trial involving 80 women with URPL and no history of thrombophilia. The participants were referred to the Infertility Clinic at Imam Reza Hospital (Milad Center) between March 2018 and February 2019. During the sixth week of gestation, the participants were assigned randomly to two groups. The treatment group (n = 40) received a daily subcutaneous injection of 40 mg of enoxaparin, while the control group (n = 40) received routine pregnancy care. Maternal and neonatal demographic data, pregnancy outcomes, complications, and live birth rates were recorded and subsequently compared between the two groups.
Results: A total of 80 eligible women were enrolled in the study, with equal distribution between the treatment and control groups. There were no significant differences in previous pregnancies or miscarriages between the groups, and the live birth rate was about 85% in both groups. The occurrence of pregnancy complications was significantly higher in the treatment group compared to the control group (38.2% VS. 5.7%; p = 0.021).
Conclusion: Treatment with enoxaparin in women with unexplained recurrent pregnancy loss and no history of thrombophilia did not improve the pregnancy outcome nor decrease pregnancy complications.
Obstetrics and Gynecology
Salma Samy Abdellateef; Safaa Kamal Marei; Nagwa Mahmoud Elghorab; Hesham Gaber Al-Anany
Articles in Press, Accepted Manuscript, Available Online from 21 February 2024
Abstract
Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection ...
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Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection (ICSI) and clinical pregnancy rates in females with history of implantation failure.
Methods: This prospective study was carried out on 109 females aged ˂ 40 y, with FSH level < 10mIU /ML, AMH > 1ng/mL, presented with either primary or secondary infertility and advised for IVF or ICSI after IVF/ICSI failure. Cases was divided in to two groups with history of implantation or previously unsuccessful IVF cycles: 1st group (n=50) did ICSI without PRP injection and 2nd group (n=50) did ICSI with PRP injection.
Results: Endometrial thickness at OR day was insignificantly different between both groups, but at ET day it was significantly elevated in PRP group in comparison with non-PRP group (P<0.001). The two groups were comparable regarding numbers of retrieved oocytes, mature oocytes, and numbers of fertilized ova but without significant differences. The numbers of good quality embryos showed no significant differences in PRP group in comparison with non-PRP group. There was no significant difference regarding numbers of embryos transferred at day of ET in both groups.
Conclusions: PRP is a new procedure of treatment in the field of reproductive medicine with high safety. Although it significantly increased endometrial thickness at day of ET day and consequently it increased the chemical pregnancy rate
Obstetrics and Gynecology
Yuni Nurwati; Hardinsyah Hardinsyah; Sri Anna Marliyati; Budi Iman Santoso; Dewi Anggraini
Articles in Press, Accepted Manuscript, Available Online from 04 March 2024
Abstract
Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives ...
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Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives and cadres in detecting risk of LBW. Methods: This study used an analytic quantitative study based on retrospective data of 165 eligible pregnant women collected from a public hospital in Ternate City (2018-2023). Body height, body weight, body mass index (BMI), mid-upper arm circumference (MUAC), nausea and vomiting, gestational age of ANC visit (AV) of the first trimester of pregnancy, as well as marital age, age, occupation, education, parity, and abortion history of pregnant women were used as research variables. Binary logistic regression was applied to develop the model. Results: Body weight, marital age, education, and AV are statistically significant as screening indicators for detecting the risk of LBW infant with Area Under Curve (AUC) is 79.6%.Conclusion: Therefore, the model can be developed as a basis for developing a simple and reliable screening tool in the first trimester to detect the risk of LBW infant that can be implemented by midwives and cadres in rural area
Obstetrics and Gynecology
Zainab Muayad Essa; Alia Kareem Mohamad AL-Qarawy; Ashwaq Kadhim Mohammed
Articles in Press, Accepted Manuscript, Available Online from 09 March 2024
Abstract
Background: Endocrine disorders like polycystic ovarian syndrome affect reproductive-age women. It causes infertility and has several clinical symptoms. Clomiphene citrate ovulation induction is a first-line treatment. Serum anti-mullerian hormone can indicate positive pregnancy outcomes in women with ...
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Background: Endocrine disorders like polycystic ovarian syndrome affect reproductive-age women. It causes infertility and has several clinical symptoms. Clomiphene citrate ovulation induction is a first-line treatment. Serum anti-mullerian hormone can indicate positive pregnancy outcomes in women with this disease, however this is controversial. Aim of the study:to assess the value of anti-mullerian hormone (AMH) as an anticipator of ovary response to clomiphene citrate in patients with “polycystic ovary syndrome (PCOS). Patients and methods: A cross-sectional study of 50 women diagnosed with Rotterdam-based polycystic ovarian syndrome by two gynaecologists was conducted. The Maternity and Paediatric Teaching Hospital in Diwaniyah Province, Iraq, conducted the study from August 1, 2022, to May 15, 2023, at the obstetrics and gynaecology department. Women with diabetes or hypertension were excluded from the trial. These women sought medical treatment for infertility and received clomiphene citrate to induce ovulation. The findings of hCG urine and blood testing divided women into positive and negative biochemical pregnancy groups. Results: The mean FSH of all recruited women was 5.19±1.14 IU/L, with no significant difference between pregnant and non-pregnant women (p = 0.849). AMH levels were significantly lower in pregnant women compared to non-pregnant women (p< 0.001). The mean AMH was 6.97±2.88 ng/ml for all enrolled women. ROC curve research determined the optimal AMH cutoff value for predicting positive biochemical pregnancy: ≤6.5 ng/ml with 100% sensitivity, 67.7% specificity, and 80.9 % accuracy. Conclusion: Serum anti-mullerian hormone accurately predicts pregnancy success in PCOS women taking clomiphene citrate to induce ovulation.
Obstetrics and Gynecology
Ashwaq Kadhim Mohammed; Zainab Muayad Essa
Articles in Press, Accepted Manuscript, Available Online from 09 March 2024
Abstract
Background: An unusual manifestation of prenatal trophoblastic illness is a twin molar pregnancy with a live foetus and a hydatidiform mole. Due to increased ovulation stimulation, this unusual scenario is rising. Most hydatidiform moles are complete with a foetus, while 0.005 to 0.01% of gestations ...
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Background: An unusual manifestation of prenatal trophoblastic illness is a twin molar pregnancy with a live foetus and a hydatidiform mole. Due to increased ovulation stimulation, this unusual scenario is rising. Most hydatidiform moles are complete with a foetus, while 0.005 to 0.01% of gestations have a partial mole. This report examined the clinical appearance and outcome of live foetuses with molar pregnancies. Methods: This study was done at Adiwaniyah, where the Maternity and Pediatrics Teaching Hospital has one obstetrics centre. The researcher reviewed 20 years of obstetric reports and found 12 cases of hydatiform mole pregnancies with ultrasound reports and/or post-partum examination of the product of gestation indicating twin pregnancy with a single viable foetus. Results: The average age was 27.00 ±6.87 years, with a range of 18-37 years. The parity breakdown was 8 (66.7%) primiparous and 4 (33.3%) multiparous. The average gestational age upon diagnosis was 19.50 ±3.09 weeks, ranging from 15 to 25 weeks. The average gestational age at delivery commencement was 26.67 ±7.09 weeks, with a range of 17-35 weeks. Seven (58.3%) amniocentesis were normal. Maternal complications included bleeding, anemia, blood transfusion, threatening miscarriage, and pre-eclampsia. End-of-gestation outcomes comprised 5 (41.7%) living and healthy newborns and 3 (25.0%) dead babies. There were 5 (41.7%) men and 2 (16.7%) women. Also reported: miscarriage, premature labour, and caesarean sections. Conclusion: Twin pregnancy with a live viable foetus and a molar pregnancy is rare, hence early detection and care are crucial to prevent difficulties for the mother and foetus.
Obstetrics and Gynecology
Francesco Fedele; Giovanna Esposito; Fabio Parazzini
Articles in Press, Accepted Manuscript, Available Online from 24 March 2024
Abstract
We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine ...
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We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine body (normal or malformed) with the constant absence of the cervix and the total or partial absence of the vagina.
We describe a case of a 17-year-old female patient. During hospitalization at out gynecologycal department, a complete digestive tract x-ray resulted in a depiction of severe congenital intestinal malrotation. An initial gynecological misdiagnosis led to two an inadequate and unsuccessful attempts of conservative surgery before reaching our academic center. Despite a finally complete diagnosis and adequate conservative surgery, the results of previous surgeries have resulted in a failure of conservative therapy and the need for demolitive surgery. Knowledge of this malformative association is crucial for planning interventional procedures.
Obstetrics and Gynecology
Anak Agung Ngurah Jaya Kusuma; Endang Sri Widiyanti; I Gede Mega Putra; Kadek Ary Widayana; William Alexander Setiawan
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics ...
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Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics of patients with pre-eclampsia and eclampsia and serum magnesium levels during MgSO4 therapy.
Methods: A cross-sectional study design used secondary data from the Emergency Maternity Room of Prof. Dr. I.G.N.G. Ngoerah Hospital. The samples were all superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia cases in 2019. We collected and analyzed characteristic and laboratory data, including the MgSO4 serum levels of the patients. Participants' baseline characteristics (CBC, blood chemistry, and MgSO4) and their diagnosis were compared using the chi-square test for categorical data and the independent t-test for numerical data.
Results: The patients with severe pre-eclampsia were 183 patients, superimposed pre-eclampsia were 41 patients, and eclampsia 15 patients. Age <35 years old was the most influential characteristic variable in superimposed pre-eclampsia (adjusted odds ratio (aOR)=0.166, p<0,001, 95%CI=0.082-0.336) and severe pre-eclampsia (aOR=3.011, p<0,001, 95%CI=1.662-5.455). Hospital referrals were the most influential characteristic variable in eclampsia (aOR=3.653, p=0.016, 95%CI=1.273-10.486). The administration of MgSO4 was significant with severe pre-eclampsia (p<0.001). The highest serum magnesium occurred 6 hours before MgSO4 administration (3.97 ± 1.28 mg/dL).
Conclusion: Patients with superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia conditions have various characteristics associated with each state. During the use of MgSO4, there was a significant association between serum magnesium levels and the therapeutic target levels.
Obstetrics and Gynecology
Shahrzad Sheikhhasani; Maryam Noorzadeh; Mahsa Naemi
Volume 9, Issue 2 , March and April 2024, , Pages 1-1
Abstract
Ovarian cancer is the second most common malignancy in women worldwide, causing many deaths each year. Chemotherapy is one of the most important therapeutic strategies that can increase the survival of these patients; however, one of the problems in chemotherapy is resistance against platinum treatment. ...
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Ovarian cancer is the second most common malignancy in women worldwide, causing many deaths each year. Chemotherapy is one of the most important therapeutic strategies that can increase the survival of these patients; however, one of the problems in chemotherapy is resistance against platinum treatment. Evaluating the effect of platinum- and non-platinum-based chemotherapy in patients with recurrent platinum-resistant ovarian cancer can enhance our view on this issue. The present review article sought to identify the treating efficacy of platinum and non-platinum-based chemotherapy in patients with recurrent platinum-resistant ovarian cancer by searching scientific databases and examining the aspects of platinum resistance in various articles. Oncological results have shown that ovarian cancer is a deadly disease, and most cases are diagnosed when the cancer spreads outside the ovary and often throughout the entire abdomen. On the other hand, in many cases, disease recurrence is associated with drug resistance. The use of a platinum-free interval has played an important role in its treatment efficacy. Understanding the cause of platinum resistance and discovering strategies to reduce drug resistance, especially to new ones, is very important. The present article suggested oncology teams agree on treatment methods and the best treatment approach against platinum resistance in malignant ovarian cancers and offer a better treatment solution by considering innovative strategies.
Obstetrics and Gynecology
Razieh Akbari; Ezat-Sadat Haj-Seyed Javadi; Zahra Panahi
Volume 9, Issue 2 , March and April 2024, , Pages 3-3
Abstract
Background: The purpose of this study was to compare the effectiveness of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy.Methods: The research was done as an RCT from 2017 to 2018. About 300 participants were randomly allocated to obtain 50 µg Buccal, 25 µg ...
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Background: The purpose of this study was to compare the effectiveness of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy.Methods: The research was done as an RCT from 2017 to 2018. About 300 participants were randomly allocated to obtain 50 µg Buccal, 25 µg Vaginal, and 50 µg Sublingual misoprostol in Kosar Hospital, Qazvin, Iran. The maternal and fetal complications, Bishop score hour 1, and hour 6 were observed.Results: There were no differences between fetal complications (p>0.05) and maternal complications (p>0.05) among the three groups. Bishop score hour 1 (P = 0.146), Bishop Score hour 6 (P = 0.704), and total dose (P = 0.15) also were no differences among these groups. Our study found a difference between the three groups (P = 0.015) in achieving standard vaginal delivery within 24 hours, as Buccal, Sublingual and Vaginal groups were performed respectively. The use of Oxytocin in the Buccal group was higher than that of other groups (P = 0.022).Conclusion: This study found that there is no difference in terms of fetal complications and maternal complications in the three groups, but there was a significant difference in Oxytocin use and vaginal delivery within 24 h from the start of induction.
Obstetrics and Gynecology
Fatemeh Davari Tanha; Mojgan Asadi; Zahra Shahraki; Zeinab Assaf; Zahra Kaveh; Mahsa Ghajarzadeh
Volume 9, Issue 2 , March and April 2024, , Pages 8-8
Abstract
Background and Objective: Sexual activity is a major determinant of health-related quality of life. The aim of this study was to investigate sexual activity in women with polycystic ovary syndrome.
Methods: A case control survey was conducted at a tertiary care university hospital (Yas Hospital Complex.). ...
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Background and Objective: Sexual activity is a major determinant of health-related quality of life. The aim of this study was to investigate sexual activity in women with polycystic ovary syndrome.
Methods: A case control survey was conducted at a tertiary care university hospital (Yas Hospital Complex.). A total of 193 women were enrolled in this study. The Female Sexual Function Index (FSFI) questionnaire was used to assess the sexual dysfunction. In this study, 100 cases with PCOS and 93 healthy controls were studied.
Results: The mean FSFI total score and all domains except orgasm were significantly lower in PCOS patients as compared to healthy controls. With an FSFI score of less than 26.55, sexual dysfunction was found in 62% of PCOS cases versus 18.2% of the control group. Multiple regression analysis showed that FSH and free testosterone were independent predictors of FSFI score. The result showed that more than sixty percent of PCOS women suffer from sexual dysfunction.
Conclusion: PCOS women need to be asked about and managed for sexual dysfunction more frequently than non-PCOS women.
Obstetrics and Gynecology
Uchenna Kenneth Ezemagu; Godwin Chinedu Uzomba; Chukwuemeka Ubochi; Rachel Ogbu; Augustine Oseloka Ibegbu; Friday Chubuzor Egba; Olisa Onuora; Paul O. Ezeonu; Thecla Ezeonu
Volume 9, Issue 2 , March and April 2024, , Pages 10-10
Abstract
Objectives: We considered maternal and birth anthropometric features and fetal sex in developing a labor protocol.Materials and Method: A prospective study of 400 mothers, having healthy pregnancies and their newborn singletons in gynecology ward of Alex Ekwueme Federal University Teaching Hospital, ...
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Objectives: We considered maternal and birth anthropometric features and fetal sex in developing a labor protocol.Materials and Method: A prospective study of 400 mothers, having healthy pregnancies and their newborn singletons in gynecology ward of Alex Ekwueme Federal University Teaching Hospital, Abakaliki. The study adopted a convenient sampling technique to select the volunteers from 1st July to December, 2020. Birth and maternal anthropometries; BMI, height, weight, birth head girth (BHG), waist girth (WG), hip girth (HG) and delivery outcomes: birth mode and duration of 1st and 2nd phases of labor, and Apgar score at 1 minute of birth were measured, using Institute of Medicine guidelines.Results: Maternal age, weight and HG, and WG at term pregnancy and fetal sex could determine birth mode and weight (P<0.05). The associations for duration of 1st phase of labor and maternal and birth anthropometries were inconsistent. Fetal sex, birth mode and features and maternal anthropometries; body fat, age, BMI and HG were associated with duration of 2nd phase of labor and Apgar score. Conclusions: Maternal anthropometries predispose birth features, and advance age of mothers, relatively large WHR and fetal macrosomia at term pregnancy could increase duration of 2nd phase of labor and risk of a male birth, developing abnormal Apgar score. The strong association between anthropometric variables of a mother and her baby suggests that anthropometric investigations could enhance the choice of birth mode and minimize vaginal birth complications. The study emphasized on the need of a sex specific state-of-the art anthropometric investigations at term pregnancy.