Obstetrics and Gynecology
Fatemeh Golshahi; Mahboobeh Shirazi; Fatemeh Rahimi Sharbaf; Mohammad Reza Zarkesh; Narges Nahavandi
Volume 6, Issue 3 , June 2021, , Pages 152-156
Abstract
The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80% mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with ...
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The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80% mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with preterm birth at this age due to preterm uterine contractions. No etiology was found for hydrops and all signs resolved thoroughly after birth without treatment. After birth, the newborn was admitted to neonatal intensive care unit and discharged after 47 days in good condition. The infant was completely healthy within three months after delivery.
Obstetrics and Gynecology
Yurkdes Aran Sittampalam; Nicole AshaThayaparan; Narasimman Sathiamurthy; Muniswaran Ganeshan
Volume 6, Issue 3 , June 2021, , Pages 157-160
Abstract
Thymomas are seldom encountered in the general population, and even more-so uncommonly encountered in pregnancy. Patients usually present with either local, compressive symptoms such as shortness of breath or are asymptomatic and diagnosed incidentally on imaging studies. A subset of them may even present ...
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Thymomas are seldom encountered in the general population, and even more-so uncommonly encountered in pregnancy. Patients usually present with either local, compressive symptoms such as shortness of breath or are asymptomatic and diagnosed incidentally on imaging studies. A subset of them may even present in association with myasthenia gravis. Management of pregnant patients with thymomas are challenging and require multi-disciplinary care involving thoracic surgeons, maternal-fetal medicine specialists, neonatologists and anaesthesiologists to facilitate safe progression of the pregnancy. We discuss the management of a patient that presented to us with a B2-type thymoma in pregnancy who successfully underwent a video-assisted thoracoscopic excision of the mass and went on to have a safe delivery. The optimal way forward in managing patients with thymomas in pregnancy would be through early recognition of the condition and instituting a mutlidisciplinary approach.
Obstetrics and Gynecology
Mohamad Kazem Momeni; Omid Bameri; Mehrangiz Ghafari; Sima Saravani; Fereshteh Javadian
Volume 6, Issue 2 , March 2021, , Pages 50-56
Abstract
Today, opportunistic fungi, especially Candida albicans, are among the most common risk factors in patients with weakened immune systems. Fungal infections caused by Candida species and increasing number of azole-resistant strains are of great importance in immunocompromised patients. The toxicity of ...
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Today, opportunistic fungi, especially Candida albicans, are among the most common risk factors in patients with weakened immune systems. Fungal infections caused by Candida species and increasing number of azole-resistant strains are of great importance in immunocompromised patients. The toxicity of the drugs used, the development of resistance to these fungi, and the problems caused by drug interactions necessitate the use of more effective drugs with less toxicity. This study aimed to evaluate the antifungal activity of medicinal plant extracts on C. albicans. In this review study, Scopus, PubMed, MEDLINE, Google Scholar, SID, and Magiran databases were searched between 2000 and 2019 to identify related articles. The search keywords were “Candida albicans”, “Complementary”, “Herbal medicine” and their Persian equivalents. All in vivo and in vitro trials were included in the study. The reviewed studies showed the effectiveness of some compounds in inhibiting the growth of C. albicans. The results of the present research were in in-vitro conditions, but they need to be conducted in-vivo for human use.
Obstetrics and Gynecology
Madhubala Manickavasagam
Volume 6, Issue 2 , March 2021, , Pages 57-64
Abstract
Background and Objective: Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics ...
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Background and Objective: Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.Methods: The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics and gynaecology department for antenatal care on their first appointment. The diagnosed participants’ knowledge, awareness and management potential about AIP was assessed.Results: The mean age was 26.9 and 24.2 years in AIP and non-anemia in pregnancy NAIP groups, respectively. First trimester early week’s appointment was 38.3% and 37.6% of AIP and NIAP groups, respectively. AIP compared to parity (χ2 = 3.0739) and gestation age (χ2 = 0.8435) was not significant at P-value<0.05. According to WHO definition, AIP was reported in 49.2% of the study population involving 30.4% of urban and 18.8% of rural population. The knowledge and awareness of pregnant women towards anemia in pregnancy was not significant with eleven predictor’s odds ratio. However, both of the groups, 60.3% of the AIP and 46.2% of the NAIP cases were aware of the anemia-related complications during pregnancy.Conclusions: First trimester anemia in pregnancy was a prominent health burden in spite of available resources and awareness programmes. There was a sensitization lacunae to rule out the misconception and the belief. A healthy state of mind and practice among women shall be instrumental in bringing about an improved perception of AIP and its prevention.
Obstetrics and Gynecology
Farzaneh Rashidi Fakari; Masoumeh Simbar; Golshan Tahmasebi; Abbas Ebadi; Fahimeh Rashidi Fakari; Malihe Nasiri; Masumeh Ghazanfarpour
Volume 6, Issue 2 , March 2021, , Pages 81-86
Abstract
Background: Menstruation with cramping pain is one of the problems that appear during adolescence. The severity of dysmenorrhea affects the extent of activity limitation. Given the high prevalence of dysmenorrhea in adolescents and the personal-social effect of this condition on their daily lives, using ...
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Background: Menstruation with cramping pain is one of the problems that appear during adolescence. The severity of dysmenorrhea affects the extent of activity limitation. Given the high prevalence of dysmenorrhea in adolescents and the personal-social effect of this condition on their daily lives, using reliable tools for assessing the severity of this condition in different populations of different countries can significantly contribute to the standard diagnosis, evaluation, and treatment of people suffering from dysmenorrhea.Methods: This cross-sectional study was performed on a population of adolescent girls (Iran) in 2019. The research was approved and monitored by the relevant supervisory body, which issued the pertinent ethics licenses and letters of introduction. Sampling was performed using the cluster method from public schools. Inclusion criteria were Iranian nationality and not having any underlying diseases. The exclusion criterion was the unwillingness to continue participation. The data collection tools were a questionnaire of demographic and menstrual information as well as verbal rating scale (VRS; for both drug and pain) and working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) questionnaires.Results: The participants had a mean age of 15.6±2.3 years and a mean age of menarche of 12.5±1.3 years. The best sensitivity and specificity of the tools were respectively calculated as 63.7% and 56.9% for WaLIDD (at point 4.5), 57.3% and 70.8% for VRS (pain; at point 1.5), and 33.9% and 72.2% for VRS (drug; at point 0.5).Conclusion: According to the results of this study, none of the tools had high specificity and sensitivity at the same time. However, WaLIDD had high sensitivity, and VRS (for both pain and drug) exhibited high specificity.
Obstetrics and Gynecology
Azam Tarafdari; Fatemeh Keikha; Mahrouz Malek; Azin Ghamari
Volume 6, Issue 2 , March 2021, , Pages 95-98
Abstract
Background and Objective: Being considered a common benign uterine disorder, Adenomyosis (AD) is defined as the presence of an endometrial gland and stroma within the myometrium. It causes symptoms such as dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility. It has a step-by-step treatment, ...
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Background and Objective: Being considered a common benign uterine disorder, Adenomyosis (AD) is defined as the presence of an endometrial gland and stroma within the myometrium. It causes symptoms such as dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility. It has a step-by-step treatment, initiating with medical therapy, conservative surgery, and finally, the hysterectomy. As some of the women with adenomyosis are nulligravid and want to become pregnant later, most patients prefer fertility-preserving surgery.Case Report: This study describes the management of diffuse posterior AD in a 36-year-old virgin female by triple flap technique and levonorgestrel intrauterine device (LNG-IUD) insertion during operation to prevent future recurrence and reduction of patient’s symptoms. The application of the triple flap technique and LNG-IUD in this patient was associated with excellent results.Conclusion: The wide excision of the lesion leads to symptom improvement, especially hypermenorrhea and dysmenorrhea; besides, the reconstruction of the uterine wall with this technique increases the risk of the possibility of future pregnancy for our patient.
Obstetrics and Gynecology
Mona Mohseni; Nasim Shokouhi; Elham Feizabad; Elham Khaghani
Volume 5, Issue 4 , December 2020, , Pages 167-171
Abstract
Background & objective: Pregnancy is a known risk factor for urinary incontinence (UI) due to physiological and anatomical changes, especially in the third trimester of pregnancy. This study aimed to determine the prevalence of UI in the third trimester of pregnancy and its related factors in ...
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Background & objective: Pregnancy is a known risk factor for urinary incontinence (UI) due to physiological and anatomical changes, especially in the third trimester of pregnancy. This study aimed to determine the prevalence of UI in the third trimester of pregnancy and its related factors in pregnant women.Materials & Methods: This cross-sectional study was conducted on 330 pregnant women in the third trimester of pregnancy, referred to the perinatal care clinic of Yas Hospital in 2016-2017. The sampling method was convenience sampling. Then, the prevalence of UI and its related factors were investigated in these participants.Results: The mean age of the subjects was 30±5 years old. Totally, 98 pregnant women (29.7%) had UI. The rate of urine leakage was mild at 26.4% and moderate or severe at 3.3%. The time of urine leakage in 6.4% of women with UI was before reaching the toilet, 1.2% was permanent, 19.4% was related to cough and sneezing, and 2.7% of women did not indicate a specific time. In evaluating the relationship between each of the variables and UI, three factors were identified to be completely related to UI, i.e., morbid obesity (P < /em>=0.038), gestational age between 32 to 37 weeks (P < /em>=0.012), and age ≥ 35 years old (P < /em>=0.009).Conclusion: It seems that one-third of pregnant women in the third trimester of pregnancy have UI, which is a multifactorial issue and therefore requires multidisciplinary programs to prevent it.
Obstetrics and Gynecology
Hana Sohrabi; Seyedeh Reyhaneh Yousefi-Sharmi; Rozbeh Sohrabi
Volume 5, Issue 4 , December 2020, , Pages 172-174
Abstract
Aplasia cutis congenita (ACC) is a rare congenital disorder characterized by localized or widespread skin absence. The most common site is the scalp and the main cause is unknown. Here we report a case of extensive ACC with scalp involvement. A female infant with an Apgar score of 9 and weighing 3406 ...
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Aplasia cutis congenita (ACC) is a rare congenital disorder characterized by localized or widespread skin absence. The most common site is the scalp and the main cause is unknown. Here we report a case of extensive ACC with scalp involvement. A female infant with an Apgar score of 9 and weighing 3406 gr was born by cesarean section in Besat Hospital, Sanandaj, Iran. A lesion measuring 5×10 cm with highly prominent vessels was on the forehead and parietal bone without scalp, skull, or bone tissue leading to the brain tissue being covered with a thin membrane. Other clinical examinations were normal. The newborn suffered from a ruptured aneurysm and intracerebral hemorrhage and underwent pharmacologic treatment. She died after 21 days of hospitalization. In order to prevent mortality in infants with skin defects, infection control is a priority. Antibiotics could be administered in cases with extensive lesions to prevent neonatal sepsis and improve scar tissue formation. Moreover, restorative measures should be taken if necessary.
Obstetrics and Gynecology
Koroush Shahsavan; Behnaz Moradi; Komeil Farajnejad Ghadi; Mohammad Ali Kazemi
Volume 5, Issue 4 , December 2020, , Pages 178-181
Abstract
Background & Objectives: Congenital partial agenesis of the portal venous system is a very rare anomaly in which part of the portal blood bypass the liver, and is usually associated with the portosystemic shunt (PSS). The prognosis is good and they usually have excellent hemodynamic status with normal ...
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Background & Objectives: Congenital partial agenesis of the portal venous system is a very rare anomaly in which part of the portal blood bypass the liver, and is usually associated with the portosystemic shunt (PSS). The prognosis is good and they usually have excellent hemodynamic status with normal fetal growth and a survival rate.Case report: In this study, we report two rare cases of fetal portal system anomalies at second trimester which mainly involved portal sinus. They are the first cases that have ever been reported without any systemic shunt. Both fetuses were born normally and have had normal outcomes ever since.Conclusion: Partial portal system agenesis with only minor changes in portal system anatomy and without PSS can be considered as variants of portal system with good outcome.
Obstetrics and Gynecology
Zahra Rezaei; SeyedeMahsa Hadifar
Volume 5, Issue 3 , November 2020, , Pages 80-83
Abstract
Background and objective: Current study was conducted to determine the effects of Oxytocin drip on operative blood loss and fluid overload during hysteroscopy.Materials and Methods: In this double-blind randomized clinical trial, 54 women with abnormal uterine bleeding who were candidates for ...
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Background and objective: Current study was conducted to determine the effects of Oxytocin drip on operative blood loss and fluid overload during hysteroscopy.Materials and Methods: In this double-blind randomized clinical trial, 54 women with abnormal uterine bleeding who were candidates for hysteroscopy were consecutively enrolled and randomly assigned to receive either oxytocin or normal saline and the alterations in serum hemoglobin, sodium, albumin, and hematocrit were compared between two groups.Results: The results demonstrated that alterations in serum hemoglobin, sodium, albumin, and hematocrit did not significantly differ between the two groups (P < /em>>0.05).Conclusion: It seems using oxytocin drip during hysteroscopy in patients with intrauterine lesions would have no effect on operative blood loss and fluid overload.
Obstetrics and Gynecology
Mehrnaz Valadan; Mohadeseh Mojarad; Elham Feizabad
Volume 5, Issue 3 , November 2020, , Pages 88-92
Abstract
Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol ...
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Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol has some side effects, including uterine cramps, vaginal hemorrhage, nausea, vomiting, and fever-like feelings, the severity of which escalates by increasing the dosage. Therefore, in this study, we aimed to compare vaginal misoprostol in two different dosages of 200 and 400 μg with a control group to prescribe the lower dosage of misoprostol in case they were equally effective.Materials & Methods: In this randomized clinical trial study, 87 patients, who had hysteroscopy indications at Yas Hospital, were randomly assigned into three groups (i.e., 200 μg vaginal misoprostol, 400 μg vaginal misoprostol, and placebo). Afterward, the dilatation time of the cervical response and side effects associated with medication and surgery were assessed.Results: The mean dilatation time in the 200 μg misoprostol, 400 μg misoprostol, and placebo groups were 46.7±35.8, 36.8±31.1, and 67.6±49.5 seconds, respectively. These differences were significant (P=0.038). Conclusion: It seems that administering vaginal misoprostol is an easy, effective, and safe procedure for cervical preparation before the hysteroscopy. Considering that increasing the dosage of misoprostol did not significantly change the dilatation time, it is recommended that 200 μg misoprostol be used to reduce the side effects.
Obstetrics and Gynecology
Sedigheh Abdollahpour; Talat Khadivzadeh; Robab Latifnejad Roudsari
Volume 5, Issue 3 , November 2020, , Pages 93-102
Abstract
Background & objective: Clinical trials are studies that can provide the most reliable evidence to investigate the impact of various interventions in health research. Due to the importance of these studies in producing valid scientific evidence, this study was conducted to critically evaluate ...
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Background & objective: Clinical trials are studies that can provide the most reliable evidence to investigate the impact of various interventions in health research. Due to the importance of these studies in producing valid scientific evidence, this study was conducted to critically evaluate the published clinical trials regarding the effectiveness of midwife-based interventions on preventing post-traumatic stress disorder after childbirth.Materials & Methods: In this critical evaluation, we searched for randomized clinical trial articles related to midwife-led interventions in preventing post-traumatic stress in reputable databases using the keywords "traumatic childbirth", "post-traumatic stress", "intervention", "counseling", "midwife", "clinical trial" and their equivalent in English, without time limit. Out of 18581 retrieved articles, 12 articles were evaluated using CONSORT-2018. This checklist consisted of 26 sections and 42 items. Each item was scored based on the report or non-report in the article under review. The tool scores ranged from zero to 42. Data were analyzed using SPSS 21.Results: The overall compliance of the quality of the reviewed articles with the checklist criteria was estimated at 60.1%. The mean overall quality was 25.1±3.6 and therefore the articles were of moderate quality. Randomization and blinding methods require more careful attention so as not to reduce the methodological accuracy of the articles. On the other hand, the title and abstract sections, background, goals, and interpretation of the results were of high quality, and the discussion section and other information were of low quality.Conclusion: In order to use the results of clinical trials in evidence-based care related to the effectiveness of midwifery-based interventions on reducing postpartum stress, improving the quality of articles is essential, and using a standard checklist should be on the agenda of authors and reviewers of journals.
Obstetrics and Gynecology
Khadije Saravani; Pantea Ramezannezhad; Razieh Behzadmehr; Rezvaneh Behzadmehr; Saeide Saeidi
Volume 5, Issue 3 , November 2020, , Pages 126-130
Abstract
Background & Objective: In this study, the relationship between ultrasonic marker of fetal lung maturity and lamellar body number was studied.Materials & Methods: A comprehensive literature review was performed on papers published from 2004 to 2016 by searching databases including NCBI, Science ...
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Background & Objective: In this study, the relationship between ultrasonic marker of fetal lung maturity and lamellar body number was studied.Materials & Methods: A comprehensive literature review was performed on papers published from 2004 to 2016 by searching databases including NCBI, Science Direct, Springer, and Web of Science as well as native databases such as Iran DAC, Islamic science citation (ISC), and Magiran with a special focus on presented articles. Keywords used include body count, fetal lung, and ultrasonic.Results: In this study we used ultrasonic marker of fetal lung maturity and related this to lamellar body count and neo natal outcome. The ultrasonic marker of fetal lung maturity can reduce mortality and morbidity in neonate.Conclusion: A limited study has been performed in the field of ultrasonic marker of fetal lung maturity and it is suggested that detailed studies be performed in this field in other parts of Iran as well.
Obstetrics and Gynecology
Golnaz Goodarzi; Sosan Rajabian; Maryam Ahmadian; Ateeh Kalateh
Volume 5, Issue 2 , October 2020, , Pages 31-38
Abstract
Background & Objective: Episiotomy is the most prevalent surgery in midwifery which can lead to infection or delay in wound healing like any other wound. Prophylactic antibiotics are currently prescribed after episiotomies in most Iranian centers. According to global efforts as well as WHO ...
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Background & Objective: Episiotomy is the most prevalent surgery in midwifery which can lead to infection or delay in wound healing like any other wound. Prophylactic antibiotics are currently prescribed after episiotomies in most Iranian centers. According to global efforts as well as WHO strategies to reduce antibacterial resistance, antibiotics are only prescribed when there is a definite medical indication and the benefit of taking them outweighs the harm. Therefore, this study aimed to compare the incidence of episiotomy site infection in two groups of primiparas with and without taking prophylactic antibiotics after normal vaginal delivery at Bent Al-Huda Hospital in Bojnourd.Materials & Methods: This double-blind randomized clinical trial was conducted on 140 primiparas (70 women in two groups, i.e., cephalexin and placebo capsules) at Bent Al-Huda Hospital in Bojnourd. After episiotomies, the patients took the prescribed medication every 6 hours for 7 days. The wound healing assessment was done by applying the REEDA scale (redness, edema, ecchymosis, discharge, and approximation of wound edges) seven days after the delivery. SPSS 18 were used to analyze the data. P-values below 0.05 were considered significant.Results: On the seventh day after the delivery, the two groups were different in terms of healing score based on the REEDA scale, and statistically significant differences were observed. The healing score was lower in the antibiotic group compared to the placebo group, indicating a better wound healing.Conclusion: The results showed the effectiveness of prophylactic antibiotics in treating episiotomy wounds.
Obstetrics and Gynecology
Zahra Rezaei; Khadijeh Adabi; Adele Sadjadi
Volume 5, Issue 2 , October 2020, , Pages 39-43
Abstract
Background & Objective: An endometrial thickness of less than 7 mm adversely affects pregnancy outcomes. There is also ample evidence of the impact of granulocyte colony-stimulating factor (G-CSF) on treatment-resistant thin endometrium. Therefore, this study compares the effects of intrauterine ...
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Background & Objective: An endometrial thickness of less than 7 mm adversely affects pregnancy outcomes. There is also ample evidence of the impact of granulocyte colony-stimulating factor (G-CSF) on treatment-resistant thin endometrium. Therefore, this study compares the effects of intrauterine and subcutaneous injections of G-CSF on increasing endometrial thickness (ET) and pregnancy outcomes in infertile women who were candidates for in vitro fertilization (IVF). Materials & Methods: In the current randomized, double-blind clinical trial, 34 patients with a history of failed IVF cycles and treatment-resistant thin endometrium were randomized into two routes of G-CSF injection, i.e., intrauterine and subcutaneous, by using a random number table method. Outcomes including ET and chemical and clinical pregnancy rates were compared in two groups.Results: ET increased significantly in both groups after G-CSF administration (intrauterine and subcutaneous); however, this increase in thickness was significantly greater in the intrauterine injection group than in the subcutaneous injection group. Pregnancy outcomes were similar in two groups. Drug side effects were significantly lower in the intrauterine injection group than in the subcutaneous injection group.Conclusion: G-CSF can significantly increase ET in cases of repeated IVF failure, and intrauterine injection of this drug was more effective than subcutaneous injection.
Obstetrics and Gynecology
Zahra Rezaei; Mehrnaz Valadan; Elahe Zabihi Soltani
Volume 5, Issue 2 , October 2020, , Pages 44-48
Abstract
Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or ...
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Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or two ovaries in women with PCOS.Materials & Methods: This study was a prospective cohort study. The study population included infertile women with PCOS resistant to clomiphene referred to the Infertility Clinic of Yas Hospital. They were candidates for LOD in 2016–2017. The serum levels of AMH and FSH were measured before and after three months in two groups of unilateral and bilateral LOD. Data were analyzed using Stata software.Results: A total of 35 female patients were enrolled in the study, 18 (51.4%) in bilateral and 17 (46%) in unilateral LOD groups; the average age of patients was 27 ± 3.4 years old. AMH levels significantly (P < /em><0.001) decreased in both unilateral and bilateral groups after LOD. FSH levels significantly (P < /em><0.001) increased in both groups after LOD, but this increase was higher in the unilateral group than in the bilateral group, and this difference was statistically significant (P < /em><0.001).Conclusion: It seems women with clomiphene-resistant PCOS when underwent unilateral or bilateral ovarian drilling experienced a significant decrease in AMH and a significant increase in FSH, indicating a decrease in their ovarian reserve.
Obstetrics and Gynecology
Arash Moshiri; Maryam Ahmadian; Seyedeh Nafiseh Naseri; Shima Sheibani; Mahboobeh Shirazi; Baratoallah Akbari; Atefeh Hoseinzadeh
Volume 5, Issue 2 , October 2020, , Pages 49-53
Abstract
Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint ...
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Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint was a history of fever and chills in the recent past two days. Since there were no suspicious findings in favor of infections, related to obstetrics and gynecology, the patient was referred to Mostafa Khomeini Hospital in Tabas (June 2020). The initial clinical examination revealed no fever, chills, cough, respiratory distress, body aches, gastrointestinal problems or anything else. The patient’s oxygen saturation level was 98%. Routine laboratorytests were requested for the patient. WBC count was 14000, lymphocyte count was 875 (6.25%), and platelet count was 117000. According to the recent history of clinical symptoms and positive paraclinical results, COVID-19 was suspected. In the chest CT findings, bilateral ground glass opacities (GGO) and consolidations were observed, which were compatible with COVID-19 pattern. Based on the positive clinical and lab tests, COVID-19 was detected and positive RT-PCR COVID-19 test confirmed our diagnosis.Conclusion: The patient was asymptomatic at the time of admission to our ward; however, she reported fever and chills in the last two days, which raised our suspicion about COVID-19. Due to significant lymphopenia and the increase in granulocytes counts, and thrombocytopenia accompanied with complementary lab tests, severe COVID-19 was diagnosed and confirmed with positive RT-PCR test.
Obstetrics and Gynecology
Madhubala Manickavasagam
Volume 5, Issue 2 , October 2020, , Pages 57-60
Abstract
Background and Objective: Management of caesarean myomectomy (CM) in lower uterine segment obstruction is a hard process. Here I present a pregnant woman with multiple fibroid pregnancy and an obstructing intramural fibroid in the lower segment. The CM procedure was modified here with initially excision ...
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Background and Objective: Management of caesarean myomectomy (CM) in lower uterine segment obstruction is a hard process. Here I present a pregnant woman with multiple fibroid pregnancy and an obstructing intramural fibroid in the lower segment. The CM procedure was modified here with initially excision of obstructing myoma and delivery of baby.Case Presentation: A primigravida woman visited emergency room with abdominal pain at 22 week gestation, receiving antenatal care elsewhere. The emergency abdomen USG showed multiple fibroids in pregnancy with a huge obstructing fibroid in lower segment and a breech presentation with no anomalies. Comparing earlier USG reports exposed that the multiple fibroids were growing across the gestation weeks along the developing fetus. The mother was followed for watchful expectancy till 37 weeks gestation and delivery was planned as elective LSCS. Cesarean myomectomy was carried out through initial excision of lower uterine segment myoma to remove the obstruction, and then deliver the baby through the same incision.Conclusion: Here the cesarean myomectomy procedure was altered from a regular one, featuring preliminary myomectomy of uterine fibroid in the lower segment, and then delivering the baby and myomectomies again. The outcome was delivering a live baby with hemostasis in a case, with multiple and large fibroids.
Obstetrics and Gynecology
Zahra Rezaei; Sedigheh Taghdisi
Volume 5, Issue 2 , October 2020, , Pages 61-67
Abstract
Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation ...
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Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation between the ovaries and fallopian tubes. Tubal surgery is hypothesized to reduce ovarian reserve due to the anatomical relationship between the ovarian arteries and nerves and fallopian tubes. There is no consensus on whether or not salpingectomy affects ovarian reserve. Some authors believe that salpingectomy has no effects, while others suggest that it diminishes ovarian reserve. Therefore, comparing fertility rates between women undergoing in vitro fertilization with tubal factor infertility with surgery, tubal factor infertility without surgery, and unexplained infertility can provide valuable data.Materials & Methods: Eighty patients who met the inclusion criteria were studied. Study groups included people with a history of tubal surgery, individuals who had tubal problems without a history of surgery, and cases with unexplained infertility. Anti-Mullerian hormone (AMH) was measured every day of the cycle and other hormones, including follicle-stimulating hormone (FSH), luteinizing hormone, prolactin, and thyroid-stimulating hormone (TSH) were assessed on days 2-5 of the cycle. On the third day of the menstrual cycle, the uterus, endometrial thickness, ovaries, the size of the ovaries, and antral follicle count were evaluated using transvaginal sonography. Following ovulation induction, treatment-related factors, namely endometrial thickness, gonadotropin (Gn) time and count, E2, viable embryos, and good quality embryos, were examined.Results: Our findings showed no difference between the study groups in terms of treatment-related factors. No significant correlation was observed between the studied groups and chemical pregnancy (P < /em>=0.9514). moreover, the studied groups were not significantly correlated with clinical pregnancy (P < /em>=0.5052).Conclusion: The AMH was correlated with FSH, AFC, E2, and gonadotropin time and count. According to the results of the present study, tubal surgery does not affect the outcome of assisted reproductive cycles.
Obstetrics and Gynecology
Maliheh Arab
Volume 5, Issue 1 , August 2020, , Pages 1-5
Abstract
Cancer in adolescent and young adults (AYA) includes people who are diagnosed with cancer at the age of 15–39. One of the main concerns and consequences of AYA cancer treatment in both sexes is infertility. Premature ovarian failure (POF) is common in multimodal chemotherapy regimens. There is ...
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Cancer in adolescent and young adults (AYA) includes people who are diagnosed with cancer at the age of 15–39. One of the main concerns and consequences of AYA cancer treatment in both sexes is infertility. Premature ovarian failure (POF) is common in multimodal chemotherapy regimens. There is a significant difference in the sensitivity of the ovary to drugs. In conclusion, in young cancer women, oophoropexy, infertility counseling, and embryo or oocyte cryopreservation should be considered. Medroxyprogesterone, oral contraceptive pill (OCP), or gonadotropin-releasing hormone (GnRH) should be prescribed in the risk of menorrhagia.
Obstetrics and Gynecology
Shahrzad Agha Amu; Fateme Silakhory; Setare Nassiri; Elham Saffarieh
Volume 5, Issue 1 , August 2020, , Pages 24-26
Abstract
Background & Objective: Spontaneous vulvar edema is not usual during pregnancy and can cause discomfort and anxiety for the patient. This is a serious situation that might be caused by some dangerous condition such as preeclampsia, diabetes vulvovaginitis, severe anemia, and neoplasms. The aim of ...
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Background & Objective: Spontaneous vulvar edema is not usual during pregnancy and can cause discomfort and anxiety for the patient. This is a serious situation that might be caused by some dangerous condition such as preeclampsia, diabetes vulvovaginitis, severe anemia, and neoplasms. The aim of this study was to evaluate and manage the vulvar edema.Case Report: In this case report we introduce a 22-year-old woman which is primigravia and have massive vulvar edema after Bronchitis and influenza at 17 weeks’ gestation. After using oseltamivir, the patient showed progressive edema during 4 hours. Her symptoms were including edema and pain in labia, then she was treated with Dexamethazone and the edema disappeared after 5 days. Conclusion: Vulvar edema is a critical situation during pregnancy that needs attention and should be treated carefully since it can cause pain and discomfort for the pregnant woman. Our experience in this case was treatment by corticosteroid that had good response.
