Farnoush Farzi; Sodabeh Kazemi; Ziba Zahiri Sorouri; Samaneh Ghazanfar; Mahin Tayefeh Ashrafiyeh; Mandana Javanak; Mohammad Shahbazi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Having body mass index more than 29 is described as obesity in pregnancy. Anesthesia management in these patients has always been challenging. A 41-year-old woman, at 37weeks’ gestation with the weight of 200kg and body mass index of 66/05 was admitted with complaint of pain to Al-Zahra Hospital ...
Read More
Having body mass index more than 29 is described as obesity in pregnancy. Anesthesia management in these patients has always been challenging. A 41-year-old woman, at 37weeks’ gestation with the weight of 200kg and body mass index of 66/05 was admitted with complaint of pain to Al-Zahra Hospital in Rasht. She reported a history of two previous caesarean sections and high blood sugar and hypothyroidism which were under control by drugs. The Anesthesiology team decided to choose Continuous Spinal Anesthesia method for her. After performing anesthesia, cesarean delivery was done and a female neonate was born with Apgar score of 5-9. They were discharged from the hospital in good condition after two days. Based on the results of this study, CSA approach is a suitable method for anesthesia management in cesarean section of obese patients. Also it is necessary to recommend these patients to refer to anesthesia counseling clinics before giving birth.
Sara Masihi; Elahe Shirazi; Farideh Moramezi; Najmieh Saadati; Mojgan Barati
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
AbstractPurpose: This study aimed to compare CGH array and karyotype for prenatal diagnosis in high-risk individuals in the first trimester screening.Materials and Methods: The present cross-sectional descriptive prospective study was performed on high-risk mothers screened in the first trimester of ...
Read More
AbstractPurpose: This study aimed to compare CGH array and karyotype for prenatal diagnosis in high-risk individuals in the first trimester screening.Materials and Methods: The present cross-sectional descriptive prospective study was performed on high-risk mothers screened in the first trimester of pregnancy. Individuals were allocated into two groups under karyotype and CGH array. Because this study is based on genetic testing data, it does not require a follow-up. Information on age, number of pregnancies, history of abortion, history of disease and screening results were collected and analyzed. Data analysis was done using SPSS Version 22 (IBM).Results: In total 247 cases were analyzed with 128 cases in the karyotype group and 119 cases in the CGH group. 116 samples (90.6%) in the karyotype group and 99 samples (83.2%) in the CGH group showed a normal karyotype. 4.2% (5 samples) and 7.9% (10 samples) of chromosomal abnormalities were trisomy in the CGH group and the karyotype group, respectively. CGH array analysis on chromosomal abnormalities identified copy number variation (CNV) in about 9.2% (11 samples) of cases. In terms of risk factors structural chromosomal, there was a statistically significant relationship in terms of history of disabled children in the family, maternal age, history of anomalies, screening of the first trimester of pregnancy, and increased NT (p<0.05).Conclusions: High-resolution arrays specifically prevented fetal malformations. Until now, normal prenatal chromosome analysis has been shown a relatively standard method but CGH may be helpful to specialists in diagnosing chromosomal abnormalities, especially in unknown chromosomal abnormalities.
Adibeh Mauwloudi; Laleh Eslamian; Vajiheh Marsousi; Ashraf Jamal; Maryam noorzadeh; Mahsa Naemi; Ali Reza Norouzi; Nazila Mesbah
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Epigenetic silencing of MLH1 in endometrial cancers is associated with larger tumor volume, increased rate of lymph node positivity, and reduced recurrence-free survival Background: The aim of this study was to determine which of the two drugs of ibuprofen, as a common non-steroidal anti-inflammatory ...
Read More
Epigenetic silencing of MLH1 in endometrial cancers is associated with larger tumor volume, increased rate of lymph node positivity, and reduced recurrence-free survival Background: The aim of this study was to determine which of the two drugs of ibuprofen, as a common non-steroidal anti-inflammatory drugs NSAID, and acetaminophen would have the least effect on postpartum hypertension in patients with preeclampsia.Methods: Clinicodemographic data including age, gestational age at delivery, body mass index, parity, and route of delivery, were collected through interviews with patients and reviewing patient records. In this double-blind clinical trial, among 84 patients included in the study, 42 patients were randomly assigned into the acetaminophen (650 mg every 6 to 24 hours) and 42 patients into the ibuprofen (600 mg every 6 to 24 hours) group. Results: The two groups were not significantly different in terms of mean age (p = 0.322), body mass index (p = 0.950), route of delivery (p = 0.657), parity (p = 0.818), and mean systolic (p = 0.530) and diastolic blood pressure (p = 0.691). Following the intervention, the duration of blood pressure control (p = 0.182), mean systolic blood pressure (p = 0.371), and mean diastolic blood pressure (p = 0.13) were not significantly different in the acetaminophen and ibuprofen groups. There was no significant difference between the two groups in terms of the number of patients and the dosage of opioids used.Conclusion: The results revealed that in patients with preeclampsia, acetaminophen and ibuprofen to control postpartum pain have a similar impact on blood pressure.
Fereshteh Ameli; Maryam Entezarian; Noraidah Masir; Tan Geok Chin
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction:The highest mortality rate in gynecologic cancers is attributed to ovarian origin. Expression of the estrogen and progesterone receptors (ER and PR); and Human epidermal growth factor receptor 2 (Her2/neu) in endometrial cancer and breast cancer were found to be associated with the response ...
Read More
Introduction:The highest mortality rate in gynecologic cancers is attributed to ovarian origin. Expression of the estrogen and progesterone receptors (ER and PR); and Human epidermal growth factor receptor 2 (Her2/neu) in endometrial cancer and breast cancer were found to be associated with the response to treatment and prognosis. However, because of inconsistent results from previous studies, the data regarding ovarian cancer are still inconclusive.Materials and methods: Current retrospective cross-sectional study was performed on 234 tissue samples of different types of ovarian tumors (benign, borderline and malignant) from the archive of the University Kebangsaan Malaysia Medical Center during 10 years. Tissue microarrays were constructed on representative areas from formalin fixed paraffin embedded tissue blocks using ER, PR and HER2 immunohistochemical staining. Results: Prevalence of ER and PR overexpression was 36% and 35% in benign, 8% and 24% in borderline tumors with 51% and 46% in malignant tumors, respectively. ERα overexpression was more common among serous malignant ovarian tumors (49%) (p<0.001). PR positivity was more prevalent in serous benign tumors (p=0.02).There was no significant relationship between stage and the status of ERα (p=0.12) and PR (p=0.19). Her2/neu overexpression was only seen in borderline neoplasms (8%) and malignant mucinous tumors (4%). No association was found between Her2/neu overexpression and the level of tumor differentiation, tumor stage, size, and patient’s age.Conclusion: The observed ERα positivity in serous carcinoma and Her2/neu overexpression in malignant mucinous tumor, could be considered as a clue for choosing therapeutic agents. The role of anti-HER2 therapy in clear cell carcinoma is still debated and needs more investigations.
Hamideh Parsapour; Aida Alizamir; Shahedeh Khansary; Nasrin Jiryaei; Fatemeh Navabi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background: Gonorrhea is an infection caused by Neisseria gonorrhoeae that is mainly transmitted through sexual intercourse. This study was performed to evaluate the frequency of Neisseria gonorrhoeae and antibiotic resistance pattern to this infection in women referred to Fatemieh Gynecology Clinic ...
Read More
Background: Gonorrhea is an infection caused by Neisseria gonorrhoeae that is mainly transmitted through sexual intercourse. This study was performed to evaluate the frequency of Neisseria gonorrhoeae and antibiotic resistance pattern to this infection in women referred to Fatemieh Gynecology Clinic in Hamadan.Methods: In this cross-sectional study using the convenience sampling method, 348 women referred to the gynecology clinic of Fatemieh Hospital in Hamadan in 2020 with complaints of vaginal discharge or vague pelvic pain were investigated. Patients were examined by a gynecologist, and if were eligible, a sample of endocervix is prepared and sent to the laboratory. Samples were cultured in a Thayer –Martin agar, then were examined by a cytopathologist for Neisseriagnore and Chlamydia and the results were recorded in a researcher-made checklist. Data were analyzed using SPSS software version 16.Results: The mean age of women was 34.93 ±7.57 years, and 72.7% lived in urban areas. Common complaints of women included pelvic inflammatory disease (56.9%), cervical discharge (73.6%), dysuria (25.6%), and dyspareunia (22.7%). None of the women had multiple sexual partners, hepatitis B or hepatitis C. one case (0.29%) of Neisseria gonorrhoeae was observed that be resistant to the antibiotics penicillin tetracycline, minocycline, and cefazolin and was sensitive to the antibiotics chloramphenicol, rifampin, nitrosamine, cefoxitin, and ceftazidime.Conclusion: It seems that in women with cervicitis at reproductive age, without a history of high-risk sexual behaviors, Neisseria gonorrhoeae infection is less common and is not a significant problem.
Somayeh Khanjani; Shamin Ghobadi; farahnaz mardanian; Leila Mousavi seresht
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: caesarian scar pregnancy became a worrisome obstetric problem as a side effect of rising number of caesarian sections these days. Furthermore, from the challenge of diagnosis in case of low suspicious in the initial prenatal sonographic screening, there is remaining debate of the standard ...
Read More
Introduction: caesarian scar pregnancy became a worrisome obstetric problem as a side effect of rising number of caesarian sections these days. Furthermore, from the challenge of diagnosis in case of low suspicious in the initial prenatal sonographic screening, there is remaining debate of the standard of management. According to rare reported cases, the most acceptable recommendation still is termination of pregnancy to decrease the chance of further maternal dreadful complication. Material and method: here we assumed to explain a rare case of scar-pregnancy with fortunate outcome.Result: A case of twin pregnancy had been terminated in gestational age of 34 weeks in a tertiary care center with history of first trimesters diagnosis of caesarian scar pregnancy, who had decided to continue pregnancy under close follow-up.Conclusion: Since pregnancy at the site of a previous cesarean section is very rare, but due to the complications of this type of pregnancy, choosing a suitable clinical approach for these patients is desirable.This type of pregnancy can increase the value of antenatal care if it can be continued until the fetus is viable and its complications, including placenta accreta and bleeding, are managed.
Ghodratolah Maddah; Mohammad Ali Mohammadzadeh Rezae; Zohreh Yousefi Zohreh Yousefi; Helena Azimi; leila mousavi seresht
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Pelvic exenteration and other type of super-radical procedure is the standard of care in the management of patients with recurrent or persistent cervical cancer. But, since the extent of surgery and possible morbidities are considered as an important challenge in low-resource countries, the present study ...
Read More
Pelvic exenteration and other type of super-radical procedure is the standard of care in the management of patients with recurrent or persistent cervical cancer. But, since the extent of surgery and possible morbidities are considered as an important challenge in low-resource countries, the present study tries to report the successful outcome of radical surgery in detailed in 7 cases in a low-economic setting. The most valuable point of success is the importance of the multidisciplinary decision, the necessity of experience in this field, psychological consultations with patients, and being prepared for the potential surgical complications. What we had noticed was the excellent survival prognosis even in curative intent. It is highly recommended, considering the psychological effect of such an extensive surgery and quality of life in these patients with advanced disease and loss of hope.
Nahid Shahbazian; Mahvash Zargar; Mojgan Barati; Najmieh Saadati; Elham direkvand
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (TPO-Ab). However, whether women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of present study ...
Read More
Background and Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (TPO-Ab). However, whether women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of present study was to comparison of pregnancy outcomes in pregnant women with positive and negative TPO-Ab. Methods: This cross-sectional study was conducted on pregnant women with positive anti-TPO Ab (n= 108) and negative anti-TPO Ab (n=340) referring to Imam Khomeini Hospital and Ahvaz clinics from January 2020 to December 2020. The pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, miscarriage, preterm birth, placental abruption, IUFD, IUGR, and TSH level, were compared between the two groups by SPSS software using student t-test and Chi-square test.Results: The mean TSH level was significantly different in women with negative TPO-Ab than those with positive TPO-Ab (Mean (SD): 2.25(1.47) vs. 4.82(9.38), P<0.0001). In addition, 81 (75.00%) women in the positive anti-TPO group and 104 (30.58%) in the negative anti-TPO group had high TSH (P<0.001). The frequency of GDM in positive anti-TPO Ab pregnant women was significantly higher than that in the negative anti-TPO Ab group (46.29% vs. 34.11%, P=0.029). The results also indicated an enhancement in the rate of miscarriage (15.74% vs. 4.11%, P<0.001) and preterm parturition (13.88% vs. 3.52%, P<0.001) in positive anti-TPO Ab women. Conclusions: Presence of positive anti-TPO Ab was significantly associated with preterm delivery, abortion and GDM in pregnancy. Treatment with Levothyroxine can reduce the risk of adverse pregnancy outcomes in women who are positive for TPOAb. .
Hamideh Pakniat; Khadijeh Elmizadeh; Fatemeh Lalouha; Hojjat Momenzade; kimia mahloojian
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background & Objective: The importance of Pap smear in cervical cancer screening is clear. However, yet no organized program has been developed in Iran to screen cervical cancer. Due to the obvious difference in prevalence of cervical cancer in Iran compared to global statistics, it is necessary ...
Read More
Background & Objective: The importance of Pap smear in cervical cancer screening is clear. However, yet no organized program has been developed in Iran to screen cervical cancer. Due to the obvious difference in prevalence of cervical cancer in Iran compared to global statistics, it is necessary to further investigate this issue. As pop smear is the most important factor to decrease the mortality and morbidity of cervical cancer in developed countries, it is important to study the results of abnormal Pap smears and the quality of the report in our region. Materials & Methods: This study was designed retrospectively with reference to the results of Pap smears performed during 3 years from 2016 in the Kosar hospital. The method of collecting samples was census. The results of Pap smears were extracted from the Hospital and 15208 pap smear results were analyzed.Results: From the 15208 women, 15150 had normal cytology results (99.62%) and 58 women had abnormal cytology (0.38%). The frequency of abnormal cytology was 0.246% (n=37) for atypical squamous cell of undetermined significance (ASCUS), 0.08% (n=12) for low-grade squamous intraepithelial lesion (LSIL), 0.006% (n=1)for ASC cannot exclude high-grade intraepithelial lesion (ASC-H), 0.046% (n=7) for high-grade squamous intraepithelial lesion(HSIL), 0.006 (n=1)for atypical glandular cells (AGC), and 0% (n=0) for invasive cancer. No SCC was found in this study. Conclusion: The prevalence of all abnormal results was much lower than other studies; However, in terms of prevalence of abnormalities, the ranking was similar to other studies.In order to obtain more accurate results, it is recommended to study other epidemiological regions.
Mahrokh Abouali Gale Dari; Mona Keivan; Farideh Moramezi; Najmieh Saadati; Roshan Nikbakht; Maryam Farzaneh
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affecting women of reproductive age. Several genetic and environmental factors are contributed to the progression of PCOS. Experimental discoveries have begun to evaluate the mechanisms involved in PCOS. There is a mechanistic link between ...
Read More
Polycystic ovary syndrome (PCOS) is a hormonal disorder that affecting women of reproductive age. Several genetic and environmental factors are contributed to the progression of PCOS. Experimental discoveries have begun to evaluate the mechanisms involved in PCOS. There is a mechanistic link between long non-coding RNAs (lncRNAs) and the pathogenesis of PCOS. LncRNAs are a class of transcripts that mediate the process of gene expressions at the level of transcription and post-transcription. It has been found that lncRNA MALAT-1 presents a vital role in regulating PCOS. MALAT-1 as a competing endogenous RNA (ceRNA) can suppress microRNAs (miRNAs) and decrease granulosa cell proliferation, apoptosis, and pathogenesis. In the present article, we summarize the functions of the lncRNA MALAT-1/miRNA axes in PCOS.
Poorya Davoodi; Delaram J. Ghadimi; Malihe Rezaei; Mohammad Amin Khazei Tabari; Aryan Shirani; Behnaz Nouri; Noosha Samieefar; Meisam Akhlaghdoust
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
AbstractObjectives: Endometriosis, a common disease of the female reproductive system, could affect many aspects of the life of women. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate COVID-19 ...
Read More
AbstractObjectives: Endometriosis, a common disease of the female reproductive system, could affect many aspects of the life of women. Along with many other diseases, COVID-19 has affected the diagnostic or treatment approaches towards endometriosis. This systematic review aims to investigate COVID-19 in endometriosis patients in terms of prognosis, diagnosis and treatment, and quality of life during the pandemic.Methods: Relevant studies were identified through searching for endometriosis and COVID-19 in different databases, including PubMed, Medline, Scopus, and Web of Science, on 17 January 2022. Peer-reviewed published articles evaluating COVID-19 and endometriosis written in English were included.Results: Out of 115 articles, 9 manuscripts met our criteria. Endometriosis does not intensify the risk of COVID-19 infection. However, COVID-19 has changed the health care of endometriosis patients. Conclusions: COVID-19 has affected endometriosis patients’ life from many aspects, including their job, lifestyle, and health care. Further studies are recommended to evaluate how the pandemic has affected endometriosis patients.
Soheila Aminimoghaddam; Zahra Vahedpoor; Shabnam Bozorgzadeh
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Abstract:Hereditary non polyposis colorectal cancer (HNPCC) also known as lynch syndrome (LS), is an autosomal dominant cancer syndrome. Besides colorectal cancers it predisposes patients to extra-colonic cancers. The screening may be effective for early detection of colorectal cancers, whereas the efficacy ...
Read More
Abstract:Hereditary non polyposis colorectal cancer (HNPCC) also known as lynch syndrome (LS), is an autosomal dominant cancer syndrome. Besides colorectal cancers it predisposes patients to extra-colonic cancers. The screening may be effective for early detection of colorectal cancers, whereas the efficacy of surveillance for other organ tumors has not yet been established. Despite several extra-colonic cancer have been reported on LS, we found a new face of it.A 43-year-old G2L2 patient with chief complaint of abnormal uterine bleeding (AUB) referred to a gynecologist. A biopsy of her endometrium showed clear cell carcinoma, and the necessary work-ups have been done. But the patient's family history demonstrated HNPCC based on the Amsterdam 2 criteria. Germline mutations in the MSH2 gene and MSH6 gene in genetic testing, was consistent with diagnosis of lynch syndrome. After some years the patient presented to our hospital for fever, shimmering and abdominal LUQ pain. The patient had dyspnea, coughing, and had lost some weight. Spiral CT scan showed a solid cyst with heterogeneous enhancement in spleen, and hepatosplenomegaly.In this paper, another case with endometrial cancer as a sentinel cancer of lynch syndrome is reported. This fact implicate that physicians should notice the family history of malignancies in patients with gynecologic cancers and consider lynch syndrome. Many case reports have been published, but any of them have not been reported spleen involvement yet.
Soudabeh Kazemi Aski,; Seyedeh Hajar Sharami; Azadeh Tavangar; ehsan Kazem Nezhad Leilie; Seyedeh Fatemeh Dalil Heirati; Atoosa Etezadi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus normal growth. The objective of this study was to compare the level ...
Read More
Background and objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus normal growth. The objective of this study was to compare the level of PAPP-A in pregnancy weeks 11-14 in women with and without intrauterine growth restriction and to assess the ability of this marker to predict adverse outcomes in pregnancy. Methods: In this Comparative Cross-sectional study, 227 pregnant women were studied during 2017. Mothers were divided into two main groups with and without intrauterine growth restriction. The relevant data, including birth weight, preeclampsia, gestational diabetes, Apgar score, and PAPP-A, were recorded on special forms. Data analysis was done using SPSS-21 software. Results: The mean age of participating women in this study was 28.8 ± 5.6 years. The median (IOR) number of gravidity and Gestational weight gain was 1 (1) and 12 (7) kg respectively. The difference in median (IOR) PAPP-A in patients with and without IUGR was statistically significant 0.64(0.57) and 1 (0.57), respectively, P= 0.001.The cut-off point for PAPP-A was 0.73 with a sensitivity=72.2% (95% CI: 64.32-79.16%) and a specify =60.5% (95% CI: 48.65 -71.56%). Conclusion: The results of this study confirm the relationship between low levels of PAPP-A and adverse outcomes of pregnancy. In the present study, the optimal cut-off point (0.73) is higher than other studies, which can be due to racial and epidemiological differences.
Maryam Nurzadeh; Maryam Moshfeghi; mamak shariat; Ashraf Jamal; Vajiheh Marsosi; Laleh Eslamian; Mahsa Naemi; Maria Nezam Nia; Fedyeh Haghollahi; Seyede Houra Mousavi Vahed
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background:A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus. Methods and material:An observational historical cohort study was conducted ...
Read More
Background:A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus. Methods and material:An observational historical cohort study was conducted on multiple pregnancies that underwent fetal reduction in Shariati Hospital and Omid Clinic between January 2018 and September 2021. The study population was divided into two groups according to gestational age at fetal reduction: 11–14 weeks' gestation (early reduction group < /span>) and 15–19 weeks’ gestation (late reduction group). The main outcome measures were the rates of pregnancy complications, pregnancy loss, preterm delivery, and adverse neonatal outcomes.Results:The study group included 107 patients with twin and multiple pregnancies that underwent abdominal MPR at 11-19 weeks’ gestation (79 in the early reduction group and 28 in the late group).The incidence of pregnancy complications (hypertension, diabetes, intrauterine growth disorder, preterm delivery, pregnancy loss) was not significantly different between the two groups (p>0.05). The percentage of NICU admission was higher in the early reduction group compared to the late group (49% vs 18.5%, p=0.004)The weight of the first newborn was significantly heavier in the late versus early reduction group (2680.55±777.52 vs 2264.4±796.82, p=0.005)Conclusion:According to the present study, fetal reduction in twin or multiple pregnancies is a safe procedure with good obstetric outcomes if done by an expert specialist, especially when it is performed in the second trimester.
Batool Hossein Rashidi; marjan ghaemi; Ensieh Shahrokh Tehrani; Marzieh Mohebbi; Marzieh savari
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. Method: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision ...
Read More
Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. Method: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.Results: Totally 337 participants were recruited. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.Conclusions: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.
Mahdi Seyfi-Ghale-Jogh; Marjan Mehrali; Fatemeh Mohammadyari; Rezvaneh Rakhshanimehr; Elahe Safari; Mohammad Salehi-Shadkami; Sepehr Nanbakhsh; Katayoun Haryalchi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background/objective: The COVID-19 pandemic has disrupted people’s lives all over the world and vaccination is one of the best ways to eradicate this pandemic and save people’s lives. Despite this, vaccines have many known and unknown side effects like fever, fatigue, headache, etc. Fertility ...
Read More
Background/objective: The COVID-19 pandemic has disrupted people’s lives all over the world and vaccination is one of the best ways to eradicate this pandemic and save people’s lives. Despite this, vaccines have many known and unknown side effects like fever, fatigue, headache, etc. Fertility is an important aspect of human life with too many concerns about its relation with COVID-19 and its vaccines. Women are complaining of menstrual irregularities like postmenopausal bleeding, heavy menstrual bleeding, polymenorrhea and fertility concerns after receiving the second dose of COVID-19 vaccine. The immunologic reactions between vaccines’ ingredients and immune system of the body, seem to be responsible for this global issue. Angiotensin-converting enzyme 2 (ACE2) and Basigin (BSG) are the receptors for SARS-COV-2. ACE2 is expressed in human respiratory system, kidney, vagina, uterus and particularly widely in the ovaries; and BSG is expressed in the uterus, ovary stroma and granulosa cells. Therefore, SARS-COV-2 can invade the target cells by attachment to ACE2 and BSG, and modulate their expression and through these probable mechanisms, it can disturb female reproduction and menstruation. Conclusion: According to these accumulated evidences, in this study, we aimed at summarizing the recent studies with focus on probable mechanisms which SARS-COV-2 and COVID-19 vaccines affect menstruation irregularities and reproduction complications.
zinat ghanbari; leila pourali; Tahereh Eftekhar; maryam deldar pesikhani; soudabeh darvish; zahra lotfi; elnaz ayati
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Defecatory dysfunction is a common problem among women who referred for urogynecological care. Pelvic organ prolapse (POP) which is a downward displacement of pelvic organs is one of the common condition among patients with defecatory problems . This study was planned to evaluate the correlation ...
Read More
Introduction: Defecatory dysfunction is a common problem among women who referred for urogynecological care. Pelvic organ prolapse (POP) which is a downward displacement of pelvic organs is one of the common condition among patients with defecatory problems . This study was planned to evaluate the correlation of obstructive defecatory symptoms with the site and severity of pelvic organ prolapse and the anorectal manometry results.Methods: This cross-sectional study was performed between Dec 2018 and Nov 2019. About 150 women with symptoms of defecatory problems were enrolled. Patients were classified in two groups according to each compartment prolapse staging and severity; stage ≤2 and stage >2. The correlation between defecatory symptoms and pelvic organ prolapse examination, anorectal examination and anal manometry were evaluated.Results: A total of 150women were evaluated. There was a significant correlation between higher stage of anterior compartment prolapse (cystocele stage>2) and constipation (P=0.035). Although all the defecatory symptoms were more frequent in anterior prolapse stage>2, but the difference was not significant (P>0.05).There was no significant correlation between defecatory symptoms and severity of posterior compartment prolapse. There was a significant correlation between stage>2 of apical prolapse and all the defecatory symptoms (P≤0.05). The abnormal anal resting and squeeze pressure and also abnormal balloon expulsion test were more frequent in stage >2 of all compartment prolapse, but the difference was not significant (P>0.05).Conclusion:Obstructive defecatory symptoms were more frequent in patients with higher stage of anterior and apical prolapse. Abnormal manometry results were more frequent in patients with defecatory dysfunction with advanced vaginal prolapse.
Marzieh Talebian; Zohreh Talebi Mazreshahi; Elham Khosravi Mashizi; Nafiseh Khalili
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There ...
Read More
Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There are some rare EP cases with negative HCG blood test. Case presentation: A 31-years old woman referred to the emergency department with hypogastric, periumbilical, and right upper quadrant intermittent pain and vaginal bleeding and prior history of EP 7-months ago that treated with methotrexate and her intra uterine device had been removed at that time. Her last menstrual period was undetermined. Although HCG blood test-qualitative was negative (2.08 IU /ml),ultrasound examination showed an 43×53 mm echogenic, heterogenic complex solid mass in the left adnexa and a large amount of echogenic fluid demonstrating hemoperitoneum. Taken surgery because of the exceeded abdominal pain revealed active bleeding in the left salpinx due to ruptured EP. Conclusion: Management of patients suspected of EP with negative HCG-blood test is difficult. In this uncommon cases in emergency, computed tomography, ultrasound and diagnostic laparoscopy or laparotomy can improve prognosis of patient.
Shahrzad Sheikhhasani; Maryam Noorzadeh; Mahsa Naemi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background: 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 ...
Read More
Background: 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. Methods: 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. Results: 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.Conclusion: 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.
Mahin Najafian; Mahtab Shariati; Sara Masihi; Roshan Nikbakht
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension. Methods: This randomized controlled ...
Read More
Introduction: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension. Methods: This randomized controlled clinical trial study was conducted on 60 pregnant women with a diagnosis of gestational hypertension and chronic hypertension. Women were randomly divided into the control (n=30) and the DASH diet (n=30) groups for 2 months and were followed until delivery. The outcomes of maternal pregnancy including the incidence of preeclampsia, placental abruption and preterm delivery (<37 weeks) were assessed during follow-up examinations. Birth weight and minute 1 and minute 5 Apgar score of the infant were also assessed. Results: After 1 and 2 months of intervention, systolic and diastolic blood pressure in the DASH diet group was significantly lower than the control group (P<0.05). The incidence of preeclampsia (P=0.035), preterm delivery (P=0.020) and placental abruption (P=0.007) in the DASH diet group was significantly lower than the control group. The mean gestational age at the time of termination of pregnancy was not significantly different between the two groups (P = 0.467). There was no significant difference between minute 1 and minute 5 Apgar scores of the infants and the mean birth weight of the infants was not significantly different between the DASH and control groups (P = 0.756, P = 0.115 and P = 0.101, respectively). Conclusion: The DASH diet could be used as an effective strategy to improve the clinical outcomes of pregnant women with gestational and chronic hypertension.
Sayedeh Elham Sharafi; Marzieh hajibabaei; Fatemeh Keikha; Ali Montazeri
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background & Objective: Oocyte donation is an assisted reproductive technique. The infertile couples' demand for using this technique have increased in recent years. This study aimed to evaluate psychiatric disorders, personality characteristics and intelligence quotient among women who are candidates ...
Read More
Background & Objective: Oocyte donation is an assisted reproductive technique. The infertile couples' demand for using this technique have increased in recent years. This study aimed to evaluate psychiatric disorders, personality characteristics and intelligence quotient among women who are candidates for oocyte donation. Material & Methods: This was a cross sectional study. Thirty-nine parous women were entered into the study. A psychiatrist interviewed participants regarding to psychiatric axis I disorders. Also, participants were asked to answer the Millon Clinical Multi axial Inventory (MCMI III) and Raven’s Standard and Progressive Matrices (RSPM). Results: The mean age of participants was 28.79 (SD = 4.1) years and it was 11.17 years (SD = 2.6) for education. The mean of donation frequency was 1.35 (SD =0.6). Twenty-one donors (53.8%) had only financial motivation and eleven (28.2%) had only altruist object. Twenty-eight (71.8%) women did not have any psychiatric axis I disorders while eight women (20.5%) had at least one disorder. Eleven participants (28.4%) suffered from at least one personality disorder. The mean intelligence quotient was 99.3 (SD =14.2). Conclusion: The results showed that oocyte donors might suffer from mental disorders and intelligence quotient problems irrespective of age, education, job status and motivation for donation. In conclusion, it seems that psychological assessment and help service is necessary for oocyte donors before any donation procedure.
Nadia Azadi; Yousra Alsinani; Mohammad Hemmatinafar; Maryam Koushkie Jahromi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Objectives: Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms in two aquatic and ...
Read More
Objectives: Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms in two aquatic and land-based trained groups before and after cessation of exercise due to COVID-19 outbreak. Methods: 90 postmenopausal women participated in the study voluntarily. The daily and sport physical activities and menopausal symptoms were assessed through interviews three months after cessation of sport activities and Questions were designed and obtained from daily physical activity form and menopausal rating scale (MRS) questionnaire respectively. Results: Before the cessation of exercise, the somatic, psychological, and sexual symptoms of menopause were lower in both active groups than the inactive group, while there was no significant difference in three categories of menopausal symptoms between aquatic and land- based exercise groups. After the cessation of exercise, menopausal symptoms in the two groups of previously active women increased significantly compared to the inactive group, so that there was no significant difference in menopausal symptoms between exercise and inactive groups.Conclusion: aquatic and land-based exercise reduces the symptoms of menopause similarly, while the beneficial effects of exercise on menopausal symptoms can disappear after the cessation of exercise for three months.
Hossam El Sokkary
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background:. The present study compares between superficial and deep myometrial invasion in type 1 endometrial cancer in relation to regional lymph nodes metastasis, so we can answer the question to do or not do lymphadenectomy, this life-threatening procedure in both superficial and deep myometrial ...
Read More
Background:. The present study compares between superficial and deep myometrial invasion in type 1 endometrial cancer in relation to regional lymph nodes metastasis, so we can answer the question to do or not do lymphadenectomy, this life-threatening procedure in both superficial and deep myometrial invasion with type 1, clinically and radiologically stage 1 endometrial cancer. Patients and methods: Patients were divided into 2 groups distributed as follows: group I includes 50 patients type 1 endometrial cancer with superficial myometrial invasion and group II includes 50 patients type 1 endometrial cancer with deep myometrial invasion. Total abdominal hysterectomy with bilateral salpingo-opherectomy with pelvic and lower para-aortic lymphadenectomy to all patients included in the study from both groups. Histopathological examinations were done to all the specimen from both groups to confirm diagnosis of type 1 endometrial cancer, depth of myometrial invasion, pathological grading and metastasis to the regional lymph nodes.Result: Considering regional lymph nodes metastasis in both groups, there is a statistical difference between group I and group II in relation to relation to regional lymph nodes metastasis as group II (cases with deep myometrial invasion) are associated with more regional lymph nodes metastasis (p= 0.0001)). Conclusion: deep myometrial invasion in type 1 endometrial cancer is associated with significant increase in regional lymph nodes metastases.
Mohammad Reza Javan; Bahareh Moghimian-Boroujeni; Hossein Ayatollahi; Amirali Ayatollahi; Nafise Amini; Elham Jafaei; maryam sheikhi; Narjes Soltani
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
AbstractBackground: Recurrent pregnancy loss (RPL) is the occurrence of three or more miscarriages before the 20th week of pregnancy. Thrombophilia factors are one of the main causes of RPL. Methods: This retrospectively study was performed on women with more than two miscarriages. 620 patients’ ...
Read More
AbstractBackground: Recurrent pregnancy loss (RPL) is the occurrence of three or more miscarriages before the 20th week of pregnancy. Thrombophilia factors are one of the main causes of RPL. Methods: This retrospectively study was performed on women with more than two miscarriages. 620 patients’ documents with pregnancy loss were investigated. Based on number of pregnancy loss, the women divided to a control group with less than three miscarriages (212) and RPL group (180). Cytogenetics analysis and thrombophilia panel (MTHFR 677 C⁄T/ FV Leiden G1691A/Prothrombin G20210A (FII), ACE I/D, PAI1) were performed for all patients.Result: In the analysis between Control and RPL groups, none of the studied polymorphisms (MTHFR 677 C⁄T /Factor V Leiden /Prothrombin G20210A/ ACE I/D/ PAI-1) showed a significant relationship (P-value ˃ 0.05). Cytogenetic analysis showed 2 numerical and 9 structural abnormalities among both groups. Statistical analysis indicated significant association between number of abortion and age (P value= 0.005, r =0.139). We even realized that there was significant relationship between polymorphism number and recurrent number of abortion (P value= 0.018, r = 0.6).Conclusion: We showed that polymorphisms analysis for thrombophilia factors is more precious test than cytogenetics analysis for RPL detection due to frequency in pregnant woman. We even indicated that no association was found between thrombophilia polymorphisms in Control and RPL groups. This means that screening for Factor V Leiden, prothrombin G20210A, MTHFR C677T, ACE I/D and PAI-1 and cytogenetic analysis in patients with a history of RPL is not recommended.
Behnaz Nouri; Maliheh Arab; mohammad nasiri
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis who ...
Read More
Background and Objective: Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis who are candidates for laparoscopic surgery.Methods: This cross-sectional study was performed on 433 patients with endometriosis who were candidates for laparoscopic surgery referred to Shohada-Tajrish Hospital in Tehran between January 2016 and December 2021. A questionnaire including demographic and clinical information, MRI, and pathology reports were collected from participants. The MRI lesions were segmented and the results were compared with pathology and clinical examination. For statistical analysis SPSS software, version 22 was used.Results: A total of 433 patients in this study with a mean age of 34.18±7.99. The average estimated duration of disease symptoms (months) was 40.58±42.33. The predictive value of clinical symptoms is weak compared to MRI. However, the probability that the disease is not present when the clinical signs be negative is acceptable in most of the endometriosis sites. MRI considerably shows the true negative rate, but its sensitivity is only relatively acceptable for the diagnosis of ascites (67.66%). Calculating the accuracy of MRI reports probably shows the overall classification of the patients via MRI test.Conclusion: despite extensive research, there are no suitable and accurate non-invasive methods for diagnosing endometriosis. MRI and clinical examination alone are not useful for definitive diagnosis and it is better to examine biomarkers and artificial intelligence for non-invasive and accurate diagnosis of this disease.
Roya KaboodMehri; seyedeh hajar sharami; Sodabeh Kazemi; Mandana Mansour Ghanaei; Seyedeh Fatemeh Dalil Heirati; Zahra Pourhabibi; Sina Montazeri
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluating relationship between AMH levels and demographic factors.Methods: In this cross-sectional ...
Read More
Background and objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluating relationship between AMH levels and demographic factors.Methods: In this cross-sectional study, conducted in Al-zahra hospital Rasht in the north of Iran, 234 patients, 18-45 years old, were enrolled. The demographic parameters (e.g. age, education, habitat and etc.) and AMH levels were recorded for each patient. The patients were devided into two groups based on their AMH levels [group 1:less than 1.1 (ng/ml) vs. group 2:more than (1.1 ng/ml)].The data were analyzed by SPSS-21 software.Results: The mean AMH level was 2.66 ng/ml. Age, education status and habitat showed significant differences among subjects with AMH levels, so that with aging the AMH levels decreased. Patients living in villages or the ones with low educational degrees and those with higher parities also revealed lower levels of AMH (p<0.05).Conclusion: There was a significant relationship between age, educational status and habitat with AMH values. Similar to other studies, we believe, that with aging the AMH levels decrease. Furthermore, the other two aforementioned demographic features could affect a woman’s ovarian reserve and fertility status, too.
Fatemeh Bahadori; Zahra Sahebazzamani; Somayeh Ghasemzadeh; Zahra Kousehlou; Leila Zarei; Marjan Hoseinpour
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
AbstractBackground& Aims:Menarche is an important stage in the development of girls which can predict the adolescent’s puberty process and fertility onset. The changes in adolescence have health consequence not only in adolescence but also over the life-course. Childhood obesity as a common ...
Read More
AbstractBackground& Aims:Menarche is an important stage in the development of girls which can predict the adolescent’s puberty process and fertility onset. The changes in adolescence have health consequence not only in adolescence but also over the life-course. Childhood obesity as a common health problem has been observed in both developed and developing countries and its prevalence is continuing to increase. The aim of this study was to identify menstrual patterns and related disorders and also to investigate the relationship between menarche age, menstrual disorders, and (BMI) in high school girls in Urmia.Materials& Methods:In this cross-sectional study 716 adolescent girls aged 14-18 years were selected with multistage sampling from high schools of Urmia. (Sept 2012 to Dec 2013) Participants completed the questionnaire of menstrual pattern characteristics including age at menarche, menstrual cycle length, dysmenorrhea, and the need for pain relief. BMI percentile was calculated and obesity was determined using the CDC’s 2000 BMI-for-age growth charts.Result:The results showed that the average of age, BMI, and menarche age were: 15.66±1.019 year, 22.05±3.91.kg/m2 and 12.87±0.98 year, respectively. The prevalence of overweight and obesity were 13.7% and 8.4%, respectively. A large majority of the subjects (76.1%) had normal, healthy weight. There was a significant association between BMI and the duration of flow, menarche age, menstruation flow, and pain severity (P<0.05).Conclusion:Based on the results, planning and intervention for decreasing the BMI in high school girls can help reduce menstrual disorders. Future studies are required to confirm and complete our results.
Atefeh Kazemi; Vahideh Rashtchi; Masoomeh Ghomi
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background: Types of major surgeries are associated with postoperative pain sometimes during the days after surgery. These pains mainly lead to the use of various analgesics and ultimately patient dissatisfaction. In the present study, we evaluated the effect of gabapentin at doses of 600 and 1200 mg ...
Read More
Background: Types of major surgeries are associated with postoperative pain sometimes during the days after surgery. These pains mainly lead to the use of various analgesics and ultimately patient dissatisfaction. In the present study, we evaluated the effect of gabapentin at doses of 600 and 1200 mg in relieving pain due to cesarean section.Methods: In this randomized clinical trial patients were randomly divided into three equal-size groups (25 patients in each group) through balanced block randomization. The first group was given 600 mg of gabapentin the second group was given 1200 mg of gabapentin one hour before surgery and the control group received a placebo. The pain intensity, occurring nausea/vomiting and drowsiness, as well as needing postoperative analgesics were assessed initially and at 2, 6, and 12 hours after surgery. The occurrence of nausea and drowsiness between groups was compared using chi-square and exact fisher teat.Results: The mean (SD) age of patients in the gabapentin 1200 mg, gabapentin 800 mg, and placebo groups were 26.32±6.15, 27.43±6.38, and 26.59±5.88, respectively (P=0.34). Pain intensity and also the rate of analgesic consumption at the different time points during the first 12 hours of surgery were significantly lower in the receiving gabapentin groups compared to the placebo group (P<0.05). Comparing the prevalence rates of nausea and vomiting and also drowsiness as the drug-related side effects don’t show a significant difference across the three groups at the different investigated time points (P>0.05). Conclusion: Gabapentin with a minimum therapeutic dose can successfully reduce postoperative pain intensity and also needs analgesics use after cesarean section.
Marzieh Mehrafza; Azadeh Raoufi; Tahereh Zare Yousefi; Elmira Hosseinzadeh; Sajedeh Samadnia; Amirhossein Tamimi; Ahmad Hosseini
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and Objective: Repeated implantation failure (RIF) is still remain an ongoing challenge. RIF may be contributed to the embryo or the endometrium, which any abnormalities of each two may result implantation failure. The aim of present study was to report the effect of endometrial injury (EI) ...
Read More
Background and Objective: Repeated implantation failure (RIF) is still remain an ongoing challenge. RIF may be contributed to the embryo or the endometrium, which any abnormalities of each two may result implantation failure. The aim of present study was to report the effect of endometrial injury (EI) during frozen embryo transfer (FET) on pregnancy outcome in RIF patients.Material and methods: In this retrospective case series, since 2018 to 2020, 20 patients with a history of RIF who underwent EI during FET cycle were evaluated. Results: Chemical, clinical and ongoing pregnancy and live birth was achieved in 8 (40%), 7 (35%), 6 (30%) and 6 (30%) patients, respectively.Conclusion: The present study shows that using EI in FET cycle is a feasible, safe and efficient method in improving clinical outcomes. More researches are needed to find out the real effect of EI during FET in RIF patients.
ahmed elkhyat; amal elsokary; shereef elshwaikh
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Study design: A prospective observational study.Patients: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced ...
Read More
Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Study design: A prospective observational study.Patients: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by dietary modifications. Patients were classified later into respondent and non-respondent. All patients were stimulated with letrozole 2.5 mg twice daily for 5 days for 6 cycles. Ovulation and pregnancy rates were assessed. Results: From 84 patients who were enrolled in our study, 33 patients were allocated into non responder group and 28 patients were allocated in responder group and It was found that despite there was statistical difference between both group as regard weight gain , weight after 6 months and BMI after 6 months , there was no significant difference between both groups as regard the ovulation rate , pregnancy rate and complications to ovulation induction (OHSS).Conclusion: weight gain in lean PCOS patients - although non-significant- but it may improve the reproductive outcomes (ovulation rate and pregnancy rate) and the need of further study with larger number and longer duration of follow up for confirmation of this results.
marjaneh zarkesh; Mandana Mansour Ghanaei; Marjan Malekifard; MARYAM GHALANDARI
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Objectives: We aimed to compare the correlation between nucleated red blood cell (NRBC) and creatine kinase (CK) levels with hypoxic-ischemic encephalopathy (HIE) in asphyxiated newborns.Materials and Methods: This case-control study included 30 asphyxiated (case) and 30 healthy neonates (control) ...
Read More
Objectives: We aimed to compare the correlation between nucleated red blood cell (NRBC) and creatine kinase (CK) levels with hypoxic-ischemic encephalopathy (HIE) in asphyxiated newborns.Materials and Methods: This case-control study included 30 asphyxiated (case) and 30 healthy neonates (control) born at Al-Zahra Hospital in Rasht, Iran. We collected the cord blood samples for CK level and NRBC at birth. The clinical stage of Sarnat indicated the severity of HIE. Data were analyzed in the two groups using IBM SPSS Statistics for Windows, version 22. Results: The case group had a higher NRBC count (P=0.001). The CK level was significantly different between the two groups and was higher in the case group than in the control group (P= 0.002). Results demonstrated a significant association between NRBC count and the occurrence of HIE in neonates with asphyxia (P = 0.021). Besides, a positive correlation was found between HIE and CK levels in the case group (r = 0.7, P=0.001).Conclusion: According to our results, NRBC count and umbilical cord CK level measurement are valuable predictors of asphyxia and HIE in neonates. In addition, measuring these parameters may help clinicians for faster diagnosis and better management.
Original Research Article
Akhmetzhanova Dinara Oralgazyevna; Entsar Hachim Muhammad; Mohammed Ali; Ahmed Jalil Kadhim; Ayad Abas Hasan; Fathi Jihad Hammady; Noora M. Hameed; Hayfaa Attia Thijail
Articles in Press, Accepted Manuscript, Available Online from 08 February 2023
Abstract
Background & Objective: Episiotomy complications include infection, pain, hematoma, and third- and fourth-degree tears, and all primiparous women must undergo this procedure routinely. The current study aimed to compare the length of perineal tears in women referred to the Basra maternity hospital ...
Read More
Background & Objective: Episiotomy complications include infection, pain, hematoma, and third- and fourth-degree tears, and all primiparous women must undergo this procedure routinely. The current study aimed to compare the length of perineal tears in women referred to the Basra maternity hospital in 2020 for their first births with and without episiotomy. Materials & Methods: The current clinical trial study involved 212 full-term, singleton, primiparous women with cephalic fetuses weighing between 2500 and 3000 grams. Randomly and evenly, the samples were divided into two test and control groups. In the test group, delivery occurred without an episiotomy, whereas in the control group, an episiotomy was performed. The length of the posterior perineal tear, the presence of an anterior perineal tear, and the necessity for repair were subsequently compared. Results: The results revealed that 45.3% of women in the test group gave birth without perineal tears, while the remainder experienced posterior perineal tears (P<0.001). The mean length of posterior perineal tears in this group was 3.64±1.15 cm, compared to 7.12±1.67 cm in the control group (P<0.001). The mean length of a second-degree tear behind the perineum in the test group was 5.32±1.17 cm, compared to 6.13±1.62 cm in the control group (P>0.05). Conclusion: Delivery without episiotomy decreased the incidence of posterior perineal tears; however, delivery without episiotomy should not be performed on all primiparous women.
Original Research Article
Alsmadi Yaseen Mohammad Ibrahim; Saad Altimimi; Aisha Kamal Mahmoud; Muqdad Hussein Ali; Naseer Mehdi Mohammed; Ruqayah Taher Habash; Ahmed S. Abed; Entsar Hachim Muhammad
Articles in Press, Accepted Manuscript, Available Online from 08 February 2023
Abstract
Background & Objective: Today, the prevalence of cervical cancer in developing societies and its impacts on various body functions, mainly sexual performance, is of particular significance. In order to examine the relationship between sexual function and its domains with different stages of cervical ...
Read More
Background & Objective: Today, the prevalence of cervical cancer in developing societies and its impacts on various body functions, mainly sexual performance, is of particular significance. In order to examine the relationship between sexual function and its domains with different stages of cervical cancer, the present study was conducted.Materials & Methods: Examined in the current study were 284 women with cervical cancer referred to the Baghdad Women's Hospitals and selected randomly. The personal profile form and the female sexual function index (FSFI) were among the research instruments. The data were investigated by statistical software SPSS.23 and the Spearman correlation coefficient test. A p-value of less than 0.05 was deemed statistically significant.Results: The results revealed that 26.8% of women complained of low sexual desire, 43.0% did not receive adequate sexual arousal, and 39.1% experienced deficient vaginal lubrication. Additionally, 46.8% of women did not experience a proper orgasm, 27.8% were dissatisfied with their sexual satisfaction, and 37.0% reported experiencing pain during intercourse. In addition, there was an inverse correlation between the stages of cervical cancer and sexual performance (r= -0.25, P= 0.002), as well as its domains, including sexual desire (r= -0.18, P= 0.02), sexual arousal (r= -0.23, P= 0.004), vaginal lubrication (r= -0.23, P= 0.003), orgasm (r= -0.20, P= 0.009), sexual satisfaction (r= -0.21, P= 0.005), and pain during intercourse (r= -0.26, P= 0.001).Conclusion: The sexual performance of cervical cancer patients is impaired, and the more advanced stages of the disease weaken sexual performance and its domains.
Original Research Article
Berikuly Duman; Ali Abdulhussain Fadhil; Samah Sajad Kadim; Ayad Abas Hasan; Naseer Mehdi Mohammed; Ebtihal Sattar Qasim; Tamara Muayad Abdullah
Articles in Press, Accepted Manuscript, Available Online from 09 February 2023
Abstract
Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications ...
Read More
Background & Objective: Preeclampsia is related to numerous maternal and fetal complications, like intrauterine increase restriction, preterm delivery, and a raised danger of baby death. In order to determine the predictive amount of uterine artery Doppler sonography indices for neonatal complications in pregnant patients with preeclampsia, the present study was conducted.Materials & Methods: In 2020, in Alwiyah Hospital for Obstetrics and Gynecology in Baghdad, 87 pregnant women with preeclampsia and 160 healthy pregnant women participated in the present prospective study. The Doppler signal of the uterine arteries was evaluated during a supine abdominal Doppler ultrasound examination executed between 26 and 36 weeks of pregnancy. The survey form was updated with information about the birth of the children following the termination of the pregnancy. The data were evaluated using SPSS.19 and independent t, Mann-Whitney, and chi-square tests.Results: The mean uterine artery pulsatility index of mothers with preeclampsia had the greatest sensitivity, specificity, and positive predictive amount of predicting a baby's low birth weight at 54.8%, 87.3%, and 91.6%, respectively. In addition, the sensitivity, specificity, and positive predictive amount of the mean uterine artery resistance index for predicting a baby's low birth weight were 65.2%, 96.4%, and 95.4%, respectively.Conclusion: Although uterine artery indices in Doppler ultrasound do not have a high sensitivity for predicting neonatal complications, abnormal indices can predict low birth weight with high confidence.
Case Report Article
Azar Danesh Shahraki; Leila Mousavi Seresht; Amir Reza Farhadi Dehkordi; Pegah Hedaiat; Fedyeh Haghollahi
Articles in Press, Accepted Manuscript, Available Online from 26 February 2023
Abstract
Invasive angiomyxoma as a mesenchymal tumor with a high recurrence rate has been reported mainly in reproductive age according to its association with the estrogenic level of plasma. Above that, it seems there is a need for further treatment despite complete resection of the tumor, to eliminate the hormonal ...
Read More
Invasive angiomyxoma as a mesenchymal tumor with a high recurrence rate has been reported mainly in reproductive age according to its association with the estrogenic level of plasma. Above that, it seems there is a need for further treatment despite complete resection of the tumor, to eliminate the hormonal state.In the present study, we sought to introduce a rare case of invasive angiomyxoma in a post-menopausal but high-risk woman, discuss the relativity of risk factors in all hormonal-dependent gynecological malignancy, and intend to seek help from colleagues' opinions and experiences about treatment. It is clearly of great importance to emphasize the role of individualized medicine in such a rare case, in conclusion, there is not any debate on the role of surgical resection but the necessity of changing in lifestyle or adjuvant systemic or local therapy, and the needed duration is doubtful.
Original Research Article
Razieh Akbari; Ezat-Sadat Haj-seyed Javadi; Zahra Panahi
Articles in Press, Accepted Manuscript, Available Online from 15 May 2023
Abstract
Background and Objective: The aim of labor induction is to stimulate uterine contractions before the spontaneous onset of labor, resulting in vaginal delivery. Misoprostol is used off-label for a variety of indications in the practice of obstetrics and gynecology. Regarding the importance and lack of ...
Read More
Background and Objective: The aim of labor induction is to stimulate uterine contractions before the spontaneous onset of labor, resulting in vaginal delivery. Misoprostol is used off-label for a variety of indications in the practice of obstetrics and gynecology. Regarding the importance and lack of similar research in Iran in Buccal, this research was done to compare the efficacy of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy.Materials & Methods: This study was conducted as a randomized clinical trial from 2017 to 2018. In this study, 300 women were randomly assigned to receive 50 µg Buccal misoprostol, 25 µg Vaginal, and 50 µg Sublingual in Kosar Hospital, Qazvin. The maternal and fetal complications, and Bishop score hour 1, and hour 6 were monitored in three groups and the findings were analyzed.Results: The results showed that 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 there groups. The results of the study showed that there was a significant difference between the three groups (P = 0.015) in achieving normal vaginal delivery within 24 hours, as Buccal, Sublingual and Vaginal groups were achieved respectively. 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.
Original Research Article
Maternal Fetal Medicine
Zahra Panahi; Sedigheh Hantoushzadeh; Soudabeh Kazemi Aski,; Saeede Eslami Khotbesara; Mamak Shariat; Fahimeh Ghotbizadeh; Razieh Akbari
Articles in Press, Accepted Manuscript, Available Online from 17 May 2023
Abstract
Introduction: Despite the high efficacy of the Apgar score to find respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one the best indicator of fetal hypoxia. Therefore it’s so beneficial to consider these criteria and ...
Read More
Introduction: Despite the high efficacy of the Apgar score to find respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one the best indicator of fetal hypoxia. Therefore it’s so beneficial to consider these criteria and its relationship with Apgar score for accurate diagnosis of prenatal respiratory distress retrospectively and by which reduces the unnecessary cesarean section(CS) rate.
Methods: 162 full-term (≥259 days) neonates delivered by CS with a diagnosis of decreased fetal heart rate (FHR) were evaluated. 1-min and 5-min Apgar scores and UApH were measured. The correlation between Apgar scores with UApH and the association between UapH and Apgar with the NICU admission were evaluated. The effect of other variables including mother’s age, gravidity, gestational age, birth weight, newborn gender, and causes of decreased FHR on Apgar scores and UApH were studied as well.
Results: The most common cause of decreased FHR was fetal distress, boys had higher weight (p=0.033) and lower UApH (p=0.049) than girls. Other parameters were not different significantly between males and females. There was a positive correlation between UApH and 1-min and 5-min Apgar scores (r=0.464 and r=0.370 respectively) when controlled for birth weight (p<0.0001). The RR for NICU admission in male acidemic neonates with abnormal 1-min Apgar was 14.05(CI95%: 5.7-34.6) in comparison to females (RR=1.06, CI95%:1-1.26).
Conclusion: Mild acidemia (UApH<7.2) at least in male fetuses would be a good predictor for postnatal complications and the need for NICU admission. Future studies with more samples are suggested.
Original Research Article
Fakhrolmolouk Yassaee; sima habibi; Reza Shekarriz-Foumani; Mehrdad Motiei Langroudi; Elena Ghotbi
Articles in Press, Accepted Manuscript, Available Online from 23 May 2023
Abstract
Background & Objective: In all surgical interventions including cesarean section, pain is a challenging issue. The aim of this study was to identify the underlying causes that affect post-cesarean pain intensity.
Materials & Methods: A total of 128 consecutive patients who underwent cesarean ...
Read More
Background & Objective: In all surgical interventions including cesarean section, pain is a challenging issue. The aim of this study was to identify the underlying causes that affect post-cesarean pain intensity.
Materials & Methods: A total of 128 consecutive patients who underwent cesarean section at Taleghani hospital were included in the study. A questionnaire was used to gather the patients’ demographic and clinical data. The length of the incision was measured with a ruler on the first day following the cesarean section. In addition, the pain intensity was assessed using a Likert scale at scales: 1, 2, 4, 8, 12, and 24, on the day after surgery and 48 hours and one week later. Descriptive statistics were calculated for all variables. Analyses were conducted using spss version 22 and a p-value < 0.05 was considered statistically significant.
Results: The study showed that overall, patient age, BMI, level of education, type of surgical incision, duration of surgery, type of cesarean section, type of anesthesia, and breastfeeding were not predictors of postoperative pain study. However, the study found that “indication of the cesarean section” and the “stage of labor” in which the cesarean was performed are correlated with postoperative pain intensity. (p-value<0.05)
Conclusion: In this study, we were able to identify 2 parameters that were independently associated which postoperative pain scores: “underlying indication of cesarean section” and the “stage of labor” in which cesarean section is performed. This information helps clinicians to identify high-risk patients in terms of postoperative pain and take early action.
Original Research Article
Reihane Sadat Hosseini; Zinat Ghanbari; Maryam Deldar Pesikhani; Parivash Jelodarian
Articles in Press, Accepted Manuscript, Available Online from 23 May 2023
Abstract
Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain came out on the 4th day ...
Read More
Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain came out on the 4th day after the operation due to the improvement of the patient's general conditions and no discharge. It is recommended to consider pelvic abscess in patients suffering from fever, pain, pelvic pressure, and diarrhea after pelvic surgeries. Early diagnosis and treatment will reduce mortality and disability in patients.
Original Research Article
Maternal Fetal Medicine
tayebeh sedighi
Articles in Press, Accepted Manuscript, Available Online from 27 May 2023
Abstract
Introduction: Elevated blood flow resistance in the uterine artery is related to the development of pre-eclampsia and fetal growth restriction, which can be evaluated with uterine artery Doppler ultrasound (UtA). However, there is a lack of studies regarding its reproducibility. Therefore, we aimed to ...
Read More
Introduction: Elevated blood flow resistance in the uterine artery is related to the development of pre-eclampsia and fetal growth restriction, which can be evaluated with uterine artery Doppler ultrasound (UtA). However, there is a lack of studies regarding its reproducibility. Therefore, we aimed to compare the reproducibility of UtA using transvaginal (TV) and transabdominal (TA) methods in both the first and second trimesters.Materials and Method: This prospective, cross-sectional study was performed in the Prenatal Clinic at Yas Hospital, Tehran University of Medical Sciences. Inclusion criteria were gestational age between 11 to 13 weeks and 18 to 22 weeks based on crown-rump length. Both TV and TA techniques were performed by an experienced specialist in maternal and fetal medicine. Intra- and inter-observer variability of the UtA pulsatility index (UtA-PI) was evaluated using intra-class correlation coefficients.Results: This study included 400 pregnant women in the first and second trimesters of pregnancy. There was no significant difference in the mean UtA-PI measured by the operators. Intra-observer and inter-observer reproducibility of TV and TA in both the first and second trimesters, based on ICC and CCC, was moderate and poor, respectively. Intra-observer ICC ranged from 0.97 to 0.85, while the inter-observer ICC ranged from 0.93 to 0.84.Conclusion: Our results showed that intra-observer and inter-observer reproducibility of TV and TA was excellent, whereas the intra-observer and inter-observer reproducibility of TV was better. Measured UtA-PI was not influenced by the operator.
