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 ...
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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 ...
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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.
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 ...
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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.
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 ...
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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 ...
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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.
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 ...
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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.
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) ...
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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.
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) ...
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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
Reproductive Medicine
Autaf Talal Shaker; Saife D. Al-Ahmer; Farah Thamer Samawi
Articles in Press, Accepted Manuscript, Available Online from 01 January 2024
Abstract
The viruses considered one of the most factors that cause infertile because it represented sexual transmission disease. Objective. The purpose of this study was to study the correlations between viruses (HSV) viral load and semen parameters in groups of fertile and infertile Iraqi men. Methods. This ...
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The viruses considered one of the most factors that cause infertile because it represented sexual transmission disease. Objective. The purpose of this study was to study the correlations between viruses (HSV) viral load and semen parameters in groups of fertile and infertile Iraqi men. Methods. This study comprised fifty infertile males and fifty fertile healthy males. Seminal fluid analysis was conducted on all participants to detect the presence of HSV using the HSV1,2 quantification kit. Results: There was a high significant correlation between sperm concentration and percentage of rapid linear progression motility (r= 0.478**) of infertile men. A strong meaningful connection was seen between the percentage of sperm concentration and both the percentage of sluggish linear or nonlinear motility (r = 0.681**) and the percentage of non-progressive motility (r = 0.604**). There was a strong negative connection (r = -0.725**) between the concentration of sperm and the number of immotile spermatozoa. On the others hand, There was a high significant correlation between rapid linear progression and slow linear or nonlinear(r =0 .413**) non-progressive motility (r = 0.704**) respectively, and high negative significant between rapid linear progression and immotile spermatozoa. The correlation between slow linear or nonlinear and non-progressive motility was highly significant (r= 0.555**) and negative significant between slow linear or nonlinear and immotile spermatozoa. Finally, A strong negative correlation (-0.813**) was observed between non-progressive motility and immotile spermatozoa. Conclusions :The study found that HSV infection had effect on semen parameters and will cause male infertility.
Original Research Article
Obstetrics and Gynecology
Khadijeh Elmizadeh; Marziyeh khezri; Hamideh Pakniat; vahideh pandamuz; nezal Azh; Simindokht Molaverdikhani
Articles in Press, Accepted Manuscript, Available Online from 02 October 2023
Abstract
Background: Cooling the uterus during cesarean section has emerged as one of the non-pharmacological management for blood loss during cesarean section. The aim of this study was to evaluate the effect of uterine cooling during the cesarean section on decreasing postpartum hemorrhage.
Methods: In this ...
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Background: Cooling the uterus during cesarean section has emerged as one of the non-pharmacological management for blood loss during cesarean section. The aim of this study was to evaluate the effect of uterine cooling during the cesarean section on decreasing postpartum hemorrhage.
Methods: In this single-blinded randomized clinical trial, a sample of 300 women with a singleton pregnancy, at 37 to 40 weeks gestation, who were scheduled for cesarean section was divided into two groups of 150 participants. In the intervention group after placental delivery, the uterus was covered with cold saline-soaked surgical sponges at 0-4°C at the time of hysterotomy repair, and the control group received standard cesarean section. The volume of blood loss, the hemoglobin level before surgery and 24 h after surgery, the need for additional oxytocic therapy, and the incidence of adverse effects were recorded.
Results: The bleeding volume and hemoglobin concentration reduction were significantly lower in the intervention group than in the control group (260.86± 150.25 Vs 214.35± 83.51, P<0.0001 and 1.24±0.75 Vs 1.54±0.92, P = 0.007 respectively). There were no statistically significant differences between the two groups in the frequency of need for additional uterotonic drugs. (18% vs. 21.33%, P = 0.475.)
Conclusion: The use of uterine cooling during cesarean section reduced the volume of blood loss and the rate of decline in hemoglobin concentration.
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 ...
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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
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 ...
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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.
Original Research Article
Obstetrics and Gynecology
Hoora Amoozegar; Nayereh Rahmati; Zahra Naseri; samira Shah-Hamzehi; mostafa vahedian; enayatollah Noori; alireza moradi
Articles in Press, Accepted Manuscript, Available Online from 15 July 2023
Abstract
Background: To evaluate the risk of uterine rupture during pregnancy, researchers use two-dimensional (2D) transvaginal ultrasound to assess lower uterine segment (LUS) thickness in the third trimester of pregnancy. This study aimed to compare the thickness of the LUS provided in a 2D transvaginal ultrasound ...
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Background: To evaluate the risk of uterine rupture during pregnancy, researchers use two-dimensional (2D) transvaginal ultrasound to assess lower uterine segment (LUS) thickness in the third trimester of pregnancy. This study aimed to compare the thickness of the LUS provided in a 2D transvaginal ultrasound with the findings during a cesarean section (C/S) of pregnant women with a history of previous C/S.
Materials and Method: This cross-sectional study was performed on 40 pregnant women referred to Izadi Obstetrics and Gynecology Hospital in Qom. All the women underwent transvaginal ultrasound followed by C/S within a maximum of one week later. Also, an expert gynecologist classified LUS thickness into four grades in the operation room.
Results: The mean age of women was 31.58 ± 4.56 years, and the mean thickness of the LUS was 2.17 ± 0.51 cm. Moreover, 57.5% of the women have grade I of LUS based on intraoperative findings. Results indicated that the mean thickness of the LUS measured by ultrasound significantly differed between the three grades detected by the gynecologist (P=0.04). However, there were no significant differences between maternal age, gestational age, parity, and time of last C/S among women with different LUS grades (P˃0.05). Transvaginal ultrasound could be helpful in evaluating the risk of scar dehiscence and uterine rupture among women with LUS grades I and II with a history of previous C/S.
Review Article
General Gynecology and Pelvic Floor
Leila Pourali; maryam salehi; reyhaneh rahmani; elmira fardi; sedigheh ayati; hasan Mehrad-Majd; mehrdad gazanchian; elham rahmanipour; mohammad ghorbani; Ali mehri
Articles in Press, Accepted Manuscript, Available Online from 16 July 2023
Abstract
Background: Vaginal birth after Caesarean (VBAC) is often offered as an option after a single caesarean section (CS).
Objectives: to evaluate the success rate of vaginal birth after two caesarean sections (VBAC-2).
Search strategy: Systematic review and meta-analysis
Selection criteria and Data collection: ...
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Background: Vaginal birth after Caesarean (VBAC) is often offered as an option after a single caesarean section (CS).
Objectives: to evaluate the success rate of vaginal birth after two caesarean sections (VBAC-2).
Search strategy: Systematic review and meta-analysis
Selection criteria and Data collection: We searched MEDLINE, EMBASE, PubMed, Scopus, using search terms (cesarean OR cesarean OR caesarean OR caesarian) AND (“Vaginal birth after” OR VBAC) AND (two OR Twice OR second OR multiple Two independent reviewers performed the study selection, and abstracted and tabulated data and pooled estimates were obtained. Meta-analyses were performed using Open-meta and Comprehensive Meta-Analysis.
Main results: Mean success rate of VBAC-2 was 72% (2174 out of 3020 cases) with a range of 24-90%. Mean hysterectomy rate was 0.43% ranging from 0% to 1.7%. Our meta-analysis showed no significant difference between VBAC-2 and CS-3 in the case of hysterectomy, with a pooled odds ratio (OR) of 0.699, but with a wide confidence interval (95% CI was 0.347-1.407). VBAC-2 being associated with 2 fold increased risk of perinatal mortality compared to CS-3.
Conclusion: Vaginal delivery is a suitable option for women with two previous cesarean sections, the outcomes are significantly more favorable for women with history of vaginal birth.
Case Report Article
Obstetrics and Gynecology
Mahsa Akbari Oryani; Mohaddeseh Shahraki; Marjaneh Farazestanian
Articles in Press, Accepted Manuscript, Available Online from 23 July 2023
Abstract
Disorders of sex development (DSD) result from intrauterine defects in sex discrimination. The clinical phenotype differs based on the disease type. Cases with ambiguous external genitalia are diagnosed at birth. However, diagnosis of cases with normal-appearing external genitalia may be delayed until ...
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Disorders of sex development (DSD) result from intrauterine defects in sex discrimination. The clinical phenotype differs based on the disease type. Cases with ambiguous external genitalia are diagnosed at birth. However, diagnosis of cases with normal-appearing external genitalia may be delayed until puberty. Here, we report a patient with a pelvic mass and a small uterus that was diagnosed by abdominal ultrasound, in addition to the history of primary amenorrhea and physical examination suggested Swyer syndrome, confirmed by genetic karyotyping. Pathological examination of the surgically removed mass revealed dysgerminoma. Until the age of 19, the patient did not have any idea about 46, XY karyotype, and assumed to be a female. The development of dysgerminoma (as a result of the simultaneous presence of gonadal dysgenesis and Y-chromosome) was another challenge that the patient had to deal with. The diagnosis of this patient at an earlier age could have prevented the development of gonadoblastoma, by removal of the streak gonads. By the presentation of this case, we intend to increase the physician’s awareness about DSDs; earlier diagnosis may help the patient deal with her disease better and reduce the risk of further complications.
Original Research Article
Gynecology Oncology
Hedyeh Mansoori; Mahmoud Shirazi
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Background & Objective: This research aimed to study the role of the meaning of life in death anxiety and suicidal thoughts in women with cancer.Materials & Methods: The method of this research is correlation. The statistical population of the study included all women with cancer referred to ...
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Background & Objective: This research aimed to study the role of the meaning of life in death anxiety and suicidal thoughts in women with cancer.Materials & Methods: The method of this research is correlation. The statistical population of the study included all women with cancer referred to Tawheed Hospital in Sanandaj City in 1400-1401. The sample size consists of one hundred people selected by purposive sampling. To collect data, Steger's Meaning in Life (MLQ), Templer's Death (DAS), and Beck's Suicidal Thoughts (BSSI) questionnaires were used. SPSS software was used in this research.Results: The information was analized using correlation tests and regression analysis. The regression conclusions showed that the meaning of life has an inverse relationship with suicidal thoughts, and death anxiety has a direct relationship with suicidal thoughts. The Pearson correlation results showed that the meaning of life predicts death anxiety and suicidal thoughts.Conclusion: In general, it can be concluded that the meaning of life plays an instrumental role in the death anxiety and suicidal thoughts of women with cancer.
Original Research Article
Obstetrics and Gynecology
fatemeh davari tanha; Mojgan Asadi; Faeze Mirbagheri; Elham Feizabad; Zahra kaveh; Kazem Mousavizadeh
Articles in Press, Accepted Manuscript, Available Online from 01 August 2023
Abstract
Background and Objective: Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age. Chronic pelvic pain is a common symptom of endometriosis and can have a significant impact on a woman's quality of life, including sexual satisfaction. Botulinum toxin ...
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Background and Objective: Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age. Chronic pelvic pain is a common symptom of endometriosis and can have a significant impact on a woman's quality of life, including sexual satisfaction. Botulinum toxin injection has been used as a treatment for chronic pelvic pain in endometriosis, but its effect on sexual satisfaction is not well understood.Methods: A randomized controlled trial was conducted to evaluate the effect of botulinum toxin injection on chronic pelvic pain and sexual satisfaction in women with endometriosis. The study included 32 women with endometriosis who were randomly assigned to receive either botulinum toxin injection or placebo. The primary outcome measure was change in chronic pelvic pain assessed using the visual analog scale (VAS) at one month after treatment. Secondary outcome measures included changes in sexual satisfaction assessed using the Female Sexual Function Index (FSFI) at one month after treatment.Results: The results showed that botulinum toxin injection significantly reduced chronic pelvic pain compared to placebo at one month after treatment (p<0.001). There was also a significant improvement in sexual satisfaction in the botulinum toxin group compared to placebo at one month after treatment (p=0.001). Conclusion: Botulinum toxin injection may be an effective treatment option for women with endometriosis, chronic pelvic pain and sexual dysfunction.This research was also registered with the code IRCT20091012002576N20 in the Clinical Trial Registration Center of Iran. Date of registration performed between July2021and July 2022
Original Research Article
Obstetrics and Gynecology
Najmiatul Fitria; Nauratul Ikramah; Ade Sukma; Hansen Nasif
Articles in Press, Accepted Manuscript, Available Online from 05 August 2023
Abstract
Background and Objective: Pregnant women need more nutritional intake than before pregnancy. If this nutritional intake is insufficient for the mother, it will result in Chronic Energy Deficiency (CED). To determine if pregnant women are experiencing malnutrition or cannot be known by measuring the Mid-Upper ...
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Background and Objective: Pregnant women need more nutritional intake than before pregnancy. If this nutritional intake is insufficient for the mother, it will result in Chronic Energy Deficiency (CED). To determine if pregnant women are experiencing malnutrition or cannot be known by measuring the Mid-Upper Arm Circumference (MUAC). Based on service regulations for pregnant women in Indonesia, the minimum number of Iron-Folic Acid (IFA) tablets pregnant women get is 120. Regarding this condition, a study was conducted to analyze the relationship between the amount of IFA consumption on MUAC and several other therapeutic outcomes
Methods: This study used a cross-sectional method by examining the patient's medical records. Patients who received IFA as many as 120 tablets or more will become the exposure group. Data will be analyzed descriptively using chi-square
Results: The MUAC size significantly differed at the end of pregnancy (p=0.01). However, overall there was no significant difference between the two groups
Conclusion: The IFA administration generally gives good results, but the optimal number of IFA doses still needs further study.
Original Research Article
Gynecology Oncology
Zahra Shiravani; Fatemehsadat Najib; Mahvash Alirahimi; Elham Askary; Tahereh Poordast; Nader Tanideh; Shohreh Roozmeh; Golsa Shekarkhar; Sana Atbaei; danilo porro; Soudabeh Sabetian; Claudia Cava
Articles in Press, Accepted Manuscript, Available Online from 03 September 2023
Abstract
The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different ...
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The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different groups containing 60 adult female rats. The rat model is categorized into 6 groups untreated and treated (Olive Oil (solvent), VTD3 (42 mcg/kg/day), OG3 (450 mg/kg/day), VTD3+OG3, Diphereline (3 mg/kg/day)). The suspension containing combination of Diphereline and supplements was injected and treated for 4 weeks to analyses the effect of supplements. The interleukin -6 (IL-6) and Tumor necrosis factor – alpha (TNFα) inflammatory responses were measured from the serum samples while endometrial implants was dissected and histopathological investigation was done. At the end of four weeks pathologic score was decreases significantly with simultaneous measurement of inflammation score of endometriotic lesion, size of implant area, IL-6, TNFα response and compared with untreated female rat. No significant different was observed in groups undergoing treatment of VTD3, OG3 and Diphereline. The combined effect of VTD3+OG3 has similar responses with Diphereline treated endometrial implants. In conclusion, treatment of VTD3 deficiency and making a change in dietary habits of high-risk population for endometriosis from adolescence may also play a preventative role in adulthood.
Original Research Article
Pathology
Nasrin Ziamajidi; Nazi Moini; Hiva Danesh; Roghayeh Abbasalipourkabir; Nahid Radnia; Zeinab Barartabar
Articles in Press, Accepted Manuscript, Available Online from 05 September 2023
Abstract
Background & Objective: Breast cancer has the highest incidence of all cancers and the incidence of this disease is increasing rapidly in many countries around the world, including Iran. In this study, some epidemiological and pathological factors have been investigated in breast cancer patients.Methods: ...
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Background & Objective: Breast cancer has the highest incidence of all cancers and the incidence of this disease is increasing rapidly in many countries around the world, including Iran. In this study, some epidemiological and pathological factors have been investigated in breast cancer patients.Methods: This is a cross-sectional study which contains 476 patients with a confirmed diagnosis of breast cancer, was conducted in Tehran, Dr. Moini Breast Clinic from 2019 to 2021. Results: The mean age of patients was 50.2±11.40 years, of which 80.9% patients over 40 years. Ductal carcinoma was the most common in terms of histology (81.7%) and most patients are in grade 2 (63.6%). According to hormonal receptors, 73.8% of women had estrogen receptor positive and 68.9% of women had progesterone receptor positive and 18.9% of patients were triple negative. There is a significant relationship between grade and lymph node involvement (P-value=0.00) and also a significant relationship between metastasis with grade (P-value = 0.00 (and metastasis with lymph node involvement (P-value = 0.00) was seen.Conclusion The results of this study show that breast cancer has a high prevalence in Iranian women in Tehran, mainly seen in the 4th and 5th decades of breast cancer. HER-2 (epidermal growth factor 2 receptor overexpression) and triple negatives were the least subgroups. Considering that diagnosis happens late and about 63.6% of patients are in grade 2, it is necessary to implement programs in the field of screening and prevention in the female population of this province.
Original Research Article
General surgery
Lobat Jafarzadeh; Shirin Alsadat Mousavi; Fatemeh Deris
Articles in Press, Accepted Manuscript, Available Online from 09 September 2023
Abstract
Background and Goal: Bleeding is a serious complication during and after hysterectomy. This study aimed to compare the short-term outcomes of ChitoHem and Surgicel use in posterior bladder bleeding during hysterectomy.Methods: In the present clinical trial, 46 patients who were candidates for abdominal ...
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Background and Goal: Bleeding is a serious complication during and after hysterectomy. This study aimed to compare the short-term outcomes of ChitoHem and Surgicel use in posterior bladder bleeding during hysterectomy.Methods: In the present clinical trial, 46 patients who were candidates for abdominal hysterectomy in Hajar Hospital in Shahrekord, Iran, were randomly divided into two groups. In group A, superficial (cauter and Surgicel) and in group B (superficial cauterand ChitoHem) were used to control bleeding. Hematocrit and hemoglobin levels were determined before, 6 and 12 hours after surgery. Drain discharge volume, time to stop bleeding and bleeding volume were also determined. The pain was determined by the VAS scale. Data were analyzed by SPSS statistical software.Results: Based on repeated-measures test, the mean of hemoglobin and hematocrit in the studied times showed a significant difference, so that in 6 and 12 hours after surgery they were significantly less than the ones before surgery, but their mean was not significantly different between the two groups. The mean pain score 1 month after surgery in group B was significantly lower than group A (P <0.001). The mean volume of drainage and clotting time in group B were significantly lower than group A (P <0.01). The mean volume of intraoperative bleeding, the frequency of vaginal bleeding and cuff-related complications was not significantly different in the two groups.Conclusion: The results of the present study indicate a better efficacy of ChitoHem on bleeding during hysterectomy surgery.
Original Research Article
General Gynecology and Pelvic Floor
Mahnaz Ashrafi; Behnood Farazmand; Souzan Soufizadeh Balaneji; Maryam Dadkhah
Articles in Press, Accepted Manuscript, Available Online from 01 October 2023
Abstract
Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ...
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Background: Polycystic ovarian syndrome (PCOS), the most common cause of infertility, is widely treated with clomiphene citrate and human gonadotropins. Letrozole, an aromatase inhibitor, can also induce ovulation in patients resistant to clomiphene. However, there has been no comprehensive study comparing ovulation induction with clomiphene and letrozole versus clomiphene and human gonadotropin. This study aimed to compare an aromatase inhibitor with human gonadotropin for patients with clomiphene-resistant polycystic ovary syndrome. Methods: This randomized clinical trial was conducted on PCOS women resistant to clomiphene at Akbarabadi hospital, Tehran, Iran. Patients were randomly divided into two groups. The first group received letrozole and clomiphene citrate and the second received clomiphene citrate and human gonadotropin.Results: Total number of 120 patients enrolled in our study. No significant difference was seen between the two groups in terms of demographic and basic clinical characteristics (P>0.05). We also found no significant difference between the two groups in terms of hirsutism, galactorrhea, pregnancy rate, human chorionic gonadotropin (HCG) intake, primary and secondary infertility, and number of follicles (P>0.05). Conclusion: The combination of letrozole and clomiphene citrate was as effective as human gonadotropin and clomiphene citrate and it could be a treatment option for patients with infertility due to PCOS.Keywords: Clomiphene, Human menopausal gonadotropin, Letrozole, Polycystic ovary syndrome, Ovulation
Original Research Article
Reproductive Medicine
Kong Chi Pham; Viet Quoc Dao; Le Thi Phuong Nguyen; Vinh Dinh Tran
Articles in Press, Accepted Manuscript, Available Online from 07 October 2023
Abstract
Objective: To determine the causes of infertility of couples examined at Da Nang Hospital for Women and Children. Methods: A cross-sectional descriptive study included 512 reproductive-age couples diagnosed with infertility and treated at Da Nang Hospital for Women and Children from August 2018 to August ...
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Objective: To determine the causes of infertility of couples examined at Da Nang Hospital for Women and Children. Methods: A cross-sectional descriptive study included 512 reproductive-age couples diagnosed with infertility and treated at Da Nang Hospital for Women and Children from August 2018 to August 2020. Results: The mean age of the men and women was 31.0 ± 4.4 years and 33.5±5.0 years, respectively. Primary infertility accounted for 70.9%, whereas secondary infertility was only 29.1%. The mean time of infertility was 3.0±2.5 years. Male factor infertility accounted for the highest rate (39.6%), followed by female infertility (30.5%). Infertility due to both male and female factors was18.0%. Among the causes of male infertility, abnormal semen analysis accounted for the highest rate (57.6%), followed by varicocele (19.3%). Among the abnormalities of semen parameters, oligo-astheno-teratozoospermia (OAT) represented the highest rate (37.5%). There were 46 cases of azoospermia, accounting for 9.0%. Endometriosis accounted for the highest rate (17.6%) among causes of female factor infertility, followed by PCOS (15.6%). There were 51 cases of diminished ovarian reserve, accounting for 9.9%. Conclusion: Male factor infertility accounted for the highest rate in this study. Among the causes of male infertility, abnormal semen analysis had the highest rate. Endometriosis and PCOS were common causes of female infertility.
Original Research Article
Obstetrics and Gynecology
Alfonsus Zeus Suryawan; Amillia Siddiq
Articles in Press, Accepted Manuscript, Available Online from 09 November 2023
Abstract
Background: Uncertainities exist about the diagnostic and prognostic role of hemocytometry values in patients with COVID-19 especially in pregnancy. This study aims to investigate hemostatic changes in pregnant woman with coronavirus disease (COVID-19) and their relationship to disease severity.Methods: ...
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Background: Uncertainities exist about the diagnostic and prognostic role of hemocytometry values in patients with COVID-19 especially in pregnancy. This study aims to investigate hemostatic changes in pregnant woman with coronavirus disease (COVID-19) and their relationship to disease severity.Methods: This research is an analytic observational study with case control design. Subject was gathered from Hasan Sadikin General Hospital patients medical records from June 2021 – March 2022. Inclusion criteria on this study is all pregnant COVID-19 patient with Prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer examination. The exclusion of this study all pregnant COVID-19 patient without required examination. PT, aPTT, and D-dimer were measured by Stago kits on a Stago automated coagulation analyzer (STA Compact Max®). Data was then analyzed by Kruskal Wallis with IBM SPSS Statistic 26th with α=0.05.Results: Statistical analysis shows there’s corelation between different severity levels with D-Dimer. This study shows mean of D-Dimer of each severity levels; asymptomatic 4.85 mg/L, mild 2.86 mg/L, moderate 5.47 mg/L and severe 14.51 mg/L (p <0.000). Changes seen after mild group which increase to 5,47 mg/dL in moderate COVID-19 and furthermore increase in severe become 14,51 mg/L. No changes in PT and aPTT was found.Conclusion: In conclusion, our findings demonstrate that coagulopathy is associated with the severity of COVID-19 illness. D-dimer is important parameter for evaluating the COVID-19 severity in pregnancy. This further could serve as diagnostic category to differ the severity of COVID-19 in pregnancy.
Original Research Article
Reproductive Medicine
Abdelrehman Saber; Mohammed Ahmed Faris; Sayed Bakry
Articles in Press, Accepted Manuscript, Available Online from 13 November 2023
Abstract
Background: Intracytoplasmic sperm injection (ICSI), a technique that involves an injection of a spermatozoon into the oocyte cytoplasm, has allowed the achievement of fertilization for a wide range of couples suffering from infertility.
Objective: The study assesses the influence of modified ICSI followed ...
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Background: Intracytoplasmic sperm injection (ICSI), a technique that involves an injection of a spermatozoon into the oocyte cytoplasm, has allowed the achievement of fertilization for a wide range of couples suffering from infertility.
Objective: The study assesses the influence of modified ICSI followed by chemically induced activation by calcimycin and Ionomycin in couples with a history of total fertilization failure (TFF).
Methods: A prospective analysis study was conducted with sibling oocytes to compare the application of calcimycin and Ionomycin after the M-ICSI technique. The study was conducted in a private IVF centre in Cairo, Egypt. A case with a TFF history assessed their fertilization rates, cleavage, and good-quality embryos on day three.
Results: 21 cycles comprised 134 oocytes treated with calcimycin and 125 oocytes treated with Ionomycin. Calcimycin-treated oocytes showed a fertilization rate of 39.5 %, a degeneration rate of 3.7 %, an arrest rate of 3.6 %, a cleavage rate of 45.5 %, and a good quality embryo rate of 37.1 %. On the other hand, ionomycin-treated oocytes showed a fertilization rate of 68.0 %, a degeneration rate of 6.0 %, an arrest rate of 3.7 %, a cleavage rate of 74.3 %, and a good quality embryo rate of 31.5 %. Ionomycin-treated oocytes had a significantly higher t-value of fertilization and cleavage rates than calcimycin-treated (p-value < 0.05).
Conclusion: M-ICSI followed by Ionomycin or ready-to-use calcimycin may treat TFF patients. Calcium increase could be achieved directly by mechanical activation and last longer by assisted oocyte activation (AOA) treatment.
Original Research Article
General Gynecology and Pelvic Floor
Rihab Majeed Shareef; Najah Shaker Yassen; Sallama Hamid Alkhudair
Articles in Press, Accepted Manuscript, Available Online from 13 November 2023
Abstract
Background: Melatonin play a role in pubertal development and reproductive function through the Hypothalamus-hypophysis-gonadal axis. In addition, melatonin production decreases with age, so that indolamine could be an anti-ageing agent. To assess Intra follicular melatonin level's role in ovarian ...
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Background: Melatonin play a role in pubertal development and reproductive function through the Hypothalamus-hypophysis-gonadal axis. In addition, melatonin production decreases with age, so that indolamine could be an anti-ageing agent. To assess Intra follicular melatonin level's role in ovarian reserve and the IVF cycle outcomes.
Patients and method: A prospective cross-sectional study was conducted from April 2022 to April 2023. Patients on a mini-long agonist, short agonist, and antagonist protocols were enrolled in the current study. Using ultrasound, the follicle development was observed from the stimulation day until the hCG day (done every 2 or 3 days).
Results: Melatonin were positively correlated with oocyte retrieved (r=0.705, P<0.001), number of fertilized oocyte (r=0.68, P<0.001), number of zygotes cleaved (r=0.660, P<0.001), high quality embryos (r=0.591, P<0.001), embryos for transplantation (r=0.604, P<0.001), percent of high quality embryos (r=0.58, P<0.001), and with percent of blastocyst rate.
Conclusion: Melatonin mean levels in follicular fluid were significantly decreased in poor response than in standard and high response. The follicular fluid melatonin levels were associated with each oocyte quantity and quality and can expect ICSI consequences and act as highly important biochemical indicators of ovarian reserve.
Original Research Article
Gynecology Oncology
Ahmad Shuib Yahaya; Mohd Norazam Mohd Abas; Jamil Omar
Articles in Press, Accepted Manuscript, Available Online from 18 November 2023
Abstract
Objective:
This study aims to analyze the survival outcomes and prognostic factors of patients with uterine sarcoma in the Department of Gynae-Oncology, between June 2015 and December 2022.
Methods:
The study population consists of patients with histopathologically confirmed uterine sarcoma. Oncological ...
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Objective:
This study aims to analyze the survival outcomes and prognostic factors of patients with uterine sarcoma in the Department of Gynae-Oncology, between June 2015 and December 2022.
Methods:
The study population consists of patients with histopathologically confirmed uterine sarcoma. Oncological data collected includes stage, pathological report and type of surgery, adjuvant therapy, recurrence, and mortality. Kaplan-Meier analysis used to estimate survival.
Results:
We identified 58 eligible uterine sarcoma patients: 13 leiomyosarcoma (22.4%), 9 endometrial stromal sarcoma (15.5%), 32 carcinosarcoma (55.2%), 2 adenosarcoma (3.4%) and another 2 were undifferentiated sarcoma (3.4%). Mean age was 56.1 (SD=12.03) and 56% patients were postmenopausal. Majority of patients presented in stage III and IV (53.4%) and only 22 patients (37.9%) in stage I. Adjuvant radiotherapy was given to 21 patients (36.2%); 8 patients (13.8%) received chemotherapy and 9 patients (15.5%) received both radiotherapy and chemotherapy. Median follow up period was 13.5 months (range: 73 months) and total of 35 patients (60.3%) had recurrence with median time to recurrence of 6.0 months (range: 35). Death occurred in 21 patients (36.2%) with median time to death 5.0 months (range: 36 months). Progression free survival (PFS) among all patients was 26.64 (range: 4.32) months with significant correlation with stage of disease. Overall survival (OS) in patients received surgery only, radiotherapy and combine radiotherapy and chemotherapy were 23.3, 54.8 and 62.4 months respectively (p value 0.03).
Conclusion:
Uterine sarcoma is a relatively rare tumor type with worse survival. Multimodality adjuvant treatments showed to improve prognosis in those patients.
Original Research Article
Reproductive Medicine
shayamaa Abd Hasan; Basma Salman Abdul Hammed; Qasim Mohammed Banjah
Articles in Press, Accepted Manuscript, Available Online from 19 November 2023
Abstract
Primary infertility affects a significant proportion of couples and is often attributed to female factors. Obesity, which is associated with increased levels of the hormone leptin, is a known risk factor for female infertility. This cross-sectional study aimed to investigate the association between BMI ...
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Primary infertility affects a significant proportion of couples and is often attributed to female factors. Obesity, which is associated with increased levels of the hormone leptin, is a known risk factor for female infertility. This cross-sectional study aimed to investigate the association between BMI and leptin levels in primary infertile females at Al-Nuaman Hospital and Al-Salama private hospital from September 2022 to March 2023. A total of 100 females were enrolled, and their BMI and serum leptin levels were measured. The participants were divided into four groups: Group 1 (normal weight, fertile), Group 2 (overweight infertile), Group 3 (obese infertile), and Group 4 (severely obese infertile) women, each consisting of 25 participants, categorized based on their BMI: normal BMI (18.5–24.9 kg/m²), overweight BMI (25–29.9 kg/m²), obesity BMI (≥30 kg/m²), and severely obese BMI (35-40 kg/m²). The mean leptin levels were compared between the four groups using ANOVA, and the association between BMI and leptin levels was assessed using Pearson's correlation coefficient. The study revealed a highly significant correlation between primary infertility and the parameters (BMI and leptin) (P < 0.001) and showed a positive correlation between leptin and BMI. It was shown that primary infertile females with a high BMI have elevated serum leptin levels. This underscores the importance of weight management in addressing primary female infertility.
Original Research Article
Gynecology Oncology
farahnaz farzaneh; Shahla Mirgaloybayat; Abbas Ali Niazi; Marziyeh Ajdary; Javid Dehghan Haghighi; Neda Eslahi; Mohammad Raisi
Articles in Press, Accepted Manuscript, Available Online from 20 November 2023
Abstract
Background & Objective: Endometrial hyperplasia is the primary precursor of endometrial cancer in the female reproductive system, with abnormal uterine bleeding (AUB) being the predominant manifestation of this condition. The purpose of this study was to determine the prevalence of endometrial hyperplasia ...
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Background & Objective: Endometrial hyperplasia is the primary precursor of endometrial cancer in the female reproductive system, with abnormal uterine bleeding (AUB) being the predominant manifestation of this condition. The purpose of this study was to determine the prevalence of endometrial hyperplasia and its correlation with various factors among patients presenting with abnormal uterine bleeding.Materials & Methods: This cross-sectional descriptive-analytical study reviewed the hospital records of all patients with abnormal uterine bleeding admitted to Ali Ebn-e Abi Taleb Hospital in Zahedan from April 2015 to April 2018. Data were analyzed using the SPSS. Results: The prevalence of endometrial hyperplasia was estimated to be 20.3%. The average age of the study subjects was about 45 years. The highest number of patients (37, 52.9%) belonged to the age group of 36-50 years. Among the different types of endometrial hyperplasia observed, the most common was "simple non-atypical hyperplasia" found in 45 patients (64.3%), while the least common was "simple atypical hyperplasia" observed in three patients (4.3%). Overall, "non-atypical hyperplasia" (including both simple and complex types) was present in 58 patients (82.85%). The prevalence of infertility, obesity, hypertension, diabetes, premature menarche, late menopause, family history, oligomenorrhea, and polycystic ovary syndrome (PCOS) was reported in 7.1%, 32.9%, 24.3%, 22.9%, 8.5%, 13.6%, 7.1%, 5.7%, and 3.4% of cases, respectively.Conclusion: women with a history of diabetes, hypertension, and obesity are at an increased risk of developing endometrial hyperplasia. Therefore, it is crucial to evaluate these patients for the presence of endometrial hyperplasia.
Original Research Article
Obstetrics and Gynecology
Fariba Seyedoshohadaei; Masomeh Rezaie; Nasrin Sofizadeh; farnaz zandvakili; Khaled Rahmani; Hosna liravi
Articles in Press, Accepted Manuscript, Available Online from 29 November 2023
Abstract
Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with ...
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Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with complaints of infertility due to lack of ovulation were randomly divided into four groups using clomiphene citrate + placebo, letrozole + placebo, clomiphene citrate + Aspirin, and letrozole + aspirin divided by block randomizes. Follicometry was performed with the help of transvaginal ultrasound on the 14th day of the cycle. In the case of a positive pregnancy, the patients underwent transvaginal ultrasound in the 6th week of pregnancy to observe the gestational sac. Patients were followed up until the 12th week of pregnancy in terms of the abortion rate.
Results: This study showed that there was no significant difference in the number of follicles of 14 to 18 mm, follicles larger than 18 mm, and the thickness of the endometrium of the studied women in the four investigated groups (p>0.05). The pregnancy test results showed that the clomiphene citrate + aspirin group and the letrozole + aspirin group each had the highest pregnancy rate with 13 people (36.1%) having a positive test.
conclusion: Although the addition of aspirin to letrozole or clomiphene citrate does not affect the number of mature follicles and the thickness of the endometrium, it can increase the probability of pregnancy.
Original Research Article
Anesthesia
Olumide Mathew Adebisi; Adebayo Augustine Adeniyi; Olabisi Timothy Adeyemo; Olayinka Tesleem Orewole; Olumide Emmanuel Adewara; Babatunde Sunday Awoyinka; Idowu Oluwaseyi Adebara; Adewumi Bakare; Oluwasesan Bamidele Afolabi; Adeola Emmanuel Adekanye
Articles in Press, Accepted Manuscript, Available Online from 01 December 2023
Abstract
Background and Objective: The commonly used analgesia for post caesarean pain include combination regimens containing acetaminophen, non-steroidal anti-inflammatory agents (NSAIDs) and opioids. The objective of this study is inter alia to determine the effects of dexamethasone as adjuvant to commonly ...
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Background and Objective: The commonly used analgesia for post caesarean pain include combination regimens containing acetaminophen, non-steroidal anti-inflammatory agents (NSAIDs) and opioids. The objective of this study is inter alia to determine the effects of dexamethasone as adjuvant to commonly used NSAIDs for post-caesarean pain management.
Materials and methods: One hundred and eighty-eight participants slated for caesarean delivery under spinal anaesthesia were randomized into two groups of 94 participants each. One group received 2ml intravenous 8mg dexamethasone while the second group received 2ml of intravenous sterile water as placebo . Both groups received similar doses of intramuscular acetaminophen and diclofenac. Intramuscular pentazocine at a dose of 0.5mg/kg body weight was used as rescue analgesia. Primary outcome was the mean summed pain intensity difference (MDPID) in the two groups while the secondary outcomes include the needs and frequency of rescue analgesia, and the levels of maternal satisfaction. P-value set as ≤0.05.
Results: The mean summed pain intensity difference (MSPID) at 24hours post-caesarean was higher in the dexamethasone group, (29.27±18.10 versus 24.24±13.14, p=0.036). The percentage of the participants that required rescue analgesia in the dexamethasone group was less (60.6% versus 76.1%, p=0.024). The Overall levels of maternal satisfaction were comparable in both groups.
Conclusion: Intraoperative dexamethasone given intravenously as adjuvant to intramuscular diclofenac and acetaminophen minimizes opioid administration within the first 24hours after caesarean section.
Original Research Article
Maternal Fetal Medicine
Mahboobeh Shirazi; Fatemeh Rahimi Sharbaf; Fatemeh Golshahi; Behrokh Sahebdel; Elham Feizabad; Leila Asadi; Afsaneh Alimadad-Tafreshi; Arash Jafariyeh; Akram Valizadeh; tayebeh sedighi; Fatemeh Takaloo; Aazam Taghavi-Zahedkalaei
Articles in Press, Accepted Manuscript, Available Online from 09 December 2023
Abstract
Background & Objective: Clinical use of uterine artery (UtA) Doppler ultrasound imaging requires reference values but despite the common use of UtA Doppler examination during pregnancy, to the best of our knowledge, there is no such range for Iranian pregnant women. Hence, this study aimed to investigate ...
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Background & Objective: Clinical use of uterine artery (UtA) Doppler ultrasound imaging requires reference values but despite the common use of UtA Doppler examination during pregnancy, to the best of our knowledge, there is no such range for Iranian pregnant women. Hence, this study aimed to investigate uterine artery Doppler indices in Iranian normal pregnancies and compare these with the other country values.Materials & Methods: This observational longitudinal study was conducted on 486 low-risk pregnant women. The amount of plausibility index (PI) and resistance index (RI) as well as the presence of diastolic notch were assessed in weeks 11 to 14, 17 to 24, and 27 to 32 through Doppler ultrasound. Results: The bilateral notch for the gestational age of 11 to 14 weeks was detected at about 6%, for the gestational age of 17 to 24 weeks it was about 4.2% and for the gestational age of 27 to 32 weeks it was about 3.6%. Reference intervals for mean uterine artery PI according to gestational ages, show a significant (p<0.001) difference between different percentages. Also, there is a significant relation between the mean uterine arteries PI/RI and the presence or absence of pregnancy complications (IUGR, premature birth, IUFD) among the participants. Conclusion: The results of this research showed that there is a significant relation between PI and pregnancy complications, while this was not detected in RI and diastolic notch. These results are relatively consistent with the findings of researchers in other countries.
Original Research Article
Obstetrics and Gynecology
Seyed Mojtaba Alavi; Mohammad Hosein Arjmandnia; meysam feizollahjani; enayatollah Noori; Maryam Yousefi
Articles in Press, Accepted Manuscript, Available Online from 12 December 2023
Abstract
Background: Placenta Accreta Spectrum is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean deliveries, which have been increasing without medical indication. This study ...
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Background: Placenta Accreta Spectrum is a condition in pregnant women where trophoblastic tissue attaches abnormally to the uterus myometrium, causing maternal deaths. Major risk factors include placenta previa and cesarean deliveries, which have been increasing without medical indication. This study aims to explore the risk factors of PAS, clinical outcomes, and strategies to minimize maternal morbidity and mortality.
Materials and Methods: A total of 142 women who had undergone at least one cesarean delivery in the past were included in our evaluation. Among them, 85 women had placenta accreta spectrum (PAS) in their current pregnancy (group 1) while the remaining 57 did not have PAS (group 2). We gathered information about their demographics and previous gynecological history, including placenta previa.
Results: The risk of placenta accreta spectrum (PAS) is significantly higher in cases where there has been a previous cesarean delivery or placenta previa (p-value<0.05). There were no significant differences between past elective or emergent CD (p-value>0.05). PAS was associated with more emergent cesarean deliveries (p-value<0.001) and hysterectomies (p-value<0.001). 97% of patients with history of placenta previa developed PAS (p-value<0.001). Most of the patients who underwent hysterectomy had PAS and placenta previa (p-value<0.001). There was no significant correlation found between previous hysteroscopies and curettages and a higher risk of PAS. (p-value>0.05)
Conclusion: Women with previous cesarean delivery are significantly at risk of placenta accreta in their future pregnancies. Pregnant women should avoid insisting on elective cesarean delivery without medical indication. Planned cesarean delivery could reduce the maternal complications
Case Report Article
Obstetrics and Gynecology
Tiarma Uli Pardede; Heronimus Hansen Kaware; Leni Suhartini
Articles in Press, Accepted Manuscript, Available Online from 13 December 2023
Abstract
Background and Objective: Degenerated Uterine Leiomyomas (ULs) is one of the most common complications of UL in pregnancy and may cause severe maternal symptoms. In this study we present the rare case of UL permagna with cystic degeneration managed with Caesarean Section (CS) and Myomectomy with uterus ...
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Background and Objective: Degenerated Uterine Leiomyomas (ULs) is one of the most common complications of UL in pregnancy and may cause severe maternal symptoms. In this study we present the rare case of UL permagna with cystic degeneration managed with Caesarean Section (CS) and Myomectomy with uterus preservation.
Methods: A 37-year-old primigravid woman was referred to the clinic with the chief complaint of huge abdominal mass that coincides with the pregnancy. Physical examination showed that the abdomen was overdistended and upon palpation a mass at processus xiphoideus height was felt. Ultrasound examination showed that the foetus had IUGR (Estimated Fetal Weight below the 10th precentile of the fetal growth curve with oligohidramnion) and also a cystic mass with a clear border. The patient was diagnosed with cystic degeneration of UL premagna and IUGR. The first-line management given was CS and myomectomy as an effort to maintain the uterus because this is a case of pregnancy with 15 years primary infertility.
Result: The overall outcome was satisfactory. The neonate came out alive, Ballard score equivalent to 32 weeks, and weighing around 1480g. The degenerated UL was successfully extracted. The patient was discharged 4 days post-operatively. The baby was treated in the NICU for prematurity and went home after the baby's weight reached 1800 grams.
Conclusion : Degenerated UL permagna in pregnancy is a very rare and serious condition. It needs to be studied further as there are no global consensus on how to manage the case.
Original Research Article
Obstetrics and Gynecology
Aida Mohamadi; Mahsa Ghajarzadeh; Fatemeh Davari Tanha; Amirreza Azimi
Articles in Press, Accepted Manuscript, Available Online from 21 December 2023
Abstract
Background: Women with multiple sclerosis (MS) suffer from a wide range of complications. The goal of this study was to compare sexual dysfunction (SD), depression, and sexual quality of life in women with MS with these problems in women without MS.
Methods: Fifty-four women with MS and 108 women without ...
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Background: Women with multiple sclerosis (MS) suffer from a wide range of complications. The goal of this study was to compare sexual dysfunction (SD), depression, and sexual quality of life in women with MS with these problems in women without MS.
Methods: Fifty-four women with MS and 108 women without MS were enrolled. All participants were asked to fill valid and reliable versions of BDI (Beck Depression Inventory), FSFI (Female Sexual Function Index), and SQOL (sexual quality of life) questionnaires.
Results: Mean scores for BDI, SQOL, and orgasm and satisfaction domains of FSFI were significantly different between case and control groups. Sexual quality of life (SQOL) had a significant positive correlation with FSFI (r=0.568, p<0.001) and a significant negative correlation with BDI scores (r=-0.528, p<0.001). A significant negative correlation was also found between FSFI and BDI scores (r=-0.325, p<0.001). According to the total FSFI cut-off point, 53.7% of cases and 44.4% of controls had SD (p=0.168).
Considering SQOL as a dependent variable and age, education level, marriage duration, husband’s age, and BDI and FSFI scores as independent variables, linear regression analysis showed that education level, BDI score, and FSFI score were independent predictors of SQOL in all participants, while among MS patients, only BDI and FSFI were significant predictors of SQOL.
Conclusion: Sexual quality of life and sexual function should be considered in women with MS, and depression should be assessed and treated as a possible risk factor.
Original Research Article
Obstetrics and Gynecology
shereef elshwaikh; Ahmed Ossman; muhammad el-masry; ahmed swelam; yasmin elmasry
Articles in Press, Accepted Manuscript, Available Online from 24 December 2023
Abstract
Aim: To evaluate changes in serum AMH levels, fertility and metabolic conditions in reproductive-age severely obese women, after bariatric surgery.
Design: prospective cohort study.
Methods: This study had been conducted on marked obese women who were referred to BS in Tanta university hospital. the ...
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Aim: To evaluate changes in serum AMH levels, fertility and metabolic conditions in reproductive-age severely obese women, after bariatric surgery.
Design: prospective cohort study.
Methods: This study had been conducted on marked obese women who were referred to BS in Tanta university hospital. the AMH and other hormones (FSH- LH- free Testosterone- SHBG- fasting Insulin) levels had been measured as part of their evaluation will be reviewed before and after (6) months the surgery. The involved women were in reproductive age between 18 and 40 years old. With BMI > 36 kg/m2 and < 42 kg/m2.
Results: From 64 female who had been enrolled, 50 patients only completed the 6 months follow up , and it was found there was a significant difference as regard the weight and the BMI , fasting insulin level and regular menstrual pattern after 6 month follow but other fertility factors including were improved but had no significant difference .
Also 20 cases (40%) had a spontaneous ovulation after 6 moth follow up after BS , and by comparing them to those who had no spontaneous ovulation ,there was a significant effect on weight reduction on occurrence of spontaneous ovulation , BMI parameter, and the level of change of BMI, regular menstrual cycle, while the other fertility related parameters although improved but failed to show any significant relationship .
Conclusion: BS and reduction of the weight had a positive effect on the reproductive performance of obese female.
Original Research Article
Maternal Fetal Medicine
Shalan HB Al-Mayoofee; Nabiha Missaoui; Sihem Hmissa; Ali Esmail Al-Snafi
Articles in Press, Accepted Manuscript, Available Online from 08 January 2024
Abstract
Background & Objective: Polycystic ovary syndrome (PCOS) is a common disease in women of childbearing age. The inflammation has participated in the metabolic disorders and irregular menstruation associated with this disease. This study was carried out to correlate between the disturbance of pro-inflammatory ...
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Background & Objective: Polycystic ovary syndrome (PCOS) is a common disease in women of childbearing age. The inflammation has participated in the metabolic disorders and irregular menstruation associated with this disease. This study was carried out to correlate between the disturbance of pro-inflammatory markers resistin, adiponectin and metabolic parameters in women with PCOS.Materials & Methods: Fasting blood samples were collected from 100 PCO married infertile women (23.30±4.659 years) attending Bint AL-Hoda and Al-Shatra hospitals in Thi- Qar province - Iraq, in addition to 50 healthy age matched (23.84±4.804 years) control, through the period from June 2022 to December 2022.Results: The BMI of PCO patients (27.22±7.20) was significantly (<0.001) more that BMI of the healthy control (22.84±4.63). PCO patients showed significantly elevation of serum levels of resistin (470.00±114.00 vs 350.00±90.60 ng/l, P<0.01 (and significant decline of adiponectin (5.13±1.22 vs 11.00±1.40 mg/l, P<0.001) in comparison with healthy control. PCO patients also showed significant elevation of the serum glucose (P<0.01), total cholesterol (P<0.05), triglycerides (P<0.001) and LDL (P<0.001). However, serum HDL level was insignificant declined and VLDL was insignificantly elevated in PCO group compared with healthy control group.Conclusion: Adiponectin and resistin represented part of the pathophysiology of PCO, and may serve as beneficial indicator in the diagnosis and treatment.
Original Research Article
Gynecology Oncology
Zahraa Al-Tamimi; Mahmood A. Al Ani
Articles in Press, Accepted Manuscript, Available Online from 11 January 2024
Abstract
Background: Asymptomatic bacteruria is a form of lower urinary tract infections (UTIs) that is significant during pregnancy for its high prevalence, high tendendency for persistence and progression to the other symptomatic forms, besides posing adverse effects on pregnancy through effects on both maternal ...
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Background: Asymptomatic bacteruria is a form of lower urinary tract infections (UTIs) that is significant during pregnancy for its high prevalence, high tendendency for persistence and progression to the other symptomatic forms, besides posing adverse effects on pregnancy through effects on both maternal and fetal morbidity. In this respect, Cranberry has been suggested in the prevention and sometimes treatment with a big conflict in results and recommendations.
Materials & Methods: In our study we tried to search its role in treatment and prevention using capsules rather than juices (the most common form in previous studies) and comparing results of its use alone versus combined with antibiotics on the outcome.
Results: Results showed that it is less effective than antibiotics in the treatment ( 56% versus 88% cure rate) (X2: 6.3492; df=l; P value =0.01174), closely effective to them in prevention (26.7% recurrence on cranberry versus 12.5% on antibiotic) (X2:0.9954;P value=0.3184), but reducing the cure rate when used in combination with antibiotics in treatment versus antibiotics alone ( 28.6% versus 57.1% response) (X2=1.1667; P value = 0.2801). Regarding the most commonly reported side effects: headache was supervening consistent with reports in previous studies, whereas gastrointestinal upset commonly experienced in cranberry juice was reported in only (8%) of study cases.
Conclusion: In view of results we recommend using cranberry especially in what seems to be less harmful formulation (capsules) in the prevention of asymptomatic bacteruria in pregnant population and discourage using it in the treatment whether alone or in combination with antibiotics.
Original Research Article
Radiology
Mohammad Babaei; Peiman Haddad; Behnood Farazmand; Mehdi Aghili; Ramin Jaberi; Farnaz Amoozgar Hashemi; Bita Kalaghchi; Hassan Ali Nedayi; Morteza Tabatabaeifar; Seyed Rabi Mahdavi; Reza Khodabakhshi; Alireza Naseri; Fatemeh Homayi; Mojtaba Vand Rajabpour
Articles in Press, Accepted Manuscript, Available Online from 11 January 2024
Abstract
Background & Objective: Considering the heterogeneity in the brachytherapy treatment process for cervical cancer in Iran, the Radiation Oncology Research Center of Tehran University of Medical Sciences) developed a guideline on brachytherapy for the treatment of patients with cervical cancer in cooperation ...
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Background & Objective: Considering the heterogeneity in the brachytherapy treatment process for cervical cancer in Iran, the Radiation Oncology Research Center of Tehran University of Medical Sciences) developed a guideline on brachytherapy for the treatment of patients with cervical cancer in cooperation with the Atomic Energy Organization of Iran, Cancer Research Institute, Iranian Society of Radiation Oncology, Iranian Association of Medical Physics, and Cancer Administration of the Ministry of Health and Medical Education.
Methods and Materials: This study was designed with the aim to provide a standard protocol of brachytherapy for the treatment of cervical cancer by the Iranian Brachytherapy Society at Radiation Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran in 2020.
Results: These guidelines, which address the principles and details of brachytherapy for cervical cancer, were localized and developed based on the references listed in the supporting document. This document was mainly developed based on a localized version of the American Brachytherapy Society (ABS) guidelines.
Conclusion: Brachytherapy should be introduced as a necessary part of the treatment plan in patients with cervical cancers. Here, we provided a comprehensive guideline for the treatment of cervical cancer radiotherapy using high-dose-rate brachytherapy which can help medical service providers involved in the treatment of cervical cancer to provide better services to cervical cancer patients and decrease the existing heterogeneity in radiotherapy approaches in Iran.
Original Research Article
Obstetrics and Gynecology
Dina Hyari; Duha Arabiat; Ayman A. Qatawneh; Murad Rabadi; Katea Albawalsah; Rula Barham; Layan Budair; Omar Ahmed Abdelwahab
Articles in Press, Accepted Manuscript, Available Online from 17 January 2024
Abstract
Background: Menstrual irregularities after COVID-19 vaccines have been widely reported. This study aims to evaluate Jordanian women's menstrual changes after receiving the COVID-19 vaccine.
Methods: This study is an analytical cross-sectional study conducted through an online self-administered questionnaire ...
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Background: Menstrual irregularities after COVID-19 vaccines have been widely reported. This study aims to evaluate Jordanian women's menstrual changes after receiving the COVID-19 vaccine.
Methods: This study is an analytical cross-sectional study conducted through an online self-administered questionnaire distributed through social media during June and July 2022. It involved 384 women between the ages of 20 and 35 who took the vaccine and did not suffer from gynaecological or medical conditions that affect menstruation, were not pregnant or lactating, were not utilising hormonal or intrauterine contraceptives, and had normal menstrual cycle length and regularity prior to vaccination.
Results: The results of this study showed a statistically significant increase in menstrual cycle length with a mean difference of 2 days (p=<0.001), but not in menstrual duration (p=0.824). 55.4% had their first period after vaccination on time. Eight participants reported new-onset intermenstrual bleeding. Additionally, 41.3% experienced changes in menstrual volume, and their first period came on time. Around one-third of women reported increased or new-onset dysmenorrhea. As for premenstrual symptoms, 30% reported increased or new-onset mood disturbances, 20.6% had changes in their sleeping patterns, 17% had increased headaches.
Conclusion: The study revealed that COVID-19 vaccination might cause changes in menstrual cycle length and new or increased menstruation problems in some women, including dysmenorrhea, premenstrual symptoms, and intermenstrual bleeding. These results emphasize the need for additional longitudinal research to understand the effect of COVID-19 vaccination on menstrual health and to provide support and education to women who experience menstrual abnormalities after vaccination.
Original Research Article
General Gynecology and Pelvic Floor
Hadeer Mahmoud Hazem; Baydaa Hussein abed awn
Articles in Press, Accepted Manuscript, Available Online from 22 January 2024
Abstract
Background & Objective: This study's main objective was to establish physical characteristics (pH and flow rate) and dental caries experience among women with PCOS and to perform an assessment of dental caries relationship to salivary antioxidant biomarker (total antioxidant capacity and uric acid).Materials ...
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Background & Objective: This study's main objective was to establish physical characteristics (pH and flow rate) and dental caries experience among women with PCOS and to perform an assessment of dental caries relationship to salivary antioxidant biomarker (total antioxidant capacity and uric acid).Materials and Methods: There was 80 women in the study (40 female with PCOS and 40 healthy female served as controls) with ages ranging from 25 to 30 years and with a range of body mass indices 18.5-24.9 (normal weight). Unstimulated saliva was obtained. Both salivary pH and flow rate were discovered immediately. After that, saliva was subjected to biochemical analysis to determine salivary TAC and UA levels using ELISA method. Dental caries diagnosis and registration were assessed using WHO in 2013.Results: In the PCOS group, the mean salivary flow rate and pH were lower than in the control group, with a statistically significant difference (P<0.05). The salivary (TAC) and (UA) mean values were higher in the PCOS group than in the healthy females, with a statistically significant difference (P<0.05). while dental caries fractions was positively not significant correlated with total antioxidant capacity and uric acid in the study group except (DMFT) was positively significant correlated with antioxidant Parameter (TAC) (P< 0.05 ) and (DS and DMFT) were positively significant with uric acid among women with PCOS (P< 0.05).Conclusions: Furthermore, Salivary TAC and UA were elevated in PCOS which can be used in the future as indicators for the PCOS diagnosis.
Systematic Review Article
Obstetrics and Gynecology
KAVITHA NAGANDLA; Keeran Rajandram; Khaisro Ali Shah; Kathy Anne Rani A/P Arulraj; Lee Huang Ming; Joanne Wong Mei Jye
Articles in Press, Accepted Manuscript, Available Online from 23 January 2024
Abstract
Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant ...
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Background & Objective: The COVID-19 pandemic has caused significant disruptions to healthcare systems worldwide, leading to changes in healthcare practices, including perinatal care delivery. As pregnant women are considered a vulnerable population, perinatal mental health has become a significant concern during the pandemic. This systematic review aims to synthesise the current scientific evidence on the impact of the COVID-19 pandemic on perinatal mental health and its associated risk factors.
Materials & Methods: The review used a structured process based on JBI and PICOS strategy and searched three databases for studies published between July 2020 to December 2022 that measured specific mental health outcomes using validated measures. The PRISMA guideline was followed for the study selection process.
Results: Among the total 45 articles that have been included, the prevalence of depression and anxiety was found to be moderate to severe in pregnant and/or postpartum women during the pandemic, with a significantly higher level compared to prior to the pandemic. Additionally, pregnant and/or postpartum who tested positive for COVID-19 were more vulnerable to anxiety and depression. Furthermore, perinatal women with pre-existing mental illness showed further deterioration during the pandemic, and lastly, pregnant and/or postpartum women had higher levels of anxiety and depression compared to non-pregnant women.
Conclusions: This systematic review finds a significant increase in depression and anxiety among pregnant women during the COVID-19 pandemic, with risk factors such as unemployment and poor social support. Healthcare professionals should establish treatment plans to prevent adverse mental outcomes for this vulnerable population.
Editorial Arcitle
General Gynecology and Pelvic Floor
Zainab Abdulrazzaq Hameed; Abdul Karim salem Mahood; Zainab Abbas Hassooni
Articles in Press, Accepted Manuscript, Available Online from 30 January 2024
Abstract
Endometrial carcinoma (EC) is one of commonest ten cancers, and represents fourth most widespread malignancy in females, it mainly happen in postmenopausal women. Endometrial cancer creates from the endometrium and is classified, depend on the development mechanism, into kinds 1 and 2, which are responsive ...
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Endometrial carcinoma (EC) is one of commonest ten cancers, and represents fourth most widespread malignancy in females, it mainly happen in postmenopausal women. Endometrial cancer creates from the endometrium and is classified, depend on the development mechanism, into kinds 1 and 2, which are responsive and non-responsive to estrogen, respectively and have significantly diverse gene expression profiles. This study was carried out in Laboratories of the College of Science/ Department of Biology and in a local lab during the period between December 2021 to August 2022. The study of PCR was used to detection HOXA11 expression .We aimed to describe the histological changes of tumors malignant and benign and normal tissues of the endometrial and determine the relationships between HOXA11 expression with the histopathological variables involving, stage, grade, muscle and lymph nodes invasiveness and histological types. results shows the values of HOXA11 expression and a significant difference (P-value>0.001) between patients with endometrial cancer and control group, these results regarding the values means of HOXA11 expression a significant difference (P-value=0.021) between patients with benign tumor and the control and the values means of HOXA11 expression a significantly difference (P-value >0.001) between patients with endometrial cancer and benign tumor.
Original Research Article
Obstetrics and Gynecology
Arti Sharma; Yashika Pehal; Namrata Saxena; Swati Agrawal
Articles in Press, Accepted Manuscript, Available Online from 31 January 2024
Abstract
Background and Objective: Iron deficiency anemia is a major public health problem worldwide. Oral iron intake is preferred, but parenteral administration of iron is necessary under certain circumstances. The objective of the present study is to compare the efficacy and safety of parenteral Iron Sucrose ...
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Background and Objective: Iron deficiency anemia is a major public health problem worldwide. Oral iron intake is preferred, but parenteral administration of iron is necessary under certain circumstances. The objective of the present study is to compare the efficacy and safety of parenteral Iron Sucrose to Ferric Carboxymaltose (FCM) in improving the hematological indices in anemic pregnant women.
Methods: The study was a comparative, observational study conducted at the Department of Obstetrics and Gynecology, SGRR Institute of Health and Medical Sciences, Dehradun from September 2018 to May 2020. The sample size was 120 pregnant women with iron deficiency anemia in each group. One group was treated with intravenous Iron Sucrose and the other group was treated with intravenous FCM. The outcome measures were improvement in hematological parameters and experienced side effects. Data was analyzed by using appropriate statistical tests.
Results: Both groups were comparable in terms of baseline parameters. Hemoglobin rise was rapid in the group treated with FCM (8.7 ± 0.47 g/dl to 11.6 ± 0.77 g/dl) than the iron sucrose (8.24 ± 0.57 g/dl to 10.60 ± 0.87g/dl) group. Rise in serum ferritin and MCV of RBC were also higher in FCM group than the iron sucrose group. Both groups have only mild side effects.
Conclusion: Hence we can conclude from our study that parenteral therapy with iron sucrose and FCM, both can successfully treat iron deficiency anemia in pregnancy but the improvement is faster, safer, and more convenient with the use of FCM than iron sucrose.
Original Research Article
Obstetrics and Gynecology
Malihe Afiat; Nayere Khadem; Behnaz Ansari; Fedyeh Haghollahi; Mohadese Dashtkoohi; Mohammad Sadeq Najafi; Mohammad Dashtkoohi; MirFarbod Hojati Bagheri; Seyede Houra Mousavi Vahed
Articles in Press, Accepted Manuscript, Available Online from 05 February 2024
Abstract
Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact ...
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Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact of enoxaparin, an LMWH, and its outcomes in women with URPL.
Methods: This study presents a single-blinded randomized clinical trial involving 80 women with URPL and no history of thrombophilia. The participants were referred to the Infertility Clinic at Imam Reza Hospital (Milad Center) between March 2018 and February 2019. During the sixth week of gestation, the participants were assigned randomly to two groups. The treatment group (n = 40) received a daily subcutaneous injection of 40 mg of enoxaparin, while the control group (n = 40) received routine pregnancy care. Maternal and neonatal demographic data, pregnancy outcomes, complications, and live birth rates were recorded and subsequently compared between the two groups.
Results: A total of 80 eligible women were enrolled in the study, with equal distribution between the treatment and control groups. There were no significant differences in previous pregnancies or miscarriages between the groups, and the live birth rate was about 85% in both groups. The occurrence of pregnancy complications was significantly higher in the treatment group compared to the control group (38.2% VS. 5.7%; p = 0.021).
Conclusion: Treatment with enoxaparin in women with unexplained recurrent pregnancy loss and no history of thrombophilia did not improve the pregnancy outcome nor decrease pregnancy complications.
Case Report Article
General surgery
Maryam Yousefi; Fariba Yarandi; Elham Shirali; Shahab Rajabzadeh; Pershang Nazemi
Articles in Press, Accepted Manuscript, Available Online from 07 February 2024
Abstract
We reported a 55-year-old woman with a history of recent surgery presented to the emergency room with complaints of erythema and foul-smelling discharge from her surgical incision site. Upon examination in the emergency room, the surgical incision site was promptly opened, thoroughly cleaned with a sizable ...
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We reported a 55-year-old woman with a history of recent surgery presented to the emergency room with complaints of erythema and foul-smelling discharge from her surgical incision site. Upon examination in the emergency room, the surgical incision site was promptly opened, thoroughly cleaned with a sizable amount of sterile normal saline, and evaluated and cultures were sent for microbiological and histological evaluation. The patient was promptly initiated on a combination antibiotic regimen, including ceftazidime, levofloxacin, metronidazole, and vancomycin, under the guidance of the infectious disease team. Fungal mycelium was found in the smear of wound discharge in recent microbiological exam. In response to the suspected fungal infection, fluconasol was promptly added to the treatment regimen to combat the fungal pathogen. According to result of microbiological cultures, non-albicans candida and its resistance to fluconasol, caspofungin was substituted. Patient's condition dramatically improved with the combined treatment of meropenem and caspofungin. The development of necrotizing fasciitis in this patient's case added a critical layer of complexity to an already challenging clinical scenario. The rapid recognition, aggressive surgical intervention, and targeted antimicrobial therapy collectively played a pivotal role in her successful recovery. This case underscores the importance of vigilance in monitoring postoperative patients, particularly those with risk factors, and highlights the need for a multidisciplinary approach in managing this severe soft tissue infection.
Original Research Article
Gynecology Oncology
Aida Uzaya; Syahrul Rauf; Trika Irianta; Firdaus Hamid; John Rambulangi; Abdul Rahman
Articles in Press, Accepted Manuscript, Available Online from 12 February 2024
Abstract
Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: ...
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Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: This study used a cross-sectional design on 81 eligible patients with ovarian neoplasms who were undergoing surgery at the Dr. Wahidin Sudirohusodo Hospital and its networking hospital from October 2021 to June 2022. The ELISA technique was used to measure serum IL-6 from the peripheral vein. In addition, the CA-125 levels, risk of malignancy (RMI) index, and proportion of blood cells were analyzed. Chi-square analysis of the data had been used.
Results: Most of the subjects were presented as malignant ovarian neoplasms (66.7%), followed by benign ovarian neoplasms (33.3%). IL-6 level ≥ 3.75 pg/mL was found in 72.8% of patients. In individuals with epithelial ovarian neoplasms, IL-6 levels did not significantly differ between malignant and benign types (p > 0.05). CA-125 levels, RMI, ascites, and tumor size differed significantly in patients with ovarian epithelial neoplasms between malignant and benign types (p <0.05). Leukocyte levels, hemoglobin levels, platelet levels, age, parity, and age of menarche were not significantly different in epithelial ovarian neoplasm patients between malignant and benign types (p > 0.05).
Conclusion: The preoperative serum IL-6 level cannot be used as a marker of ovarian malignancy. However, this study confirms the relationship between the CA-125 level, RMI, ascites, and tumor size with the malignancy of ovarian tumors.
Original Research Article
Obstetrics and Gynecology
Salma Samy Abdellateef; Safaa Kamal Marei; Nagwa Mahmoud Elghorab; Hesham Gaber Al-Anany
Articles in Press, Accepted Manuscript, Available Online from 21 February 2024
Abstract
Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection ...
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Background and Objective: Intrauterine infusion of autologous platelet-rich plasma (PRP) is a novel modality that has a role in the treatment of thin endometrial layer. This study aimed to assess the efficacy of intrauterine infusion of autologous PRP on success rate of intracytoplasmic sperm injection (ICSI) and clinical pregnancy rates in females with history of implantation failure.
Methods: This prospective study was carried out on 109 females aged ˂ 40 y, with FSH level < 10mIU /ML, AMH > 1ng/mL, presented with either primary or secondary infertility and advised for IVF or ICSI after IVF/ICSI failure. Cases was divided in to two groups with history of implantation or previously unsuccessful IVF cycles: 1st group (n=50) did ICSI without PRP injection and 2nd group (n=50) did ICSI with PRP injection.
Results: Endometrial thickness at OR day was insignificantly different between both groups, but at ET day it was significantly elevated in PRP group in comparison with non-PRP group (P<0.001). The two groups were comparable regarding numbers of retrieved oocytes, mature oocytes, and numbers of fertilized ova but without significant differences. The numbers of good quality embryos showed no significant differences in PRP group in comparison with non-PRP group. There was no significant difference regarding numbers of embryos transferred at day of ET in both groups.
Conclusions: PRP is a new procedure of treatment in the field of reproductive medicine with high safety. Although it significantly increased endometrial thickness at day of ET day and consequently it increased the chemical pregnancy rate
Original Research Article
Pathology
maryam deldar; Robab Anbiaee; Masoumeh Keshvari
Articles in Press, Accepted Manuscript, Available Online from 28 February 2024
Abstract
Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: ...
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Background: Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival.
Objectives: This study aimed to investigate the factors affecting the pathological complete response in breast cancer patients treated with NACT.
Methods: We identified non-metastatic breast cancer patients receiving NACT during 2010–2020. Patients’ and disease characteristics, rates of pCR based on these characteristics were recorded in different subgroups. Analyzes were performed by descriptive and analytical statistics using SPSS.ver26.
Results: 204 patients had mean age of 45.3 years, 32.4% had grade 3, and 89.7% had ductal histology. Overall pCR rate was 33.3% and differed according to disease subtype (p<0.001), receptor status (p<0.001), grade (p=0.015), ki-67 (p=0.004), but not according to age, BMI, menopausal status, tumor size, surgery type after NACT.
Conclusion: In our study, pCR rates are conformed with other studies. Many patients have residual disease following NACT that suggests lower survival or higher risk of recurrence, therefore determining the factors affecting the pathological complete response can help physicians in treatment decisions.
Original Research Article
Gynecology Oncology
Fatemeh Sedaghat; zahra Shiravani; Ali Mohammad Karimi; Mohammad Reza Haghshenas; Abbas Ghaderi; Mohammad Javad Fattahi
Articles in Press, Accepted Manuscript, Available Online from 02 March 2024
Abstract
Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial ...
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Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial cancer patients. We also investigated the correlations between serum levels of IL-27 and the demographic and clinicopathologic features of the patients.
Material and Method: In this case-control study 65 endometrial cancer patients and 58 sex-age-match healthy controls were investigated. Serum levels of IL-27 in both cases and the control group were assessed by a reliable and specific sandwich enzyme-linked immunosorbent assay (ELISA) kit and results were analyzed with SPSS.
Results: We observed that the serum level of IL-27 in EC patients was dramatically higher than in the control group (P=0.003). Additionally, Higher grades of EC (grade II and III) showed higher IL-27 serum levels compared to the control (P=0.006 and P=0.01 respectively). No significant correlations between serum levels of IL-27 and lymph node involvement, tumor stage, tumor size, and demographic features of the patients were detected.
Conclusion: Our results showed that there is a statistically significant difference between serum levels of IL-27 in EC patients and controls. Therefore, the serum level of IL-27 may exert a role in the pathogenesis of endometrial carcinoma although further studies are needed.
Original Research Article
Gynecology Oncology
Maha Saad Maki; Mohammed S. Ali; Hala Rawi
Articles in Press, Accepted Manuscript, Available Online from 03 March 2024
Abstract
Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed ...
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Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed by ultrasound. On the same day, a serum sample was taken to measure the levels of macrophage inhibitory cytokine-1 and high-sensitivity C-reactive protein using an enzyme-linked immunosorbent assay and particle-enhanced immunoturbidimetric assay, respectively. The study grouped the participants into two categories: control and patient.Result: We conducted a study with 91 pregnant women, out of which 30 had symptoms of threatened miscarriage such as vaginal spotting or bleeding, while the remaining 61 were healthy. In our study, we found that the concentration levels of serum Macrophage inhibitory cytokine-1 varied significantly between the two groups (control and patient groups) with a P-value of 0.005. The mean concentration for the control group was 622.77 ± 15.10, while for the patient group, it was 1860.13 ± 33.60. Additionally, we observed that high-sensitivity c-reactive protein (HS CRP) had a significant correlation with threatened miscarriage, with a P-value of 0.001. The mean concentration for the control group was 7.49 ± 0.89, while for the patient group, it was 16.02 ± 2.11.Conclusion: The results of this study provide valuable insights into the pathophysiology of miscarriage and may pave the way for the development of novel therapeutic interventions to prevent this adverse pregnancy outcome.
Original Research Article
Obstetrics and Gynecology
Yuni Nurwati; Hardinsyah Hardinsyah; Sri Anna Marliyati; Budi Iman Santoso; Dewi Anggraini
Articles in Press, Accepted Manuscript, Available Online from 04 March 2024
Abstract
Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives ...
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Abstract Background and Objective: Nowadays, a simple and reliable screening tool to identify the risk of low birth weight (LBW) infant remains limited, particularly in rural areas where advanced technology is not available. Hence, this study has developed a reliable tool to be simply used by midwives and cadres in detecting risk of LBW. Methods: This study used an analytic quantitative study based on retrospective data of 165 eligible pregnant women collected from a public hospital in Ternate City (2018-2023). Body height, body weight, body mass index (BMI), mid-upper arm circumference (MUAC), nausea and vomiting, gestational age of ANC visit (AV) of the first trimester of pregnancy, as well as marital age, age, occupation, education, parity, and abortion history of pregnant women were used as research variables. Binary logistic regression was applied to develop the model. Results: Body weight, marital age, education, and AV are statistically significant as screening indicators for detecting the risk of LBW infant with Area Under Curve (AUC) is 79.6%.Conclusion: Therefore, the model can be developed as a basis for developing a simple and reliable screening tool in the first trimester to detect the risk of LBW infant that can be implemented by midwives and cadres in rural area
Original Research Article
Obstetrics and Gynecology
Zainab Muayad Essa; Alia Kareem Mohamad AL-Qarawy; Ashwaq Kadhim Mohammed
Articles in Press, Accepted Manuscript, Available Online from 09 March 2024
Abstract
Background: Endocrine disorders like polycystic ovarian syndrome affect reproductive-age women. It causes infertility and has several clinical symptoms. Clomiphene citrate ovulation induction is a first-line treatment. Serum anti-mullerian hormone can indicate positive pregnancy outcomes in women with ...
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Background: Endocrine disorders like polycystic ovarian syndrome affect reproductive-age women. It causes infertility and has several clinical symptoms. Clomiphene citrate ovulation induction is a first-line treatment. Serum anti-mullerian hormone can indicate positive pregnancy outcomes in women with this disease, however this is controversial. Aim of the study:to assess the value of anti-mullerian hormone (AMH) as an anticipator of ovary response to clomiphene citrate in patients with “polycystic ovary syndrome (PCOS). Patients and methods: A cross-sectional study of 50 women diagnosed with Rotterdam-based polycystic ovarian syndrome by two gynaecologists was conducted. The Maternity and Paediatric Teaching Hospital in Diwaniyah Province, Iraq, conducted the study from August 1, 2022, to May 15, 2023, at the obstetrics and gynaecology department. Women with diabetes or hypertension were excluded from the trial. These women sought medical treatment for infertility and received clomiphene citrate to induce ovulation. The findings of hCG urine and blood testing divided women into positive and negative biochemical pregnancy groups. Results: The mean FSH of all recruited women was 5.19±1.14 IU/L, with no significant difference between pregnant and non-pregnant women (p = 0.849). AMH levels were significantly lower in pregnant women compared to non-pregnant women (p< 0.001). The mean AMH was 6.97±2.88 ng/ml for all enrolled women. ROC curve research determined the optimal AMH cutoff value for predicting positive biochemical pregnancy: ≤6.5 ng/ml with 100% sensitivity, 67.7% specificity, and 80.9 % accuracy. Conclusion: Serum anti-mullerian hormone accurately predicts pregnancy success in PCOS women taking clomiphene citrate to induce ovulation.
Original Research Article
Obstetrics and Gynecology
Ashwaq Kadhim Mohammed; Vian Hussam Almansi Alqani; Zainab Muayad Essa
Articles in Press, Accepted Manuscript, Available Online from 09 March 2024
Abstract
Background: An unusual manifestation of prenatal trophoblastic illness is a twin molar pregnancy with a live foetus and a hydatidiform mole. Due to increased ovulation stimulation, this unusual scenario is rising. Most hydatidiform moles are complete with a foetus, while 0.005 to 0.01% of gestations ...
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Background: An unusual manifestation of prenatal trophoblastic illness is a twin molar pregnancy with a live foetus and a hydatidiform mole. Due to increased ovulation stimulation, this unusual scenario is rising. Most hydatidiform moles are complete with a foetus, while 0.005 to 0.01% of gestations have a partial mole. This report examined the clinical appearance and outcome of live foetuses with molar pregnancies. Methods: This study was done at Adiwaniyah, where the Maternity and Pediatrics Teaching Hospital has one obstetrics centre. The researcher reviewed 20 years of obstetric reports and found 12 cases of hydatiform mole pregnancies with ultrasound reports and/or post-partum examination of the product of gestation indicating twin pregnancy with a single viable foetus. Results: The average age was 27.00 ±6.87 years, with a range of 18-37 years. The parity breakdown was 8 (66.7%) primiparous and 4 (33.3%) multiparous. The average gestational age upon diagnosis was 19.50 ±3.09 weeks, ranging from 15 to 25 weeks. The average gestational age at delivery commencement was 26.67 ±7.09 weeks, with a range of 17-35 weeks. Seven (58.3%) amniocentesis were normal. Maternal complications included bleeding, anemia, blood transfusion, threatening miscarriage, and pre-eclampsia. End-of-gestation outcomes comprised 5 (41.7%) living and healthy newborns and 3 (25.0%) dead babies. There were 5 (41.7%) men and 2 (16.7%) women. Also reported: miscarriage, premature labour, and caesarean sections. Conclusion: Twin pregnancy with a live viable foetus and a molar pregnancy is rare, hence early detection and care are crucial to prevent difficulties for the mother and foetus.
Case Report Article
Gynecology Oncology
elham sharafkhani
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. ...
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Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. Fertility may be affected depending on the cancer stage. In advanced stages (3 and 4), removing all tumoral implants with both the uterus and ovaries (debulking surgery) may be the first surgical goal, and it can be anticipated that the possibility of pregnancy will be diminished. We presented a case of a 38-year-old woman who became pregnant three years after being diagnosed with LGSOC at stage 3c. Although the standard surgery at a higher stage is debulking surgery and we resected all tumoral implants, the decision was made to preserve the uterus for her since there were no signs of tumor metastasis to the uterus, and the patient wanted to be pregnant. The patient underwent surgery then followed by a standard chemotherapy regimen with carboplatin (AUC 6) and paclitaxel (175 mg/m2) every three weeks for four cycles. During the three years of follow-up, there were no signs of tumor return; she decided to get pregnant by egg donation through an in vitro fertilization (IVF) procedure. She received routine supplements during her pregnancy with the incidence of gestational diabetes and HTN. A cesarean section was done in the week 35th, and the twin infants were born in good condition and with good APGAR scores.
Systematic Review Article
Gynecology Oncology
Kavitha Nagandla; Khine Khine Lwin; Phyu Synn Oo; Thin Thin Win; Afshan Sumera
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched ...
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Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched the literature and extracted data from all studies that examined the efficacy and safety of platinum and taxanes in managing cervical cancer during pregnancy. A quantitative synthesis of the published articles was performed and Kaplan–Meier survival curves were estimated to determine the overall and progression-free survival.
Results: Overall, 43 studies with 114 patients were included in this systematic review. All patients received neoadjuvant chemotherapy during pregnancy; the majority received platinum-based chemotherapy. Cisplatin was the main platinum-based chemotherapy agent in 49% (n = 56) of patients, followed by combined platinum and paclitaxel therapy in 36% (n = 41) of patients. A few and two patients were treated with single-agent vincristine and platinum with external beam radiation therapy, respectively. Bleomycin and 5-fluorouracil were administered to two patients. The most frequent complications were grade 2 thrombocytopenia and grade 3 hepatotoxicity in 32 (28%) and 18(20.5%) cases, respectively. The common fetal complications were low birth weight and growth restriction. Chemotherapy was well tolerated by most women in the case group. The progression-free survival was 35% (n = 22).
Conclusion: Platinum and taxane neoadjuvant chemotherapy has proven to be safe and effective in preventing cervical cancer disease progression until definitive surgical treatment.
Case Report Article
Obstetrics and Gynecology
Francesco Fedele; Giovanna Esposito; Fabio Parazzini
Articles in Press, Accepted Manuscript, Available Online from 24 March 2024
Abstract
We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine ...
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We report the association between situs viscerum inversus and complete cervicovaginal agenesis. Situs viscerum inversus, a rare anomaly, is characterized by a mirror-image of the visceral organs. Cervicovaginal atresia is a rare variety of Müllerian duct aplasia, characterized by a functioning uterine body (normal or malformed) with the constant absence of the cervix and the total or partial absence of the vagina.
We describe a case of a 17-year-old female patient. During hospitalization at out gynecologycal department, a complete digestive tract x-ray resulted in a depiction of severe congenital intestinal malrotation. An initial gynecological misdiagnosis led to two an inadequate and unsuccessful attempts of conservative surgery before reaching our academic center. Despite a finally complete diagnosis and adequate conservative surgery, the results of previous surgeries have resulted in a failure of conservative therapy and the need for demolitive surgery. Knowledge of this malformative association is crucial for planning interventional procedures.
Original Research Article
Obstetrics and Gynecology
Anak Agung Ngurah Jaya Kusuma; Endang Sri Widiyanti; I Gede Mega Putra; Kadek Ary Widayana; William Alexander Setiawan
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics ...
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Background and Objective: Pre-eclampsia is one of the pregnancy complications that can result in maternal and neonatal morbidity and mortality. Magnesium sulfate (MgSO4) is one of the effective drugs to prevent and stop seizures in pre-eclampsia and eclampsia. This study aimed to investigate the characteristics of patients with pre-eclampsia and eclampsia and serum magnesium levels during MgSO4 therapy.
Methods: A cross-sectional study design used secondary data from the Emergency Maternity Room of Prof. Dr. I.G.N.G. Ngoerah Hospital. The samples were all superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia cases in 2019. We collected and analyzed characteristic and laboratory data, including the MgSO4 serum levels of the patients. Participants' baseline characteristics (CBC, blood chemistry, and MgSO4) and their diagnosis were compared using the chi-square test for categorical data and the independent t-test for numerical data.
Results: The patients with severe pre-eclampsia were 183 patients, superimposed pre-eclampsia were 41 patients, and eclampsia 15 patients. Age <35 years old was the most influential characteristic variable in superimposed pre-eclampsia (adjusted odds ratio (aOR)=0.166, p<0,001, 95%CI=0.082-0.336) and severe pre-eclampsia (aOR=3.011, p<0,001, 95%CI=1.662-5.455). Hospital referrals were the most influential characteristic variable in eclampsia (aOR=3.653, p=0.016, 95%CI=1.273-10.486). The administration of MgSO4 was significant with severe pre-eclampsia (p<0.001). The highest serum magnesium occurred 6 hours before MgSO4 administration (3.97 ± 1.28 mg/dL).
Conclusion: Patients with superimposed pre-eclampsia, severe pre-eclampsia, and eclampsia conditions have various characteristics associated with each state. During the use of MgSO4, there was a significant association between serum magnesium levels and the therapeutic target levels.
Original Research Article
Gynecology Oncology
Ganesalingam Murali; CheeMeng Yong; Nagandla Kavitha; Chew Hua Yeoh
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological ...
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Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological cancers over 8 years from January 2011 to 31 December 2019 that were identified through hospital databases. Patient demographic characteristics, indications, surgical characteristics and outcomes were retrospectively assessed. Overall survival (OS) was analysed with Kaplan-Meier method and log rank test. Cox proportional hazards regression was used to model survival outcomes. Twenty- one patients were identified with recurrent cervical, endometrial, ovarian and, or vaginal cancer underwent PE. Local disease recurrence was the most common indication in 80.9%. The primary tumor origin was the cervix in 80.9%, followed by endometrial origin 9.5%. PE was performed as curative intent in 62% and in 38% as palliative intent. The most common early complication was wound infections and late complications included deep vein thrombosis, lymphocyst and recurrent urinary tract infections. The median survival at 6 months is 85.7% and 12 months is 57.1 %. Our five-year OS was 54.3 % (95% CI 34.2, 74.6). Our case series illustrates pelvic exenteration provides about 54.3% of 5-year survival chance in a selected group of patients. The early-and late complications rate are similar to those described historically. Pelvic exenteration results in sustained survival in selected patients and continued efforts must focus on identifying those patients who could potentially benefit most from PE.
Systematic Review Article
Reproductive Medicine
Achmad Kemal Harzif; Mila Maidarti; Costan Tryono Parulian Rumapea; Sarah Miriam Ratna Pratamasari; Heidi Dewi Mutia; Nafi’atul Ummah; Aisyah Retno Puspawardani; Putri Nurbaeti; Budi Wiweko
Articles in Press, Accepted Manuscript, Available Online from 06 April 2024
Abstract
Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. ...
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Abstract:
Background and Objective: Endometriosis is one of the primary etiology of subfertility in women; in severe cases, endometriosis surgery could result in infertility due to oophorectomy. Ovarian tissue cryopreservation is a method by which the ovarian cortex is frozen and retransplanted in patients. This method is unaffected by the menstrual cycle, can restore ovarian hormonal function, and does not require sperm donor or ovulation induction. This systematic review aims to review the utility of ovarian tissue cryopreservation in endometriosis patients.
Methods: We searched the literature using keywords such as “fertility preservation,” “cryopreservation,” “endometriosis,” and “ovarian tissue cryopreservation” for relevant articles in Pubmed and Embase. We included all relevant articles, including case reports, cohort studies, and clinical trials.
Results: A total of 6 articles were included in this systematic review, including three retrospective studies and three case reports. In screening for candidates of ovarian tissue cryopreservation, serum antimullerian hormone (AMH) is a good marker for primordial follicle count. Patients undergoing ovarian tissue implantation after cryopreservation demonstrated an excellent pregnancy rate (41.2%) in one study. Follicle viability and hormonal function were preserved post-transplantation.
Conclusion: The current evidence shows that endocrine function and fertility in patients grafted with cryopreserved ovarian tissue are good. However, the evidence on the long-term outcome of ovarian tissue cryopreservation in endometriosis patients is lacking.
Original Research Article
General surgery
Ruqayah Ali Salman; Aiyat Alshugary
Articles in Press, Accepted Manuscript, Available Online from 12 April 2024
Abstract
Background & Objective: In 2020, breast cancer claimed the lives of approximately 684,996 women worldwide. The use of cancer biomarkers has greatly improved the effectiveness of treatment and early detection. The objective of this study was to identify testin as a potential biomarker.Materials & ...
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Background & Objective: In 2020, breast cancer claimed the lives of approximately 684,996 women worldwide. The use of cancer biomarkers has greatly improved the effectiveness of treatment and early detection. The objective of this study was to identify testin as a potential biomarker.Materials & Methods: Sixteen women participated by providing serum samples for measuring testin concentrations in Iraqi breast cancer patients. Additionally, a control group of 20 healthy individuals was selected. The testin protein concentration was detected using the serum ELISA method.Results: A significant difference was observed between the age groups of patients and healthy women. The majority of women with breast cancer were recorded to be in their thirties to sixties, with 16 (26.7%), 21 (35%), and 19 (31.7%) cases respectively. On the other hand, there were fewer breast cancer cases recorded in the twenties, with only 1 (1.7%) case out of the total study population of 60 (100%). This difference was found to be statistically significant, with a P-value of 0.01.Conclusion: The present study discovered that breast cancer patients have higher levels of testin compared to healthy women. There is a growing body of evidence suggesting that testin contributes to the development of breast cancer, making it an appealing protein to focus on for cancer treatment.
Original Research Article
Gynecology Oncology
Mervet B. Jasim; Asmaa B. Al-Obaidi; Enas Adnan Abdulrasul
Articles in Press, Accepted Manuscript, Available Online from 12 April 2024
Abstract
Background: The infection can present in newborns in different ways, ranging from no noticeable symptoms to more serious conditions like meningoencephalitis, myocarditis, and disseminated sepsis.Methods: A cross-sectional study was conducted from November 2022 to June 2023. The study included 100 pregnant ...
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Background: The infection can present in newborns in different ways, ranging from no noticeable symptoms to more serious conditions like meningoencephalitis, myocarditis, and disseminated sepsis.Methods: A cross-sectional study was conducted from November 2022 to June 2023. The study included 100 pregnant women with gestational ages ranging from 0 to 16 weeks, aged between 15 and 40 years. Each participant completed a standardized questionnaire. Afterward, placental tissue samples were collected from women who underwent elective termination of pregnancy. These samples were then analyzed for the presence of Coxsackievirus B (CVB) genome using a molecular biology approach. The detection process involved RNA extraction, cDNA, and qRT-PCR.Results: A total of 100 women who had abortions were included in this study. Out of these, 88 had missed abortions, 10 had incomplete abortions, and 2 had spontaneous abortions. The mean ages of the women were as follows: 28±2.8 years for missed abortions, 29±1.5 years for incomplete abortions, and 32±0.5 years for spontaneous abortions. The mean gestational ages were 10±1.1 weeks for missed abortions, 10±1.5 weeks for incomplete abortions, and 14 weeks for spontaneous abortions. Our investigation found no presence of Coxsackie B virus nucleic acid in the placental tissues obtained from the women who had abortions. The internal control (quality control) and positive control both yielded positive results.Conclusion: Despite the assay's high sensitivity for accurate detection, the study produced only null findings. These negative results are likely to be true negatives, indicating the absence of the target analyte.
Original Research Article
Gynecology Oncology
Ali D. Marhash; Mohammed S. Abdul-Razaq; Milal Muhammad AL-Jeborry; Wisam Jasim; Safa Khaleel khalaf
Articles in Press, Accepted Manuscript, Available Online from 13 April 2024
Abstract
Background and objective: Worldwide, cervical cancer stands as the leading cause of cancer-related fatalities. Cervical cancer is unequivocally attributed to the human papillomavirus (HPV) infection, which is both essential and adequate for its development. The particular prevalence of HPV in the population ...
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Background and objective: Worldwide, cervical cancer stands as the leading cause of cancer-related fatalities. Cervical cancer is unequivocally attributed to the human papillomavirus (HPV) infection, which is both essential and adequate for its development. The particular prevalence of HPV in the population of Iraq is currently unclear. The objective of this study is to determine the frequency of HPV and identify the most common genotypes present in a sample of the Iraqi population. Materials and Methods: From November 2022 to December 2023, a total of 300 women with cervical anomalies, who were referred to the Gynecological Oncology Departments in multiple hospitals in Babylon and Baghdad, had cervical swabs collected. Real-time polymerase chain reaction was utilized to conduct HPV DNA testing on all specimens.Result: A total of 300 women between the ages of 20 and 60 were screened during the collecting period. The average age was 30 years. The prevalence of High-risk HPV was 16.7% overall. The age group of women between 30 and 40 years exhibited the highest overall prevalence of HPV. Our population survey indicates a higher prevalence of genotyping for HPV 16, 18, and 31.Conclusion: In this work, we used multiplex real-time pcr. This approach has numerous advantages, including HPV detection and genotyping to known prevalent genotypes as well as cost effective and no time consuming.
