Mina Jafarabadi; Fatemeh Ramezanzadeh; Samarand Salimi; Tahereh Forooghifar
Volume 2, Issue 1 , March and April 2017
Abstract
Background: Both in-vitro maturation and in-vitro fertilization have been used successfully to treat females with polycystic ovarian syndrome, who plan to have child. This study compared outcome of these two approaches to fertilize females with polycystic ovary side effects.
Methods: This prospective ...
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Background: Both in-vitro maturation and in-vitro fertilization have been used successfully to treat females with polycystic ovarian syndrome, who plan to have child. This study compared outcome of these two approaches to fertilize females with polycystic ovary side effects.
Methods: This prospective study was conducted at Vali-Asr reproductive health research center and included all females with polycystic ovarian syndrome, who underwent in-vitro maturation or in-vitro fertilization from January 2005 to January 2008. Measurements included demographic data, total cost (including drug and laboratory procedures), outcome (chemical and clinical pregnancy), and systemic complication (ovarian hyper-stimulation syndrome), obtained from the patients’ clinical files. Patients were informed about the procedures, side effects and goals, and the signed consent form for surgical approaches and use of their data in medical research. Finally, these variables were compared between the two groups.
Results: The in-vitro maturation and in-vitro fertilization groups included 20 and 22 patients, respectively. The range of body mass index was between 17.4 and 28.3 kg/m2 and the mean age of the patients was 29.35 ± 4.94 and 28.95 ± 3.84 years, respectively (P > 0.05). The total cost was significantly lower in in-vitro maturation group compared to in-vitro fertilization (201.6 ± 60.1 USD versus 380.5 ± 143.8 USD, respectively, P < 0.001). Positive outcomes were achieved significantly more frequently with the in-vitro fertilization method (1 chemical and no clinical pregnancy in in-vitro maturation versus 7 and 6 in in-vitro fertilization group, respectively, P < 0.001). Although, the rate of ovarian hyper-stimulation syndrome was higher in in-vitro fertilization than in in-vitro maturation approach, yet, it was not statistically significant (P = 0.233).
Conclusions: Our findings showed the superiority of execution of the in-vitro fertilization approach compared with the in-vitro maturation method in infertile females with polycystic ovary syndrome, who planned to have a child. However, in-vitro maturation approach is cheaper than in-vitro fertilization and is also associated with lower risk of ovarian hyper-stimulation syndrome.
Zinat Ghanbari; Tahereh Foroughifar; Jayran Zebardast; Samrand Salimi; Saman Tootoonchi; Sara Shabihkhani; Mahnaz Mokhtari Garakani; Tayebeh Forooghifar
Volume 2, Issue 2 , May and June 2017
Abstract
Background: It seems that some herbal medicines such as sage or vitagnus traditionally used as treatment agents are effective on menopausal symptoms such as hot flashes; therefore, the current study aimed at assessing the effect of vitagnus on menopausal symptoms.
Methods: The current study was a ...
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Background: It seems that some herbal medicines such as sage or vitagnus traditionally used as treatment agents are effective on menopausal symptoms such as hot flashes; therefore, the current study aimed at assessing the effect of vitagnus on menopausal symptoms.
Methods: The current study was a prospective clinical trial conducted on 100 menopausal patients divided into 3 groups. In each group, hot flash was treated with vitagnus, sage, or placebo pills and patients were followed-up at the days 15 and 30 after the treat- ment. The data were analyzed by descriptive (percentage, mean, and standard deviation) and inferential (chi-square, t-test, McNa-mara, repeated ANOVA) statistics with SPSS software, version 21 (IBM SPSS, Armonk, NY, USA).
Results: Average of hot flash in vitagnus group was 55.19 ± 14.53; it was also 60.26 ± 14.44 and 60.73 ± 12.30 in the sage and control groups. According to the Cooperman questionnaire score, comparison of hot flash data showed no significant difference between the groups before treatment (the Cooperman questionnaire score < 14) (P = 0.894), (15 - 20) (P = 0.262), (21 - 35) (P = 0.800), (35 < the Cooperman questionnaire score) (P = 0.867). The current study analysis showed no significant difference between the groups in the severity of menopause symptoms at 15-day follow-up (the Cooperman questionnaire score < 14) (P = 0.477), (the Cooperman’s questionnaire score 15 to 20) (P = 0.620), (the Cooperman questionnaire score 21 to 35) (P = 0.243), (35 < the Cooperman questionnaire score) (P = 0.278). But, the severity of menopause symptoms at 30-day follow-up showed significant differences between the groups, except between 15 - 20 and 21 - 35 scores (the Cooperman questionnaire score < 14) (P = 0.306), (15 - 20) (P = 0.005), (21 - 35) (P = 0.007), (35 < the Cooperman questionnaire score) (P = 0.785).
Conclusions: The results of the current study showed that vitagnus and sage were effective on the reduction of menopausal symptoms in postmenopausal females. The effect of placebo on the improvement of menopausal symptoms was significant and it is recommended to be used as an agent to reduce the psychological outcomes of menopause.
Masoumeh Mirteimouri; Seyedeh Azam Pourhoseini; Fahimeh Ghaneie Motlagh
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: HELLP syndrome is a life-threatening complication of preeclampsia. We report a young pregnant woman with HELLP syndrome who was diagnosed, managed, and delivered in a timely manner.
Case Presentation: A 23-year-old second gravida twin pregnant woman was referred to our clinic due to high ...
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Introduction: HELLP syndrome is a life-threatening complication of preeclampsia. We report a young pregnant woman with HELLP syndrome who was diagnosed, managed, and delivered in a timely manner.
Case Presentation: A 23-year-old second gravida twin pregnant woman was referred to our clinic due to high blood pressure. After delivery, she experienced a hemolytic condition with elevated liver enzymes and thrombocytopenia, defined as HELLP syndrome. After confirmation of HELLP syndrome by laboratory tests, the patient underwent hemodialysis and plasmapheresis. 10 days later, she was discharged under good general condition.
Conclusions: Women with a history of HELLP syndrome are considered to have an increased risk of death. Therefore, this life threatening condition should be closely monitored and treated in a timely manner.
Elham Keshavarz; Afarin Sadeghian; Ali Ganjalikhan Hakemi; Fatemeh Talei Khtibi
Volume 2, Issue 4 , November and December 2017, , Pages 1-5
Abstract
Background: Pre-eclampsia complicates 5% to 8% of all pregnancies and annual incidence of pre-eclampsia is about 5% of all pregnancies around the world and is a significant cause of both maternal and fetal mortality and morbidity if left untreated.
Objectives: According to previous studies, blood supply ...
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Background: Pre-eclampsia complicates 5% to 8% of all pregnancies and annual incidence of pre-eclampsia is about 5% of all pregnancies around the world and is a significant cause of both maternal and fetal mortality and morbidity if left untreated.
Objectives: According to previous studies, blood supply distribution within the uterus is not similar in central compared with lateral sites, thus site of implantation and the resulting location of the placenta are likely to have a profound effect on the pregnancy outcome.
Methods: The researchers conducted a case-control study over 1-year period at a referral obstetric hospital in the south of Tehran. Overall, 121 females with three degrees of pre-eclampsia were considered as cases and 258 females with normal pregnancy were the controls. The females were aged 20 to 40 years old and their gestational age was between 14 and 26 weeks.
Results: The researchers recorded the participants’ blood pressures and locations of placenta during this period with consideration of their past and present obstetric history as well as medical and familial history. As a result, pregnancies complicated by pre-eclampsia were more commonly associated with lateral placentation in the second trimester when compared with non-pre eclampsia pregnancies.
Discussion: This study suggests that placental location, which is easily assessed at middle trimester of pregnancy by routine screening ultrasonography, is an ideal predictive test for evaluating the risk of developing pre-eclampsia.
Gynecology Oncology
Tahereh Ashrafganjoei; nooshin amjadi; Robabeh Taheripanah; Hamed talayeh; maryam Talayeh; Nasim Noorinasab
Articles in Press, Accepted Manuscript, Available Online from 26 April 2024
Abstract
Introduction: The administration of tamoxifen to post-menopausal patients with breast cancer may lead to vaginal bleeding, necessitating a thorough understanding of associated factors. Our objective was to investigate sonographic, hysteroscopic, and pathologic findings in breast cancer patients experiencing ...
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Introduction: The administration of tamoxifen to post-menopausal patients with breast cancer may lead to vaginal bleeding, necessitating a thorough understanding of associated factors. Our objective was to investigate sonographic, hysteroscopic, and pathologic findings in breast cancer patients experiencing vaginal bleeding following tamoxifen use.Methods: In this cross-sectional study, we evaluated women with post-menopausal breast cancer reporting vaginal bleeding while undergoing tamoxifen treatment for more than six months. Data collection involved a checklist encompassing ultrasonographic, hysteroscopic, and pathologic findings.Results: The study included 100 patients with a mean age of 56.2 ± 2.9 years and a mean endometrial thickness of 14.5 ± 3.4 mm. Notably, 25% of the patients exhibited abnormally large uterine size. Ultrasonography revealed polyps and myomas in 36% and 15% of cases, respectively. Positive hysteroscopy findings were observed in 72%, comprising polyps in 36%, hyperplasia in 32%, and atrophy in 4%. Pathological assessment identified abnormal features in 31% as polyps, 34% as hyperplasia, 4% as atrophy, and 5% as cancerous lesions.Conclusion: Patients who received tamoxifen had high endometrial thickness due to endometrial polyp, it seems that clinicians can consider using hysteroscopy with dilation and curettage in these patients.
Gynecology Oncology
Haleh Ayatollahi; Samira Jahangard
Volume 6, Issue 1 , January 2021, , Pages 35-41
Abstract
Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is 11%. In this paper, we reported a case of choriocarcinoma with brain metastasis, ...
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Background: Choriocarcinoma is the most aggressive kind of gestational trophoblastic neoplasia (GTN). Although the risk of brain metastasis in GTN is rare, in patients with choriocarcinoma, the incidence of brain metastasis is 11%. In this paper, we reported a case of choriocarcinoma with brain metastasis, which was successfully treated with an etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine (EMACO) regimen.Case presentation: A 34-year-old woman was presented with vaginal bleeding, dyspnea, and moderate abdominal pain. She had a menstrual delay of about two weeks. She had a primary β-human chorionic gonadotropin (β-hCG) of 132 600 mIU/mL. On lung computed tomography (CT) scan images, a metastatic lesion with a size of 68×50 mm was observed in the lower lobe of the left lung. The patient underwent dilation and curettage (D&C) that revealed choriocarcinoma. Brain magnetic resonance imaging (MRI) also showed a small metastatic mass with a size of 7 mm at the right occipital lobe. The patient was started on chemotherapy with an EMACO regimen. The patient’s β-hCG decreased continuously, and it was negative after the fourth cycle and six sessions of radiotherapy. It also remained negative six months after chemotherapy. The final examinations of the patient had no abnormal findings. Conclusion: Brain metastasis may be relatively asymptomatic in patients with choriocarcinoma, and it should be considered by physicians, even when there are no neurological symptoms. Also, the EMACO regimen seems to be an appropriate regimen for the treatment of metastatic choriocarcinoma.
Fariba Behnam Far; Khadijeh Eghbali; Leila Mousavi Seresht
Volume 4, Issue 1 , March and April 2019, , Pages 36-41
Abstract
Background: Gestational trophoblastic neoplastic (GTN) as the one of curable malignancy all around the world has higher incidence rate in developing country, so study on its behavior, risk factor, and treatment failure reason is encouraging in such countries
Methods: This study was a descriptive, cross-sectional ...
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Background: Gestational trophoblastic neoplastic (GTN) as the one of curable malignancy all around the world has higher incidence rate in developing country, so study on its behavior, risk factor, and treatment failure reason is encouraging in such countries
Methods: This study was a descriptive, cross-sectional study which tries to examine the GTN cases medical record in referral university hospitals in Isfahan from 2011 to 2016 to examine the risk factor and the factor that affecting treatment response rate. The patients were studied in two divided group based on the FIGO scoring system.
Results: 70 GTN patients were identified over these 5 years. 59 patients were in the low-risk group and 11 patients were in the high-risk group. 100% of the patients in the low-risk group and 90.1% of the patients in the high-risk group responded to the first and second line treatment. In the follow-up one case of recurrence within the low risk patient and one case of mortality from the high-risk patients was reported. In the high-risk metastatic group, there was 1 case of unusual metastasis site at the kidney and the commonest site of distant metastasis was lung.
Conclusion: Response rate in the low-risk GTN patients was excellent (100%) and it was more than 90% in the high-risk GTN patients. Therefore, if GTN patients are treated in reference centers, the response rate will be favorable. Patients with brain metastases have good chances of recovery if treated timely.
Pathology
Amal Abd El hafez
Volume 7, Issue 1 , September and October 2021, , Pages 38-44
Abstract
Background & Objective: Adult granulosa cell tumors (AGCTs) are potentially malignant ovarian neoplasms with a well-known tendency for local spread and recurrence, years after prolonged follow-up. This study investigated the immunohistochemical (IHC) expression of SMAD3 (mothers against decapentaplegic ...
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Background & Objective: Adult granulosa cell tumors (AGCTs) are potentially malignant ovarian neoplasms with a well-known tendency for local spread and recurrence, years after prolonged follow-up. This study investigated the immunohistochemical (IHC) expression of SMAD3 (mothers against decapentaplegic homolog 3) in AGCTs to evaluate its association with a number of confirmed AGCT prognostic variables. Prognostic predictors of recurrence in AGCT were further defined.Methods: Upon database search, the clinicopathological data, slides, and paraffin blocks of 35 AGCTs were retrospectively retrieved from archives, then examined histopathologically, staged, and stained immunohistochemically using anti-SMAD3. After H scoring of SMAD3, the clinicopathological associations were investigated in positive- and negative-SMAD3 expression groups using appropriate statistical methods. Regression analysis was performed to define independent predictors of recurrence in AGCT.Results: SMAD3 was actively expressed in the nuclei of 51.4% of AGCTs. It was significantly associated with tumor recurrence, capsular rupture, and size (P < /em>=0.011, 0.018, and 0.028, respectively), but not with age, presentation, laterality, stage, tumor morphological pattern, or mitotic index. Capsular rupture and tumor size were defined as highly significant (P < /em>≤0.001), as well as SMAD3+ve expression and FIGO stage as significant independent predictors of recurrence (P < /em>=0.05 and 0.049, respectively) in AGCT.Conclusion: SMAD3 is actively expressed in the tumor cell nuclei of around one half of AGCTs and this expression associates with high propensity for tumor recurrence, capsular rupture, and increasing tumor size. Along with the other observed independent predictors of recurrence, SMAD3 may provide an outline for direct discovery of new risk-stratification criteria as well as therapeutic targets for AGCTs.
maliheh Arab; shahla Noori Ardabili; poria Ganji
Volume 3, Issue 1 , March and April 2018, , Pages 39-44
Abstract
Introduction Endometrial cancer is one of the most common malignancies in women globally. The laparoscopic approach from endometrial cancer is suggested in the medical literature. The aim of the present review is to clarify clinical points of laparoscopic operation in endometrial cancer. A search using ...
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Introduction Endometrial cancer is one of the most common malignancies in women globally. The laparoscopic approach from endometrial cancer is suggested in the medical literature. The aim of the present review is to clarify clinical points of laparoscopic operation in endometrial cancer. A search using keywords included endometrial carcinoma, and treatment and laparoscopy were conducted on PubMed, Up-To-Date, Ovid and Clinical Key databases up to 2016.
Conclusion This present review research showed over 1600 full-text manuscripts, of which, 18 were relevant to this article. The laparoscopic approach to endometrial cancer is categorized as follows: 1) Comparison of complications and advantages of laparoscopy and laparotomy in endometrial cancer; 2) Hospitalization days; 3) Blood transfusion and blood loss; 4) Comparison of the operation time of laparoscopy versus laparotomy; 5) Conversion of laparoscopy to laparotomy; 6) Comparison of endometrial cancer lymphadenectomy in laparoscopy with laparotomy; 7) Laparoscopy of endometrial cancer in old age; 8) Surgical experience and learning curve; 9) Technical points in laparoscopic endometrial cancer surgery; 10) Comparison of endometrial cancer survival in laparoscopy and laparotomy methods; 11) Cost issues.
Obstetrics and Gynecology
Zahra Soleimani; Mansoor Nourmohammadi; Neda Hashemi; Maryam Aghaei
Volume 8, Issue 1 , January and February 2023, , Pages 41-46
Abstract
Background & Objective: Considering the importance of good sleep quality during pregnancy and the adverse effects of poor sleep quality on mother before and after childbirth and also its adverse effects on the fetus and newborn, identifying the related factors to sleep disturbance is important. ...
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Background & Objective: Considering the importance of good sleep quality during pregnancy and the adverse effects of poor sleep quality on mother before and after childbirth and also its adverse effects on the fetus and newborn, identifying the related factors to sleep disturbance is important. Therefore, this study was conducted to evaluate the relationship between prenatal and sleep quality in pregnant women.Materials & Methods: The present cross-sectional study was done on 150 pregnant women who were referred to Baqiyatallah Hospital, Tehran, Iran. Convenience sampling method was used for choosing participants. Pittsburgh Sleep Quality Index (PSQI) and Prenatal Distress Questionnaire (PDQ) were used for gathering information.Results: The prevalence rates of poor sleep quality in first, second and third trimesters were 36%, 54% and 62%, respectively. In all three trimesters, the newborn health parameter had the highest score and relationship score had the lowest score. There was a statistically significant relationship between prenatal concerns and sleep quality of pregnant women in all three trimesters of pregnancy (P<0.05).Conclusion: We found the significant relationship between pregnancy concerns and sleep quality of pregnant women in all three trimesters of pregnancy, and this finding indicates the direct effect of pregnancy concerns on sleep quality during pregnancy. Therefore, it is necessary to plan and perform the necessary interventions to minimize the concerns of pregnant women.
Gynecology Oncology
Farah Farzaneh; Shaghayegh Hooshmand Chayijan; Hanieh Najafi Arab; Farima Rahimi Mansour; Amirreza Keyvanfar; Zahra Bakhtiyari
Volume 9, Issue 1 , January and February 2024, , Pages 45-52
Abstract
Background & Objective: Uterine fibroids (UFs) are the most common pelvic tumors among women at reproductive age, affecting women’s quality of life even their confidence with its symptoms. We designed a study to investigate the clinical, laboratory, and imaging characteristics of Iranian ...
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Background & Objective: Uterine fibroids (UFs) are the most common pelvic tumors among women at reproductive age, affecting women’s quality of life even their confidence with its symptoms. We designed a study to investigate the clinical, laboratory, and imaging characteristics of Iranian women with UF.Materials & Methods: This cross-sectional study was performed from April 2016 to September 2022 at Imam Hossein hospital (Tehran, Iran). We included all women with UF referring to the Obstetrics and Gynecology Clinic of Imam Hossein Hospital. Based on a checklist, a research team interviewed the patients to investigate clinical characteristics. Also, we explored laboratory and transvaginal sonography (TVS) findings of all patients.Results: The mean age of 439 studied patients was 44.47±8.80 years (range: 23-81). The most prevalent underlying disease was hypertension (17.1%), followed by thyroid diseases (15.7%) and diabetes mellitus (13.7%). The patients mainly complained of AUB (abnormal menstrual bleeding) (60.0%) and abdominal pain (23.7%). The mean NLR (neutrophil to lymphocyte ratio) and the mean PLR (platelet to lymphocyte ratio) were significantly higher than the normal upper limit (P<0.001). The largest diameter of UF was 49.89±47.92 mm. Most fibroids were located anteriorly (43.1%). The multivariate linear regression model revealed that age (β=-0.931, 95%CI= (-1.657, -0.204), P=0.012) and number of fibroid (β=22.418, 95%CI= (16.360, 28.476), P<0.001) could predict the size of fibroid.Conclusion: Our results showed that NLR and PLR were increased in UF patients. It seems that patient’s age and number of fibroids may be the predictive factors for UF's size.
Obstetrics and Gynecology
Zahra Rezaei; Sedigheh Taghdisi
Volume 5, Issue 2 , October 2020, , Pages 61-67
Abstract
Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation ...
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Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation between the ovaries and fallopian tubes. Tubal surgery is hypothesized to reduce ovarian reserve due to the anatomical relationship between the ovarian arteries and nerves and fallopian tubes. There is no consensus on whether or not salpingectomy affects ovarian reserve. Some authors believe that salpingectomy has no effects, while others suggest that it diminishes ovarian reserve. Therefore, comparing fertility rates between women undergoing in vitro fertilization with tubal factor infertility with surgery, tubal factor infertility without surgery, and unexplained infertility can provide valuable data.Materials & Methods: Eighty patients who met the inclusion criteria were studied. Study groups included people with a history of tubal surgery, individuals who had tubal problems without a history of surgery, and cases with unexplained infertility. Anti-Mullerian hormone (AMH) was measured every day of the cycle and other hormones, including follicle-stimulating hormone (FSH), luteinizing hormone, prolactin, and thyroid-stimulating hormone (TSH) were assessed on days 2-5 of the cycle. On the third day of the menstrual cycle, the uterus, endometrial thickness, ovaries, the size of the ovaries, and antral follicle count were evaluated using transvaginal sonography. Following ovulation induction, treatment-related factors, namely endometrial thickness, gonadotropin (Gn) time and count, E2, viable embryos, and good quality embryos, were examined.Results: Our findings showed no difference between the study groups in terms of treatment-related factors. No significant correlation was observed between the studied groups and chemical pregnancy (P < /em>=0.9514). moreover, the studied groups were not significantly correlated with clinical pregnancy (P < /em>=0.5052).Conclusion: The AMH was correlated with FSH, AFC, E2, and gonadotropin time and count. According to the results of the present study, tubal surgery does not affect the outcome of assisted reproductive cycles.
Atiyeh Mirfendereski; Khadijeh Abadian
Volume 4, Issue 2 , May and June 2019, , Pages 78-80
Abstract
Background & Objective: The history of infection is confirmed by serological tests and the incidence and severity of congenital Toxoplasma infection depend on the gestational age at the time of maternal infection. A precise serological diagnosis is important in the management of toxoplasmosis, and ...
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Background & Objective: The history of infection is confirmed by serological tests and the incidence and severity of congenital Toxoplasma infection depend on the gestational age at the time of maternal infection. A precise serological diagnosis is important in the management of toxoplasmosis, and timely treatment prevents the complications of the infection. This study aimed to manage a case of acute toxoplasmosis during pregnancy and its results.
Case Report: In the present study, a pregnant woman was diagnosed with acute toxoplasmosis by considering the positive result of antibodies specific to Toxoplasma gondii and was treated based on the principal treatment that prevented congenital toxoplasmosis in her fetus.
Conclusion: Preventing acute Toxoplasma infection is very effective during pregnancy. Timely treatment can prevent the fetal and neonatal complications of toxoplasmosis.
Behnaz Moradi; Mohammad Ali Kazem; Mahboobeh Shirazi
Volume 3, Issue 2 , May and June 2018, , Pages 83-86
Abstract
Introduction: Many different Doppler-derived techniques have been proposed for overall assessment of cardiovascular well-being. In this report, 3 cases of high output cardiac failure were presented with the aim of evaluating the effect of fetal weight on fetal combined cardiac output (CCO).
Patients ...
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Introduction: Many different Doppler-derived techniques have been proposed for overall assessment of cardiovascular well-being. In this report, 3 cases of high output cardiac failure were presented with the aim of evaluating the effect of fetal weight on fetal combined cardiac output (CCO).
Patients Information: The first and second cases were referred to Yas Hospital for the management of fetal anemia at 31and 29 weeks of gestation, respectively, and the third case had a large solid and vascular sacrococcygeal teratoma at 17 weeks. The fetal weight in the first case was less than 10 percentile, in the second case was in normal limit, and in the third one was above 90 percentile. Left ventricle, right ventricle, CCO, and weight-indexed CCO were assessed for both fetuses and all were above normal limit, indicating high output cardiac failure. Right to left cardiac output ratio also increased obviously.
Conclusion: The fetal growth restriction overestimates the weight-indexed CCO and the weight above 90 percentile underestimates it. In these conditions, CCO seems more precise in demonstrating the true burden on fetal heart in comparison with weight-indexed CCO.
Obstetrics and Gynecology
Azam Tarafdari; Fatemeh Keikha; Mahrouz Malek; Azin Ghamari
Volume 6, Issue 2 , March 2021, , Pages 95-98
Abstract
Background and Objective: Being considered a common benign uterine disorder, Adenomyosis (AD) is defined as the presence of an endometrial gland and stroma within the myometrium. It causes symptoms such as dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility. It has a step-by-step treatment, ...
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Background and Objective: Being considered a common benign uterine disorder, Adenomyosis (AD) is defined as the presence of an endometrial gland and stroma within the myometrium. It causes symptoms such as dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility. It has a step-by-step treatment, initiating with medical therapy, conservative surgery, and finally, the hysterectomy. As some of the women with adenomyosis are nulligravid and want to become pregnant later, most patients prefer fertility-preserving surgery.Case Report: This study describes the management of diffuse posterior AD in a 36-year-old virgin female by triple flap technique and levonorgestrel intrauterine device (LNG-IUD) insertion during operation to prevent future recurrence and reduction of patient’s symptoms. The application of the triple flap technique and LNG-IUD in this patient was associated with excellent results.Conclusion: The wide excision of the lesion leads to symptom improvement, especially hypermenorrhea and dysmenorrhea; besides, the reconstruction of the uterine wall with this technique increases the risk of the possibility of future pregnancy for our patient.
General Gynecology and Pelvic Floor
Parvin Bastani; Malahat Ebrahimpour; Fatemeh Mallah; Sakineh Hajebrahimi; Hanieh Salehi Pourmehr
Volume 7, Issue 2 , September and October 2021, , Pages 105-113
Abstract
Background & Objective: Pelvic organ prolapse (POP) is accompanied by a remarkable decline in the quality of life. Determining the best surgical approach for women with POP is difficult because of outcome variations. We compared the outcomes of pelvic organ prolapse (POP) treatment by abdominal sacrocolpopexy ...
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Background & Objective: Pelvic organ prolapse (POP) is accompanied by a remarkable decline in the quality of life. Determining the best surgical approach for women with POP is difficult because of outcome variations. We compared the outcomes of pelvic organ prolapse (POP) treatment by abdominal sacrocolpopexy (ASC) and vaginal sacrospinous ligament suspension (SSLS) for advanced apical prolapse beyond the level of the hymen (stage≥ II). Materials & Methods: This retrospective study was conducted on a case series of 58 ASC and 48 SSLS surgeries, which were performed through the posterior approach for advance prolapse during January 2019-April 2020. Pelvic Floor Disability Index (PFDI-20) questionnaire was completed both at the first visit and a year postop. All patients were visited ten days after the procedure and re-visited after 2, 4, 6, and 12 months.Results: Of a total of 106 women, 80 cases completed the study (n=40 in each group). Within-group analysis showed that the overall score of PFDI-20 and its subscales decreased in both evaluated groups after surgery (P < /em><0.001). However, the between-group analysis revealed that this reduction in the ASC group was statistically significant in the total score of PFDI, POPDI-6, and UDI-6 subscales (P < /em><0.05). In addition, vaginal length was demonstrated to improve in both groups, which was statistically significant in the ASC group (P < /em>=0.001). The stage of prolapse was improved in both groups (P < /em><0.001), and it was more significant in the ASC group (P < /em>=0.049). There was no statistically significant difference between the SSLS and ASC in terms of the rate of satisfaction (93% vs. 100%; P < /em>=0.241).Conclusion: According to our findings, ASC and SSLS diminished the symptoms of POP. The surgery approach should be chosen based on the condition of patients, POP stage, and the experience of surgeons.
Reproductive Medicine
Mitra Bakhtiari; Tahereh Babaei; Mostafa Safarpour; Mojtaba Esmaeili; Mojtaba Esmaeili; Rezvan Asgari
Volume 5, Issue 3 , November 2020, , Pages 115-125
Abstract
Background & objective: Various parameters can affect the success of intra cytoplasmic sperm injection (ICSI). This study aims to compare the results of fertility in formerly infertile couples who underwent ICSI considering different parameters.Materials & Methods: In this retrospective ...
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Background & objective: Various parameters can affect the success of intra cytoplasmic sperm injection (ICSI). This study aims to compare the results of fertility in formerly infertile couples who underwent ICSI considering different parameters.Materials & Methods: In this retrospective study, 261 cases of infertile couples who referred to Motazedi Infertility Center in Kermanshah, and had successful ICSI from 2011 to 2017, were examined. Statistical analysis was performed after collecting the data.Results: The highest ICSI success rates were in the age range of 31-40 years (58.2%), and 21-30 years (55.8%), in men and women, respectively. Regarding the duration of infertility, the highest success rate was observed in couples who were infertile for less than five years (51.8%). In this study, all the patients’ endometrial thicknesses were normally higher than 4 mm. In terms of the number of embryos formed, the success percentage was 68% with three formed embryos. The hormonal variations and distribution percentages were as following: AMH ranging from 1.01 to 5 ng/mL (55.6%), TES ranging from 0 to 50 nmol/L (53%), TSH ranging from 1.01 to 5 μU/mL (81.6%), FSH ranging from 5.01 to 10 IU/L (58.9%), PRO ranging from 5.01 to 10 ng/mL (24%), LH ranging from 1.01 to 5 IU/L (46.7%), and DHEA-S ranging from 1.01 to 5 ng/mL (18.9%).Conclusion: According to the results, it seems that the success of ICSI technique in infertile couples depends on some parameters including variations in reproductive hormones, number of embryos, couples’ ages, and duration of infertility.
Nadereh Behtash; Setareh Akhavan
Volume 4, Issue 3 , September and October 2019, , Pages 120-126
Abstract
Uterine sarcomas (US) are relatively rare malignant tumor of the uterine mesenchymal tumor. The present study evaluated the outcomes of patients with different types of uterine sarcoma in Iranian women during a 5-years survey. During 2014-2019, a case series of twenty-three patients of US (four cases ...
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Uterine sarcomas (US) are relatively rare malignant tumor of the uterine mesenchymal tumor. The present study evaluated the outcomes of patients with different types of uterine sarcoma in Iranian women during a 5-years survey. During 2014-2019, a case series of twenty-three patients of US (four cases of leiomyosarcoma (LMS), nine cases of endometrial stromal sarcoma (ESS), seven cases of carcinosarcoma (CS), and three cases of adenosarcoma (AS)) were studied. One case of AS needed adjuvant radiotherapy and a recurrence was occurred in this case four years later. Two cases of CS have died during study period. All of ESS cases were alive by the study duration. One case who did not receive radio/chemotherapy experienced a bronchial recurrence after 8-years of ESS diagnosis Immunohistochemistry test on tumoral cells of three patients for vimentin+Ki67, BCL2+CD64+Ki67, ER+PR+WT1+Ki67 expressions were 30%, 30%, 15% respectively. Two cases of CS died during the study period. Even with multimodalities of treatment, the prognosis of uterine sarcoma is still poor and early diagnosis seems to improve the prognosis of the patients.
Malihe Hasanzadeh; Estak Rezaee
Volume 3, Issue 3 , September and October 2018, , Pages 129-131
Abstract
Introduction: Swyer syndrome is determined by primary amenorrhea, normal external genitalia, and the presence of a vagina, uterus, and 46XY karyotype. The aim of this case report was to introduce a patient with Swyer syndrome referred with pain and an abdominal mass.
Patient Information: This case study ...
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Introduction: Swyer syndrome is determined by primary amenorrhea, normal external genitalia, and the presence of a vagina, uterus, and 46XY karyotype. The aim of this case report was to introduce a patient with Swyer syndrome referred with pain and an abdominal mass.
Patient Information: This case study was done in Gynecology Clinic of Ghaem Hospital in Mashhad, Iran, in 2015. A single 18-year-old woman came to the clinic with complaints of primary amenorrhea, pain, and abdominal mass underwent laparotomy. Based on her histopathology report which indicated a left ovary dysgerminoma and a right ovary gonadoblastoma, a bilateral salpingo-oophorectomy, followed by chemotherapy, was conducted. The patient was under Bleomycin, Etoposide and Platinum (BEP) chemotherapy and has been living without evidence of recurrence.
Conclusion: A genetic disorder in patients younger than 20 years with an ovarian mass and diagnosis of dysgerminoma should be rejected.
Obstetrics and Gynecology
Zena M. Al Hindawi
Volume 8, Issue 2 , March and April 2023, , Pages 137-142
Abstract
Background & Objective: Infertility in women can be attributed to a wide variety of factors, including inherited and acquired abnormalities of the uterus. Ultrasonography is used for determining the thickness of the endometrium during various phases of the menstrual cycle. The purpose of this ...
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Background & Objective: Infertility in women can be attributed to a wide variety of factors, including inherited and acquired abnormalities of the uterus. Ultrasonography is used for determining the thickness of the endometrium during various phases of the menstrual cycle. The purpose of this study is to determine the thickness of the endometrium in women who are unable to conceive using ultrasound imaging during the secretory phase.Materials & Methods: A total of 134 adult females between the ages of 22 and 45 were examined by means of an endo-vaginal and transabdominal approach with EVN 4-9 MHZ and CA1-7AD probes, respectively, during the course of this research project, which took place in Imam Al-Hujjah Charitable Hospital, Karbala, Iraq, between February 2021 and April 2022.Results: The findings showed that primary infertility accounted for 69.4% of cases, which was significantly higher than women with secondary infertility, which accounted for 30.6% of cases. There were 68.8% of women who presented with primary infertility who had endometrial thickness between 9-12 mm, and there were 31.1% of women who presented with secondary infertility who had this thickness. 65.8% of women who are experiencing primary infertility and 34.1% of women who are experiencing secondary infertility have an endometrial thickness of 14-18 mm. Our study showed that 40% of women who suffer from primary infertility and 60% of those who have secondary infertility have an endometrial thickness of 19-23 mm.Conclusion: When it comes to diagnosing and treating infertility, ultrasound is a crucial tool for measuring the thickness of the endometrium in women.
Obstetrics and Gynecology
Farzaneh Rashidi Fakari; Zahra Kiani
Volume 6, Issue 3 , June 2021, , Pages 143-146
Abstract
COVID‐19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general ...
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COVID‐19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general population. On the other hand, given the previous experiences with SARS and MERS, pregnant women are likely to be at high risk for COVID-19 and its complications. Comparing the results of studies on COVID-19 during pregnancy and that of the general population, it can be concluded that pregnant women develop COVID-19 at a younger age than the general population. The results showed that due to changes during pregnancy, pregnant women have a higher risk for COVID-19 than other people, perhaps due to the lower mean age of COVID-19 in pregnant women, this leads to less COVID-19 on the adverse pregnancy outcomes.
General surgery
Behnaz Nouri; Ladan Ajori; Maliheh Arab; Sepideh Sattarzad Fathi
Volume 9, Issue 2 , March and April 2024, , Pages 154-160
Abstract
Background & Objective: The aim of this study was to describe the female to male (FTM)transgenders demographic, epidemiologic characteristics and outcomes after laparoscopic hysterectomy and bilateral oophorectomy surgery by one surgeon in FTM transgender people.
Materials & Methods: This retrospective ...
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Background & Objective: The aim of this study was to describe the female to male (FTM)transgenders demographic, epidemiologic characteristics and outcomes after laparoscopic hysterectomy and bilateral oophorectomy surgery by one surgeon in FTM transgender people.
Materials & Methods: This retrospective cohort study on FTM patients that referred to one of the referral centers for transgender surgeries in the capital of Iran (Tehran) since 2016 and 2022. Consecutive method used for sampling method. Data analyzing was done by SPSS, descriptive statistical, Pearson correlation coefficient and t-test.
Results: We identified 105 FTM transgender patients undergoing laparoscopic hysterectomy and bilateral oophorectomy. The mean age was 24.74±5.41 years, and the mean age of first experience of transgender was10.51±3.68 years. There was a significant correlation between transgender and marital status (P<0.04, r= 0.2) and unemployment (P<0.05, r= 0.5). There was a significant correlation between age of first experiences of transgender and educational status (P<0.05, r= -0.1).49.5%of patients have complications after surgery.
Conclusion: Hysterectomy and bilateral oophorectomy by laparoscopic approach may have appropriate outcomes for reassignment surgery. Also, this study suggests that probably less educational, occupational problems occur for transgender patients if they undergo gender reassignment surgery at a younger age.
Sedigheh Ayati; Leila Pourali; Atiyeh Vatanchi; Lida Jedi; Zahra Mohades Ardebili
Volume 3, Issue 4 , November and December 2018, , Pages 173-176
Abstract
Background & Objective: HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelet count; it probably shows a severe form of preeclampsia. This syndrome usually occurs in third trimester of pregnancy and may be associated with severe complications, including subcapsular ...
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Background & Objective: HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelet count; it probably shows a severe form of preeclampsia. This syndrome usually occurs in third trimester of pregnancy and may be associated with severe complications, including subcapsular liver hematoma, eclampsia, pulmonary edema, liver or renal dysfunction, and even maternal death. This study aimed to report a case of maternal death misdiagnosis of HELLP syndrome.
Case Report: A 28-year-old pregnant woman with gestational age of 28 weeks referred to an emergency ward because of epigastric pain, nausea, and vomiting. She was discharged after receiving outpatient treatment. The next day, she was referred to the hospital because of seizure, decreased level of consciousness, and hypertension. A cesarean section was performed immediately. Unfortunately, some hours after the surgery, cardiac arrest occurred and she died in intensive care unit (ICU).
Conclusion: Nausea, vomiting, and epigastric pain in the late second or third trimester of pregnancy are among the significant symptoms which should be seriously taken into consideration. Therefore, it is recommended that a patient be hospitalized and precise evaluation be performed to rule out the life-threatening differential diagnoses, like HELLP syndrome, and to prevent dangerous complications which can lead to maternal death.
Gynecology Oncology
Maliheh Hasanzadeh; Seyedeh Sara Nourbakhsh; Amir Hosein Jafarian; Parnian Malakuti
Volume 5, Issue 4 , December 2020, , Pages 175-177
Abstract
Introduction: Vaginal adenosis is one of the precursor lesions of the vaginal clear cell adenocarcinoma (CCA). The most common symptom of vaginal adenosis is abnormal vaginal pain and bleeding. About 90% of women exposed to diethylstilbestrol (DES) during pregnancy have vaginal and cervical adenosis ...
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Introduction: Vaginal adenosis is one of the precursor lesions of the vaginal clear cell adenocarcinoma (CCA). The most common symptom of vaginal adenosis is abnormal vaginal pain and bleeding. About 90% of women exposed to diethylstilbestrol (DES) during pregnancy have vaginal and cervical adenosis in female fetus. DES has been reported rarely with no history of fetal use.Case Presentation: In this article, we report two vaginal adenosis patients with no history of DES during pregnancy. There was no vaginal cancer in the follow-up of the patients.Conclusion: Vaginal adenosis is considered as a non-common differential diagnosis of vaginal bleeding that can be diagnosed by physical examination, colposcopy, and biopsy.
Obstetrics and Gynecology
Mandana Mansour Ghanaei; Sude Amir Afzali; Ali Morady; Roxana Mansour Ghanaie; Seyed Mohammah Asghari Ghalebin; Elahe Rafiei; Roya Kabodmehri
Volume 7, Issue 3 , January and February 2022, , Pages 177-185
Abstract
Background & Objective: Accordingly, this study aimed to assess pregnancy outcomes and pathological findings of the placenta caused by intrauterine growth restriction (IUGR) with or without pre-eclampsia (PE).Materials & Methods: This cohort study was conducted on two groups: Group I was ...
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Background & Objective: Accordingly, this study aimed to assess pregnancy outcomes and pathological findings of the placenta caused by intrauterine growth restriction (IUGR) with or without pre-eclampsia (PE).Materials & Methods: This cohort study was conducted on two groups: Group I was PE-induced IUGR (PE-IUGR), and group II was idiopathic IUGR (I-IUGR). Pregnancy and neonatal outcomes were evaluated in both groups. The placental assessment was also performed based on pathological findings. Data were compiled and analyzed by SPSS 21. An analytical study was conducted on the groups based on t (or non-parametric Mann-Whitney), chi-square, and Fisher’s exact tests.Results: The findings of this study showed that maternal age, body mass index (BMI), the incidence of preterm delivery, and low birth weight were higher in the PE-IUGR group (P < /em><0.001 in all) than in the I-IUGR group, and the difference was statistically significant. Additionally, circulatory disorders and impaired anomalies were higher in the PE-IUGR group (P < /em>>0.001) than in the I-IUGR group.Conclusion: Placental disorders and reduced blood flow to the fetus due to placental disorders might lead to low birth weight and preterm delivery.
