Obstetrics and Gynecology
Tajossadat Allameh; Maryam Dehghan
Volume 6, Issue 4 , August 2021, , Pages 202-208
Abstract
Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical ...
Read More
Background & Objective: The objective of this study was to evaluate colposcopic, endocervical curettage (ECC) and endometrial curettage (EMC) findings in comparison with Pap smears findings.Materials & Methods: Out of 100,000 Pap smears, a total number of 75 eligible women with atypical glandular cells (AGCs) referred to gynecology clinics in Isfahan, Iran, and seventy women were selected to undergo Pap smear test, colposcopic examination and ECC. EMC was performed in women older than 35. Pap smear test results were classified as normal, inflammation, AGCs and necrosis. Colposcopy, ECC and EMC findings were classified as normal, benign and malignant pathologic lesions.Results: Repetitive Pap smears findings were as follows: 15.7% were normal, 77.2% had inflammation, 4% had AGC and 3.1% had necrosis. Based on colposcopy findings, 61.2%, 7.5%, and 31.3% of the samples were classified as normal, benign and malignant, respectively. ECC findings in 95.5% of women was indicative of benign lesions and malignant lesions in 4.5%. EMC findings showed that 79.7% were normal, 8.5% had benign lesions and 11.9% had malignant lesions. Pap smears with several AGCs were associated with benign lesions in 24.2% of the cases and premalignant and malignant lesions in 14.2% of the cases.Conclusion: According to our study, due to the significant association between AGC cytology and pathologic cervical and endometrial lesions, intensive assessment is necessary in women with AGC Pap smears, especially in older and post-menopausal women, in order to reduce mortality.
Obstetrics and Gynecology
Melad Alias Alsanity; Chiman Younus Hasan
Volume 8, Issue 3 , May and June 2023, , Pages 240-248
Abstract
Background & Objective: Fertility control has been used for thousands of years in a variety of ways. Women need to use contraceptive methods correctly to reduce unintended pregnancies and maternal mortality. The purpose of this research was to determine the factors that have an impact on the ...
Read More
Background & Objective: Fertility control has been used for thousands of years in a variety of ways. Women need to use contraceptive methods correctly to reduce unintended pregnancies and maternal mortality. The purpose of this research was to determine the factors that have an impact on the use of contraception in our community.Materials & Methods: During the time period of December 2021 to April 2022, a descriptive cross-sectional study was conducted in primary healthcare centers in the city of Duhok, which is located in the Kurdistan Region of Iraq. A total of 400 married women between the ages of 18-45 years were studied. Information on sociodemographic characteristics, obstetrical history, contraceptive methods used, deciding factors, and discontinuation were obtained from respondents. The statistical calculations were performed in John's Macintosh Project (JMP project, version 14.3.0, Apple Macintosh. USA).Results: Out of 400 women, 269 (67.25%) were aged 18-34, 106 (26.50%) completed primary education, and 204 (51.00%) desired to conceive. The most frequently used method was withdrawal 257 (64.25%), followed by oral contraceptive pills 43 (10.75%), Intrauterine contraceptive devices 39 (9.75%), and male condoms 35 (8.75%). For the purpose of becoming pregnant, 256 (64.00%) women stopped using contraceptives. Most of the failure rates were seen among withdrawal users, which recorded 77 (19.25%), and those who experienced side effects were 42 (10.50%).Conclusion: In every district of Dohuk, there is a need for comprehensive, easily accessible, client-centered, and modern family planning services. Educational program is requested to improve the behavior and attitude toward family control.
Anesthesia
Dariush Abtahi; Mehrdad Feizi; Shahram Sayadi; Ardeshir Tajbakhsh; Samira Abbaspour; Sara Salarian; Alireza Mirkheshti
Volume 7, Issue 4 , March and April 2022, , Pages 314-322
Abstract
Background and Objective: This study was performed to determine and compare the ED90 of prophylactic oxytocin (OX) infusion after delivery of the placenta during cesarean section (CS) in low- and high-risk parturients for uterine atony.Methods: This experimental study was a single-blind and dose-response ...
Read More
Background and Objective: This study was performed to determine and compare the ED90 of prophylactic oxytocin (OX) infusion after delivery of the placenta during cesarean section (CS) in low- and high-risk parturients for uterine atony.Methods: This experimental study was a single-blind and dose-response study using a 9:1 biased-coin sequential allocation method to estimate the ED90 of prophylactic infusion of OX in women with high and low risk for uterine atony who underwent CS. The total administrated OX dose of each patient was determined in the two study groups. The primary outcome was the ED90 for desirable uterine tone based on the opinion of the in-charge obstetrician. The number of subjects receiving supplemental uterotonics was compared.Results: In the low-risk group, three (3.7%), out of the 41 parturients, did not achieve a satisfactory suitable response to OX dose of 9; on the other hand, 24 high-risk parturients (58%) did not achieve a satisfactory and reasonable response to OX dose of 9. The OX ED90 was significantly greater for the high risk-group (11.55 units, 10.39-14.86) than the low-risk group (8.13 units, 8.31-9.56). Fisher’s exact probability test showed a significant difference in ED90 of OX between the two groups (P < /em>=0.02).Conclusion: The present study results showed that the mean ED90 of OX in low-risk parturients was significantly lower than that of high-risk ones. We suggest differentiation between low-risk and high-risk parturients in the guidelines of OX administration.
Gynecology Oncology
Hossam Hassan Aly Hassan El Sokkary
Volume 8, Issue 4 , July and August 2023, , Pages 357-365
Abstract
Background & Objective: The present study compares between superficial and deep myometrial invasion in type 1 endometrial cancer in relation to regional lymph nodes metastasis, so we can answer the question to do or not do lymphadenectomy, this life-threatening procedure in both superficial ...
Read More
Background & Objective: The present study compares between superficial and deep myometrial invasion in type 1 endometrial cancer in relation to regional lymph nodes metastasis, so we can answer the question to do or not do lymphadenectomy, this life-threatening procedure in both superficial and deep myometrial invasion with type 1, clinically and radiologically stage 1 endometrial cancer.Materials & Methods: Patients were divided into 2 groups distributed as follows: group I includes 50 patients type 1 endometrial cancer with superficial myometrial invasion and group II includes 50 patients type 1 endometrial cancer with deep myometrial invasion. Total abdominal hysterectomy with bilateral salpingo-opherectomy with pelvic and lower para-aortic lymphadenectomy to all patients included in the study from both groups. Histopathological examinations were done to all the specimen from both groups to confirm diagnosis of type 1 endometrial cancer, depth of myometrial invasion, pathological grading and metastasis to the regional lymph nodes.Results: Considering regional lymph nodes metastasis in both groups, there is a statistical difference between group I and group II in relation to regional lymph nodes metastasis as group II (cases with deep myometrial invasion) are associated with more regional lymph nodes metastasis (P= 0.0001)).Conclusion: Deep myometrial invasion in type 1 endometrial cancer is associated with significant increase in regional lymph nodes metastases.
Obstetrics and Gynecology
Zinatossadat Bouzari; Tara Mohammadi; Mohammad Ranaei; Karimollah Hajian-Taliki; Azita Ghanbarpour
Volume 7, Issue 5 , July and August 2022, , Pages 414-421
Abstract
Background & Objective: Gestational diabetes mellitus (GDM) is also defined as a metabolic disease associated with relative insulin resistance during pregnancy, and elevated circulating insulin may increase the risk of EH and EC development. This study aimed to investigate the association between ...
Read More
Background & Objective: Gestational diabetes mellitus (GDM) is also defined as a metabolic disease associated with relative insulin resistance during pregnancy, and elevated circulating insulin may increase the risk of EH and EC development. This study aimed to investigate the association between GDM and the incidence of EH and EC.Materials & Methods: We conducted a retrospective case-control study, including 300 women with abnormal uterine bleeding (AUB) referred to Ayatollah Rouhani Hospital in Babol. Cases (n=152) were patients with HC and EC based on medical records, and the controls (n=148) were individuals without HC and EC. The groups were compared according to demographic information, GDM or diabetes mellitus (DM) history, and body mass index (BMI). The Chi-square, independent t-test, and logistic regression analyses were performed to compare groups.Results: Of 300 women studied, 72 people (24.1%) had a GDM history, and 64 people had a diabetes mellitus history. There was a significant difference between the incidence of EC and EH with GDM (P < /i>=0.001). Both GDM and DM were associated with the increased EC (OR: 17.98, 95% CI: 6.73-48.08, and OR: 1.84, 95% CI: 1.26-2.68, respectively). GDM was also associated with the increased risk of EH (OR: 6.68, 95% CI: 2.77-16.10), whereas diabetes mellitus had not a significant role in the increased risk of EH (P < /i>=0.14). Conclusion: This study indicated that a GDM history is significantly associated with HC and EC. Therefore, to prevent and control these two complications in the future, management and monitoring of diabetes during pregnancy should be considered.
Obstetrics and Gynecology
Nadia Azadi; Yousra Alsinani; Mohammad Hemmatinafar; Maryam Koushkie Jahromi
Volume 8, Issue 5 , September and October 2023, , Pages 472-480
Abstract
Background & Objective: Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms ...
Read More
Background & Objective: Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms in two aquatic and land-based trained groups before and after cessation of exercise due to COVID-19 outbreak.Materials & Methods: 90 postmenopausal women participated in the study voluntarily. The daily and sport physical activities and menopausal symptoms were assessed through interviews three months after cessation of sport activities and qestions were designed and obtained from daily physical activity form and menopausal rating scale (MRS) questionnaire respectively.Results: Before the cessation of exercise, the somatic, psychological, and sexual symptoms of menopause were lower in both active groups than the inactive group, while there was no significant difference in three categories of menopausal symptoms between aquatic and land-based exercise groups. After the cessation of exercise, menopausal symptoms in the two groups of previously active women increased significantly compared to the inactive group, so that there was no significant difference in menopausal symptoms between the exercise and inactive groups.Conclusion: aquatic and land-based exercise reduces the symptoms of menopause similarly, while the beneficial effects of exercise on menopausal symptoms can disappear after the cessation of exercise for three months.
Reproductive Medicine
Marzieh Mehrafza; Azadeh Raoufi; Elmira Hosseinzadeh; Gholam Reza Pourseify; Tahereh Zare Yousefi; Termeh Shakery; Amirhossein Tamimi
Volume 7, Issue 6 , September and October 2022, , Pages 518-523
Abstract
Background & Objective: Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation ...
Read More
Background & Objective: Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation failure patients. The aim of the present study was to describe the impact of intrauterine platelet-rich plasma infusion on the live birth rate in patients with repeated implantation failure.Materials & Methods: The present retrospective uncontrolled study was performed on 96 patients with more than two failed intracytoplasmic sperm injection cycles at Mehr medical institute between 2019 and 2021. Forty-eight hours before embryo transfer, patients received 1 mL lympho-platelet-rich plasma through an intrauterine insemination catheter. Patients were evaluated for pregnancy rate. Endometrial preparation for frozen-thawed embryo transfer was performed.Results: Participants' basal and stimulation characteristics, including gonadotropin dosage, the total number of oocytes, metaphase II oocytes and embryos, endometrial thickness, embryo transfer, quality of transferred embryos, and blastocyst transfer rate were evaluated. A total of 33 and 27 chemical (34.3%) and clinical pregnancies (28.1%) were achieved. Twenty (20.8%) and nineteen (20%) cycles resulted in ongoing pregnancies or live births, respectively. Conclusion: The current study suggests that platelet-rich plasma infusion 48 hours before frozen-thawed embryo transfer may be a good option for repeated implantation failure patients and results in 20% live birth.
Obstetrics and Gynecology
Mina EL Hiyani; Sakhr Ahizoune; Asmaa Mdaghri Alaoui; Othmane Benlenda; Amal Thimou Izgua
Volume 8, Issue 6 , November and December 2023, , Pages 587-598
Abstract
Background & Objective: The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and ...
Read More
Background & Objective: The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and pregnant women who have contracted COVID-19. Therefore, this study aimed to establish a risk map for managing dyspneic parturients suffering from COVID-19-related pneumopathy during delivery.Materials & Methods: This study focuses on examining potential risks beforehand in the context of the management of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery, executed using the method FMECA (Failure Mode, Effects and Criticality Analysis); this was conducted from September to December 2021 in the maternity service of the Hospital Center ElJadida, Morocco.Results: The risk analysis of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery revealed thirteen failure modes. Proposed are corrective measures aimed at addressing the failure modes of criticality class C3 whose vital risks are linked to the care of the dyspneic parturient suffering from COVID-19-related pneumopathy at the level of the reanimation service and the level of the neonatal intensive care unit.Conclusion: Employing risk mapping is a fundamental instrument for the ongoing enhancement of quality to maximize the safety of the parturient care process by changing the organizational culture from a reactive to a preventive approach.
Nadereh Behtash; Azam-sadat Mousavi
Volume 1, Issue 1 , May and June 2016
Abstract
Dear Colleague,
Today is a great day for all of us. Three decades of hard work in promoting education, training and conducting numerous complicated surgeries have resulted in significant number of obstetricians and gynecologists across the country. Today, there are programs teaching top-tier subspecialties ...
Read More
Dear Colleague,
Today is a great day for all of us. Three decades of hard work in promoting education, training and conducting numerous complicated surgeries have resulted in significant number of obstetricians and gynecologists across the country. Today, there are programs teaching top-tier subspecialties within this field. Moreover, hundreds of Seminars have been held during the past twenty years by our colleagues. Considering this strong potential, now is the time for us to share our knowledge and experiences in a comprehensive international research journal. Continuing this path is only possible with your contribution and collaboration. In this journal, we are pleased to invite all researches within the field to spread their deep and valuable expert opinions and knowledge to other expertises throughout the world. The editorial board wishes to dedicate this journal to our patients whom happen to be our best teachers.
Nafiseh Ansarinejad; Bahareh Abbasi; Maryam Sadat Sadat Rasul; Farshid Fardad; Tayeb Ramim
Volume 1, Issue 2 , September and October 2016
Abstract
Background: Anemia is prevalent in 32% to 60% of patients with cancer due to an underlying disease, nutritional deficiencies and complications of medication used in chemotherapy. National Comprehensive Cancer Network (NCCN) recommends the use of oral or intravenous iron supplementation in patients with ...
Read More
Background: Anemia is prevalent in 32% to 60% of patients with cancer due to an underlying disease, nutritional deficiencies and complications of medication used in chemotherapy. National Comprehensive Cancer Network (NCCN) recommends the use of oral or intravenous iron supplementation in patients with iron deficiency anemia.
Maryam Deldar Pasikhani; Zinat Ghanbari; Fateme Talei Khatibi; Ali Ganjalikhan Hakemi; Elaheh Miri Ashtiani
Volume 1, Issue 3 , November and December 2016
Abstract
Background: Urgency is a characteristic for overactive bladder and is defined by a sudden obligatory need for urination, a feeling that can be hardly stopped. Many methods such as drug therapy and feedback have been used to treat urinary incontinency.
Objectives: The aim of this study was to assess ...
Read More
Background: Urgency is a characteristic for overactive bladder and is defined by a sudden obligatory need for urination, a feeling that can be hardly stopped. Many methods such as drug therapy and feedback have been used to treat urinary incontinency.
Objectives: The aim of this study was to assess and compare the effect of medication, biofeedback or biofeedback plus medication on urge- urinary incontinency and quality of life of patients.
Methods: This was a case-control randomized clinical trial performed on patients referred to Imam Khomeini hospital in 2014. Patients were divided into three groups of drug (Tolterodine), biofeedback, and biofeedback plus drug. Biofeedback group underwent two sessions of treatment weekly for four weeks, and the drug group received tolterodine (4 mg slow release) for four weeks. The third group received both of them. Quality of life and urinary incontinency symptoms were compared between the three groups and analyzed, using SPSS Version 16 software (IBM, Armonk, USA).
Results: Meaningful differences were observed between the three groups with respect to change in the total score of the questionnaire (P < 0.001). Between the groups, drug therapy had the most effect on improving the total score of the questionnaire, with a mean change of 25.44 ± 1.80. No meaningful difference was observed between drug plus biofeedback and biofeedback group (P =0.114). By comparing the mean incontinency score, we found a meaningful difference between the drug and biofeedback groups and the biofeedback and biofeedback plus drug groups (P < 0.001 and P < 0.002, respectively); however, no meaningful difference was found between the biofeedback plus drug group and the drug group in mean incontinency score (P = 0.187).
Conclusions: Our study results revealed that tolterodine and biofeedback both increased quality of life indices and decreased the severity of urinary incontinency significantly in our participants. However, drug plus biofeedback treatment improved the severity and quality of urinary incontinency, but did not improve quality of life of the patients. Therefore, physicians should consider improving the quality of life of patients as well.
Mansooreh Zanjani; Jalil Kohpayeh; Zhila Karimi
Volume 2, Issue 1 , March and April 2017
Abstract
Background: Vaginal misoprostol is said to dissolve better in an acidic environment, thus, in this study we aimed to evaluate the influence of increasing vaginal acidity on the effectiveness of vaginal misoprostol for the induction of midtrimester pregnancy using acidic environment.
Methods: A total ...
Read More
Background: Vaginal misoprostol is said to dissolve better in an acidic environment, thus, in this study we aimed to evaluate the influence of increasing vaginal acidity on the effectiveness of vaginal misoprostol for the induction of midtrimester pregnancy using acidic environment.
Methods: A total of 40 women requiring second trimester pregnancy termination were randomly assigned to one of two treatment groups: (A) in the saline group, 400 µg of intra-vaginal misoprostol was moistened in normal saline before the vaginal insertion as controls (n = 20); and (B) in the acetic acid group, the acidity of the vagina was increased with 3% of acetic acid, (4 mL of 3% acetic acid was delivered into the vagina every 6 hours) before the insertion of an initial dose of 400 µg misoprostol (n = 20). Then 200 µg dosage was repeated every 4 hours for a maximum of 5 doses within 24 hours. If the patient did not have adequate uterine contractions, the same regimen was repeated over the following 24 hours and if no response was achieved, this was considered a failure of therapy.
Results: There was no significant difference in the vaginal pH between the control and intervention groups before the vaginal application of acetic acid (5.80 ± 0.62 versus 5.89 ± 0.49, P = 0.622,). The vaginal pH was significantly lower in the acetic acid group after the vaginal application of acetic acid compared to the control group (5.11 ± 0.56 versus 5.80 ± 0.62, P = 0.001). Overall, 95% of pregnancies were successfully terminated in the acetic acid group compared to 85% in the control group. These differences were not statistically significant (P =0.241). The success rate within 24 hours and 48 hours, the adverse effects, mean termination time, total misoprostol administered, and the number of curettage were, also, comparable between the two groups.
Conclusions: Findings from this study shows that increasing Vaginal acidity does not improve the efficacy of misoprostol administered intra-vaginally for the second trimester pregnancy termination.
Zahra Shahraki; Khadije Rezaie Keikhaie; Nooshin Amjadi; Zohrehsadat Hashemi Bonjar; Hosseinali Jahantigh; Fatemeh Doosti; Mahboobeh Shirazi
Volume 2, Issue 2 , May and June 2017
Abstract
Background: Preeclampsia is one of the causes of maternal and prenatal mortality and morbidity. The 24-hour urine sample is considered as a gold standard for preeclampsia diagnosis and shortening the time of urine collection will result in the patients’ convenience and shorter hospitalization. ...
Read More
Background: Preeclampsia is one of the causes of maternal and prenatal mortality and morbidity. The 24-hour urine sample is considered as a gold standard for preeclampsia diagnosis and shortening the time of urine collection will result in the patients’ convenience and shorter hospitalization. The goal of this study was to determine thee diagnostic accuracy of 4 hour urine protein in comparison with 24 hour urine protein in pregnant women.
Methods: One hundred pregnant women, with a gestational age of more than 20 weeks, and were suspicious to preeclampsia were enrolled. The 24-hour as well as the 4-hour urine sample were collected. All data were analyzed using the SPSS software, version 20 (SPSS Inc., Chicago, IL, USA). The correlation coefficient was used to determine relationship between the 4 and 24-hour urine proteins. receiver operating characteristic (ROC) curve was used to determine optimal cut-off values of 4 hour proteinuria.
Results: The mean age and mean gestational age of participants was 26.8 & 6.1 years and 34.1 & 3.4 weeks. The mean 4-hour urine protein was 165.6 & 170.2 mg and the mean 24 hour urine protein was 926 & 1013 mg. The mean age, 4-hour urine protein, and 4 as well as 24 hour urine volumes were significantly different between cases with no, mild, or severe proteinuria. Pearson correlation coefficient between 4 and 24 hour proteinuria was strong (r = 0.97 and p < 0.001). The best cut off point for 4-hour proteinuria to determine proteinuria was 69.5 mg with a sensitivity of 93% and specificity of 100%. (Area under the curve = 0.99, p < 0.001).
Conclusions: Women that are suspicious to have preeclampsia, the total 4-hour urine protein values positively correlated with values of 24-hour samples.
Sedighe Ayati; Leila Pourali; Atiyeh Vatanchi; Sara Mirzaeian; Elnaz Ayati; Zahra Mohaddes Ardebili
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: Myoma is the most common benign tumor of the female genital tract. The incidence of myoma increases with age. It mostly presents in the fifth decade of life. Since myoma is often asymptomatic and incidentally diagnosed, the true prevalence is unknown. This tumor may also become symptomatic ...
Read More
Introduction: Myoma is the most common benign tumor of the female genital tract. The incidence of myoma increases with age. It mostly presents in the fifth decade of life. Since myoma is often asymptomatic and incidentally diagnosed, the true prevalence is unknown. This tumor may also become symptomatic and affect women’s quality of life. This study was performed to report a rare case of vaginal myomectomy in post-partum severe hemorrhage caused by a submucosal myoma.
Case Report: A 39-year-old G2P1 woman with previous cesarean section and decreased fetal movement at 38th week of gestation was hospitalized. In sonography and biophysical profile, due to fetal compromised, pregnancy was terminated. After delivery of fetus, a submucosal myoma (12 × 12 cm) was protruded through cervical canal. Massive hemorrhage occurred and then vaginal myomectomy was done and the bed of myoma was packed with two long gauzes that removed after one day.
Conclusions: Vaginal myomectomy after natural vaginal delivery or possibly during cesarean section is a safe and reliable method to remove submucosal myomas especially large myomas and decrease the risk of complications and costs of re-surgery. Due to the increased risk of hemorrhage, it is better to conduct this surgery in third-level referral hospitals.
Setareh Akhavan; Nadereh Behtash; Mohsen Esfandbod; Mitra Moddares Gilani; Azam-Sadat Mousavi; Shahrzad Sheikh Hasani
Volume 2, Issue 4 , November and December 2017, , Pages 1-4
Abstract
Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death in women. Primary surgery, followed by adjuvant chemotherapy is the basis of treatment for this disease. A standard treatment includes primary surgery and if possible optimal debulking surgery (tumor residue of <; 1 cm), followed ...
Read More
Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death in women. Primary surgery, followed by adjuvant chemotherapy is the basis of treatment for this disease. A standard treatment includes primary surgery and if possible optimal debulking surgery (tumor residue of <; 1 cm), followed by a chemotherapy; paclitaxel carboplatin is the standard regimen in ovarian cancer. Given that the main method of spreading this disease is in the peritoneal cavity, the systemic chemotherapy brings about numerous complications; moreover, as the method of prescribing a drug inside the peritoneum causes a high drug concentration in the peritoneal cavity, conducting an intraperitoneal chemotherapy has been examined clinically. In cases of ovarian cancer recurrence, performing a secondary cytoreductive surgery, in addition to hyperthermic intraperitoneal chemotherapy (HIPEC), has led to a good survival among patients. Currently, studies are ongoing to better explain the effects of this treatment method compared to previous methods.
Maternal Fetal Medicine
Maryam Saraei; Maryam Shefaat; Omid Aminian; Sahar Eftekhari; Elahe Hesari; Atefeh Behkar; Arezu Najafi
Articles in Press, Accepted Manuscript, Available Online from 26 April 2024
Abstract
Background and Objective: Pregnancy is an exceptionally delicate time in the lives of most women. Sleep disorders during pregnancy can substantially impact a healthy pregnancy. This study investigated the relationship between sleep quality during pregnancy and adverse maternal and fetal pregnancy outcomes.Methods: ...
Read More
Background and Objective: Pregnancy is an exceptionally delicate time in the lives of most women. Sleep disorders during pregnancy can substantially impact a healthy pregnancy. This study investigated the relationship between sleep quality during pregnancy and adverse maternal and fetal pregnancy outcomes.Methods: This was a prospective cohort study on 500 pregnant women referred to the perinatology clinic. The Pittsburgh Sleep Quality Index questionnaire was used to evaluate sleep quality, and demographic data were collected from the case file of routine prenatal checkups. The study participants were followed until delivery. The association between sleep quality and postpartum complications, such as preterm birth, infant Apgar score, and NICU admission, was investigated. Results: This study included 500 pregnant women with a mean age of 31.12 ± 5.84. The number of pregnancies ranged from 1 to 7, with a mean of 2.55±1.30. Of the infants, 12% of infants were born prematurely and 27.8% required NICU admission. Poor sleep quality was found to be associated with preterm delivery (OR: 1.27, p = 0.039) and preeclampsia (OR: 0.543, p = 0.004). Women who experienced preeclampsia during pregnancy (p = 0.01), delivered via cesarean section (p = 0.009), and had infants weighing more than 2500 g (p = 0.07) exhibited significantly poorer sleep quality.Conclusion: We found that sleep quality was associated with preterm birth, cesarean section delivery, maternal preeclampsia risk, and the 5-minute Apgar score. Considering the impact of a mother’s sleep quality on pregnancy outcomes, assessing mothers' sleep health appears essential in prenatal care.
Leila Pourali; Sedigheh Ayati; Atiyeh Vatanchi; Anis Darvish
Volume 4, Issue 1 , March and April 2019, , Pages 42-44
Abstract
Introduction: Postpartum hemorrhage has different etiologies. One of the rare causes is inner myometrial laceration that makes the diagnosis more difficult. This report aimed to introduce a case of massive postpartum hemorrhage following an inner myometrial laceration.
Case Report: A 24-year-old primigravid ...
Read More
Introduction: Postpartum hemorrhage has different etiologies. One of the rare causes is inner myometrial laceration that makes the diagnosis more difficult. This report aimed to introduce a case of massive postpartum hemorrhage following an inner myometrial laceration.
Case Report: A 24-year-old primigravid woman referred to an academic Hospital due to hypertension of 140/90 and diagnosis of preeclampsia. Her pregnancy was terminated at 39th gestational week. She received two doses of 25 μg misoprostol sublingually. Subsequently, an induction was performed and normal vaginal delivery occurred. A 2800 gr infant was born. After the delivery, the patient suffered from massive postpartum hemorrhage which continued in spite of all medical treatments. With regard of unstable vital signs, laparotomy was done. By transverse uterine incision, a longitudinal inner myometrial laceration was found in the lower uterine segment, which was repaired, thus, hemorrhage was controlled.
Conclusion: An inner myometrial laceration is one of the differential diagnoses of postpartum hemorrhage which should be taken into consideration. Laparotomy and hysterotomy for repairing the inner myometrial laceration would control postpartum hemorrhage and could avoid hysterectomy.
Gynecology Oncology
Nadereh Behtash; Fahimeh Sabet; Narges Izadi-mood; Mojgan Karimi-Zarchi
Volume 6, Issue 1 , January 2021, , Pages 42-49
Abstract
Vulvar Paget’s disease is rare among patients with vulvar cancer. Commonly, this disease is presented in the vulva and seen in postmenopausal women. In this study, we reported five cases of vulvar Paget’s disease referred to Bahman Hospital, Tehran, Iran, from 2013 to 2019. The median ...
Read More
Vulvar Paget’s disease is rare among patients with vulvar cancer. Commonly, this disease is presented in the vulva and seen in postmenopausal women. In this study, we reported five cases of vulvar Paget’s disease referred to Bahman Hospital, Tehran, Iran, from 2013 to 2019. The median age of patients diagnosed with Paget’s vulvar disease was 56.2 years (ranges from 52 to 62 years); the oncology history of patients was negative. All patients underwent surgery, including wide local excision, hemivulvectomy, and bilateral vulvectomy. The invasive disease was observed in three patients. Surgical margins in three patients were involved by Paget’s disease, and one recurrence (25%) was observed. Paget’s disease should be diagnosed and treated by surgery as soon as possible to avoid worsening the prognosis of patients and recurrence.
Leila Pirzade; Setare Nassiri; Mohammad Reza Vakili; Maryam Ameri
Volume 3, Issue 1 , March and April 2018, , Pages 45-48
Abstract
Introduction: Bartholin gland primary cancer occurs scarcely. Adenoid cystic carcinoma of the Bartholin gland is one of the rarest types of primary adenocarcinoma. Treatment delayed can lead to high rate of local recurrence and distant metastasis. The aim of this experimental case study was to discuss ...
Read More
Introduction: Bartholin gland primary cancer occurs scarcely. Adenoid cystic carcinoma of the Bartholin gland is one of the rarest types of primary adenocarcinoma. Treatment delayed can lead to high rate of local recurrence and distant metastasis. The aim of this experimental case study was to discuss a woman with misdiagnosed and mistreated ACC-BG, as a benign situation.
Patient Information: In this experimental case study, a 54-year-old woman referred to Joint Committee in Gynecology Oncology Department of Imam Khomeini Hospital of Tehran University of Medical Sciences, Tehran, Iran on Aug 2016 with a large mass within her vaginal distal wall. This woman was undertaken marsupialization for Bartholin cyst. Because of the bizarre manifestation of intervention, the biopsy was performed and revealed as adenoid cystic carcinoma of the Bartholin gland. Therefore, wide local excision and ipsilateral inguinal lymphadenectomy were considered. Adjuvant irradiation was planned. nificant difference in glucose levels in the first and second fingertip blood drops (p=0.257), while there was a significant difference between glucose levels in the first and second fingertip blood drops with standard venous sample (p<0.05). There was also a significant correlation between 2 drops in expression of glucometry results.
Conclusion: Adenoid cystic carcinoma of the Bartholin gland is very rare, but despite its low prevalence, it should be considered especially in the older patient or when the Bartholin cyst is unusually large and sticking to the surrounding tissue to prevent delays in diagnosis and treatment
Obstetrics and Gynecology
Zahra Akbarian Rad; Shahla Yazdani; Mina Galeshi; Neda Eftekhari; Fatemeh Shafizadeh
Volume 7, Issue 1 , September and October 2021, , Pages 45-51
Abstract
Background & Objective: Premature preterm rupture of membranes (PPROM) occurs in about 2-5% of singleton pregnancies and is known to cause one-third of preterm births. Our primary aim was to determine the maternal and neonatal outcomes in PPROM cases in mothers with a gestational age of less than ...
Read More
Background & Objective: Premature preterm rupture of membranes (PPROM) occurs in about 2-5% of singleton pregnancies and is known to cause one-third of preterm births. Our primary aim was to determine the maternal and neonatal outcomes in PPROM cases in mothers with a gestational age of less than 37 weeks.Methods: In this prospective cross-sectional study, eligible singleton women between 24+0-37+6 weeks of gestation with the PPROM enrolled who had referred to Ayatollah Rouhani Hospital in Babol, Iran, during the years 2019-2020. Maternal and neonatal outcomes were obtained by the checklist.Results: The mean age of the studied mothers was 29.3± 6.19 years, and their mean body mass index was 30.6 ±5. The incidence of chorioamnionitis at the gestational age of >32 weeks was more than that in women at gestational age equal to or over 32 weeks (P < /em>≤0.0001). Vaginal bleeding was almost more than twice as high in women with a gestational age of less than 32 weeks compared to those with a gestational age equal to or over 32 weeks (P < /em>≤0.0001). Neonatal morbidity was higher in all cases at less than 32 weeks of gestation (P < /em>≤0.0001). The neonatal mortality rate was 5.35%, but it was 25% at less than 32 weeks of gestation (P < /em>≤0.0001). The latency period greater than 7 days had more odds ratio for neonatal morbidity.Conclusion: Due to the high incidence of maternal and neonatal outcomes in gestational age less than 32 weeks, it is suggested that appropriate instructional materials and proper proceeding should be taken to prevent preterm labor and preterm rupture of the membranes.
Obstetrics and Gynecology
Fadhil Hussam; Shaymaa Abdulhameed Khudair; Waleed K. Alkhafaje; Yasir S. Alnassar; Rashad M. Kaoud; Ahmed Najm Abed; Haneen Saad Jabbar; Hiba Ali Numan
Volume 8, Issue 1 , January and February 2023, , Pages 47-52
Abstract
Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to ...
Read More
Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to female infertility. About 10-12% of couples struggle with infertility, a multifaceted issue with ramifications for society, the economy, and culture. The majority of female infertility cases are caused by issues with egg production. By analyzing samples from infertility clinics, the current study aims to investigate the degree of female infertility in Erbil, Iraq, while covering all facets of the condition.Materials & Methods: 595 infertile females receiving medical counseling from three infertile institutions between February 2020 to December 2021 were screened for the current study. In addition to anthropometric measurements, information about the etiology, duration, and lifestyle, factors of infertility has been gathered using a standardized questionnaire. Additionally, the sample was subjected to clinical examinations. Five groups of reproductive abnormalities were identified. Around 61.79% of women in the infertile group for the first two years had tubal obstruction, and 49.92% had hormonal deficiencies. Ovulation defects (4.62%) and undersized uteri (4.82%) predominated in the >10-year infertile group. Both weight and body mass index have shown a favorable association with infertility duration.Results: Our findings demonstrated a significant correlation between body mass index and infertility. Most academic and wealthy groups pursued medical advice to resolve issues related to infertility.Conclusion: Finally, it is suggested that female infertility can be managed and cured with hormone therapy, laparoscopic procedures, minor surgical procedures, and medicine.
Gynecology Oncology
Forozan Milani; Seyedeh Hajar Sharami; Negar Gholamalipour; Ehsan Kazemnezhad Leyli; Seyedeh Fatemeh Dalil Heirati; Yalda Donyaei-Mobarrez
Volume 9, Issue 1 , January and February 2024, , Pages 53-62
Abstract
Background & Objective: Evaluation of the alpha-fetoprotein is one of the screening tests during pregnancy. The purpose of this study was to determine the relationship between the level of alpha-fetoprotein in amniotic fluid (AF-AFP) and adverse pregnancy outcomes.Materials & Methods: This ...
Read More
Background & Objective: Evaluation of the alpha-fetoprotein is one of the screening tests during pregnancy. The purpose of this study was to determine the relationship between the level of alpha-fetoprotein in amniotic fluid (AF-AFP) and adverse pregnancy outcomes.Materials & Methods: This comparative analytical study was performed on 244 pregnant women who referred to a private prenatal clinic in Rasht (Iran). Amniocentesis was performed on pregnant women with maternal serum alpha-fetoprotein (MS-AFP) was higher than 2.5MoM in the second trimester and based on this finding, participants were divided into four groups of 61 patients. The first group (control group) included pregnant women with normal MS-AFP, the second group included pregnant women with high MS-AFP and normal AF-AFP, the third group included pregnant women with high MS-AFP and low AF-AFP and the fourth group included pregnant women with high MS-AFP and high AF-AFP.Results: Adverse outcomes include abortion (6.6%), stillbirth (6.6%), IUGR (18%), LBW (29.5%), PTL (21.3%), fetal abnormalities (4.9%), preeclampsia (14.8%), gestational diabetes (8.2%), in the fourth group (high AF-AFP) was higher than other groups. The incidence of adverse pregnancy outcomes in the fourth group was 1.2 times higher than the control group, and this relationship was borderline statistically significant (P=0.056).Conclusion: Considering that adverse pregnancy outcomes are important causes of mortality and morbidity, early diagnosis of high-risk pregnancies and efforts for preventive interventions can be associated with reducing mortality and morbidity. Therefore, evaluation of the level AF-AFP can be helpful in determining adverse pregnancy outcomes.
Maternal Fetal Medicine
Parichehr Pooransari; Mahboobeh Shirazi
Volume 5, Issue 2 , October 2020, , Pages 68-71
Abstract
Background & Objective: Screening tests for common aneuploidy, especially trisomies 21, 18, and 13, should be offered to pregnant people of all ages at first and second trimesters. Theses include combined tests (nuchal translucency (NT)+biochemical pregnancy-associated plasma protein-A (PAPP-A), ...
Read More
Background & Objective: Screening tests for common aneuploidy, especially trisomies 21, 18, and 13, should be offered to pregnant people of all ages at first and second trimesters. Theses include combined tests (nuchal translucency (NT)+biochemical pregnancy-associated plasma protein-A (PAPP-A), free beta-human chorionic gonadotropin (β-hCG)) and quad test. If the tests are positive based on cut-off value of 1:250, diagnostic tests such as amniocentesis and chorionic villus sampling (CVS) are suggested. The current study aimed to comparatively evaluate the results of these screening tests and amniocentesis.
Materials & Methods: This practical-basic study was designed to evaluate the accuracy of first and second trimester screening tests with amniocentesis results. A total of 45 subjects were selected from the patients referred for abnormal screening tests toShohadaya-ye-Tajrish hospital in Tehran, Iran, during 2014-2015. The results of tests (combined or quad) were positive based on cut-off value of 1:250. Data was collected through a questionnaire containing such information as age, gravidity, previous aneuploidy births, placenta location, blood group, amniotic fluid color, type of sampling needle, and mode of needle entrance.Results: The mean age of patients was 33.16 years. There was significant p-value between positive results of amniocentesis and age of the patients. Out of 45 amniocentesis tests, four had abnormal results (two in the first trimester (2/17) and two in the second trimester (2/24)). Also, three items were T21 and the forth was translocation between chromosome 11-22. We had one fetal loss due to amniocentesis procedure.Conclusion: Diagnostic tests are suggested for better evaluation of abnormal results. These screening tests have false positive and negative results. We attempted to evaluate the real results with invasive tests. Further research is needed to investigate the accuracy of screening aneuploidy tests.
Fatemeh Sharifzadeh Mahalati; Mina Moeini Chaghervand; Shahrzad Hashemi Dizaji; Maryam Chamani
Volume 4, Issue 2 , May and June 2019, , Pages 81-85
Abstract
Background & Objective: Neonates with birth weights below the 10th percentile of gestational age- and sex-specific reference are known as neonates with intrauterine growth restriction (IUGR). Neonates with IUGR are more prone to diseases, infections, respiratory failure, and neonatal mortality. This ...
Read More
Background & Objective: Neonates with birth weights below the 10th percentile of gestational age- and sex-specific reference are known as neonates with intrauterine growth restriction (IUGR). Neonates with IUGR are more prone to diseases, infections, respiratory failure, and neonatal mortality. This study aimed to evaluate the association between perinatal Doppler findings and hematological indices in neonates with intrauterine growth restriction at gestational ages of 32 to 36 weeks.
Materials & Methods: In this analytical cross-sectional study conducted at Akbarabadi Hospital from 2016 to 2017, 90 neonates with IUGR who underwent umbilical artery Doppler ultrasound during pregnancy were haphazardly selected and the umbilical artery Doppler velocity was compared with neonatal hematological indices.
Results: Results indicated that 48, 25, and 17 neonates had normal, absent, and reverse Doppler, respectively. A decreased umbilical artery Doppler velocity was associated with a reduction in platelet level (P < /em>=0.004) and an increase in NRBC level (P < /em>=0.002). Considering a P-value>0.05, white blood cell and hemoglobin levels had no associations with umbilical artery Doppler. However, IVH was correlated with the severity of abnormal umbilical artery Doppler (P < /em>=0.001). There was no significant relationship between hyperbilirubinemia and abnormal umbilical artery Doppler (P < /em><0.05).
Conclusion: The severity of thrombocytopenia and the level of NRBC in IUGR neonates are directly related to abnormal umbilical artery Doppler and consequently, chronic hypoxia in these neonates. Furthermore, IVH is more likely to occur in neonates with chronic hypoxia. Early and perinatal diagnoses of these abnormalities can help us treat them faster and reduce long-term morbidities.
Elham Shirali; Fariba Yarandi; Nadereh Behtash; Omid Hemmatian
Volume 3, Issue 2 , May and June 2018, , Pages 87-91
Abstract
Aims: Cervical cancer is one of the most common cancer in the female since 1990. Neoadjuvant chemotherapy (NACT) uses before surgery, especially in countries with limited radiotherapy facilities. The aim of the present review was to study the effect of NACT before radical surgery in comparison with other ...
Read More
Aims: Cervical cancer is one of the most common cancer in the female since 1990. Neoadjuvant chemotherapy (NACT) uses before surgery, especially in countries with limited radiotherapy facilities. The aim of the present review was to study the effect of NACT before radical surgery in comparison with other treatments and various clinical outcomes.
Information and Methods: This study is a systematic review and includes previous publishes about cervical cancer and effect of NACT before radical surgery. Over 40 previous studies were reviewed, none of them was case report, at least 5 studies were randomized clinical trials and 6 of them were meta-analysis or systematic review.
Findings: NACT before surgery demonstrates advantages to reduce the rate of lymph node metastasis and parametrial infiltration, so improves progression-free survival in patients with pelvic lymph node invasion (Approximately 35% of stage IB2–IIB bulky). NACT also decreases tumor volume and minimizes the need for adjuvant radiotherapy, thus NACT under consideration of quality of life and cost-effectiveness should be recommended. NACT is really effective in decreasing incidence of pathological risk factors.
Conclusion: NACT response associated with the stage of diagnosis, tumor size and pathology of the specimen (Squamous tumor has a better response than a non-squamous tumor). NACT seems to be feasible in the management of stage IB bulky cervical cancer, NACT followed by surgery represent an alternative to primary chemoradiotherapy in young and sexually active patients.
