Obstetrics and Gynecology
Najmiatul Fitria; Nauratul Ikramah; Ade Sukma; Hansen Nasif
Articles in Press, Accepted Manuscript, Available Online from 05 August 2023
Abstract
Background and Objective: Pregnant women need more nutritional intake than before pregnancy. If this nutritional intake is insufficient for the mother, it will result in Chronic Energy Deficiency (CED). To determine if pregnant women are experiencing malnutrition or cannot be known by measuring the Mid-Upper ...
Read More
Background and Objective: Pregnant women need more nutritional intake than before pregnancy. If this nutritional intake is insufficient for the mother, it will result in Chronic Energy Deficiency (CED). To determine if pregnant women are experiencing malnutrition or cannot be known by measuring the Mid-Upper Arm Circumference (MUAC). Based on service regulations for pregnant women in Indonesia, the minimum number of Iron-Folic Acid (IFA) tablets pregnant women get is 120. Regarding this condition, a study was conducted to analyze the relationship between the amount of IFA consumption on MUAC and several other therapeutic outcomesMethods: This study used a cross-sectional method by examining the patient's medical records. Patients who received IFA as many as 120 tablets or more will become the exposure group. Data will be analyzed descriptively using chi-squareResults: The MUAC size significantly differed at the end of pregnancy (p=0.01). However, overall there was no significant difference between the two groupsConclusion: The IFA administration generally gives good results, but the optimal number of IFA doses still needs further study.
Maternal Fetal Medicine
rana razavi; samira jahangard
Volume 7, Issue 1 , September and October 2021, , Pages 52-58
Abstract
Pregnant women appear to be more severely affected by COVID-19. Coagulopathy is known as one of the most challenging effects of COVID-19, and the effects of acute airway diseases resulting from the coronavirus on pregnant mothers and their fetuses can be dangerous. Two women who where pregnant suffering ...
Read More
Pregnant women appear to be more severely affected by COVID-19. Coagulopathy is known as one of the most challenging effects of COVID-19, and the effects of acute airway diseases resulting from the coronavirus on pregnant mothers and their fetuses can be dangerous. Two women who where pregnant suffering from coagulopathy (one of them with disseminated intravascular coagulation (DIC) and the other one with hypercoagulation) and COVID-19 infection are reported in this study. During hospitalization due to severe vaginal bleeding and placental detachment, cesarean section was performed on the first caseand because of acute severe DIC, she received a massive transfusion. The second patient epigastric pain and tachycardia. COVID-19 might have a variety of effects on pregnancy outcome, from vascular and placental involvement to respiratory involvement; there is an association between the coronavirus and hyper-coagulopathy state and coagulopathy like DIC.
Gynecology Oncology
Afsaneh Tehranian; Akram Ghahghaei-Nezamabadi; Maryam Motiei Langeroudi; Reyhaneh Aghajani
Volume 8, Issue 1 , January and February 2023, , Pages 53-56
Abstract
Background & Objective: We compared two different methods of visual inspection of the cervix, including Visual inspection of the cervix with acetic acid (VIA) and Visual inspection of the cervix with Lugol's iodine (VILI) in terms of sensitivity and specificity in diagnosis of pre-malignant cervical ...
Read More
Background & Objective: We compared two different methods of visual inspection of the cervix, including Visual inspection of the cervix with acetic acid (VIA) and Visual inspection of the cervix with Lugol's iodine (VILI) in terms of sensitivity and specificity in diagnosis of pre-malignant cervical lesions in comparison to colposcopy guided biopsy.Materials & Methods: In this cross-sectional study, a total number of 200 women who were referred to the colposcopy clinic of Arash women’s hospital (Tehran, Iran) for cervical cancer screening, underwent VIA, VILI, and colposcopy guided biopsy during 2018-2019.Results: The calculated sensitivity and specificity of VIA and VILI in this population were (100% and 69.5%) and (100% and 60%), respectively, whereas the sensitivity and specificity of both VIA and VILI tests in combination were 100% and 77.2%. The positive and negative predictive values were 32.7% and 100%, respectively, when combined form of VIA and VILI was applied in this population.Conclusion: VIA and VILI alone or in combination could be used as screening tests to evaluate the presence of cervical cancer and in case of positive results, supplementary tests such as colposcopy guided biopsy could be performed for definite diagnosis.
Reproductive Medicine
Mohammad Ebrahim Parsa Nejad; Elnaz Fathi Kaljahi; Sareh Dousfatemeh
Volume 9, Issue 1 , January and February 2024, , Pages 63-69
Abstract
Background & Objective: In this placebo-controlled randomized clinical trial, we aimed to investigate the effect of low molecular weight heparin (LMWH) on the assisted reproductive technology (ART) success rate in women without thrombophilic disorder undergoing assisted reproductive technology.Materials ...
Read More
Background & Objective: In this placebo-controlled randomized clinical trial, we aimed to investigate the effect of low molecular weight heparin (LMWH) on the assisted reproductive technology (ART) success rate in women without thrombophilic disorder undergoing assisted reproductive technology.Materials & Methods: The study population consisted of 276 patients referred to the infertility center at Shiraz University of Medical Sciences and who underwent in vitro fertilization (IVF) for the first time. Patients were randomly assigned into two groups (control group = 137 women who underwent IVF and received placebo; case group = 139 women who underwent IVF and received LMWH). The case group was treated with LMWH and the control group received placebo. Specifications for egg harvesting, processing sperm, the number of fertilized eggs and embryos, the number of frozen and transferred embryos, and the IVF outcome were assessed.Results: The mean age of subjects was 32.59 ± 4.41 years old in the case group and 32.62 ± 5.18 in the control group (p = 0.955). The final outcome of IVF treatment in the control group was treatment failure (62%), clinical pregnancy (21.2%), chemical pregnancy (5.9%), and live birth (7.3%), while in the case group, it was treatment failure (48.2 %), clinical pregnancy (21.6%), chemical pregnancy (2.2%), and live births (28.1%). There was a significant difference in IVF outcome in the two groups (P < 0.001).Conclusion: Given the significant difference in the number of live births and reduction of pregnancy complications in the LMWH group, it can be concluded that LMWH prophylaxis may be effective in ART success.
Obstetrics and Gynecology
Fatemeh Golshahi; Fariba Yarandi; Sara Ramhormozian; Elham Shirali
Volume 7, Issue 2 , September and October 2021, , Pages 121-125
Abstract
With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive ...
Read More
With increase in the second-trimester pregnancy termination, debates continue on the most suitable mode of termination. Misoprostol is used as an agent for the medical abortion. Some authors believe that uterine rupture risk as a complication of medical termination is higher in the patients with positive cesarean section history while some others have no report of such effect. This complication cannot be predicted and can occur under various circumstances with different misoprostol regimens. Hereby, we reported three cases with positive cesarean section history undergoing second-trimester pregnancy termination due to preterm premature rupture of the membranes (PPROM) who developed uterine rupture with similar misoprostol dosages. Finally, we conclude that more cautions should be undertaken in the setting of PPROM with previous history of cesarean section or gestational age >20 weeks about uterine rupture risk and full recommended misoprostol dose must not be administered to prevent life-threatening events.
Obstetrics and Gynecology
Hamideh Gholami; Sahar Farahmand; Fatemeh Moradiha
Volume 8, Issue 2 , March and April 2023, , Pages 150-156
Abstract
Background & Objective: Labor pain is one of the most severe pains that a woman may experience, so it is important to research the methods to reduce this pain. Paracetamol infusion is an efficient and available remedy to alleviate labor pain in an active phase. This study was conducted to assess ...
Read More
Background & Objective: Labor pain is one of the most severe pains that a woman may experience, so it is important to research the methods to reduce this pain. Paracetamol infusion is an efficient and available remedy to alleviate labor pain in an active phase. This study was conducted to assess the efficacy of intravenous paracetamol injection on reducing labor pain.Materials & Methods: In this double-blind randomized clinical trial study, the number of 110 nulliparous pregnant women who were candidates for vaginal delivery were included in the study. After the onset of the active phase of labor, the control group received only 300 cc normal saline and the intervention group received 300 cc normal saline plus one gram of paracetamol. The maternal pain score, duration of the first and second stages of labor, delivery type and Apgar score were compared between two groups. Repeated measure ANOVA was used for comparison of means of the VAS score between groups based on repeated observations.Results: The mean age of the patients was 25.09 ± 4.2 years (18-35 years). The mean length of the first stage (2.85 vs. 3.52 hours, P = 0.001) and second stage (38.77 vs. 43.44 minutes, P = 037) in the intervention group was significantly lower than the control group. Moreover, the mean score of pain was significantly lower in the paracetamol group at all times than the control group (P <0.05).Conclusion: The prescription of intravenous paracetamol not only reduces pain during labor in women but also reduces the duration of different stages of labor, increases patients’ satisfaction with natural childbirth, and reduces the demand for Cesarean.
Obstetrics and Gynecology
Fatemeh Golshahi; Mahboobeh Shirazi; Fatemeh Rahimi Sharbaf; Mohammad Reza Zarkesh; Narges Nahavandi
Volume 6, Issue 3 , June 2021, , Pages 152-156
Abstract
The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80% mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with ...
Read More
The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80% mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with preterm birth at this age due to preterm uterine contractions. No etiology was found for hydrops and all signs resolved thoroughly after birth without treatment. After birth, the newborn was admitted to neonatal intensive care unit and discharged after 47 days in good condition. The infant was completely healthy within three months after delivery.
General Gynecology and Pelvic Floor
Mona K. Omar; Ayman S. Dawood; Samah Ahmed Radwan; Ahmed M. Ossman
Volume 9, Issue 2 , March and April 2024, , Pages 163-173
Abstract
Background & Objective: Conservative treatment of placenta accreta spectrum (PAS) become increasingly performed, especially due to acceptance of many obstetricians to preserve the uterus. To evaluate cesarean scar integrity following PAS conservative surgery using Shehata's technique and other conservative ...
Read More
Background & Objective: Conservative treatment of placenta accreta spectrum (PAS) become increasingly performed, especially due to acceptance of many obstetricians to preserve the uterus. To evaluate cesarean scar integrity following PAS conservative surgery using Shehata's technique and other conservative techniques because more than one level of pelvic devascularization was used. This cross-sectional study was conducted at Tanta University in the period from June 1, 2019 to October 31, 2022.
Materials & Methods: All patients underwent conservative uterine sparing technique (Shehata's technique) were assessed by 2 D ultrasound at 6-18 months later to detect the integrity of the CS scar. Fifty women with a history of other conservative treatment of PAS used as control.
Results: Women who were operated with Shehata’s technique showed less incidence of scar dehiscence with less size of scar defects and more thickness of the myometrium over the scar site and more vascularity of these scars.
Conclusion: Shehata's technique resulted in a more integrated scar with less incidence of dehiscence and more vascularity of the compared to other conservative methods of treatment of PAS. Therefore, it is an effective and safe method in treatment of PAS.
Obstetrics and Gynecology
Haleh Ayatollahi; Somayeh Ghasemzadeh; Sedigheh Ghasemiyan Dizaj Mehr
Volume 7, Issue 3 , January and February 2022, , Pages 192-199
Abstract
Background & Objective: At the beginning of the pandemic COVID-19, most health facilities suspended non-emergency surgeries to ensure emergency care capacity. Due to the need for surgery, and insufficient information about the complications of surgery in these patients, the present study aimed to ...
Read More
Background & Objective: At the beginning of the pandemic COVID-19, most health facilities suspended non-emergency surgeries to ensure emergency care capacity. Due to the need for surgery, and insufficient information about the complications of surgery in these patients, the present study aimed to investigate the outcome of surgeries in patients with COVID-19 in Motahari Hospital in Urmia.Materials & Methods: This cross-sectional study was performed on 112 patients diagnosed with COVID-19 who underwent surgery. A Checklist including the following data was extracted from the patients' medical records, symptoms, laboratory tests, and any complications related to surgery up to one month after separate surgery.Results: A total of 6.3% of patients had limited complications due to the incision site after the surgery. The results did not show a significant relationship between age, type of anesthesia, and the type of operation with complications. However, the highest percentage of complications was seen in less than 40 years and emergency surgeries. It was found that patients with a history of diabetes had the highest rate of complications (57.1%), although there was no significant relationship between the underlying disease and complications (P = 0.40). In our study, none of the patients experienced complications such as vascular thrombosis or embolism, respiratory failure, and heart failure, or the need for cardiopulmonary resuscitation. Overall, 17.9% of patients needed ICU admission (mean 2.16 ± 1.50 days), indicating a higher ICU hospitalization demand. Also, in terms of in-ward hospitalization, patients with complications had a longer hospital stay than uncomplicated patients (7.85 ± 3.36 days) vs. (5.13 ± 1.66), which was not statistically significant (P = 0.88).Conclusion: The results show that surgery is not directly associated with an increased risk of mortality and complications in patients with COVID-19. On the other hand, Underlying diseases, age, and the urgency of surgery are associated with a higher risk for complications than COVID-19.
Maternal Fetal Medicine
Ali Reza Norouzi; Mahsa Siavashi; Fatemeh Norouzi; Maryam Talayeh; Somayyeh Noei Teymoordash
Volume 6, Issue 4 , August 2021, , Pages 217-223
Abstract
Background & Objective: Gestational diabetes mellitus (GDM) is the most prevalent disorder during pregnancy, which is the result of insulin resistance and hyperinsulinemia due to the secretion of placental diabetogenic hormones. This study aimed to investigate the utility of glycated hemoglobin ...
Read More
Background & Objective: Gestational diabetes mellitus (GDM) is the most prevalent disorder during pregnancy, which is the result of insulin resistance and hyperinsulinemia due to the secretion of placental diabetogenic hormones. This study aimed to investigate the utility of glycated hemoglobin A1c (HbA1c) alone and in combination with hematocrit for early detection of gestational diabetes mellitus.Materials & Methods: In this prospective cohort research, 373 pregnant women who referred to prenatal clinics were included. Hematocrit and HbA1c were determined at gestational age of 12 to 16 weeks and compared with the oral glucose tolerance test (OGTT) results at gestational age of 24-28 weeks.Results: The best cut-off hematocrit for determining pregnancy diabetes mellitus was 37.3. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 70.15%, 64.12%, 32.71 %, and 89.51% respectively.In terms of HbA1c, the best cut-off value to determine GDM in pregnant women was 5, with a sensitivity of 98.51%, specificity rate of 99.02%, PPV of 95.07%, and NPV of 99.49%. In terms of diagnosing GDM, the area under the ROC curve (AUC) for HbA1c was equal to 0.985 which was higher than the AUC for the combination of HbA1c with HCT.Conclusion: Measuring HbA1c can be useful as a screening test for GDM, which is an inexpensive and available test. The combined evaluation of HbA1c and hematocrit did not improve the diagnostic value of HbA1c in GDM screening compared to exclusive evaluation of HbA1c.
Obstetrics and Gynecology
Sahar Hassan; Nassrin Malik Aubead
Volume 8, Issue 3 , May and June 2023, , Pages 255-267
Abstract
Background & Objective: Congenital anomalies are a global issue and the primary reason of death in both developed and advanced countries. Congenital anomalies occur at varying rates in various populations. The purpose of this research was to determine the prevalence and pattern of ...
Read More
Background & Objective: Congenital anomalies are a global issue and the primary reason of death in both developed and advanced countries. Congenital anomalies occur at varying rates in various populations. The purpose of this research was to determine the prevalence and pattern of congenital anomalies in newborns, as well as the associated maternal and environmental factors in newborns, presented at the Babylon teaching hospital for motherhood and pediatrics in AL-Hilla city, between 2017 and 2021.Materials & Methods: This study follows a descriptive design, and was based on population data from the statistic registry covering the AL-Hilla city, Iraq, 2017 to 2021. The registry covers live and still births. Also, maternal and neonatal information regarding sex, birth weight, parental consanguinity, and maternal age, were recorded.Results: There were 214 congenitally deformed newborns among the 46,777 births in AL-Hilla city. There were 109 males (50.69 percent) and 103 females (47.90 percent). The most common congenital malformations discovered were those relating to the neurological system, followed by those relating to the musculoskeletal system.Conclusion: Anomalies in the central nervous system were most apparent, however, this research can help to determine the approximate distribution of the prevalence of congenital anomalies in AL-Hilla city in Iraq. Also, by identifying their main types, information can be applied to improve the clinical performance and public policies of Iraq.
Maternal Fetal Medicine
Mahboobeh Shirazi; Mohammadreza Zarkesh; Maliheh Fakehi; Marjan Ghaemi
Volume 7, Issue 4 , March and April 2022, , Pages 329-334
Abstract
Background & Objective: This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.Materials & Methods: This retrospective cohort study was recruited in an academic hospital affiliated ...
Read More
Background & Objective: This study aimed to compare the neonatal outcomes and infant development one year after birth at different gestational ages of elective cesarean section (CS) beyond 38 weeks.Materials & Methods: This retrospective cohort study was recruited in an academic hospital affiliated with Tehran University of Medical Sciences between June 2018 and June 2020. The subjects of the study were the women who were scheduled for elective CS and divided into 3 groups according to the gestational age (38 0/7 to 38 6/7 as group A, 39 0/7 to 39 6/7 as group B, and 40 0/7 to 40 6/7 as group C). The neonatal outcomes and the growth and development status were evaluated by ages and stages questionnaires® (ASQ) after 12 months and compared between groups.Results: Totally, 952 neonates were eligible for this study. In groups A, B, and C, CS was performed in 314, 409, and 229 neonates, respectively. The first minute Apgar was significantly lower in the neonates with lesser gestational age at delivery (P < /em>=0.026). Indeed, neonatal hospitalization, hypoglycemia, and jaundice in group A were significantly higher than in other groups (P < /em><0.001). Regarding psychomotor development, the scores related to gross motor and problem-solving abilities in group A were significantly lower than those in other groups (P < /em><0.05).Conclusion: It is suggested to plan elective CS beyond 39 weeks of gestation to decrease prenatal morbidities and improve psychomotor development one year after birth.
Obstetrics and Gynecology
Ali Abdulhussain Fadhil; Ghazi Mohamad Ramadan; Zahraa A. Al-Ajeeli; Noora M. Hameed; Wael Dheaa Kadhim; Ahmed S. Abed; Iman Hazim Jirjees; Anwar Sabbah Hussen
Volume 8, Issue 4 , July and August 2023, , Pages 374-381
Abstract
Background & Objective: Low and high hemoglobin concentration is one of the main concerns of women during pregnancy due to its high prevalence and adverse effects. The present study aimed to examine the correlation between maternal hemoglobin concentration and the baby's birth weight and height ...
Read More
Background & Objective: Low and high hemoglobin concentration is one of the main concerns of women during pregnancy due to its high prevalence and adverse effects. The present study aimed to examine the correlation between maternal hemoglobin concentration and the baby's birth weight and height in 326 pregnant women referred to the Alwiyah hospital for obstetrics and gynecology in Baghdad, Iraq, in 2019.Materials & Methods: In the current descriptive-analytical study, pregnant women were classified into two groups: anemia and normal; four groups of moderate to severe anemia, mild, regular, and high hemoglobin; and eight groups with intervals of 12 g/L from severe anemia to high hemoglobin. This study's variables included infants' age, number of children, education level, socioeconomic status, weight, and height. The data was analyzed using SPSS version 19, descriptive statistics, t-test, and logistic regression. In this study, the level of statistical significance was deemed to be 0.001.Results: The results showed that the probability of low birth weight and abnormal height increases 4.96 times and 4.13 times, respectively, in mothers with high hemoglobin concentrations versus mothers with low hemoglobin concentrations; these ratios are statistically significant (P<0.001). Also, hemoglobin concentrations ranging from 104 to 115 g/L have the lowest probability. Furthermore, hemoglobin concentrations greater than 125 g/L are statistically significant (P<0.001).Conclusion: The current study revealed that high maternal hemoglobin concentrations during pregnancy could significantly impact the baby's weight and height.
Gynecology Oncology
Behnaz Nouri; Mohadese Alemi; Ahmad Reza Baghestani
Volume 7, Issue 5 , July and August 2022, , Pages 429-436
Abstract
Background & Objective: Endometriosis is associated with the increased risk of coronary heart disease and immune alterations, which may be attributed to the altered lipid profile and decreased serum level of 25–hydroxyl vitamin D (25(OH)D). The present study aimed to evaluate the effect of ...
Read More
Background & Objective: Endometriosis is associated with the increased risk of coronary heart disease and immune alterations, which may be attributed to the altered lipid profile and decreased serum level of 25–hydroxyl vitamin D (25(OH)D). The present study aimed to evaluate the effect of radical laparoscopic surgery of endometriosis on serum lipid profile and 25(OH)D.Materials & Methods: This cross-sectional study was performed on 47 women aged 15 to 45, with body mass index <30kg/m2, who were referred to Shohaday-eTajrish Hospital, from May 2018 until Jan 2020, for surgical treatment of endometriosis and did not have a systemic disease and did not use oral contraceptives and/or other hormonal therapies three months before surgery were enrolled into the study. The serum lipid profile and 25(OH)D levels of patients two months after surgery were compared with presurgical levels. The results were analyzed by using paired t-test.Results: A total of 47 patients completed the study (mean age: 32.8±7.5years). About half had no pregnancies (49.1%). Comparing the serum lipid profile of patients before and two months after surgery showed a significant decrease in triglyceride from 108.4±46.2 to 86.4±51.1 mg/dL (P < /i>=0.001), ], total cholesterol from 172.5±26.5 to 160.0±28.3mg/dl (P < /i>=0.002), and low-density lipoprotein levels from 97±28.3 to 89.8±26.1 mg/dL (P < /i>=.003); however, high-density lipoprotein and 25(OH)D levels did not show a significant difference (P < /i>>0.05). Conclusion: the results of the current study showed that laparoscopic resection of endometriotic lesions resulted in a significant reduction of the unfavorable lipid profile after two months, but not 25(OH)D levels.
Obstetrics and Gynecology
Farima Rahimi Mansour; Farah Farzaneh; Mohammad Mahdi Dabbagh; Amirreza Keyvanfar
Volume 8, Issue 5 , September and October 2023, , Pages 488-493
Abstract
Background & Objective: Aluminum (Al) is used in different industries to produce cosmetics, supplements, drugs, food packaging, toothpaste, kitchen utensils, and antiperspirants. Uterine fibroid (UF) is women's most prevalent benign tumor during the reproductive ages. Since Al can accumulate ...
Read More
Background & Objective: Aluminum (Al) is used in different industries to produce cosmetics, supplements, drugs, food packaging, toothpaste, kitchen utensils, and antiperspirants. Uterine fibroid (UF) is women's most prevalent benign tumor during the reproductive ages. Since Al can accumulate in the body's organs, it may play a role in the pathogenesis of UF. This study aimed to measure Al levels in serum and uterine samples (normal uterine tissue of control and UF patients, and leiomyoma of UF patients).Materials & Methods: In this descriptive study, we included ten women who underwent hysterectomy (five women due to UF and five women for a reason other than UF). Samples were obtained from serum, normal uterine tissue, and leiomyoma. Tissue and serum samples were digested with nitric acid (HNO3) and hydrogen peroxide (H2O2). Eventually, the Al levels in samples were analyzed by inductively coupled plasma atomic emission spectroscopy (ICP-AES).Results: Al level was higher in the serum of the control group compared with UF patients (326.8 ± 360.8 µg/L vs. 211.2 ± 56.4 µg/L, P =0.310). Al level was higher in the control group compared with the normal tissue of UF patients (410.2 ± 244.7 µg/L vs. 300 ± 138.0 µg/L, P=0.465). Besides, leiomyoma had a higher Al level compared with the normal tissue of UF patients (1482.2 ± 2062.9 µg/L vs. 300 ± 138.0 µg/L, P=0.138).Conclusion: The results showed that Al levels of tissue and serum samples in various groups differed, but these differences were not statistically significant.
Obstetrics and Gynecology
Mitra Modares Gilani; Azam Sadat Mousavi; Setareh Akhavan; Shahrzad Sheikhhasani
Volume 7, Issue 6 , September and October 2022, , Pages 530-535
Abstract
Background & Objective: Cervical cancer is one of the most common cancers in women. One of the most important indicators that deal with all aspects of the patients' health is the Health-related quality of life (QOL). In this study, the QOL of women with cervical cancer in Iran was investigated.Materials ...
Read More
Background & Objective: Cervical cancer is one of the most common cancers in women. One of the most important indicators that deal with all aspects of the patients' health is the Health-related quality of life (QOL). In this study, the QOL of women with cervical cancer in Iran was investigated.Materials & Methods: The present cross-sectional study examined the QOL of 139 patients with cervical cancer referred to Imam Khomeini hospital, affiliated with the Tehran University of Medical Sciences. For this study, a specific questionnaire of QOL in patients with cervical cancer was used. To determine the predictors of cervical cancer patients, the QOL linear regression model was used.Results: Findings of this study showed that the total score of QOL of patients was 20.97±1.29. Moreover, in the regression model, a significant relationship was observed between the type of treatment and patients' QOL scores and those patients who had neoadjuvant therapy plus surgery (β=-17.45, P < /i>=0.02) and those who received brachytherapy (β=- 14.86 and P < /i>=0.09) had a significantly lower QOL score.Conclusion: Overall, the QOL of people with cervical cancer was moderate. Implementing educational programs for service providers and choosing the appropriate type of treatment according to the stage of the disease and the patient's age can help control this type of disease and its complications and improve the QOL of patients.
Obstetrics and Gynecology
Abdaladeem Yousif Jasem; Mohammed Shnain Ali; Abas O. Hadi; Shaymaa Abdulhameed Khudair; Shamam Kareem Oudah; Mutni A Majeed; Zainab H. J. Alhassona
Volume 8, Issue 6 , November and December 2023, , Pages 607-613
Abstract
Background & Objective: The birth weight is an essential indicator of a baby's health. The birth of infants with low birth weight (LBW) is one of the most significant health issues and one of the leading causes of infant mortality. The current study aimed to investigate the impact of demographic ...
Read More
Background & Objective: The birth weight is an essential indicator of a baby's health. The birth of infants with low birth weight (LBW) is one of the most significant health issues and one of the leading causes of infant mortality. The current study aimed to investigate the impact of demographic and delivery factors on low- and normal-weight infants.Materials & Methods: The current retrospective study collected data from all 2,731 babies born in Basra in 2022 and their mothers from electronic files. The data consists of demographic information and delivery factors. Babies were divided into two groups based on their weight: LBW (n=192) and normal (n=768). Data analysis was performed with SPSS version 19 and the chi-square, Fisher, Mann-Whitney, and logistic regression tests. The level of statistical significance was determined to be equal to 0.05.Results: The results showed that the variable of intrauterine age less than 37 weeks increases the risk of having a baby with LBW by 1.84 times (0.95CI=0.52-3.12), age less than 20 years increases the risk by 1.76 times (0.95CI=0.83-2.64), BMI in the thin range increases the risk by 1.42 times (0.95CI=0.87-1.84), and anemia with hemoglobin less than 11 g/dl increases the risk by 1.34 times (0.95CI=0.76-1.86).Conclusion: The results revealed that age, BMI, anemia, and intrauterine age impact birth weight. Therefore, controlling the risk factors mentioned above in mothers before becoming pregnant can reduce the number of LBW babies.
Setareh Akhavan; Azamsadat Mousavi; Abbas Alibakhshi
Volume 1, Issue 1 , May and June 2016
Abstract
Borderline ovarian tumors (BOT) consist of epithelial ovarian lesions that express cytological features of malignancy, but unlike malignant ovarian tumors, do not show obvious stromal invasion. The tumor incidence is between 1.8 and 4.8 per 100,000 females per year. The two major groups of BOT include ...
Read More
Borderline ovarian tumors (BOT) consist of epithelial ovarian lesions that express cytological features of malignancy, but unlike malignant ovarian tumors, do not show obvious stromal invasion. The tumor incidence is between 1.8 and 4.8 per 100,000 females per year. The two major groups of BOT include serous BOT (S-BOT) and mucinous BOT (M-BOT). S-BOTs are divided into two categories: tumors limited to ovary and tumors spreading outside the ovary. M-BOTs are divided into two categories. The more common type is intestinal that constitutes 85% of cases and the second type is endocervical or Mullerian. Mullerian M-BOTs is bilateral in 40% of cases, while it is accompanied by pelvic endometriosis in 20-30% of patients. Microscopic examination by intraoperative frozen section is necessary because macroscopic view of ovarian tumors alone is not reliable. It is better to perform conservative surgery until the final report is ready in patients who wish to preserve their fertility. It is hard to differentiate them based on clinical characteristics. Values of tumor markers including CA125, CA19-9 and CEA in diagnosis of BOT are confirmed. Standard treatment of BOT is surgery as is the case with invasive epithelial ovarian cancer. In the majority of patients referred for BOT, since there is no suspicion of malignancy, staging is not performed. In these cases, making decision to repeat surgery and staging depend on factors such as the type of histology, abdominal exploration results in the previous surgery and probability of the presence of residual tumor.
Obstetrics and Gynecology
Seema Chigateri; suchith hoblidar; suma S Moni; Rathnamala M Desai; Carol S Luke
Articles in Press, Accepted Manuscript, Available Online from 26 April 2024
Abstract
Background: Establishing a consensus on the appropriate use of prophylactic antibiotics in elective laparoscopic procedures for benign gynecological conditions would be beneficial.Objectives: The necessity of preventive antibiotics during laparoscopy for uncomplicated gynecologic conditions is currently ...
Read More
Background: Establishing a consensus on the appropriate use of prophylactic antibiotics in elective laparoscopic procedures for benign gynecological conditions would be beneficial.Objectives: The necessity of preventive antibiotics during laparoscopy for uncomplicated gynecologic conditions is currently being debated. This study aims to ascertain the need for prophylactic antibiotics in preventing early post-surgery infections and febrile morbidity in elective laparoscopic surgery for benign gynecologic conditions.Materials and methods: One hundred women who underwent uncomplicated laparoscopic surgeries were studied for four years. Participants were randomly divided into two groups, and demographic data and postoperative outcomes were analyzed. Infections at the surgical site, fever, urinary tract infections, and respiratory infections were the outcomes studied.Results: The studied variables and the post-operative outcomes assessed did not vary between the two groups. Conclusion: Routine use of antibiotics in laparoscopic gynecologic surgery may not be necessary, as postoperative infection rates remain low even in cases where antibiotics are not administered.
Obstetrics and Gynecology
Minoo Gharouni; Abolfazl Mehdizadeh Kashi; Shahla Chaichian; Zahra Azizian; Kobra Tahermanesh; Samaneh Rokhgireh
Volume 8, Issue 1 , January and February 2023, , Pages 57-62
Abstract
Background & Objective: Fast-track surgery (FTS) consists of different pathways to decrease surgical complications and improve outcomes and patient satisfaction. FTS in an elective gynecologic laparoscopic surgery has not been well assessed. No consensus guidelines have been developed for gynecologic ...
Read More
Background & Objective: Fast-track surgery (FTS) consists of different pathways to decrease surgical complications and improve outcomes and patient satisfaction. FTS in an elective gynecologic laparoscopic surgery has not been well assessed. No consensus guidelines have been developed for gynecologic laparoscopic surgeries. The purpose of this study is to evaluate enhanced recovery after surgery (ERAS) for total laparoscopic hysterectomy.Materials & Methods: 260 patients underwent for laparoscopic hysterectomy surgery. All patients were divided into two groups as follows: one group received traditional laparoscopic hysterectomy surgery and the intervention group was treated under ERAS protocol. ERAS protocol includes not receiving preoperative mechanical bowel preparation and laxatives as well as fasting 6 h and not drinking liquids 2h before surgery. The patients were allowed to resume the ordinary diet 6h post-operation. Ondansetron 4 mg were prescribed after surgery for nausea and vomiting, pain was controlled with non-narcotic analgesics diclofenac suppository 100 mg/q12 h and paracetamol 1000 mg/q6 h until discharge. Urinary catheter was removed whenever possible and early ambulation occurred 6h after the surgery.Results: A total of 260 patients were studied. Regarding the length of hospitalization, significant differences were shown between the groups (P<0.001). Return to daily functions was occurred earlier in the fast-track surgery group than another group. Complications and VAS pain scores showed no significant differences between the groups.Conclusion: Our results show that ERAS surgery has fewer side effects and better outcomes which make it more suitable for patients undergoing laparoscopic hysterectomy.
Gynecology Oncology
Tahereh Ashrafganjoei; Maryam Talayeh; Somayeh Noei Teymoordash; Mohammad Hashemi Bahremani; Hamed talayeh
Volume 7, Issue 1 , September and October 2021, , Pages 59-62
Abstract
Uterine adenosarcoma (UA) is an infrequent malignancy which contains the epithelium of benign glands and malignant mesenchymal elements. Low-grade adenosarcoma has a sarcomatous part that is uniformly low grade. Uterine adenosarcoma includes 8% of all uterine sarcomas and less than 0.2% of uterine neoplasms. ...
Read More
Uterine adenosarcoma (UA) is an infrequent malignancy which contains the epithelium of benign glands and malignant mesenchymal elements. Low-grade adenosarcoma has a sarcomatous part that is uniformly low grade. Uterine adenosarcoma includes 8% of all uterine sarcomas and less than 0.2% of uterine neoplasms. It is more common in perimenopausal or postmenopausal women. Due to the rarity of uterine adenosarcoma, limited information is available to help guide treatment.A 33-year-old woman, who had one child referred to ???? with a complaint of abnormal uterine bleeding for one year; the sonography reported a polyp in fundal cavity of uterus. The patient underwent hysteroscopy and curettage. The pathology examination revealed uterine adenosarcoma which led to a total hysterectomy and bilateral salpingo-oophorectomy.Abnormal uterine bleeding is the most common symptom of UA. At a young age there is a possibility of misdiagnosis. Hysteroscopy should also be performed if symptomatic or enlarge polypoid lesions are diagnosed preoperatively.
Obstetrics and Gynecology
Ahmed Elkhyat; Amal Elsokary; Shereef Elshwaikh
Volume 9, Issue 1 , January and February 2024, , Pages 70-75
Abstract
Background & Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Materials & Methods: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by ...
Read More
Background & Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Materials & Methods: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by dietary modifications. Patients were classified later into respondent and non-respondent. All patients were stimulated with Letrozole 2.5 mg twice daily for five days for six cycles. Ovulation and pregnancy rates were assessed.Results: From 84 patients who were enrolled in our study, 33 patients were allocated into non responder group and 28 patients were allocated to the responder group, and it was found that despite there was statistical difference between both groups as regard weight gain, weight after six months and BMI after six months, there was no significant difference between both groups as regard the ovulation rate, pregnancy rate and complications to ovulation induction ovarian hyperstimulation syndrome (OHSS).Conclusion: weight gain in lean PCOS patients - although non-significant- but it may improve the reproductive outcomes (ovulation rate and pregnancy rate) and the need of further study with larger number and longer duration of follow up for confirmation of these results.
Gynecology Oncology
Tajossadat Allameh; Maryam Nazemi; Leila Mousavi Seresht; Behnoosh Mohamadi
Volume 7, Issue 2 , September and October 2021, , Pages 126-130
Abstract
This case report aimed to describe the clinical symptoms, pathological features, treatment, and prognosis of two cases of vulvar dermatofibrosarcoma protuberans (DFSP). Two Iranian women aged 37 and 35 presented with a nodular mass lesion in labia major and were initially diagnosed with DFSP in the vulva. ...
Read More
This case report aimed to describe the clinical symptoms, pathological features, treatment, and prognosis of two cases of vulvar dermatofibrosarcoma protuberans (DFSP). Two Iranian women aged 37 and 35 presented with a nodular mass lesion in labia major and were initially diagnosed with DFSP in the vulva. Magnetic resonance imaging of the abdominopelvic region showed a small round lesion in the right side of the vulva vaginal region. The excisional procedure was performed under general anesthesia, and postoperative recovery was uneventful. Histopathology reported DFSP, which is a rare vulvar tumor. The patients were further investigated by computed tomography scan for metastasis, showing that the chest, abdomen, and pelvis were normal. The outcome was favorable. The DFSP is a rare tumor, constituting only 0.1% of all malignancies. Vulvar DFSP is exceptionally rare.
Obstetrics and Gynecology
Yurkdes Aran Sittampalam; Nicole AshaThayaparan; Narasimman Sathiamurthy; Muniswaran Ganeshan
Volume 6, Issue 3 , June 2021, , Pages 157-160
Abstract
Thymomas are seldom encountered in the general population, and even more-so uncommonly encountered in pregnancy. Patients usually present with either local, compressive symptoms such as shortness of breath or are asymptomatic and diagnosed incidentally on imaging studies. A subset of them may even present ...
Read More
Thymomas are seldom encountered in the general population, and even more-so uncommonly encountered in pregnancy. Patients usually present with either local, compressive symptoms such as shortness of breath or are asymptomatic and diagnosed incidentally on imaging studies. A subset of them may even present in association with myasthenia gravis. Management of pregnant patients with thymomas are challenging and require multi-disciplinary care involving thoracic surgeons, maternal-fetal medicine specialists, neonatologists and anaesthesiologists to facilitate safe progression of the pregnancy. We discuss the management of a patient that presented to us with a B2-type thymoma in pregnancy who successfully underwent a video-assisted thoracoscopic excision of the mass and went on to have a safe delivery. The optimal way forward in managing patients with thymomas in pregnancy would be through early recognition of the condition and instituting a mutlidisciplinary approach.
Anesthesia
Maryam Sadat Hosseini; Dariush Abtahi; Ardeshir Tajbakhsh; Farah Farzaneh; Shahram Sayadi; Nooshin Amjadi; Maral Hosseinzadeh
Volume 8, Issue 2 , March and April 2023, , Pages 157-166
Abstract
Background & Objective: Delayed diagnosis and treatment of postpartum hemorrhage could result in mortality. Today, there is a strong desire to determine the factors affecting postpartum hemorrhage, particularly fibrinogen levels. This study aimed to investigate the role of plasma fibrinogen ...
Read More
Background & Objective: Delayed diagnosis and treatment of postpartum hemorrhage could result in mortality. Today, there is a strong desire to determine the factors affecting postpartum hemorrhage, particularly fibrinogen levels. This study aimed to investigate the role of plasma fibrinogen levels in postpartum hemorrhage and severe postpartum hemorrhage.Materials & Methods: This cross-sectional study was conducted on 169 term pregnant women who were candidates for an elective Cesarean section. Fibrinogen and other coagulating factors were measured before and at the end of the surgery, and twenty-four hours after surgery. Bleeding volume was also measured during and at the end of the surgery, and twenty-four hours after that. The relationship between coagulation factors and the amount of bleeding was examined using statistical tests.Results: Mean plasma fibrinogen levels measured before, at the end of, and 24 hours after surgery were 247.65±91.07 mg/dl, 219.4±75.60 mg/dl, and 223.91±65.44 mg/dl, respectively. Sixty-five patients (38.5%) had postpartum hemorrhage (1000-2000mL) and seven patients (4.1%) had severe postpartum hemorrhage (>2000mL). Of the cases with preoperative fibrinogen levels less than 200mg/dl, 72% had postpartum hemorrhage and 14% had the severe form. There was a strong association between the patient's plasma fibrinogen level with PPH and sPPH (P=0.000).Conclusion: This study showed a strong correlation between plasma fibrinogen levels and postpartum hemorrhage and severe postpartum hemorrhage. In addition, it has been shown that low plasma fibrinogen levels could be a direct prognostic factor for postpartum hemorrhage and severe postpartum hemorrhage. Younger women and preoperative anemia were other strong predictors.
