Tahereh Ashrafganjoei; Donya Khosravi
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: The aim of this study was to describe clinical findings of prolapse of fallopian tube to vaginal vault following abdominal hysterectomy for multiple leiomyomas of uterine and to correlate it with other features.
Case Presentation: A patient with history of leiomyomas and abnormal uterine ...
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Introduction: The aim of this study was to describe clinical findings of prolapse of fallopian tube to vaginal vault following abdominal hysterectomy for multiple leiomyomas of uterine and to correlate it with other features.
Case Presentation: A patient with history of leiomyomas and abnormal uterine bleeding was admitted with abdominal pain and scheduled for abdominal hysterectomy. Intra operative inspection showed multiple leiomyomas of uterine. One year after operation of total abdominal hysterectomy, the patient presented with abdominal pain, dyspareunia, and purulent vaginal discharge and therefore, referred to our center for further evaluation. In the vaginal examination, a protruding red mass with fibrotic fimberia was observed. The right fallopian tube (FT) with its fimbria prolapsed to vaginal vault as a granulation tissue was removedfrom vaginal cuff and sent to pathology. The pathologist reported fallopian tube tissue. Post-operative course was uneventful and the patient was discharged on 2nd day of post hysterectomy with good general condition. Six-month follow-up showed abolished purulent discharge. The site of resected vaginal cuff was intact in vaginal examination.
Conclusions: Intra vaginal prolapse of the fallopian tube is a rare sequel of hysterectomy. Clinicians should be aware of this disregarded sequel when dealing with postysterectomy vaginal discharge.
Leila Mousavi Seresht; Meysam Izadi; Zohreh Yousefi; Amir Hosein Jafarian; Nooshin Babapour; Laya Shirinzadeh; Zahra Rastin
Volume 2, Issue 4 , November and December 2017, , Pages 1-3
Abstract
Introduction: In patients with female genital tract cancers, during treatment, differentiating between a tumor recurrence and a benign phenomenon is of great importance. This study aimed to report a case of retroperitoneal lymphocele in a patient with primary ovarian cancer.
Case Presentation: A 49-year-old ...
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Introduction: In patients with female genital tract cancers, during treatment, differentiating between a tumor recurrence and a benign phenomenon is of great importance. This study aimed to report a case of retroperitoneal lymphocele in a patient with primary ovarian cancer.
Case Presentation: A 49-year-old woman diagnosed with papillary serous ovarian carcinoma was referred to the oncology clinic in 2017. She was treated with an optimal surgical staging and underwent adjuvant chemotherapy. After 3 courses of chemotherapy, she complained of a large abdominal mass in the umbilical area. Evaluating the mass confirmed retroperitoneal lymphocele, which was treated with a non-surgical therapy.
Conclusions: Pelvic mass in patients with previous ovarian cancer is not necessarily due to the recurrence of the tumor and the possibility of lymphocele diagnosis should be considered. Since preventing the causes of lymphocele is very difficult, it is only necessary to carefully follow-up and provide essential consultations for high risk patients.
General surgery
Lobat Jafarzadeh; Shirin Alsadat Mousavi; Fatemeh Deris
Articles in Press, Accepted Manuscript, Available Online from 09 September 2023
Abstract
Background and Goal: Bleeding is a serious complication during and after hysterectomy. This study aimed to compare the short-term outcomes of ChitoHem and Surgicel use in posterior bladder bleeding during hysterectomy.Methods: In the present clinical trial, 46 patients who were candidates for abdominal ...
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Background and Goal: Bleeding is a serious complication during and after hysterectomy. This study aimed to compare the short-term outcomes of ChitoHem and Surgicel use in posterior bladder bleeding during hysterectomy.Methods: In the present clinical trial, 46 patients who were candidates for abdominal hysterectomy in Hajar Hospital in Shahrekord, Iran, were randomly divided into two groups. In group A, superficial (cauter and Surgicel) and in group B (superficial cauterand ChitoHem) were used to control bleeding. Hematocrit and hemoglobin levels were determined before, 6 and 12 hours after surgery. Drain discharge volume, time to stop bleeding and bleeding volume were also determined. The pain was determined by the VAS scale. Data were analyzed by SPSS statistical software.Results: Based on repeated-measures test, the mean of hemoglobin and hematocrit in the studied times showed a significant difference, so that in 6 and 12 hours after surgery they were significantly less than the ones before surgery, but their mean was not significantly different between the two groups. The mean pain score 1 month after surgery in group B was significantly lower than group A (P <0.001). The mean volume of drainage and clotting time in group B were significantly lower than group A (P <0.01). The mean volume of intraoperative bleeding, the frequency of vaginal bleeding and cuff-related complications was not significantly different in the two groups.Conclusion: The results of the present study indicate a better efficacy of ChitoHem on bleeding during hysterectomy surgery.
Maternal Fetal Medicine
Fatemeh Bahadori; Zahra Fakour; Roghayeh Redaei; Hamid Reza Khalkhali; Zahra Sahebazzamani
Volume 6, Issue 1 , January 2021, , Pages 10-15
Abstract
Background & Objective: This study aimed to assess the effect of betamethasone on neonatal and maternal complications of late preterm labor. Materials and Methods: The women at the gestational age of 34 weeks to 36 weeks and 6 days who referred to Shahid Motahari Hospital, Urmia, Iran for premature ...
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Background & Objective: This study aimed to assess the effect of betamethasone on neonatal and maternal complications of late preterm labor. Materials and Methods: The women at the gestational age of 34 weeks to 36 weeks and 6 days who referred to Shahid Motahari Hospital, Urmia, Iran for premature labor or had a maternal indication of pregnancy termination were selected for this study. The participants were classified into the case group receiving two doses of 12 mg intramuscular betamethasone every 24 h or the control group who did not receive betamethasone. The incidence of respiratory distress syndrome (RDS), need for mechanical or noninvasive ventilation, days of stay in Neonatal Intensive Care Unit (NICU) or Neonatal Ward, umbilical arterial blood gases, maternal hyperglycemia, and wound infection were evaluated.Results: A total of 200 pregnant women were enrolled with a mean age of 27.06±6.55 years. Out of 200 neonates, 52 cases had RDS of which 21 received betamethasone. The first-minute Apgar score was 6.96±0.75 in the control and 7.57±0.67 in the case groups (P < /em><0.001). The incidence of RDS, need for surfactant administration, noninvasive ventilation, and days of stay at NICU or Neonatal Ward were significantly different between the study groups. However, because of the low number of cases (2 cases), we did not find a significant difference in the need for mechanical ventilation between the two groups (P < /em>=0.041). There was maternal hyperglycemia in 65% of women in the test group. Conclusion: Administration of betamethasone in late premature pregnancies can be effective in the reduction of neonatal complications without any increase in maternal complications.
Pathology
Bahman Fouladi; Khadijeh Rezaei Keikhaie; Nesa Rajabpoor Nikoo; Salia Amini Poya; Solaiman Saravani; Jebraeil Farzi
Volume 5, Issue 1 , August 2020, , Pages 11-18
Abstract
Background & Objective: Vulvovaginal candidiasis (VVC) is a common vaginal yeast infection in women. The present study aimed to determine the phenotype of Candida albicans and non-albicans Candida species in VVC cases.Materials & Methods: This was a cross-sectional study on 65 patients suspected ...
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Background & Objective: Vulvovaginal candidiasis (VVC) is a common vaginal yeast infection in women. The present study aimed to determine the phenotype of Candida albicans and non-albicans Candida species in VVC cases.Materials & Methods: This was a cross-sectional study on 65 patients suspected of VVC through a visit by a gynecologist. They were cultured on CHROMagar and Sabouraud dextrose agar (SDA). If morphology of the colonies could be detected through microscopic inspection, physiological tests were used to identify individual yeast species.Results: Out 65 colonies, 53.8% had negative cultures. The frequency of positive cultures for Candida were also calculated (C. albicans = 38.5%, C. glabrata = 6.15%, and C. krusei = 1.53%). Most of culture-negative cases had no history of antibiotic therapy (94.3%) while most of culture-positive cases had a history of fluconazole therapy (56% in C. albicans isolates and 40% in non-C. albicans isolates). Relapse rate was calculated as 29.2%. Of studied patients, 80% had no underlying disease, 15.4% had a history of diabetes, and 4.6% had a history of corticosteroid therapy. Less than half negative-culture cases had an undergraduate degree (45.7%).Conclusion: The incidence of VVC depends on various factors including occupation, underlying disease and history of antibiotic therapy. The most common cause of VVC is C. glabrata, secondary to C. albicans. Relapse infection rates can be reduced by increasing knowledge on clinical data, underlying diseases, mechanism of the organism, cause of infection, and effective treatment.
Mahboobeh Shirazi; Soheila Sarmadi; Shirin Niromanesh; Fatemeh Rahimi Sharbaf; Behrokh Sahebdel; Fatemeh Golshahi; Leila Asadi; Maedeh Rahmanzadeh
Volume 4, Issue 1 , March and April 2019, , Pages 12-15
Abstract
Background & Objective: Diagnosing fetal disorders and abnormalities in the early stages of pregnancy can prevent future adverse conditions for the infant and his/her family. This study aimed to evaluate the sensitivity and specificity of the first- and second-trimester screening tests for identifying ...
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Background & Objective: Diagnosing fetal disorders and abnormalities in the early stages of pregnancy can prevent future adverse conditions for the infant and his/her family. This study aimed to evaluate the sensitivity and specificity of the first- and second-trimester screening tests for identifying fetal chromosomal disorders in pregnant women.
Materials & Methods: A total of 960 pregnant women participated in this retrospective cohort study that was performed at Yas Hospital. The participants’ mean age was 31.07±0.17 years. In the present study, all pregnant women, who referred to Yas Hospital for their first- and second-trimester screening tests, were studied from 2015 to 2017.
Results: Most of the participants (43.4%) were primigravida. The sensitivity of the first-trimester screening test was 70%, and its specificity was 80.3%. The sensitivity and specificity of the second-trimester screening test were 45% and 94.5%, respectively.
Conclusion: Despite recent advances in the prenatal field, the accuracy of screening tests may still vary depending on maternal age and other existing characteristics. Consequently, in parents consulting, the possibility of false positives and negatives should be considered in the tests.
Sarah Khalifa; Maha E Muhammad; Rasha A. Khairy MD; Hala N Hosni; Ahmed M Abd E
Volume 3, Issue 1 , March and April 2018, , Pages 13-18
Abstract
Aims: Supporting evidences have been proposed that tumor initiating cells or cancer stem cells (CSCs) are principally sharing into tumor progress and relapse. Aldehyde dehydrogenase 1A1 (ALDH1A1), a stem cell marker, has currently been implicated in multiple human malignancies including ovarian carcinomas. ...
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Aims: Supporting evidences have been proposed that tumor initiating cells or cancer stem cells (CSCs) are principally sharing into tumor progress and relapse. Aldehyde dehydrogenase 1A1 (ALDH1A1), a stem cell marker, has currently been implicated in multiple human malignancies including ovarian carcinomas. The aims of this study were to assess immunohistochemical (IHC) expression of ALDH1A1 in ovarian epithelial tumors, tracking stem cells during ovarian cancer development and its relation with the clinicopathological features of such tumors.
Materials and Methods: In this experimental study, 42 paraffin blocks of ovarian tumor cases were retrieved retrospectively from the department of pathology, faculty of medicine, Cairo University during January 2013 to January 2015. Ovarian tumor paraffin blocks included 14 benign cystadenomas 14 border line tumors and 14 carcinomas. IHC reactions were carried out by using ALDH1A1 monoclonal antibody. Cases were classified into two groups of low and high ALDH1A1 expression. The chi-squared test (χ2) was used and data analyzes by SPSS 22 software.
Findings: High ALDH1A1 expression was reported in 50.0% of benign cystadenomas, 50.0% of borderline tumors and 85.7% of ovarian carcinomas with significant positive association with ovarian carcinomas (p=0.025). In ovarian carcinomas, positive relationship was detected between high ALDHA1 expression and advancing tumor grades but it didn’t reach statistical significance (p=0.054), no any significant relations were detected between ALDH1A1 immunohistochemical expression and age of patients, the documented size, laterality, histologic types and FIGO stage in all tumors (p>0.05).
Conclusion: ALDH1A1 is a potential biomarker for detecting CSCs in ovarian carcinomas and a prognostic marker. Also, it may act as a target for future therapy.
Obstetrics and Gynecology
Soudabeh Kazemi Aski; Seyedeh Hajar Sharami; Azadeh Tavangar; Ehsan Kazemnezhad; Seyedeh Fatemeh Dalil Heirati; Atoosa Etezadi
Volume 9, Issue 1 , January and February 2024, , Pages 14-21
Abstract
Background & Objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus in normal growth. The objective of this study was to compare the level ...
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Background & Objective: The initial diagnosis of predictive markers is essential for the IUGR. High levels of PAPP-A lead to increased levels of free IGF-1, which in turn reflects the function of the placenta and the fetus in normal growth. The objective of this study was to compare the level of PAPP-A in pregnancy weeks 11-14 in women with and without intrauterine growth restriction and to assess the ability of this marker to predict adverse outcomes in pregnancy.Materials & Methods: In this Comparative Cross-sectional study, 227 pregnant women were studied during 2017. Mothers were divided into two main groups, with and without intrauterine growth restriction. The relevant data, including birth weight, preeclampsia, gestational diabetes, Apgar score, and PAPP-A, were recorded on special forms. Data analysis was done using SPSS-21 software.Results: The mean age of participating women in this study was 28.8 ± 5.6 years. The median (IOR) number of gravidity and Gestational weight gain was one (1) and 12 (7) kg, respectively. The difference in median (IOR) PAPP-A in patients with and without IUGR was statistically significant 0.64(0.57) and one (0.57), respectively, P= 0.001. The cut-off point for PAPP-A was 0.73 with a sensitivity=72.2% (95% CI: 64.32-79.16%) and a specificity =60.5% (95% CI: 48.65 -71.56%).Conclusion: The results of this study confirm the relationship between low levels of PAPP-A and adverse outcomes of pregnancy. In the present study, the optimal cut-off point (0.73) is higher than other studies, which can be due to racial and epidemiological differences.
Obstetrics and Gynecology
Tahereh Behrouzi lak; Behrouz Ilkhanizadeh; Somayeh Ghasemzadeh; Sahel Khalilzadeh
Volume 7, Issue 1 , September and October 2021, , Pages 15-19
Abstract
Background and Objective: One of the most common causes of maternal mortality in the first trimester of pregnancy is ectopic pregnancy (EP). Adenosine deaminase (ADA) plays an essential role in production, maturation and function of lymphoid cells, which is produced in all tissues of the body. Total ...
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Background and Objective: One of the most common causes of maternal mortality in the first trimester of pregnancy is ectopic pregnancy (EP). Adenosine deaminase (ADA) plays an essential role in production, maturation and function of lymphoid cells, which is produced in all tissues of the body. Total serum adenosine deaminase levels decrease during normal pregnancy. Considering the importance of early detection of EP, this study aimed to investigate the relationship between adenosine deaminase and EP in pregnant women referred to Motahari Hospital in Urmia from 2017 to 2018.Material and Methods: This study consisted of two groups of patients including patients with EP as a case group and patients with normal pregnancy confirmed by sonography as a control group. The level of βHCG and serum ADA levels were compared in the two groups. P-values less than 0.05 were considered as significant.Results: In this study, 94 pregnant women were enrolled, including 47 patients as control group with normal pregnancy and 47 patients as case group with EP. The mean ADA level in patients with EP and the control group were 12.21±8.17 IU/L and 8.44±6.21 IU/L (P < /em>=0.01), respectively. The mean βHCG level in women with EP was 3215.60±1400.71 mIU/mL. In women with normal pregnancy, it was 11926.96±3408.23 mIU/mL (P < /em>=0.001).Conclusion: High levels of ADA can be helpful in the early diagnosis of EP.
Gynecology Oncology
Tajossadat Allameh; Maryam Sadat Mirazimi; Fahimeh Sabet; Leila Mousavi Seresht; Fariba Behnamfar
Volume 8, Issue 1 , January and February 2023, , Pages 17-22
Abstract
In gynecological cancers, sentinel lymph node (SLN) mapping has been proposed as an alternative to complete lymph node dissection. The goal of this study was to determine sentinel lymph node mapping's sensitivity, specificity, NPV, and PPV versus gold standard surgery (complete lymph node dissection) ...
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In gynecological cancers, sentinel lymph node (SLN) mapping has been proposed as an alternative to complete lymph node dissection. The goal of this study was to determine sentinel lymph node mapping's sensitivity, specificity, NPV, and PPV versus gold standard surgery (complete lymph node dissection) in patients with metastatic illness. A total of 26 patients were prospectively enrolled from spring 2021 to winter 2022. Sentinel lymph node mapping with complete pelvic lymph node dissection was done in all of them, and para-aortic lymphadenectomy was detected in 11 (43.33%) patients. At least one sentinel lymph node was successfully mapped in 22 (84.6%) patients. Three patients (11.5%) had positive lymph nodes, with an 85.7% sensitivity (95 percent CI) to detect node positive illness, a specificity of 74.93%, an NPV of 99.6 (99.5 CI), and a PPV of 5.9% calculated. There were no serious adverse effects due to blue dye. The accuracy rate of sentinel lymph node mapping by methylene blue was 75.1%.
Obstetrics and Gynecology
Zahra Rezaei; Mehrnaz Valadan; Elahe Zabihi Soltani
Volume 5, Issue 2 , October 2020, , Pages 44-48
Abstract
Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or ...
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Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or two ovaries in women with PCOS.Materials & Methods: This study was a prospective cohort study. The study population included infertile women with PCOS resistant to clomiphene referred to the Infertility Clinic of Yas Hospital. They were candidates for LOD in 2016–2017. The serum levels of AMH and FSH were measured before and after three months in two groups of unilateral and bilateral LOD. Data were analyzed using Stata software.Results: A total of 35 female patients were enrolled in the study, 18 (51.4%) in bilateral and 17 (46%) in unilateral LOD groups; the average age of patients was 27 ± 3.4 years old. AMH levels significantly (P < /em><0.001) decreased in both unilateral and bilateral groups after LOD. FSH levels significantly (P < /em><0.001) increased in both groups after LOD, but this increase was higher in the unilateral group than in the bilateral group, and this difference was statistically significant (P < /em><0.001).Conclusion: It seems women with clomiphene-resistant PCOS when underwent unilateral or bilateral ovarian drilling experienced a significant decrease in AMH and a significant increase in FSH, indicating a decrease in their ovarian reserve.
Mojgan Karimi Zarchi; Abolfazl Mehdizadeh Kashi; Leila Allahqoli; Razieh Sadat Tabatabai; Farimah Shamsi; Nafiseh Hashemian Asl
Volume 4, Issue 2 , May and June 2019, , Pages 57-61
Abstract
Background & Objective: This study investigated the recurrence and survival rates of patients with borderline ovarian tumors in Yazd in the last 10 years.
Materials & Methods: This census survival study was performed on 24 patients with borderline ovarian tumors who referred to hospitals ...
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Background & Objective: This study investigated the recurrence and survival rates of patients with borderline ovarian tumors in Yazd in the last 10 years.
Materials & Methods: This census survival study was performed on 24 patients with borderline ovarian tumors who referred to hospitals affiliated to Yazd University of Medical Sciences from 2006 to 2016. A data collection checklist was used as a measurement tool and was completed by the researcher by reviewing the subjects’ medical records. The questionnaire included age, infertility, the number of delivery, contraceptive use, body mass index, time of diagnosis, time to start the treatment, whether alive or not, stage of the disease, the type of pathology, the type of surgery, and postoperative treatment. Data was analyzed by SPSS 16 using descriptive statistics.
Results: The mean age of these 24 patients was 33.58±10.61 and the mean recurrence time was 14±2 months. Sixteen (66.7%) patients had serous tumors and 8 (33.3%) patients had mucinous tumors. Among them, 18 (75%) patients underwent a hysterectomy, 2 (8.3%) patients underwent an oophorectomy and 4 (16.7%) patients underwent both total abdominal hysterectomy (TAH) and oophorectomy. Of the 24 studied patients, 4 patients (16.7%) received medicinal treatment (clomiphene citrate, HCG, HMG) after surgery. Three patients experienced recurrences, all in the contralateral ovary.
Conclusion: The recurrence time of epithelial borderline ovarian tumor was 14±2 months. There was no significant relationship between postoperative medicinal treatment and the recurrence rate.
Setareh Akhavan; Jila Agah; Abbas Alipour
Volume 3, Issue 2 , May and June 2018, , Pages 59-63
Abstract
Aims: Ovarian cancer is the 4th cause of women’s mortality occurring due to cancer. Malignant germ cell tumors (GCTs) account for 5% of malignant ovarian tumors and 70% of ovarian tumors in women between the ages of 10-30 years old. The aim of the present study was to detect the frequency of malignant ...
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Aims: Ovarian cancer is the 4th cause of women’s mortality occurring due to cancer. Malignant germ cell tumors (GCTs) account for 5% of malignant ovarian tumors and 70% of ovarian tumors in women between the ages of 10-30 years old. The aim of the present study was to detect the frequency of malignant ovarian germ cell tumor and distribution of demographic features in the most crowded gynecology oncology clinic.
Materials and Methods: This cohort descriptive-analytical study was conducted on cases with malignant ovarian tumor managed in Vali-Asr hospital, Tehran, Iran, from 2001 to 2018 (n=1540). The malignant germ cell tumors cases were extracted (n=128) and evaluated in point of epidemiologic and demographic data via the software SPSS 24.
Findings: 128 patients (8.3%) had GCTs. The average age was 23.88±7.85 years. 79.7% lived in the city, 76.6% had medium economic status and 53.6% had normal body mass index. Premature puberty was revealed in one person. Karyotype XY was detected in 5 persons. About 70.3% of the patients had no parity. In parous women, the highest percentage was related to a childbirth (55.0%). A history of infertility was detected at 6.1%. In 10 patients, the tumor was detected during pregnancy.
Conclusion: The highest frequency is related to the early young women with no considerable association with socioeconomic and weight status. It is possible that parity would be a protective factor for this tumor. In the case of adnexal mass during pregnancy, Malignant Germ cell tumors should be rolled out.
Maternal Fetal Medicine
Maryam Kashanian; Arezoo HoseiniMoghaddam; Seyyed Ali Javad Moosavi; Narges Sheikhansari; Hoda Abdollahi
Volume 6, Issue 2 , March 2021, , Pages 65-71
Abstract
Background and Objective: Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.Methods: The study was designed as a historical ...
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Background and Objective: Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.Methods: The study was designed as a historical cohort among pregnant women with and without asthma. A total number of 583 asthmatic patients were allocated to the case group and 753 women without asthmatic history were placed in the control group. Pregnancy, labor and neonatal outcomes were compared between the two groups.Results: The baseline characteristics of the women in both groups did not show significant differences. Gestational hypertension was more in the asthmatic group [43 (7.37%) VS 26 (3.45%), P < /em>=0.001]. Also the rate of preterm delivery was higher in asthmatic women [72 (12.34%) VS 77 (10.22%) in the control group, P < /em>=0.04]. However, the rate of preeclampsia was less in the asthmatic group [29 (4.97%) VS 71 (9.42%), P < /em>=0.008]. Apgar score at minutes 1 and 5 was less in asthmatic group. Intra Uterine Fetal Demise (IUFD) [24 (4.1%) VS 13(1.7%), P value=0.009], and neonatal death [31 (5.31%) VS 10 (1.32%), P < /em>=0.001] were more in the asthmatic group. The maternal and neonatal complications did not show significant differences in various severities of asthma. Multivariate regression model showed more risks for neonatal death [adjusted odds ratio (AOR)=4.18; CI95% 2.03-8.60], IUFD (AOR=2.43; CI95% 1.22-4.82), gestational hypertension (AOR= 1.43; CI 95% 1.40-1.45), and lower risk for preeclampsia (AOR 0.37; CI95%0.17-0.79) in asthmatic women.Conclusion: Regardless of the fact that asthmatic mothers had higher frequencies of gestational hypertension, IUFD and neonatal death, the effect of asthma on perinatal outcome is minimal, probably because of efficient medical control.
Obstetrics and Gynecology
Mitra Modares Gilani; Fariba Yarandi; Narges Zamani; Shaghayegh Nowroozi; Sara Ramhormozian; Elham Shirali
Volume 7, Issue 2 , September and October 2021, , Pages 77-82
Abstract
Background & Objective: Estradiol and misoprostol have been used for the enhancement of transformation zone (TZ) visibility in vaginal colposcopy. However, no consensus has been reached on the superiority of one medication over the other. This study aimed to compare the efficacy of estradiol and ...
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Background & Objective: Estradiol and misoprostol have been used for the enhancement of transformation zone (TZ) visibility in vaginal colposcopy. However, no consensus has been reached on the superiority of one medication over the other. This study aimed to compare the efficacy of estradiol and misoprostol for the enhancement of TZ visibility in vaginal colposcopy of premenopausal and postmenopausal women.Materials & Methods: In this clinical trial, 78 patients with unsatisfactory colposcopy were randomly divided into three groups. Group 1 (n=25) received 25 µg of vaginal estradiol for 14 days prior to colposcopy. Group 2 (n=27) received 400 µg of misoprostol 12 h prior to colposcopy. Group 3 (n=26) served as the control group and did not receive any medication. Visibility of the TZ, age, body mass index (BMI), history of vaginal delivery, history of sexually transmitted diseases, history of human papillomavirus (HPV), the reason for colposcopy, and drug-related side effects were compared among the three groups and also between premenopausal and postmenopausal women. Data were analyzed using analysis of variance (ANOVA), Kruskal-Wallis, Chi-square, and Fisher’s exact tests.Results: The percentage of TZ visibility was 72%, 55.6%, and 26.9% in the estradiol, misoprostol, and control groups, respectively (P < /em>=0.005). These values were 70%, 33.3%, and 0%, respectively, in postmenopausal women (P < /em>=0.043) and 60%, 72.7%, and 33.3%, respectively, in premenopausal women (P < /em>=0.152). Regarding drug-related side effects, there was no statistically significant difference between the three groups (P < /em>=0.374).Conclusion: Estradiol was significantly superior to misoprostol for the enhancement of TZ visibility, particularly in postmenopausal women, with no difference regarding side effects.
Obstetrics and Gynecology
Mehrnaz Valadan; Mohadeseh Mojarad; Elham Feizabad
Volume 5, Issue 3 , November 2020, , Pages 88-92
Abstract
Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol ...
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Background & Objective: Hysteroscopy is an impressive diagnostic and therapeutic procedure for uterine cavity abnormalities. There are several methods for cervical preparation prior to hysteroscopy, among which misoprostol (a prostaglandin E1 analog) is the most common. However, misoprostol has some side effects, including uterine cramps, vaginal hemorrhage, nausea, vomiting, and fever-like feelings, the severity of which escalates by increasing the dosage. Therefore, in this study, we aimed to compare vaginal misoprostol in two different dosages of 200 and 400 μg with a control group to prescribe the lower dosage of misoprostol in case they were equally effective.Materials & Methods: In this randomized clinical trial study, 87 patients, who had hysteroscopy indications at Yas Hospital, were randomly assigned into three groups (i.e., 200 μg vaginal misoprostol, 400 μg vaginal misoprostol, and placebo). Afterward, the dilatation time of the cervical response and side effects associated with medication and surgery were assessed.Results: The mean dilatation time in the 200 μg misoprostol, 400 μg misoprostol, and placebo groups were 46.7±35.8, 36.8±31.1, and 67.6±49.5 seconds, respectively. These differences were significant (P=0.038). Conclusion: It seems that administering vaginal misoprostol is an easy, effective, and safe procedure for cervical preparation before the hysteroscopy. Considering that increasing the dosage of misoprostol did not significantly change the dilatation time, it is recommended that 200 μg misoprostol be used to reduce the side effects.
Mohammad Ranaei; Emad Kohsari; Mina Galeshi; Shahla Yazdani
Volume 4, Issue 3 , September and October 2019, , Pages 99-104
Abstract
Background & Objective: Adenomyosis is a prevalent gynecological disorder among women with no specified causes. It is characterized by nonspecific symptoms, and can present itself as abnormal uterine bleeding, abdominal pain, menstrual disorders, and the like. Its diagnosis is made based on the pathologic ...
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Background & Objective: Adenomyosis is a prevalent gynecological disorder among women with no specified causes. It is characterized by nonspecific symptoms, and can present itself as abnormal uterine bleeding, abdominal pain, menstrual disorders, and the like. Its diagnosis is made based on the pathologic histological examination of hysterectomized samples. This study aimed to evaluate the correlation of adenomyosis with other benign endometrial disorders in hysterectomized samples.
Materials & Methods: In this paper a total of 413 patients who referred to Rouhani Hospital of Babol, form 2012 to 2017, and underwent a hysterectomy surgery with pathological reports confirming the diagnosis of adenomyosis, were studied. After reviewing the medical records, the patients’ data, including their age, weight, number of deliveries, place of residence, and main complaints at the time of referral as well as benign endometrial pathologies correlated with adenomyosis, were examined. Finally, the obtained data were analyzed using statistical tests.
Results: The prevalence of adenomyosis in this study was 21.7%. The patients’ most common complaints were abnormal uterine bleeding (86.4%), dysmenorrhea (39.2%), abdominal pain (31.2%), dyspareunia (21.1%), mass outflow (15%), and pelvic pain (9.4%). In the current study, the benign pathologies correlated with adenomyosis were leiomyoma (52.5%), uterine polyp (11.9%), adenomyoma (5.1%), and hyperplasia (0.5%).
Conclusion: In the present study, the prevalence of adenomyosis was high and abnormal uterine bleeding was the patients’ most prevalent complaint. Moreover, leiomyoma had the highest correlation with adenomyosis.
Saeed Alborzi; Bahieh Namavar Jahromi; Morvarid Ahmadbeigi
Volume 3, Issue 3 , September and October 2018, , Pages 105-110
Abstract
Aims: Ovarian endometrioma is a prevalent gynecologic disease in women of reproductive age that is accompanied with a number of symptoms and has a high recurrence rate after hormone therapy and surgery. The aim of this study was to evaluate the effectiveness of sclerotherapy with 95% ethanol in patients ...
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Aims: Ovarian endometrioma is a prevalent gynecologic disease in women of reproductive age that is accompanied with a number of symptoms and has a high recurrence rate after hormone therapy and surgery. The aim of this study was to evaluate the effectiveness of sclerotherapy with 95% ethanol in patients with recurrent ovarian endometriomas.
Materials & Methods: In this pre-post clinical trial, 14 patients with infertility and recurrent ovarian endometriomas were examined during a period from December 2012 to December 2013 in Ghadir Mother and Child Hospital affiliated with Shiraz University of Medical Sciences. These subjects had undergone a laparotomy to remove their cysts at least once. They were selected using convenience sampling method. The patients underwent sclerotherapy with 95% ethanol and referred 1, 3, 6, and 12 months after the procedure for their periodic examinations and levels of FSH, AMH, CA125, E2, AFC, mass size, and pelvic pain were measured. The data were analyzed using repeated measures analysis of variance (ANOVA) by SPSS 14 software.
Findings: While the level of FSH significantly decreased (p=0.01), the AMH level began to increase after the treatment (p=0.17); however, this increase was not significant. The AFC level increased with the aid of the treatment (p=0.002). The mass size and the patients’ pain also significantly decreased (p<0.05). Four cases of pregnancy happened. In 2 of the patients, the cysts recurred and grew again.
Conclusion: Sclerotherapy with 95% ethanol can be used as an appropriate alternative therapy in patients with recurrent endometriomas.
Obstetrics and Gynecology
maryam dehghan; tajosadat alameh; Zahra Allameh; zahra Seyed-Hoseini
Volume 8, Issue 2 , March and April 2023, , Pages 113-119
Abstract
Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly ...
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Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter or misoprostol modes. Cervical ripening in Foley catheter group was done with transcervical Foley catheter 18, and in misoprostol group with 25 μg single dose vaginal misoprostol (The maximum allowed dose for patients was 6 doses.). Bishop score, Apgar score, active phase duration, stage 2 duration and insertion to delivery interval were the main outcomes.Results: The mean time of ripening and the active phase in vaginal misoprostol group was significantly shorter than in Foley catheter group (2.32 versus 5.11 hours respectively, P-value = 0.0001). After intervention, Bishop score in vaginal misoprostol group was significantly more than Foley catheter group (8.70 versus 6.68 respectively, P-value = 0.0001). Insertion to delivery interval in vaginal misoprostol group was 9.54 hours and in Foley catheter group was 12.88 hours (P-value = 0.0001). The hospitalization time in Foley catheter group was significantly more than vaginal misoprostol group (P-value = 0.0001). The other outcomes were similar between groups.Conclusion: By the decreasing in the total time from insertion to birth, vaginal misoprostol was more effective than Foley catheter, as a cervical ripening method in our study.
Obstetrics and Gynecology
Robabeh MohammadBeigi; Ayda Fathollahpour; Asadolah Fathollahpour; Maryam Kashanian; Narges Sheikhansari
Volume 6, Issue 3 , June 2021, , Pages 116-121
Abstract
Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials ...
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Background & Objective: The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).Materials & Methods: The study was performed as a descriptive cross-sectional study on pregnant women who were admitted to the labor ward for delivery. Serum level of 25-hydroxyvitamin D [25(OH) D], was measured and compared in women and the umbilical cord blood. The relationship between 25(OH) D levels and anthropometric neonatal factors including birth weight, birth length and head circumference was evaluated.Results: A total of 106 pregnant women (53 Iranians and 53 Afghan refugees’ women) were evaluated. There was a significant correlation between maternal serum level of 25(OH) D and that of their neonates, both in Iranians and Afghans considering gestational age as a confounding factor (R=0.62, P < /em>=0.000). Maternal and neonatal 25(OH) D levels were significantly higher in Iranians than Afghans (27.2±11.5 ng/mL VS 21.9±12.7 ng/mL, P < /em>=0.026 and 26.5±11.2 VS 17.3±11.4, P < /em>=0.000) respectively. However, neonatal weight and head circumference (HC), were not different in Iranians and Afghans except for neonatal height which was higher in Afghans (P < /em>=0.015) irrespective of lower amount of neonatal 25(OH) D levels.The mean cord levels of vitamin D in boys and girls did not show a significant difference. There was no significant correlation between 25(OH) D serum level and pregnant women’s level of education, pre-labor rupture of membranes (PROM), past medical history (PMH), taking supplements and smoking.Conclusion: Maternal and neonatal 25(OH) D levels did not influence neonatal anthropometry.
Obstetrics and Gynecology
Razieh Akbari; Ezat-Sadat Haj-Seyed Javadi; Zahra Panahi
Volume 9, Issue 2 , March and April 2024, , Pages 131-136
Abstract
Background & Objective: The purpose of this study was to compare the effectiveness of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy.Materials & Methods: The research was done as an RCT from 2017 to 2018. About 300 participants were randomly allocated to ...
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Background & Objective: The purpose of this study was to compare the effectiveness of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy.Materials & Methods: The research was done as an RCT from 2017 to 2018. About 300 participants were randomly allocated to obtain 50 µg Buccal, 25 µg Vaginal, and 50 µg Sublingual misoprostol in Kosar Hospital, Qazvin, Iran. The maternal and fetal complications, Bishop score hour 1, and hour 6 were observed.Results: There were no differences between fetal complications (p>0.05) and maternal complications (p>0.05) among the three groups. Bishop score hour 1 (P = 0.146), Bishop Score hour 6 (P = 0.704), and total dose (P = 0.15) also were no differences among these groups. Our study found a difference between the three groups (P = 0.015) in achieving standard vaginal delivery within 24 hours, as Buccal, Sublingual and Vaginal groups were performed respectively. The use of Oxytocin in the Buccal group was higher than that of other groups (P = 0.022).Conclusion: This study found that there is no difference in terms of fetal complications and maternal complications in the three groups, but there was a significant difference in Oxytocin use and vaginal delivery within 24 h from the start of induction.
Khadije Rezaei keykhaei; Nesa Rajabpour Nikoo; Hamid Vaez; Leili Rezaei keikhaei; Mahboobeh Shirazi; Marjan Ghaemi; Soleiman Saravani; Sanaollah Raeiszadeh; Asadollah Rezaei
Volume 4, Issue 4 , September and October 2019, , Pages 141-145
Abstract
Background & Objective: Mycoplasma hominis, which belongs to the Mycoplasmataceae family, is an opportunistic pathogen of the genitourinary system. Mycoplasma genitalium, causing urethritis-endometritis-cervicitis, plays a role in prostatitis This study aimed to investigate the prevalence of M. genitalium ...
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Background & Objective: Mycoplasma hominis, which belongs to the Mycoplasmataceae family, is an opportunistic pathogen of the genitourinary system. Mycoplasma genitalium, causing urethritis-endometritis-cervicitis, plays a role in prostatitis This study aimed to investigate the prevalence of M. genitalium and M. hominis among women with vaginal infection in Zabol, Iran.
Materials & Methods: In this cross-sectional study, 69 endocervical samples were taken from women aged 18 to 60 years who suffered from vaginal infections. DNAs extracted from the samples were applied as a template for 16SrDNA coding gene amplification using specific primers in two separate PCR reactions.
Results: The highest infection rate was in the age group of 25 to 35 years, with a prevalence of 75%. The highest rate of negative PCR results (54%) was in the age group of 25 to 35 years, followed by the age groups of 36 to 45 years (28%), 18 to 24 years (4%), and older than 45 years (3%). The lowest rate was in the age group younger than 18 years (2%). Considering their levels of education, the highest rate of infection was seen in the subjects with bachelor’s degrees. The rate of Mycoplasma genitalium infection was equal in the subjects who had and did not have a miscarriage (50%). Only 5.7% of the subjects with negative PCR samples had a miscarriage and the rest (94.3%) did not experience a miscarriage.
Conclusion: Overall, the present study showed that the rate of Mycoplasma vaginal infections was very low Also there is no significance deference for infection rate between pregnant women with or without miscarriage history. However, those with Mycoplasma-negative PCR samples had a low miscarriage rate.
Mahdieh Kafaee Ghaeini; Mohammad Reza Amin-Naseri; Marzieh Aghahoseini
Volume 3, Issue 4 , November and December 2018, , Pages 149-155
Abstract
Background & Objective: Studies have shown that despite the numerous research carried out regarding infertility treatment, there is still a long way to treat this disease satisfactorily. Spending a lot of time and money on infertility treatments proves the necessity of designing a model which could ...
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Background & Objective: Studies have shown that despite the numerous research carried out regarding infertility treatment, there is still a long way to treat this disease satisfactorily. Spending a lot of time and money on infertility treatments proves the necessity of designing a model which could predict the result of treatment methods with an acceptable accuracy; a model that could help physicians to get rid of trial and error for treatment methods which should step by step be applied on an infertile couple. Intracytoplasmic Sperm Injection (ICSI) is one of the assisted reproductive techniques. Statistics have indicated that the probability of pregnancy occurrence is only about 30% using this method. In this paper, a model which could predict the result of (ICSI) was presented using the decision tree and support vector machine methods.
Materials & Methods: The applied data were collected in seven months from December 2012 to June 2013 by analyzing 251 treatment cycles in Omid Fertility Clinic. Input variables of the model were parameters like couple’s medical records, hormonal tests, the cause of infertility, and the like. The output variable was the occurrence or nonoccurrence of the clinical pregnancy (the pregnancy resulting in the formation of the fetal heart). One of the innovations of this study was that the input variables of the model were only preoperative, while in previous studies, having information about some of the surgery stages, such as quality of the egg and the like, was required to anticipate the result of the surgery.
Results: The obtained accuracy using the decision tree and support vector machine methods were 70.3% and 75.7%, respectively.
Conclusion: The results of the current study demonstrated that the support vector machine method had a better performance compared to the decision tree method. Presented model predicts the occurrence or nonoccurrence of a clinical pregnancy follows (ICSI), with a precision of 75.7%.
Reproductive Medicine
Shamim Ashrafi Mahabadi; Farzaneh Tafvizi
Volume 5, Issue 4 , December 2020, , Pages 149-158
Abstract
Background and Objectives: Soluble Leptin Receptor (sOB-R) is the most important leptin-binding protein that can affect the level of active biological leptin. The Gln223Arg polymorphism in the leptin receptor gene is associated with obesity, which can be a factor for infertility. The purpose of ...
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Background and Objectives: Soluble Leptin Receptor (sOB-R) is the most important leptin-binding protein that can affect the level of active biological leptin. The Gln223Arg polymorphism in the leptin receptor gene is associated with obesity, which can be a factor for infertility. The purpose of this study was to evaluate the sOB-R levels in women with unexplained infertility and to investigate the effect of leptin receptor (LEPR) gene polymorphism on sOB-R serum level.Methods: One hundred and two women with unexplained infertility and 112 fertile women were studied in this case-control study. The subjects in both groups had a normal hormonal profile with the age below 40 years. The sOB-R levels were measured using ELISA method.Results: There was a 2-fold decrease in sOB-R level in the infertile group compared to the control group (P < /em>=0.001). Although sOB-R levels were lower in overweight and obese infertile subjects, this difference was not significant. However, this difference was significant compared to the control group. There was a direct correlation between BMI, age, and infertility. Although sOB-R levels in Arg/Arg genotypes were higher in the infertile group than Gln/Gln and Arg/Gln genotypes, they were not statistically significant. A significant decrease was observed in sOB-R levels of Gln/Gln and Arg/Gln genotypes in the infertile group compared to the control.Conclusion: There was a reverse correlation between sOB-R levels and unexplained infertility. It seems that by a decrease in serum sOB-R, the serum leptin levels increase which can enhance leptin inhibitory effects in infertility.
Gynecology Oncology
Azam-Sadat Mousavi; Setareh Akhavan; Fareideh Sabzi shahrbabaki; Narges Izadi-mood; Fariba Yarandi; Mehran Ghazimoghadam; Mohammad Pouryasin; Saina Nassiri; Mamak Shariat; Ali Pouryasin
Volume 7, Issue 3 , January and February 2022, , Pages 151-157
Abstract
Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with ...
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Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with abnormal cytological results regarding the histopathological cut-off.Materials & Methods: In this cross-sectional study, 360 non-pregnant women (≥ 21 years) who had faced abnormal cytological findings (ASC-US and LSIL) were enrolled and referred for further diagnostic tests. The INNO-LiPA® HPV Genotyping Extra-II and Aptima HPV assay kits were used in DNA- and E6/E7 mRNA-based methods for detection of HR-HPV. Regarding the CIN-2+ histopathological cut-off, the diagnostic value of each molecular-based assay was calculated.Results: Among the study participants, 260 cases had ASC-US, and 100 had LSIL. The overall positivity rate for DNA- and mRNA-based methods was 74.4% (268/360) and 64.2% (231/360), respectively. Fifty-nine (16.4%) individuals showed CIN-2+. The DNA-based test showed higher sensitivity (100%) than the mRNA-based method (93.2%), while the mRNA-based method revealed greater clinical specificity (41.5%) compared to the DNA-based test (30.6%).Conclusion: Our results revealed appropriate clinical sensitivity of the molecular-based methods for triage of Iranian women with abnormal cytological results; however, the mRNA-based method showed greater specificity for detection of CIN-2+.
