Obstetrics and Gynecology
Fatemeh Keikha; Mahnaz Veisian
Volume 6, Issue 4 , August 2021, , Pages 174-180
Abstract
Background & Objective: Some studies have suggested the association between the risk of osteoporosis and atherosclerosis. So, we aimed to compare the serum lipid levels of postmenopausal women with reduced bone density to serum lipid levels of those with normal bone density.Materials & Methods: In ...
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Background & Objective: Some studies have suggested the association between the risk of osteoporosis and atherosclerosis. So, we aimed to compare the serum lipid levels of postmenopausal women with reduced bone density to serum lipid levels of those with normal bone density.Materials & Methods: In this cross-sectional study, all 48-65 year-old women, menopause for more than 1 year prior to the study, who referred to Akbarabadi Hospital, Tehran, Iran, during September 2011-March 2013 were recruited. They underwent bone densitometry using the Dual-Energy X-Ray Absorptiometry Method and were divided into two groups: normal density (control group) and low density (case group). Body mass index (BMI) and waist circumference were measured. After 14 hours, fasting serum levels of lipid, fasting blood sugar (FBS), and HbA1C were checked. Hypercholesterolemia, as low high density lipoprotein (HDL) (<35 mg/dL) and high cholesterol levels (>200 mg/dL), were compared between the groups in addition to low density lipoprotein (LDL) levels.Results: The data of 241 women were analyzed. The mean±SD levels of serum TC were 192±24.7 and 185±19 mg/dL, in the case and control groups, respectively (P < /em>=0.009), and that of serum LDL levels were 112±20.2 and 105±17 g/dL, respectively (P < /em>=0.005). There was a significant and negative correlation between the women’s Z-score and their cholesterol level (r=-0.162, P < /em>=0.012). Regression results revealed that the following factors significantly affected Z-score: BMI, LDL, TC, and duration of menopause.Conclusion: Serum LDL and TC levels were higher in menopausal women with reduced bone density, which indicates the relationship between hypercholesterolemia and reduced bone density.
Obstetrics and Gynecology
Fariba Almassinokiani; Mahzad Alimian; Parinaz Hamednasimi
Volume 8, Issue 3 , May and June 2023, , Pages 210-216
Abstract
Background & Objective: Hysterectomy is the most common gynecological surgery. Every year, numerous women around the world undergo this type of surgery for various reasons. Regardless of the type of surgery, bleeding during surgery and after surgery is the most common consequence? Tranexamic ...
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Background & Objective: Hysterectomy is the most common gynecological surgery. Every year, numerous women around the world undergo this type of surgery for various reasons. Regardless of the type of surgery, bleeding during surgery and after surgery is the most common consequence? Tranexamic acid is a cheap, available and low-complication drug that has been considered in recent years to control bleeding. The present study investigated the effectiveness of Tranexamic acid on the bleeding during laparotomy hysterectomy in women aged 35 to 55 years.Materials & Methods: This study was a randomized, double-blind clinical trial performed on 80 patients undergoing laparotomy hysterectomy. Using a random number table, patients were divided into two groups A (receiving Transid) and the other group receiving drug B (not receiving Transid), both of which received 100 ml of normal saline prepared to reduce bias in the prepared syringe.Results: Mean age of the patients was 46.24 ± 5.21 years. Based on the results of mean hemoglobin before surgery, the rate of infection, infusion and induction in the control and intervention groups were not statistically different (P > 0.05). Also, the mean hemoglobin variables before and after hemorrhage were estimated by the surgeon and hemorrhage estimated according to Hernandez formula were not statistically different in the two groups (P > 0.05).Conclusion: Tranexamic acid administration has no effect on the amount of bleeding during hysterectomy laparotomy.
Obstetrics and Gynecology
Tajossadat Allameh; Maryam Kalatehjari
Volume 7, Issue 4 , March and April 2022, , Pages 279-285
Abstract
Background & Objective: Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes ...
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Background & Objective: Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes of colposcopy in contrast to Pap smear. The current study aims to assess the values of colposcopy for cervical cancer diagnosis.Materials & Methods: This is a cross-sectional study conducted on 94 patients diagnosed with high-grade squamous intraepithelial lesion (HSIL). After that, colposcopy was performed for all patients, and findings were presented as normal, chronic cervicitis, the thin acetowhite lesion (AWL), dense/thick AWL, AVP, pilling, and cauliflower-like mass. The biopsies were taken and pathological studies, as the gold standard was interpreted as normal, cervicitis, atypical squamous cells of undetermined significance (ASCUS), cervical intraepithelial neoplasia-1, -2 or -3 (CIN-1, -2 or -3), carcinoma-in-situ (CIS), adenocarcinoma and invasive squamous cell carcinoma (SCC).Results: The pap-smear results were significantly associated with the biopsy reports (P < /em><0.001; kappa=0.225). Besides, significant concordance was found between colposcopy and biopsy (P < /em><0.001; kappa=0.247). The total sensitivity and specificity of colposcopy were based on the biopsy findings as the gold standard was 97% and 41%, respectively (P < /em><0.001).Conclusion: Colposcopy was significantly sensitive and specific for diagnosing both non-malignant CIN-1 and malignant cervical lesions, but not for CIN-2, -3, and CIS lesions. Further evaluations are strongly recommended.
Obstetrics and Gynecology
Fatemeh Bahadori; Zahra Sahebazzamani; Somayeh Ghasemzadeh; Zahra Kousehlou; Leila Zarei; Marjan Hoseinpour
Volume 8, Issue 4 , July and August 2023, , Pages 327-334
Abstract
Background & Objective: Menarche is an important stage in the development of girls which can predict the adolescent’s puberty process and fertility onset. The changes in menstrual cycle have health consequences not only in adolescence but also over the life-course. Childhood obesity as ...
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Background & Objective: Menarche is an important stage in the development of girls which can predict the adolescent’s puberty process and fertility onset. The changes in menstrual cycle have health consequences not only in adolescence but also over the life-course. Childhood obesity as a common health problem has been observed in both developed and developing countries, and its prevalence is continuing to increase. The aim of this study was to identify menstrual patterns and related disorders and also to investigate the relationship between menarche age, menstrual disorders, and (BMI) in high school girls in Urmia.Materials & Methods: In this cross-sectional study, 716 adolescent girls aged 14-18 years were selected with multistage sampling from high schools of Urmia (Sept 2012 to Dec 2013). Participants completed the questionnaire of menstrual pattern characteristics including age at menarche, menstrual cycle length, dysmenorrhea, and the need for pain relief. BMI percentile was calculated and obesity was determined using the CDC’s 2000 BMI-for-age growth charts.Results: The results showed that the average of age, BMI, and menarche age were: 15.66±1.019 year, 22.05±3.91 kg/m2 and 12.87±0.98 year, respectively. The prevalence of overweight and obesity were 13.7% and 8.4%, respectively. A large majority of the subjects (76.1%) had a normal, healthy weight. There was a significant association between BMI and the duration of flow, menarche age, menstruation flow, and pain severity (P<0.05).Conclusion: Based on the results, planning and intervention for decreasing the BMI in high school girls can help reduce menstrual disorders. Future studies are required to confirm and complete our results.
Maternal Fetal Medicine
Maryam Moshfeghi
Volume 7, Issue 5 , July and August 2022, , Pages 382-390
Abstract
Background & Objective: The aim of this study was to evaluate the effectiveness of adjunctive pessary therapy after cerclage in increasing the gestational age (GA) to 37 weeks in women with cervical insufficiency (CI).Materials & Methods: This randomized controlled trial (RCT) was conducted at ...
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Background & Objective: The aim of this study was to evaluate the effectiveness of adjunctive pessary therapy after cerclage in increasing the gestational age (GA) to 37 weeks in women with cervical insufficiency (CI).Materials & Methods: This randomized controlled trial (RCT) was conducted at the infertility department of Royan Institute, Tehran, Iran. A total of 170 singleton pregnant women aged 18-42 years old, diagnosed with CI by GA 14-24weeks, who had intact membrane with no signs of intrauterine infection, vaginal bleeding, or uterine contraction, were enrolled. Patients were randomized 1:1 to receive either cervical cerclage or pessary after cerclage. The primary outcome was spontaneous preterm birth (SPB) (<37weeks). The secondary outcomes were GA at the time of delivery, SPB (less than 34, 32 & 28 weeks), delivery method, neonatal outcomes, maternal adverse events, and maternal satisfaction with the intervention.Results: The incidence of SPB (<37, 34, 32 & 28weeks), method of delivery, GA at time of delivery, and neonatal outcomes were not significantly different between the two groups. The incidence of vaginal bleeding (P < /i>=0.007) and pelvic pain (P < /i>=0.03) significantly was less in the intervention group. The mean score of satisfaction in the intervention group was significantly higher than the control group < /span> (P < /i>=0.01). Conclusion: The placement of an adjunctive pessary for pregnant women with singleton pregnancy and CI, did not result in a lower rate of SPB (<37weeks) compared to cerclage alone. However, pregnancy complications after the intervention until delivery were less in these women, while the level of satisfaction was higher.
Obstetrics and Gynecology
Mahin Najafian; Mahtab Shariati; Roshan Nikbakht; Sara Masihi
Volume 8, Issue 5 , September and October 2023, , Pages 438-445
Abstract
Background & Objective: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension.Materials ...
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Background & Objective: Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension.Materials & Methods: This randomized controlled clinical trial study was conducted on 60 pregnant women with a diagnosis of gestational hypertension and chronic hypertension. Women were randomly divided into the control (n=30) and the DASH diet (n=30) groups for 2 months and were followed until delivery. The outcomes of maternal pregnancy including the incidence of preeclampsia, placental abruption and preterm delivery (<37 weeks) were assessed during follow-up examinations. Birth weight and minute 1 and minute 5 Apgar score of the infant were also assessed.Results: After 1 and 2 months of intervention, systolic and diastolic blood pressure in the DASH diet group was significantly lower than the control group (P<0.05). The incidence of preeclampsia (P=0.035), preterm delivery (P=0.020) and placental abruption (P=0.007) in the DASH diet group was significantly lower than the control group. The mean gestational age at the time of termination of pregnancy was not significantly different between the two groups (P = 0.467). There was no significant difference between minute 1 and minute 5 Apgar scores of the infants and the mean birth weight of the infants was not significantly different between the DASH and control groups (P = 0.756, P = 0.115 and P = 0.101, respectively).Conclusion: The DASH diet could be used as an effective strategy to improve the clinical outcomes of pregnant women with gestational and chronic hypertension.
Obstetrics and Gynecology
Farzaneh Abedini; Mahdis Mohammadian Amiri; Mahsa Danaei; Nooshin Eshraghi
Volume 7, Issue 6 , September and October 2022, , Pages 489-496
Abstract
Background & Objective: Premature rupture of membranes (PROM) and preterm delivery are the most important problems observed in pregnancies that can cause many consequences. The present study investigated the relationship between amniotic fluid index (AFI) and uterocervical angle in patients with ...
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Background & Objective: Premature rupture of membranes (PROM) and preterm delivery are the most important problems observed in pregnancies that can cause many consequences. The present study investigated the relationship between amniotic fluid index (AFI) and uterocervical angle in patients with PROM between 24 and 34 weeks of gestation.Materials & Methods: This study was a cohort study carried out on 50 pregnant women with PROM. Inclusion criteria were 24 to 34 weeks of gestation and singleton deliveries. Demographic characteristics and pregnancy history of the subjects were determined through interviews and examinations. Moreover, AFI and uterocervical angle were determined based on ultrasound results. Subjects were followed up until delivery.Results: Mean age of the patients was 25.14±5.32 years; 23 patients (46%) had delivery latency less than 7 days. The mean uterocervical angle in the delivery latency group ≤7 was significantly higher than that in the group more than 7 days (P < /i> <0.001). Moreover, the mean AFI in the delivery latency group ≤7 was significantly higher (P < /i> <0.001). The uterocervical angle above 107.7 with a sensitivity of 87% and a specificity of 88.9% had a predictive power and its area under curve (AUC) was 0.912 (P < /i> <0.001). The mean AFI below 5.4 with a sensitivity of 81.5% and a specificity of 65.5% had a predictive power (AUC: 0.866, P < /i> <0.001). Conclusion: Uteroservical angle and AFI can be good predictors for assessing delivery latency in women with PROM. Furthermore, the mean uterocervical angle in the delivery latency group ≤7 days is significantly higher than that in the group more than 7 days, but conversely AFI is less.
Obstetrics and Gynecology
Atefeh Kazemi; Vahideh Rashtchi; Masoomeh Ghomi
Volume 8, Issue 6 , November and December 2023, , Pages 556-562
Abstract
Background & Objective: Some types of major surgeries are associated with postoperative pain, sometimes during the days after surgery. These pains mainly lead to the use of various analgesics and, ultimately, patient dissatisfaction. In the present study, we evaluated the effect of gabapentin ...
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Background & Objective: Some types of major surgeries are associated with postoperative pain, sometimes during the days after surgery. These pains mainly lead to the use of various analgesics and, ultimately, patient dissatisfaction. In the present study, we evaluated the effect of gabapentin at doses of 600 and 1200 mg on relieving pain due to cesarean section.Materials & Methods: In this randomized clinical trial, patients were randomly divided into three equal-size groups (25 patients in each group) through balanced block randomization. The first group was given 600 mg of gabapentin, the second group was given 1200 mg of gabapentin one hour before surgery, and the control group received a placebo. The pain intensity, nausea, vomiting, and drowsiness, as well as the need for postoperative analgesics, were assessed initially and at 2, 6, and 12 hours after surgery. The occurrence of nausea and drowsiness between groups was compared using the chi-square and Fisher's exact tests.Results: The mean (SD) age of patients in the gabapentin 1200 mg, gabapentin 600 mg, and placebo groups was 26.32±6.15, 27.43±6.38, and 26.59±5.88, respectively (P=0.34). Pain intensity and the rate of analgesic consumption at different time points during the first 12 hours of surgery were significantly lower in the receiving gabapentin groups than in the placebo group (P<0.05). Comparing the prevalence rates of nausea and vomiting and also drowsiness, as the drug-related side effects don’t show a significant difference across the three groups at the different investigated time points (P>0.05).Conclusion: Gabapentin with a minimum therapeutic dose can successfully reduce postoperative pain intensity and also needs analgesic use after a cesarean section.
Elham Shirali; Fariba Yarandi; Majid Safavi; Omid Hemmatian
Volume 1, Issue 1 , May and June 2016
Abstract
Introduction: Early diagnosis of endometrial cancer in younger female patients has good prognosis and better survival because of lower stage and lower grade. Endometrial cancer should be diagnosed early at lower stage because of signs and symptoms of patients. We report on a usual case of endometrial ...
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Introduction: Early diagnosis of endometrial cancer in younger female patients has good prognosis and better survival because of lower stage and lower grade. Endometrial cancer should be diagnosed early at lower stage because of signs and symptoms of patients. We report on a usual case of endometrial cancer that was miss diagnosed because she insisted on the protection of her hymen and virginity.
Case Presentation: We report a usual case of endometrial cancer that was miss-diagnosed because the patient insisted on the protection of her hymen and virginity. A 32-year-old virgin female did not permit a general gynecologist for endometrial biopsy or curettage, to protect her hymen and virginity; the patient had stage IV endometrial cancer.
Conclusions: In conclusion, patients with persistent signs and symptoms should be considered for endometrial cancer especially patients with high risk factors: nulliparity, late menopause, obesity, diabetes mellitus, unopposed estrogen therapy, tamoxifen therapy, atypical endometrial hyperplasia, Lynch II syndrome, etc. However, the most important issue for patients with persistent symptoms and risk factors for endometrial cancer in highly religious countries is obtaining a document for the gynecologist that endorses patient virginity.
Zohreh Yousefi; Shohreh Saied; Amir Hosein Jafarian; Jelveh Jalili
Volume 1, Issue 2 , September and October 2016
Abstract
Introduction: Peritoneal tuberculosis (PTB) and ovarian cancer have overlapping nonspecific symptoms and signs. No pathognomonic clinical features or imaging findings can help to distinguish definite diagnosis of extra pulmonary TB. Peritoneal TB can be easily confused with peritoneal carcinomatosis ...
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Introduction: Peritoneal tuberculosis (PTB) and ovarian cancer have overlapping nonspecific symptoms and signs. No pathognomonic clinical features or imaging findings can help to distinguish definite diagnosis of extra pulmonary TB. Peritoneal TB can be easily confused with peritoneal carcinomatosis or advanced ovarian carcinoma; therefore, it is difficult to distinguish these two entities. The current study described two cases of peritoneal tuberculosis mimicking advanced ovarian cancer.
Case Presentation: In the first case, the initial manifestation was lower abdominal pain. The imaging indicated ovarian mass, ascites and hepatic surface nodularity, omental and peritoneal thickening. Also, titer of tumor marker CA-125 was more than 600 units. In laparoscopy, disseminated peritoneal seeding was observed. Frozen section of sampling these lesions reported tuberculosis. Biopsy of ovarian mass reported fibrothecoma. Concurrent with this patient, the second case referred to the same center, Department of Gynecology Oncology at Ghaem Hospital, Mashhad University, Iran, in 2015. Her presentation was fever and remarkable weight loss during the last three months. She had a multiloculated pelvic mass with septation in sonography and peritoneal seeding with pleural effusion in computed tomography (CT) scan. Peritoneal tuberculosis was recognized through laparotomy and both patients received anti-TB treatment and now they are in good health status.
Conclusions: Peritoneal tuberculosis should always be considered in differential diagnosis of patients with evidences suggesting advanced ovarian cancer..
Setare Nasiri; Shahrzad Sheikh Hasani; Azamosadat Mousavi; Mitra Modarres Gilani; Setare Akhavan; Mohammad Rahim Rahim Vakili
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: Mesonephric adenocarcinoma of uterine cervix is a rare variant of primary endocervical adenocarcinoma and a few cases have been reported previously. In fact in non-metastatic adenocarcinoma of the cervix, less than 5% possess mesonephric type. Because of the low incidence of mesonephric ...
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Introduction: Mesonephric adenocarcinoma of uterine cervix is a rare variant of primary endocervical adenocarcinoma and a few cases have been reported previously. In fact in non-metastatic adenocarcinoma of the cervix, less than 5% possess mesonephric type. Because of the low incidence of mesonephric adenocarcinoma, various methods have been proposed for treatment of mesonephric adenocarcinoma. Nevertheless, there is no unity in treatment approaches.
Case Presentation: Here, we present a 45-year woman who had bloody discharge for 6 months period. Hormonal profile such as thyroid stimulating hormon (TSH) and prolactin was normal and all imaging studies showed a cervical fibroma as a mass. Abdominal hysterectomy -bilateral salpingectomy was performed. After pathologic report as a mesonephric adenocarcinoma, she received radiation and then she was candidate for bilateral oophorectomy.
Conclusions: Because of the diversity and an unusual appearance of mesonephric adenocarcinoma with aproblematic case of cervical mass, it is very important to consider mesonephric adenocarcinoma as a type of diagnosis. Numerous differential diagnoses should be considered for management of this type of carcinoma. In order to make a diagnosis, deep biopsy of infiltrative mass of uterine cervix, is mandatory.
Maryam Moshfeghi; Mohammad Hossein Eftekhari
Volume 2, Issue 1 , March and April 2017
Abstract
Introduction: When a mother is contaminated with the parasitic protozoan Toxoplasma gondii as a primary infection in pregnancy, the golden test to confirm fetus infection is polymerase chain reaction (PCR), for the parasite DNA in amniotic fluid that may reach fetus and cause congenital toxoplasmosis. ...
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Introduction: When a mother is contaminated with the parasitic protozoan Toxoplasma gondii as a primary infection in pregnancy, the golden test to confirm fetus infection is polymerase chain reaction (PCR), for the parasite DNA in amniotic fluid that may reach fetus and cause congenital toxoplasmosis. Toxoplasmosis sometimes appears with very rare presentations that should be considered and treated to save mother and her baby.
Case Presentation: A 28-year-old pregnant mother was referred to the perinatology clinic of Shariati hospital, Tehran, Iran, for the diagnosis of her fetus problem. She was a rare case of congenital toxoplasmosis.
Conclusions: Diagnosis of toxoplasmosis in pregnancy is based on seroconversion of antibodies; based on many studies in the literature, the best method to confirm fetus is PCR for Toxoplasma gondii DNA in amniotic fluid.
Soodabeh Darvish; Koorosh Etemad; Azar Mosaheb; Ghasem Yazdanpanah
Volume 2, Issue 2 , May and June 2017
Abstract
Objectives: This study aimed to compare maternal and neonatal side effects of natural vaginal delivery (NVD) under neuro-axial analgesia with usual NVD and C-section.
Methods: In this single center prospective cohort study, deliveries carried out in a 7 months’ period were evaluated after getting ...
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Objectives: This study aimed to compare maternal and neonatal side effects of natural vaginal delivery (NVD) under neuro-axial analgesia with usual NVD and C-section.
Methods: In this single center prospective cohort study, deliveries carried out in a 7 months’ period were evaluated after getting informed consent. The study is approved by the ethics committee of Shahid Beheshti University of Medical Sciences. Mothers were categorized into 3 groups of C-section, NVD with an analgesia, intervention, and usual NVD. Afterwards, maternal and neonatal side effects after delivery were assessed using physical examinations, laboratory results, and interviews.
Results: Overall, 121 mothers were equally assigned to 3 groups. No significant differences were found in the first and fifth-minute APGAR scores of the neonates born in these 3 groups. Moreover, none of the neonates’ fifth-minute APGAR scores were less than 7. In addition, hypoxia (umbilical artery pH < 7.2) was observed more in the neonates delivered by NVDs with analgesia interventions compared to the other 2 groups. In comparison with the mothers in the other 2 groups, headache and pruritus were more prevalent among the mothers who had NVDs under neuro-axial analgesia.
Conclusions: Given the advantages of natural vaginal deliveries for mothers and their fetuses and considering the side effects of C-sections without medical indications, propagating painless NVDs could be a proper solution for increasing the prevalence rate of NVDs in the society. Conducting further studies on larger samples is recommended.
Setare Nasiri; Azamosadat Mousavi; Shahrzad Sheikh Hasani; Mohammad Rahim Rahim Vakili; Mitra Modarres Gilani; Setare Akhavan; Monire Mirzaei
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: The incidence of vulvar cancer is nearly 5% of all gynecologic malignancies and almost 95% of vulvar cancers are squamous cell carcinoma (SCC). Recurrence is possible in 4 ways: local, regional, pelvic, and distant. In a cohort of 391 patients with vulvar SCC, distant metastasis was reported ...
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Introduction: The incidence of vulvar cancer is nearly 5% of all gynecologic malignancies and almost 95% of vulvar cancers are squamous cell carcinoma (SCC). Recurrence is possible in 4 ways: local, regional, pelvic, and distant. In a cohort of 391 patients with vulvar SCC, distant metastasis was reported 5% .The common sites of distant metastasis are pelvic nodes, lung, and liver. Both skin and bone metastasis are rare in vulvar SCC.
Case Presentation: The current report presented a 58-year-old female with the diagnosis of vulvar SCC. She was the 11th cutaneous metastasis, 13th bone metastasis, and the 1st case with simultaneous bone and skin metastasis reported in the last 60 years.
Conclusions: It is necessary to consider any lesion on the vulve, especially in menopause females, and it should be the low threshold for biopsy to avoid delay in detection. After completion of selective treatment, the exact follow-up should be considered to discover metastases.
Behnaz Moradi; Fatemeh Shakki Katouli; Masoumeh Gity; Mohamad Ali Kazemi; Madjid Shakiba; Farzaneh Fattahi Masrour
Volume 2, Issue 4 , November and December 2017, , Pages 1-8
Abstract
Objectives: The current study aimed at providing detailed information about the distribution, associated anomalies, and syndromes in Iranian fetuses with neural tube defects (NTDs).
Methods: The current study was conducted in Yas Females’ referral and teaching hospital in 18 months from 2014 to ...
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Objectives: The current study aimed at providing detailed information about the distribution, associated anomalies, and syndromes in Iranian fetuses with neural tube defects (NTDs).
Methods: The current study was conducted in Yas Females’ referral and teaching hospital in 18 months from 2014 to 2016. All fetuses with a prenatally detected neural tube defect were included in the study. Neural tube defect characterization, gestational age, maternal reproductive factors, maternal risk factors, and associated anomalies were recorded.
Results: Neural tube abnormalities were identified prenatally in 80 fetuses: 40 cases of ex/anencephaly, 22 cases of spina bifida, 13 cases of cephalocele and 5 cases of anencephaly /craniorachischisis. All the cases were detected before 21st week of gestation and 92.5% of the ex/anencephaly cases were diagnosed in the 1st trimester. Moreover, 40% of the open spina bifida cases in the current study were myelocele, while 75% of them referred only due to abnormal cranial findings. Incomplete consumption of folate was the most common associated risk factor (45%). Associated anomalies were recorded in 53 (66%) fetuses, with more prevalence in the fetuses with spina bifida (90%). Among the associated anomalies, central nervous system (CNS) anomalies were the most common type (26.26%). Chiari II was found in all the cases of open spina bifida and the ventriculomegaly rate was 30% in this group. Extremities anomalies and spine deformities were the 2nd and 3rd common associated findings, respectively. Limb-body-wall complex/amniotic band syndrome was the most common identified associated syndrome (6%).
Conclusions: Results of the current study confirmed the high prevalence of associated anomalies in neural tube defect cases and revealed the capability of detailed sonography to detect and define such abnormalities.
Masoumeh Rahimian; Setare Nassiri; Elham Saffarieh
Volume 4, Issue 1 , March and April 2019, , Pages 16-23
Abstract
Background & Objective: Pregnancy is one of the most important stages of a woman’s life. Although this is a pleasant period for most women, it is often considered as a stressful period accompanied by physiological and psychological changes. This study aimed to examine pregnant women’s ...
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Background & Objective: Pregnancy is one of the most important stages of a woman’s life. Although this is a pleasant period for most women, it is often considered as a stressful period accompanied by physiological and psychological changes. This study aimed to examine pregnant women’s attitude towards sexual desire and its relationship with quality of life and rumination in the last trimester of pregnancy.
Materials & Methods: The statistical population of this descriptive correlational study included all pregnant women in the last trimester of pregnancy. A total of 280 women were selected using a random sampling method. Data were collected using the Index of Sexual Desire, Rumination Scale, and Quality of Life Questionnaire. The data were analyzed by SPSS 11.5 using simultaneous regression analysis.
Results: The results showed that rumination was significantly and negatively predicted by sexual desire. Moreover, the subscales of physical functioning, emotional problems, and general health were positively and significantly predicted by sexual desire. However, sexual desire could not significantly predict other subscales of quality of life, namely fatigue or vitality, emotional health, social functioning, pain, and physical health status.
Conclusion: Our finding revealed that, if guided and employed properly, sexual desire during pregnancy can moderate stress.
Gynecology Oncology
Khadijeh Elmizadeh; Fatemeh Lalooha; Shahrzad Sheikh Hassani; Solmaz Chmanara
Volume 6, Issue 1 , January 2021, , Pages 16-21
Abstract
Background & Objective: This study aimed to examine the extent to which postcoital bleeding (PCB) can be a predictive factor for cervical cancer.Materials & Methods: In this observational study we selected and evaluated 280 females with PCB referred to Kowsar Hospital of Qazvin, Iran from 2017 ...
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Background & Objective: This study aimed to examine the extent to which postcoital bleeding (PCB) can be a predictive factor for cervical cancer.Materials & Methods: In this observational study we selected and evaluated 280 females with PCB referred to Kowsar Hospital of Qazvin, Iran from 2017 to 2019.Results: Among the 189 patients diagnosed as normal in their Pap smear results, one patient had cancer in her biopsy results. A closer look at the biopsy results of the patients showed 45 patients as normal, 64 patients with cervical infection, 31 patients with polyp cervix, 45 patients with cervical intraepithelial neoplasia 1 (CIN 1), and one patients with squamous cell carcinoma (SCC). Among 63 patients diagnosed with atypical squamous cells of undetermined significance (ASCUS), three showed CIN 2 and CIN 3 in their biopsies. Furthermore, out of 21 patients with low-grade squamous intraepithelial lesion (LSIL), three patients had CIN 2 and CIN 3, one patient had carcinoma, and one had SCC. In addition, all of the patients with high-grade squamous intraepithelial lesion (HGSIL) were diagnosed with CIN 2, CIN 3, and SCC.Conclusion: Because of the higher rate of cervical cancer in women with PCB and inconsistent screening programs in developing countries, it is essential to carefully consider the symptoms of PCB despite having a normal Pap smear.
Azar Ahmadzadeh; Nahid Shahbazian; Boshra Arkavazi
Volume 3, Issue 1 , March and April 2018, , Pages 19-22
Abstract
Aims Tumor markers are very applicable for examining differential diagnoses of adenosine masses. Increases in CA 19-9 have been reported in epithelial ovarian and endometrial tumors. Dermoid cysts are the most prevalent ovarian germ cell tumors. The aim of the present study was to examine Cancer Antigen ...
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Aims Tumor markers are very applicable for examining differential diagnoses of adenosine masses. Increases in CA 19-9 have been reported in epithelial ovarian and endometrial tumors. Dermoid cysts are the most prevalent ovarian germ cell tumors. The aim of the present study was to examine Cancer Antigen 19-9 (CA 19-9) tumor marker in ovarian dermoid cysts.
Information and Methods This descriptive-analytic study was conducted using hospital records. By referring to archives of a Imam Khomeini Hospital, Ahwaz, Iran in 2016, the information of 73 patients with ovarian dermoid cysts were extracted that include their demographic information, cyst size, the location of involvement, the presence of symptoms of malignancy in sonography reports, and CA 19-9 serum levels prior to surgery. A pathologic report was used for the final mass diagnosis and determining the type of mass extracted from the patients’ bodies. Data were analyzed by SPSS 22 software using independent-sample t-test, chi-square test and Pearson correlation coefficient.
Findings All patients under study were diagnosed with dermoid cysts. In 9 patients (12.85%), symptoms of malignancy were reported in their sonography reports. The mean serum levels of CA 19-9 tumor marker was 46.13±11.65U/ml. There was a direct correlation between mass size and CA 19-9 serum concentrations (r=0.24). In 20% of the patients, the concentrations of CA 19-9 were normal.
Conclusion The CA 19-9 serum concentration is related to tumor size in cases of mature cystic teratoma. In most cases of unilateral mature cystic teratomas, the right ovary is mainly preferred to involve.
Gynecology Oncology
Arvin Arian; Masume Giti; Azamosadat Moosavi; Setare Akhavan; Arash Azhideh; Mehran Arab-Ahmadi
Volume 5, Issue 1 , August 2020, , Pages 19-23
Abstract
Background & Objective: Endometrial cancer is the most frequent genitourinary tract malignancy in women. Women with endometrial cancer mostly refer at early stages of the disease which leads to good prognosis. Magnetic resonance imaging (MRI) has a crucial role in staging of the cancer. As there ...
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Background & Objective: Endometrial cancer is the most frequent genitourinary tract malignancy in women. Women with endometrial cancer mostly refer at early stages of the disease which leads to good prognosis. Magnetic resonance imaging (MRI) has a crucial role in staging of the cancer. As there are little studies regarding the correlation between histopathology and International Federation of Gynecology and Obstetrics (FIGO) staging in Iranian women with endometrial cancer, we designed this study to assess the relationship between histopathology and FIGO staging with MRI in Iranian women with endometrial cancer.Materials & Methods: This retrospective study was conducted in Imam Khomeini hospital complex between January 2015 and January 2018. All MRIs were performed on a 3T system. All imaging was done in Imam Hospital under observation of attending Radiologists with 10 and 20 years of work experience in women’s imaging who conducted this research. Obtained surgical specimens were assessed by an expert pathologist in the field of cancer and type of cancers were determined.Results: Thirty two women with proved endometrial cancer (D&C or endometrial biopsy) were enrolled. Mean age was 55.2±10.7 years and all women referred to our clinic with vaginal bleeding. The most common FIGO staging was IA (14, 43.75%) and the most frequent pathology was endometrioid type adenocarcinoma (30, 93.7%) (60% well differentiated, 13.3% moderately differentiated, and 26.6% poorly differentiated). Most cases with endometrioid type poorly differentiated referred with IIIC1 stage of cancer, most patients with endometrioid type well differentiated referred with stage IA, a patient with clear cell cancer referred with stage IIIB, and patients with sarcoma referred with stages IB, and IV.Conclusion: Patients with poor differentiated endometrial cancer referred with higher stages of the cancer.
Obstetrics and Gynecology
Mahboobeh Shirazi; Mehnoosh Torkzaban; Samira Fallah; Marjan Ghaemi
Volume 7, Issue 1 , September and October 2021, , Pages 20-24
Abstract
Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management ...
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Background and Objective: Pain is the most common side effect of induced medical abortion. However, the optimal analgesia method remains as a clinical challenge. This study aimed to compare the efficacy of two methods of administration of diclofenac as a prophylactic or a therapeutic in pain management in induced second-trimester medical abortion. Materials and Methods: This randomized clinical trial study was conducted upon pregnant women who were candidates for induced medical abortion and referred to a tertiary educational hospital between October 2019 and December 2020. Participants were divided into two groups based on the mode of diclofenac administration, which was either simultaneously with the first dose of misoprostol or after beginning of the pain. Pain severity, induction-to-abortion time interval, total misoprostol dosage, Hemoglobin concentration, length of hospitalization, and size of retained pregnancy products by ultrasound, and the cumulative dose of opioid usage were compared between the groups.Results: The severity of pain which was measured by a visual analog scale (VAS), residual of conceived products, hospitalization days, and the total misoprostol dosage were significantly lower (P < /em><0.05) in the prophylaxis compared to the treatment group.Conclusion: Simultaneous administration of diclofenac with misoprostol as prophylactic method of pain management may be an optimal method in induced medical abortion in the second trimester.
Obstetrics and Gynecology
Roshan Nikbakht; Narges Dibavand; Shabnam Salemi; Ali Reza Sattari; Maryam Farzaneh
Volume 9, Issue 1 , January and February 2024, , Pages 22-28
Abstract
Background & Objective: The presence of air in the catheter was found to affect the success of embryo transfer into the uterine cavity. This study determined the chances of achieving pregnancy using the intrauterine insemination (IUI) method with different air volumes inside the IUI catheter.Materials ...
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Background & Objective: The presence of air in the catheter was found to affect the success of embryo transfer into the uterine cavity. This study determined the chances of achieving pregnancy using the intrauterine insemination (IUI) method with different air volumes inside the IUI catheter.Materials & Methods: This clinical trial study was performed on 521 IUI cycles among 270 couples from 2013 to 2014. The patients were divided into three groups (each group of 90 patients), based on three volumes of air inside the catheter (0.0 ml, 0.5 ml, and 1 ml). Other variables, include the woman’s age, menstrual cycle status, duration of infertility, type of infertility, sperm morphology, total motile sperm count (TMSC), number of motile sperm inseminated (NMSI), and pregnancy rate or the success rates of IUI were evaluated.Results: The mean age of women and men were 33 and 30 years, respectively. Based on three volumes of air inside the catheter (0.0 ml, 0.5 ml, and 1.0 ml), the pregnancy rates were 5%, 9.4%, and 16.5%, respectively. TMSC of more than 5.6x106 and NMSI of more than 3.4x106 were associated with the chance of IUI achievement. At the same time, there was no significant relationship between the woman’s age, irregular menstrual cycles, and duration of infertility with the success rate of IUI. We found that the air volume of 1.0 ml inside the IUI catheter significantly increased the pregnancy rate compared to other groups.Conclusion: The volume of air within the catheter had a significant relationship with the success rate of IUI.
Obstetrics and Gynecology
Mahnaz Ashrafi; Sahar Golmohammadi
Volume 8, Issue 1 , January and February 2023, , Pages 23-28
Abstract
Background & Objective: Clomiphene resistance is an important problem among women with Polycystic Ovarian Disease (PCOD) suffering from infertility. Recognition of the causes would result in better prognosis in these patients. This study was performed to determine different PCOD phenotypes and ...
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Background & Objective: Clomiphene resistance is an important problem among women with Polycystic Ovarian Disease (PCOD) suffering from infertility. Recognition of the causes would result in better prognosis in these patients. This study was performed to determine different PCOD phenotypes and their effects on clomiphene resistance in infertile women.Materials & Methods: In this descriptive-comparative cross-sectional study, 200 consecutive PCOD women with infertility taking clomiphene who were reffered to Akbarabadi hospital in 2017 and 2018 were enrolled. Different PCOD phenotypes and their effects on clomiphene resistance among these women were assessed.Results: The results showed that A, B, C, and D phenotypes were observed in 79 (39.5%), 13 (6.5%), 51 (25.5%), and 57 (28.5%) patients, respectively. Sixty-one patients (30.5%) had resistance. Despite no significant difference between phenotypes (P=0.064), the most common PCOD phenotype was A (HA+OA+PCO) found in 39.2% and D (OA+PCO) was seen in 29.8% of the patients.Conclusion: According to the results, there was no significant association between PCOD phenotypes and clomiphene resistance. Finally, A and D phenotypes were frequent types with clomiphene resistance.
Nahid Shahbazian; Mahvash Zargar; Mojgan Barati; Najmieh Saadati; Elham direkvand
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Background and Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (TPO-Ab). However, whether women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of present study ...
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Background and Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (TPO-Ab). However, whether women with anti-thyroid peroxidase antibody (TPOAb) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of present study was to comparison of pregnancy outcomes in pregnant women with positive and negative TPO-Ab. Methods: This cross-sectional study was conducted on pregnant women with positive anti-TPO Ab (n= 108) and negative anti-TPO Ab (n=340) referring to Imam Khomeini Hospital and Ahvaz clinics from January 2020 to December 2020. The pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, miscarriage, preterm birth, placental abruption, IUFD, IUGR, and TSH level, were compared between the two groups by SPSS software using student t-test and Chi-square test.Results: The mean TSH level was significantly different in women with negative TPO-Ab than those with positive TPO-Ab (Mean (SD): 2.25(1.47) vs. 4.82(9.38), P<0.0001). In addition, 81 (75.00%) women in the positive anti-TPO group and 104 (30.58%) in the negative anti-TPO group had high TSH (P<0.001). The frequency of GDM in positive anti-TPO Ab pregnant women was significantly higher than that in the negative anti-TPO Ab group (46.29% vs. 34.11%, P=0.029). The results also indicated an enhancement in the rate of miscarriage (15.74% vs. 4.11%, P<0.001) and preterm parturition (13.88% vs. 3.52%, P<0.001) in positive anti-TPO Ab women. Conclusions: Presence of positive anti-TPO Ab was significantly associated with preterm delivery, abortion and GDM in pregnancy. Treatment with Levothyroxine can reduce the risk of adverse pregnancy outcomes in women who are positive for TPOAb. .
Obstetrics and Gynecology
Arash Moshiri; Maryam Ahmadian; Seyedeh Nafiseh Naseri; Shima Sheibani; Mahboobeh Shirazi; Baratoallah Akbari; Atefeh Hoseinzadeh
Volume 5, Issue 2 , October 2020, , Pages 49-53
Abstract
Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint ...
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Background: In this present study, we reported a 31-week pregnant woman who had a history of fever and chills in the past two daysreferred to Mostafa Khomeini Hospital in Tabas.Case report: A 29-year-old pregnant woman with a gestational age of 31 weeks presented to the gynecology clinic. Her chief complaint was a history of fever and chills in the recent past two days. Since there were no suspicious findings in favor of infections, related to obstetrics and gynecology, the patient was referred to Mostafa Khomeini Hospital in Tabas (June 2020). The initial clinical examination revealed no fever, chills, cough, respiratory distress, body aches, gastrointestinal problems or anything else. The patient’s oxygen saturation level was 98%. Routine laboratorytests were requested for the patient. WBC count was 14000, lymphocyte count was 875 (6.25%), and platelet count was 117000. According to the recent history of clinical symptoms and positive paraclinical results, COVID-19 was suspected. In the chest CT findings, bilateral ground glass opacities (GGO) and consolidations were observed, which were compatible with COVID-19 pattern. Based on the positive clinical and lab tests, COVID-19 was detected and positive RT-PCR COVID-19 test confirmed our diagnosis.Conclusion: The patient was asymptomatic at the time of admission to our ward; however, she reported fever and chills in the last two days, which raised our suspicion about COVID-19. Due to significant lymphopenia and the increase in granulocytes counts, and thrombocytopenia accompanied with complementary lab tests, severe COVID-19 was diagnosed and confirmed with positive RT-PCR test.
Leili Bargi; Changiz Ahmadizadeh
Volume 4, Issue 2 , May and June 2019, , Pages 62-68
Abstract
Background & Objective: Cervical cancer is the second most prevalent cancer in women worldwide and is one of the leading causes of deaths in women with cancer in developing countries. The most well-known cause of this cancer is being infected with human papillomavirus (HPV). This study aimed ...
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Background & Objective: Cervical cancer is the second most prevalent cancer in women worldwide and is one of the leading causes of deaths in women with cancer in developing countries. The most well-known cause of this cancer is being infected with human papillomavirus (HPV). This study aimed at evaluating the concurrent methylation pattern of the human papillomavirus genome in studying the DAPK1 gene as a diagnostic biomarker in cervical cancer.
Materials & Methods: This study was approved by the Ethics Committee of the Islamic Azad University of Tabriz under the following ethical code, i.e., IR.IAU.TABRIZ.REC1398.001.This case-control study was conducted on 150 paraffin-embedded samples (75 marginal samples and 75 cervical cancer tissue samples) taken from women with cervical cancer. After extracting the total DNA, spectrophotometry and electrophoresis were performed on agarose gels to determine the quantity and quality of the extracted DNA. Changes in the DAPK1 gene methylation pattern were examined using High Resolution Melt Analysis Curve Method.
Results: The changes in theDAPK1 gene expression in the cervical tumor tissues increased compared to the marginal tissues, indicating a statistically significant difference (P < /em><0/0001).
Conclusion: The results of the current study showed that the DAPK1 gene can be introduced as a possible prognosis for cervical cancer diagnosis and treatment. However, more extensive studies with more samples are needed to be carried out.
