Parisa Dini; Mansoureh Shabani Zanjani; Mansoureh Vahdat; Vahideh Estaraei
Volume 3, Issue 2 , May and June 2018, , Pages 65-71
Abstract
Aims: Since there is no consensus on the best diagnostic method for perimenopausal women with abnormal uterine bleeding. The aim of this study was to investigate the association between endometrial thickness in transvaginal ultrasound and the results of Pipelle endometrial sampling in perimenopausal ...
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Aims: Since there is no consensus on the best diagnostic method for perimenopausal women with abnormal uterine bleeding. The aim of this study was to investigate the association between endometrial thickness in transvaginal ultrasound and the results of Pipelle endometrial sampling in perimenopausal women with abnormal uterine bleeding.
Materials and Methods: In this cross-sectional descriptive study, all perimenopausal women with abnormal uterine bleeding who referred to Rasoul Akram and Akbarabadi Hospitals, Tehran, Iran in 2016 and 2017 were considered. The current study was carried out on a corpus of 68 perimenopausal women with abnormal uterine bleeding. All these patients underwent a transvaginal ultrasound conducted by an operator. Afterward, all of them had a Pipelle endometrial sampling performed by a gynecologist. The current study was carried out on a corpus of 68 perimenopausal women with abnormal uterine bleeding. A chi-square, Mann Whitney, and Kruskal Wallis tests were used. The obtained data were analyzed using SPSS 22.
Findings: A statistical mean endometrial thickness in patients with benign diagnoses was 7.55±2.72mm and it was 15.57±2.99mm in patients with malignant diagnoses which indicated no statistically significant difference (p<0.001). Evaluating a receiver operating characteristic curve (ROC) demonstrated that the cut-off point of endometrial thickness was 10.50 with a sensitivity of 85% and a specificity of 85%.
Conclusion: Determining the cut-off point of 10.50mm for endometrial thickness using transvaginal ultrasound in perimenopausal women is a suitable, non-invasive method, the results of which can predict the results of Pipelle endometrial sampling well.
Radiology
Maryam Rahmani; Behnaz Moradi; Masoumeh Gity; Mohammadreza Chavoshi; Sedigheh Hantoushzadeh; Soudabeh Kazemi Aski; Seyedeh Fatemeh Mahdipour Keivani; Narges Badraghe; Mohammad Ali Kazemi
Volume 6, Issue 2 , March 2021, , Pages 72-80
Abstract
Background and Objective: To evaluate the clinical course and CT findings of pregnant womenMethods: Fourthy (25 pregnant and 15 non-pregnant) patients were entered to the study. Chest CT features and clinical findings were evaluated between two groups. Data related to pregnancy and fetal status evaluated ...
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Background and Objective: To evaluate the clinical course and CT findings of pregnant womenMethods: Fourthy (25 pregnant and 15 non-pregnant) patients were entered to the study. Chest CT features and clinical findings were evaluated between two groups. Data related to pregnancy and fetal status evaluated in the pregnant group.Result: The average age of pregnant patients was 33.1±5.75 years and the non-pregnant group was 35.4±6.88 years. The gestational age ranged from 7 weeks to 39weeks+2days (mean =31weeks+5days). No significant difference was seen between the two groups about clinical findings except the duration of symptoms before CT which was more in pregnant patients (6.71 ± 5.5 days vs 3.53 ± 1.92 days). Two mortalities in pregnant and one in non-pregnant patients , 2(8%) cases of premature rupture of membranes (PROM), 3 (12%) cases of intra-uterine fetal death (IUFD), 3 (12%) cases of fetal distress and 2 (8%) cases of IUGR in pregnant group. Fifteen pregnant patients gave birth .No positive PCR result was detected in newborns. Unlike the control group, the common CT findings were ground-glass pattern.Conclusion: In summary, although we found the clinical findings in pregnant and control group were similar but pattern of CT involvement was different in pregnant patients and rate of ICU admission and mortality rate were more than control group. This viral pneumonia was associated with some important complications such as IUFD in severely involved mothers. CT could be an efficient tool for the early detection and severity assessment in the pregnant patients with COVID-19 pneumonia.
Obstetrics and Gynecology
Mandana Mansour Ghanaei; Effat Ebadollahi Nodeh; Seyed Mohammah Asghari Ghalebin; Seyedeh Hajar Sharami; Katayoun Haryalchi
Volume 7, Issue 2 , September and October 2021, , Pages 83-88
Abstract
Background & Objective: Opioids that are used during anesthesia may prolongate intestinal peristalsis. This study aimed to examine the effect of oral methylnaltrexone (OMNTX) on ileus after hysterectomy.Materials & Methods: This study was performed as a randomized, double-blind screening for ...
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Background & Objective: Opioids that are used during anesthesia may prolongate intestinal peristalsis. This study aimed to examine the effect of oral methylnaltrexone (OMNTX) on ileus after hysterectomy.Materials & Methods: This study was performed as a randomized, double-blind screening for an elective abdominal hysterectomy at Alzahra Hospital in Rasht, Iran; 33 patients were assigned to the OMNTX group (25 mg) and 33 to the placebo group using the random block method. Patients were asked and recorded about gas passing, constipation, vomiting, itching, and urinary retention.Results: There was a significant difference in the meantime of initiation of intestinal sound (P < /em>=0.039) and constipation (P < /em>=0.62) between the two groups. There was a positive correlation coefficient in the placebo group (P < /em>=0.02) between the hours of surgery and the time of initiation of bowel movements after the surgery. Still, there was not in the OMNTX group (P < /em>=0.0001). The mean onset of bowel sounds after the surgery was not related to age (P < /em>=0.599) and the duration of surgery significantly (P < /em>=0.926).Conclusion: It is possible that OMNTX before the surgery can trigger bowel sounds sooner after the surgery and prevent ileus.
Obstetrics and Gynecology
Sedigheh Abdollahpour; Talat Khadivzadeh; Robab Latifnejad Roudsari
Volume 5, Issue 3 , November 2020, , Pages 93-102
Abstract
Background & objective: Clinical trials are studies that can provide the most reliable evidence to investigate the impact of various interventions in health research. Due to the importance of these studies in producing valid scientific evidence, this study was conducted to critically evaluate ...
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Background & objective: Clinical trials are studies that can provide the most reliable evidence to investigate the impact of various interventions in health research. Due to the importance of these studies in producing valid scientific evidence, this study was conducted to critically evaluate the published clinical trials regarding the effectiveness of midwife-based interventions on preventing post-traumatic stress disorder after childbirth.Materials & Methods: In this critical evaluation, we searched for randomized clinical trial articles related to midwife-led interventions in preventing post-traumatic stress in reputable databases using the keywords "traumatic childbirth", "post-traumatic stress", "intervention", "counseling", "midwife", "clinical trial" and their equivalent in English, without time limit. Out of 18581 retrieved articles, 12 articles were evaluated using CONSORT-2018. This checklist consisted of 26 sections and 42 items. Each item was scored based on the report or non-report in the article under review. The tool scores ranged from zero to 42. Data were analyzed using SPSS 21.Results: The overall compliance of the quality of the reviewed articles with the checklist criteria was estimated at 60.1%. The mean overall quality was 25.1±3.6 and therefore the articles were of moderate quality. Randomization and blinding methods require more careful attention so as not to reduce the methodological accuracy of the articles. On the other hand, the title and abstract sections, background, goals, and interpretation of the results were of high quality, and the discussion section and other information were of low quality.Conclusion: In order to use the results of clinical trials in evidence-based care related to the effectiveness of midwifery-based interventions on reducing postpartum stress, improving the quality of articles is essential, and using a standard checklist should be on the agenda of authors and reviewers of journals.
Shapoor Shoja; Seyedeh Reyhaneh Yousefi Sharami; Shole Shahgheibi; Farnaz Zand-Vakili; Shamsi Zare; Daem Roshani; Nasrin Sofizadeh
Volume 4, Issue 3 , September and October 2019, , Pages 105-110
Abstract
Background & Objective: The induction of labor is needed to terminate pregnancy in pregnant women lacking labor pain. Common indications of labor induction include rapture of membranes without labor pain, hypertension, fetus’ unreassuring conditions and post-term pregnancies. The purpose of ...
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Background & Objective: The induction of labor is needed to terminate pregnancy in pregnant women lacking labor pain. Common indications of labor induction include rapture of membranes without labor pain, hypertension, fetus’ unreassuring conditions and post-term pregnancies. The purpose of this study is to compare and contrast vaginal misoprostol with Foley catheter in cervical ripening and the induction of labor.
Materials & Methods: This study was done on pregnant women who showed pregnancy termination indication for any cause, using randomized clinical trial method. Inclusion criteria in this study included gestational age equal to or greater than 37 weeks and ultrasonography of the first trimester, unfit cervix Bishop Score 1 equal to or less than 4, single-shot pregnancies, vertex display, intact membrane and the subject’s consent to participate in the research. Patients were divided into two equal groups of 60. Oxytocin was used for the induction of labor if the patient did not enter the active phase.
Results: In this study, the average age of women in Foley catheter group and misoprostol group were 27.03±4.04 and 26.85±3.49 respectively in which there was no meaningful difference statistically. However, the average age of women with cesarean delivery was statistically more than the average age of women with NVD. Bishop score 2 has demonstrated more increase in comparison to Bishop score 1 among Foley catheter group rather than misoprostol group. The average of labor speed, the number of women with NVD and the failure of induction in Foley catheter group exceeded those in misoprostol group.
Conclusion: According to the results gained in this study, Foley catheter application for induction of labor had better outcomes in comparison to vaginal misoprostol. It can even be a better alternative for vaginal misoprostol; hereby the side effects of misoprostol such as possible tachysystol and fetus distress can be prevented.
Monireh Rahimkhani; Alireza Mordadi; Mohammad Zayandeh; Laya Sam
Volume 3, Issue 3 , September and October 2018, , Pages 111-114
Abstract
Aims: Preterm labors and abortions are among dangers that threaten mothers’ and infants’ lives. Several bacterial, viral, and parasitic agents can cause preterm labor and abortion. Among these bacterial agents, Chlamydia trachomatis plays a very key role. The aim of this study was to detect ...
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Aims: Preterm labors and abortions are among dangers that threaten mothers’ and infants’ lives. Several bacterial, viral, and parasitic agents can cause preterm labor and abortion. Among these bacterial agents, Chlamydia trachomatis plays a very key role. The aim of this study was to detect and isolate Chlamydia trachomatis from urine and its role in preterm labor.
Materials & Methods: This cross sectional study was carried out from 2016 to 2017 in AlMahdi Clinic under the supervision of Tehran University of Medical Sciences. 119 pregnant women who were in the first trimester of pregnancy (between 12 and 14 weeks) referred to a health center for screening tests were selected using available sampling method and were collected their urine samples. The obtained samples were centrifuged and the DNA was extracted from urine sediment. Using specific PCR kits for detecting Chlamydia trachomatis, the presence or absence of this bacteria was investigated in the urine sediment. The data were analyzed using Chi square test.
Findings: The rate of isolating Chlamydia trachomatis from the urine of these pregnant women was 6.72%. There was no significant relationship between chlamydia infection and history of abortion (p=0.93).
Conclusion: The level of the isolation of Chlamydia trachomatis from the urine of pregnant women is twice more than the level of its isolation from samples taken from vaginal and cervical discharge in pregnant women. Therefore, urine is an appropriate sample for the diagnosis of Chlamydia trachomatis since the sampling method is non-invasive and has more positive cases
Obstetrics and Gynecology
Shahla Mirgaloybayat; Sharareh Saneei; Marziyeh Ajdary; Saeedeh Sarhadi; Neda Eslahi; Foroogh Sadat Mousavi; Farahnaz Farzaneh
Volume 8, Issue 2 , March and April 2023, , Pages 120-124
Abstract
Background & Objective: Determining the correct date of pregnancy and fetal age has a very important role in the management of pregnancy from the first trimester to delivery, which makes it necessary to know the exact method in this field. Therefore, this study aimed to compare the accuracy ...
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Background & Objective: Determining the correct date of pregnancy and fetal age has a very important role in the management of pregnancy from the first trimester to delivery, which makes it necessary to know the exact method in this field. Therefore, this study aimed to compare the accuracy of ultrasound at 8-16 weeks with Naegele’s Revised Rule of the delivery date.Materials & Methods: This study was performed on 50 pregnant women. After recording demographic information and age of delivery, sonography of weeks 8-16 and Naegel’s Revised Rule were also recorded. A Paired t-test was used to compare data.Results: The results of our study showed that the average difference between the Naegele’s Revised Rule and real age was 3.52 days, which is a significant difference. However, the average difference between the estimated date by ultrasound and real age is 0.58 days, which is not a significant difference. Ultrasound is more accurate than the Naegele’s Revised Rule, which still did not differ significantly from the actual date of delivery by grouping by age, sex of the fetus, number of pregnancies, and deliveries.Conclusion: Ultrasound has more accuracy in accurately estimating the date of delivery, and therefore using this method and relying on it has more reliability than the Naegele’s Revised Rule.
Obstetrics and Gynecology
Farah Farzaneh; Sama Mohammadi; Elnaz Ghaffari; Afsaneh Hosseini; Sarang Younesi; Mohammad Mahdi Taheri Amin; Payam Balvayeh; Fariba Navid Pour; Shahla Noori Ardebili
Volume 6, Issue 3 , June 2021, , Pages 122-127
Abstract
Background & Objective: Cervical cancer is the second most common cancer and the fourth leading cause of death in women. Among the risk factors for cervical cancer, human papillomavirus (HPV) is the most important one.Materials & Methods: In this cross-sectional and retrospective study conducted ...
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Background & Objective: Cervical cancer is the second most common cancer and the fourth leading cause of death in women. Among the risk factors for cervical cancer, human papillomavirus (HPV) is the most important one.Materials & Methods: In this cross-sectional and retrospective study conducted from 2016 to 2020, 261 women with cervical intra-epithelial neoplasia (CIN) grade two and three referred to one of the gynecological oncology clinics of Shahid Beheshti University of Medical Sciences, who were eligible to enter the study and were evaluated by the research unit of the relevant university after receiving an ethics code. During the study, patients whose cervical cancer was confirmed by colposcopic diagnostic method, HPV screening was performed by COBAS method and lesions were sampled to determine the type of HPV.Results: Evaluation of the frequency distribution of colposcopic results compared to HPV, indicated that HPV-16 is the most common type of HPV in high grade CIN lesions. After HPV-16, other types of HPV are next in terms of frequency indicating the importance of other types of HPV. HPV-18 was also observed in people with CIN.Conclusion: Performing a similar study with a larger number of samples at the national level is suggested. If the results of a larger study are consistent with this study, it would be for the best to highlight the role of other types of HPV in cervical cancer screening in women.
Maternal Fetal Medicine
Zahra Panahi; Fahimeh Ghotbizadeh Vahdani; Saeede Eslami Khotbesara; Razieh Akbari; Sedigheh Hantoushzadeh; Soudabeh Kazemi Aski; Mamak Shariat
Volume 9, Issue 2 , March and April 2024, , Pages 137-143
Abstract
Background & Objective: Despite the high efficacy of the Apgar score in finding respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one of the best indicators of fetal hypoxia. Therefore, it’s so beneficial to consider ...
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Background & Objective: Despite the high efficacy of the Apgar score in finding respiratory distress, a low Apgar score doesn’t necessarily indicate fetal hypoxia-asphyxia. Umbilical Artery pH (UApH) is one of the best indicators of fetal hypoxia. Therefore, it’s so beneficial to consider these criteria and their relationship with the Apgar score for accurate diagnosis of prenatal respiratory distress retrospectively which reduces the unnecessary cesarean section (CS) rate.
Materials & Methods: 162 full-term (≥259 days) neonates delivered by CS with the diagnosis of decreased fetal heart rate (FHR) were evaluated. 1-min and 5-min Apgar scores and UApH were measured. The correlation between Apgar scores with UApH and the association between UapH and Apgar with the NICU admission were evaluated. The effect of other variables including mother’s age, gravidity, gestational age, birth weight, newborn sex, and causes of decreased FHR on Apgar scores and UApH were studied as well.
Results: The most common cause of decreased FHR was fetal distress, boys had higher weight (P=0.033) and lower UApH (P=0.049) than girls. Other parameters were not different significantly between both sexes. There was a positive correlation between UApH and 1-min and 5-min Apgar scores (r=0.464 and r=0.370 respectively) when controlled for birth weight (P<0.0001). The RR for NICU admission in male acidemic neonates with abnormal 1-min Apgar was 14.05 (CI95%: 5.7-34.6) in comparison to females (RR=1.06, CI95%: 1-1.26).
Conclusion: Mild acidemia (UApH<7.2) at least in a male fetus would be a good predictor for postnatal complications and need for NICU admission. Future studies with more samples are suggested.
Behnaz Nouri; Paricheher pooransari; Fateme Ghorbani
Volume 4, Issue 4 , September and October 2019, , Pages 146-150
Abstract
Background & Objective: Cesarean hysterectomy is a major surgical risk happening in the setting of life threatening hemorrhagic events during or immediately after the cesarean section. In this study we assessed patients undergoing cesarean hysterectomy to determine their general and clinical characteristics.
Materials ...
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Background & Objective: Cesarean hysterectomy is a major surgical risk happening in the setting of life threatening hemorrhagic events during or immediately after the cesarean section. In this study we assessed patients undergoing cesarean hysterectomy to determine their general and clinical characteristics.
Materials & Methods: In this descriptive cross-sectional study, 34 consecutive patients undergoing cesarean hysterectomy in training hospitals in Tehran, Iran, from 2016 to 2017 were enrolled. The age, BMI, gravid, parity, Apgar score, risk factors, chief complaints, drug history, and previous medical and surgical history were assessed and finally the preventability rate was determined.
Results: The chief complaint was vaginal leak (VL), abnormal uterine bleeding (AUB), labor pain, and preeclampsia in 38.2%, 29.4%, 14.7%, and 2.9% of patients respectively, and the other patients had more than one complaint. Type of surgery was total, and supra-cervical in 58.8%, 41.2% of patients respectively. Bladder injury occurred in 41.2% of patients. Two cases were preventable, one was non-preventable, and all others were mixed.
Conclusion: It may be concluded that the general characteristics among our patients undergoing cesarean hysterectomy is similar to those reported by similar studies. However further studies with larger sample size and multi-center sampling among Iranian patients are needed to develop more definite results.
Elham Saffarieh; Setare Nassiri; Ramin Pazoki
Volume 3, Issue 4 , November and December 2018, , Pages 157-163
Abstract
Background & Objective: This study aimed to evaluate the Obstetrics and Gynecology Department of Semnan University of Medical Sciences in 2015 and compare it with the existing evaluation conducted in 2002 to promote the quality of education in this department.
Materials & Methods: An accreditation ...
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Background & Objective: This study aimed to evaluate the Obstetrics and Gynecology Department of Semnan University of Medical Sciences in 2015 and compare it with the existing evaluation conducted in 2002 to promote the quality of education in this department.
Materials & Methods: An accreditation pattern was used in the current study. In 2000, the Obstetrics and Gynecology Department of Amir-al-Momenin Teaching Hospital in Semnan designed its internal evaluation pattern, in which all educational, research, and therapeutic goals, institutional and organizational status, educational process, and equipment availability status were examined. A total of 40 questionnaires were applied. In each questionnaire, the criteria were scored from 1 to 5 (very poor to excellent). Gorman’s classification was employed for final analysis and a score lower than 2.51 was considered as unsatisfactory.
Results: In this evaluation, the educational goals achieved a score of 4.3 and were in the strong range of Gorman’s classification. The educational programs obtained a score of 5 and were in the range of very strong. Both educational goals and educational programs showed a significant progress compared to 2002. The educational process with a score of 3.11 was more than satisfactory; the therapeutic goals with a score of 4.3 were in the strong range; the institutional and organizational status of the department with a score of 4.43 was in the strong range; and the research goals with a score of 5 were in the strong range. Additionally, space, human resources, and equipment scored 4.4 based on Gorman’s classification and were in the strong range.
Conclusion: Overall, based on the obtained results, the Obstetrics and Gynecology Department with a score of 4.23 was in the strong range of Gorman’s classification, indicating its desirable status. Moreover, the therapeutic-research and educational goals showed a significant progress compared to 2002.
Obstetrics and Gynecology
Khadijeh Elmizadeh; Misa Naghdipour; Fatemeh Lalooha; Seyedeh Masoomeh Hosseini Valmi; Ali Massoudifar; Marzieh Sarafraz
Volume 7, Issue 3 , January and February 2022, , Pages 158-164
Abstract
Background & Objective: Hysterectomy is one of the major gynecologic operations. This procedure can be performed by different methods including abdominal, vaginal, and laparoscopic hysterectomy. In fast-track hysterectomy (FTH), patients do not receive opioids during surgery and there is no ...
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Background & Objective: Hysterectomy is one of the major gynecologic operations. This procedure can be performed by different methods including abdominal, vaginal, and laparoscopic hysterectomy. In fast-track hysterectomy (FTH), patients do not receive opioids during surgery and there is no need for a 12-hour pre-surgery hospitalization. Patients are encouraged to eat and move at most 6 hours after operation. This study was performed to compare the outcomes of FTH with those of routine abdominal hysterectomy (RAH).Materials & Methods: This case-control pilot study was carried out on 82 candidates for hysterectomy at Kowsar Training Hospital in Qazvin, Iran, during 2016. Patients were divided into two randomized groups of FTH and RAH. Parameters such as pain visual analogue scale (VAS) after 3, 6, 12, and 24 hours, diet tolerance, analgesic dose, postoperative nausea and vomiting, hospital stay, postoperative adverse effects, gas passing time, and readmission were investigated and compared between two groups.Results: Analgesic use, gas passing time, and hospital stay were significantly lower in the FTH group (P < /em>=0.0001). While postoperative nausea and vomiting, adverse effects, food tolerance, and readmission rate were the same in both groups (P < /em>>0.05). Moreover, diet tolerance was observed in all patients. In general, pain VAS was lower in FTH with significant difference at 3rd (P < /em>=0.002) and 12th (P < /em>=0.001) hours, and at suture removal time (P < /em>=0.026).Conclusion: It can be concluded that FTH may result in reduced pain, analgesic use, gas passing time, and hospital stay in comparison with RAH.
Maternal Fetal Medicine
Seddighe Borna; Marjan Ghaemi; Fatemeh Golshahi; Mamak Shariat; Mahboobeh Shirazi; Behrokh Sahebdel
Volume 5, Issue 4 , December 2020, , Pages 159-166
Abstract
Background & objective: Premature preterm rupture of membrane (PPROM) is a cause of preterm birth. This study investigated the effectiveness of Doppler ultrasound in predicting fetal complications and neonatal outcomes of pregnant women with PPROM.Materials & Methods: In this cross-sectional ...
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Background & objective: Premature preterm rupture of membrane (PPROM) is a cause of preterm birth. This study investigated the effectiveness of Doppler ultrasound in predicting fetal complications and neonatal outcomes of pregnant women with PPROM.Materials & Methods: In this cross-sectional study, a total of 23 pregnant women with PPROM were chosen in their 24 to 34 weeks of gestational age. The fetuses’ blood flow indices were evaluated by Doppler ultrasound pulsatility index (PI) in the middle cerebral, main pulmonary, right kidney, and fetal umbilical arteries and descending aorta at admission (because of PPROM) and 24 hours before delivery. Neonatal outcomes were assessed within the first week of birth.Results: The kidney artery PI increased (P < /em>=0.047) and pulmonary artery PI decreased (P < /em>=0.024) at pregnancy termination time. There was a negative correlation between the 5-minute Apgar score and fetal umbilical artery PI at admission (P < /em>=0.003) and pregnancy termination times (P < /em>=0.031). The fetal umbilical artery PI of neonates with abnormal brain ultrasound imaging results significantly decreased at admission (P < /em>=0.002) and pregnancy termination times (P < /em>=0.004).Conclusion: Fetal artery Doppler ultrasound PI may be a valid tool for predicting neonatal outcomes of women with PPROM.
Obstetrics and Gynecology
Khadije Rezaie keikhaie; Leili Rezaie Kahkha; Zahra Shahraki; Sairo Esbati; Mahdi Afshari; Atefeh Kamali; Mahboobeh Shirazi; Maryam Moshfeghi
Volume 6, Issue 4 , August 2021, , Pages 181-187
Abstract
Background & Objective: Spontaneous preterm birth (SPB) occurs in about 10 to 12 percentage of pregnancies and causes many complications and mortality during pregnancy periods (1). The aim of this study was to determine the evaluation of uterocervical angle compared to cervical length as a sonographic ...
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Background & Objective: Spontaneous preterm birth (SPB) occurs in about 10 to 12 percentage of pregnancies and causes many complications and mortality during pregnancy periods (1). The aim of this study was to determine the evaluation of uterocervical angle compared to cervical length as a sonographic method in predicting preterm delivery for patients who were undergoing the transvaginal cerclage.Materials & Methods: The present study was performed on 91 pregnant women who were candidates for cerclage in 2019-2020. In this study, about 16.48 percentage of births were preterm and 27.47 percentage were post-term. During the study, routine cervical evaluation was performed by post-cerclage ultrasound and transvaginal ultrasound was performed in all patients one week after cerclage. Additional evaluation with transvaginal ultrasound was performed at intervals determined by the treating physicians with final ultrasound evaluation of the cervix up to 28 weeks of gestation. Finally, the obtained data were entered into SPSS 22 and statistically analyzed using t-test, Chi-square and Fisher's exact test.Results: The results of the present study showed that considering the existing thresholds (95 and 105) for the anterior uterosacral angle and the threshold 25 for the cervical length index, all these indices were included 100% sensitive.Conclusion: This sensitivity in the case of UCA higher than 95°C was about 80%, but the disadvantage of these indicators was their low specificity, so that these indicators were different ranging from 30% in the case of (UCA 105) to 7.15% in the case of (UCA 95).
Obstetrics and Gynecology
Fereshteh Fakour; Roya Kaboodmehri; Amirhossein Hajizadeh Fallah; Maryam Dourandeesh; Fatemeh Gholamalipour; Seyedeh Maryam Attari; Forozan Milani; Zahra Pourhabibi
Volume 8, Issue 3 , May and June 2023, , Pages 217-222
Abstract
Background & Objective: Most pain relief methods are associated with some side effects and limitations. Magnesium sulfate, due to its osmotic properties and absorption of cervical water (moisture) can shorten labor duration and decrease labor pain via improving effacement and cervical edema. ...
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Background & Objective: Most pain relief methods are associated with some side effects and limitations. Magnesium sulfate, due to its osmotic properties and absorption of cervical water (moisture) can shorten labor duration and decrease labor pain via improving effacement and cervical edema. The aim of our study was to evaluate the effect of intravaginal magnesium sulfate on pain severity and duration of the first and second stages of labor.Materials & Methods: In this double-blind randomized clinical trial study, 70 nulliparous women were allocated into two groups after the beginning of the active phase of labor. In group 1, 10 ccs of magnesium sulfate 50% was poured on the whole cervix during the vaginal examination. In group 2, a placebo (sterile water) in a similar way and amount was used. Then the two groups were compared in variables of demographic, obstetrics, clinical, pain severity, duration of the first and second stages of labor, and maternal and neonatal outcomes.Results: In different dilatations, pain severity in group 1 was significantly lower (P=0.0001). The duration of the first and second stages of labor was shorter in group 1 (P =0.0001). The two groups were similar in neonatal outcomes, drug side effects, and treatment satisfaction (P >0.05).Conclusion: Intravaginal magnesium sulfate improves the condition of the cervix, reduces the duration and the severity of labor pain, and has no medical or neonatal side effects.
Obstetrics and Gynecology
Maryamsadat Hosseini; Farah Farzaneh; Mahsa Mirhadi; Seyed Ali Akbar Mahdavi Anari; Ladan Ajori; Saghar Salehpour; Tayebeh Jahed Bozorgan; Parichehr Pooransari; Shideh Ariana; Minoo Yaghmaei; Behnaz Nouri; Shahrzad Zadehmodarres; Sedighe Hosseini; Mehrdad Haghighi; Mir Mohammad Miri; Seyedpouzhia Shojaei; Ali Reza Mirkheshti; Dariush Abtahi; Tannaz Valadbeigi
Volume 7, Issue 4 , March and April 2022, , Pages 286-295
Abstract
Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation ...
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Background & Objective: The COVID-19 infection remains a major pandemic threatening global health. Studies revealed that pregnant women are more prone to develop severe illness, with an increased risk of morbidity and mortality. So the objective of this study is to report the clinical presentation and perinatal outcomes after COVID-19 infection during pregnancy or the puerperium.Materials & Methods: In this case series study, since February 2020, 25 pregnant women with a definitive diagnosis of the COVID-19 infection were registered. Their clinical signs and symptoms, laboratory findings, CT manifestations, pregnancy status, were recorded at the first visit, and they were followed six months after diagnosis.Results: The most common symptoms were cough, feeling feverish, and dyspnea. Twenty mothers required hospitalization, 5 out of 20 monitored in COVID-ICU. The chest CT scan demonstrated a grand glass appearance in 77% of cases among admitted patients. The total mortality rate in C-ICU (COVID-19 ICU) admitted patients were 80%.Conclusion: In this case series, among 25 pregnant women with confirmed COVID-19, the most vulnerable patients were in the early third trimester and twin pregnancy.
Maternal Fetal Medicine
Maryam Nurzadeh; Maryam Moshfeghi; Mamak Shariat; Ashraf Sadat Jamal; Vajiheh Marsoosi; Laleh Eslamian; Mahsa Naemi; Maria Nezam Nia; Fedyeh Haghollahi; Seyede Houra Mousavi Vahed
Volume 8, Issue 4 , July and August 2023, , Pages 335-341
Abstract
Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational ...
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Background & Objective: A number of procedures have been developed for multifetal pregnancy reduction (MPR) to reduce the overall number of fetuses in the gestation and improve the maternal outcomes as well as the outcomes of the surviving fetus.Materials & Methods: An observational historical cohort study was conducted on multiple pregnancies that underwent fetal reduction in Shariati Hospital and Omid Clinic between January 2018 and September 2021. The study population was divided into two groups according to gestational age at fetal reduction: 11–14 weeks' gestation (early reduction group) and 15–19 weeks’ gestation (late reduction group). The main outcome measures were the rates of pregnancy complications, pregnancy loss, preterm delivery, and adverse neonatal outcomes.Results: The study group included 107 patients with twin and multiple pregnancies that underwent abdominal MPR at 11-19 weeks’ gestation (79 in the early reduction group and 28 in the late group). The incidence of pregnancy complications (hypertension, diabetes, intrauterine growth disorder, preterm delivery, and pregnancy loss) was not significantly different between the two groups (P >0.05). The percentage of NICU admission was higher in the early reduction group compared to the late group (49% vs 18.5%, P=0.004). The weight of the first newborn was significantly heavier in the late versus early reduction group (2680.55±777.52 vs 2264.4±796.82, P=0.005).Conclusion: According to the present study, fetal reduction in twin or multiple pregnancies is a safe procedure with good obstetric outcomes if done by an expert specialist, especially when it is performed in the second trimester.
General Gynecology and Pelvic Floor
Nahla W. Shady; Hassan A. Farouk; Hany F. Sallam
Volume 7, Issue 5 , July and August 2022, , Pages 391-398
Abstract
Background & Objective: To see if 900 mg of vaginal isonicotinic acid hydrazide (INH) given 12 hours before insertion of a T380A copper intrauterine device (IUD) was more effective than placebo in increasing insertion ease and reducing insertion discomfort in nulliparous ...
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Background & Objective: To see if 900 mg of vaginal isonicotinic acid hydrazide (INH) given 12 hours before insertion of a T380A copper intrauterine device (IUD) was more effective than placebo in increasing insertion ease and reducing insertion discomfort in nulliparous ladies.Materials & Methods: A double-blind, randomized controlled study recruited nulliparous women who wanted to use the Copper IUD for contraception. Women who were WHO-eligible for IUD implantation were recruited and randomly assigned (1:1) to vaginal INH 900 mg or placebo (n=100 in each group), 12 hours before the IUD was placed. The primary endpoint was the ease of insertion for the providers. The number of unsuccessful IUD insertions was also recorded.Results: The groups had similar baseline characteristics. The ease of insertion score in the INH group was lower than in the placebo group (3 (2-5).5 vs. 6 (3-8); P=0.01), indicating that physicians in the INH group had an easier time inserting the device. The INH group had a reduced mean pain score during the procedure (3.97 ± 0.991 vs. 6.42 ± 0.66; P=0.001). In the INH group, two incidences of failed IUD insertion occurred (2%) compared to four cases in the control group (4 percent). 0.594 is the p-value. Conclusion: Self-administered INH 900 mg vaginally 12 hours before a copper T380A IUD insertion successfully reduced discomfort during insertion and improved women's satisfaction and ease of insertion as measured by physicians in nulliparous teenagers and young ladies.
Gynecology Oncology
Batool Hossein Rashidi; Marjan Ghaemi; Ensieh Shahrokh Tehrani; Marzieh Mohebbi; Marzieh Savari
Volume 8, Issue 5 , September and October 2023, , Pages 446-456
Abstract
Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials ...
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Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.Results: Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.
Obstetrics and Gynecology
Awgichew Behaile Teklemariam; Endriyas Kelta Wabalo; Tesfaye Adugna Leta; Semira Shimeles Assefa; Endeshaw Chekol Abebe
Volume 7, Issue 6 , September and October 2022, , Pages 497-506
Abstract
Background & Objective: Pregnancy-induced hypertensive disorders (PIHD) are the main reasons for maternal and perinatal mortality, as they complicate 10% of pregnancies worldwide. Serum lactic acid dehydrogenase (LDH) and gamma-glutamyl transferase (GGT) are possible markers reflecting the occurrence ...
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Background & Objective: Pregnancy-induced hypertensive disorders (PIHD) are the main reasons for maternal and perinatal mortality, as they complicate 10% of pregnancies worldwide. Serum lactic acid dehydrogenase (LDH) and gamma-glutamyl transferase (GGT) are possible markers reflecting the occurrence of pregnancy-associated complications like preeclampsia and eclampsia. There is a paucity of data with conflicting results showing serum LDH and GGT on PIHD in Ethiopia. This investigation aimed to assess the serum LDH and GGT levels in pregnant women with PIHD along with their correlation with the severity of the disease at Jimma Medical Center (JMC), Ethiopia.Materials & Methods: This hospital-based comparative cross-sectional study was undertaken from August 03 to September 27, 2020, in JMC. A total of 97 study participants were recruited. Serum GGT and LDH levels were determined using a fully automated Roche Cobas 6000 chemistry analyzer. The data were analyzed using SPSS 25.0. One-way ANOVA and independent samples t-test were employed to compare serum GGT and LDH levels with categories of PIHD.Results: The significantly highest mean serum levels of LDH (580.9±193.8 U/L) and GGT (86.1±29.2 U/L) were observed in eclamptic women compared to gestational hypertensive (276.7±60.7 and 38.3±16.9 U/L) and preeclamptic patients (353±132.8 and 48.8±29.9 U/L), respectively. Both serum GGT and LDH levels were found to correlate with the severity of preeclampsia, respectively significantly.Conclusion: Serum LDH and GGT were found to be at the highest levels in eclamptic than preeclamptic and gestational hypertensive women. Blood pressure, gestational age, and severity of hypertensive disorders of pregnancy were predictor variables associated with serum GGT and LDH.
Obstetrics and Gynecology
Aditi Agarwal; Rajiv Acharya; Shikha Agarwal; Vineeta Gupta
Volume 8, Issue 6 , November and December 2023, , Pages 563-570
Abstract
Background & Objective: The maintenance of an appropriate weight before and during pregnancy has a significant effect on pregnancy outcomes. Therefore, this study attempts to explore the relationship between pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in the Indian ...
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Background & Objective: The maintenance of an appropriate weight before and during pregnancy has a significant effect on pregnancy outcomes. Therefore, this study attempts to explore the relationship between pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) in the Indian antenatal population. This was a prospective study.Materials & Methods: This study was conducted on a total of 301 pregnant women who fulfilled the inclusion criteria booked from the first trimester till delivery in the department of Obstetrics and Gynecology, SGRRIM & HS, from January 2020 to June 2021. The weight and height of the participants were recorded at their first visit to the antenatal clinic using standard protocol. BMI was recorded and GWG was calculated at each antenatal clinic visit. BMI and GWG were correlated with antepartum, intrapartum and postpartum complications with the application of appropriate statistical tests.Results: In our study, higher pre-pregnancy BMI and GWG significantly increased the risk of perinatal adverse outcomes. Increased rates of cesarean section (57.1%), operative vaginal delivery (9.5%), gestational diabetes mellitus (9.5%), and pre-eclampsia (28.6%) were observed in obese women as compared to women with normal pre-pregnancy BMI and gestational weight gain. These were found to be statistically significant (p-value <0.001).Conclusion: Appropriate nutrition prior to and throughout the pregnancy plays an important role in determining the health of both mother and fetus. There is a positive correlation between early pregnancy BMI and GWG, and the course of pregnancy, and its outcome.
Mahboobeh Shirazi; Shirin Niroomanesh; Fatemeh Rahimi Shaarbaf; Maryam Rabiei; Mitra Eftekhariyazdi
Volume 1, Issue 1 , May and June 2016
Abstract
Introduction: The incidence of very echogenic amniotic fluid on ultrasonographic examination at term pregnancy is very low and its causes and significance in outcome of pregnancy are not well- understood. In previous studies, meconium was considered to be an important cause of very echogenic amniotic ...
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Introduction: The incidence of very echogenic amniotic fluid on ultrasonographic examination at term pregnancy is very low and its causes and significance in outcome of pregnancy are not well- understood. In previous studies, meconium was considered to be an important cause of very echogenic amniotic fluid and follow-up with amniocentesis and fetal well-being tests were recommended; however, in recent studies vernix caseosa has been identified to be an important cause. As a result, termination of pregnancy should not be performed due to discovery of ultrasonographic echogenic amniotic fluid because it is not associated with adverse pregnancy outcomes.
Case Presentation: We report a single term pregnancy with very echogenic amniotic fluid diagnosed by ultrasonography that was terminated by cesarean section.
Conclusions: There were no adverse outcomes for the mother or neonate and the amniotic fluid was clear at the time of delivery.
Malihe Hasanzadeh; Shahnaz Ahmadi
Volume 1, Issue 2 , September and October 2016
Abstract
Background: Human papillomavirus (HPV) is thought to be the most common sexually transmitted viral disease. This infection continues to be an important topic. One of the most important conferences on human papillomavirus infection and related cancers is EUROGIN. The program also includes state of the ...
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Background: Human papillomavirus (HPV) is thought to be the most common sexually transmitted viral disease. This infection continues to be an important topic. One of the most important conferences on human papillomavirus infection and related cancers is EUROGIN. The program also includes state of the art science on anogenital and head and neck cancer, inspiration, cooperation, and forums to share expertise and learn from leading experts in the field.
Methods: We reported an abstract of important articles and researches presented in this congress.
Results: HPV had rolled in oropharyngeal cancer. KI67/P16 is important for deciding on treatment of patients with HPV high-risk positive. Methylation can be used in the management of HPV high-risk patients. 9-valent HPV vaccination can prevent different anogenital cancers.
Conclusions: HPV has important role in different cancers. HPV vaccination can prevent a variety of anogenital cancers related to HPV.
Maryam Kashanian; Sara Norouzi; Nooshin Eshraghi; Mohammadreza Babai; Soheila Aminimoghaddam
Volume 1, Issue 3 , November and December 2016
Abstract
Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented ...
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Introduction: Pseudoaneurysm of the uterine arteries is a rare cause of late postpartum hemorrhage (PPH) but could potentially be a life threatening complication.
Case Presentation: We report a case of a patient with pseudoaneurysm of the uterine arteries following a cesarean section, who presented with late PPH. Bilateral uterine artery ligation was done to conserve the uterus, however, the hemorrhage did not cease. In order to control the bleeding, embolization was suggested. During angiography, a pseudoaneurysm of the feeding femoral artery was noticed and embolization was performed to save the patient.
Discussion: Uterine artery pseudoaneurysm is one of the uncommon causes of secondary postpartum hemorrhage and could lead to a life-threatening situation. Management should be multidisciplinary and the gold standard for treatment and diagnosis is through interventional radiology.
Zahra Vahedpoor; Tahereh Khamechian; Nazila Zandi
Volume 2, Issue 1 , March and April 2017
Abstract
Introduction: Uterine smooth muscle tumors are the most common human neoplasms. These tumors are clinically classified into two groups of benign and malignant. However, uterine smooth muscle tumors of uncertain malignant potential (STUMP) are another group between these two groups that cause many diagnostic ...
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Introduction: Uterine smooth muscle tumors are the most common human neoplasms. These tumors are clinically classified into two groups of benign and malignant. However, uterine smooth muscle tumors of uncertain malignant potential (STUMP) are another group between these two groups that cause many diagnostic problems. The present report aimed at introducing a case of STUMP mistaken with ovarian tumor in a female with polio.
Case Presentation: A 43-year-old female with the complaint of abdominal pain and distention, which had started 3 years ago, referred to our center, Kashan, Iran. Abdominal examination showed firm and irregular distention greater than term pregnancy. Ultrasonography, CT scan, and MRI of the abdomen and the pelvis revealed multiple intramural and subserosal fibroids in the uterus, and a large complex cyst in the abdomen and pelvis that probably originated from the ovary. Laparotomy results showed 2 tumors arising from the anterior surface of the uterus sized 15 × 25 cm, which were extended under the liver, and attached to the omentum and posterior peritoneum of the abdominal cavity wall with moderate ascites. The tumors, which weighted 10 kg along with the uterus, were removed and the patient was discharged after two days in good general health. The pathology report was as follows: uterine adenomyosis and smooth muscle tumors of uncertain malignant potential (STUMP).
Conclusions: STUMP has unpredictable various clinical presentations. Even imaging may mislead the clinicians. Therefore, in patients with pelvic tumors and even with a strong suspicion of ovarian and retroperitoneal tumors, this type of uterine tumors should also be considered, moreover, appropriate treatment should be considered to preserve or not to preserve fertility.
