Obstetrics and Gynecology
Mona Mohseni; Nasim Shokouhi; Elham Feizabad; Elham Khaghani
Volume 5, Issue 4 , December 2020, , Pages 167-171
Abstract
Background & objective: Pregnancy is a known risk factor for urinary incontinence (UI) due to physiological and anatomical changes, especially in the third trimester of pregnancy. This study aimed to determine the prevalence of UI in the third trimester of pregnancy and its related factors in ...
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Background & objective: Pregnancy is a known risk factor for urinary incontinence (UI) due to physiological and anatomical changes, especially in the third trimester of pregnancy. This study aimed to determine the prevalence of UI in the third trimester of pregnancy and its related factors in pregnant women.Materials & Methods: This cross-sectional study was conducted on 330 pregnant women in the third trimester of pregnancy, referred to the perinatal care clinic of Yas Hospital in 2016-2017. The sampling method was convenience sampling. Then, the prevalence of UI and its related factors were investigated in these participants.Results: The mean age of the subjects was 30±5 years old. Totally, 98 pregnant women (29.7%) had UI. The rate of urine leakage was mild at 26.4% and moderate or severe at 3.3%. The time of urine leakage in 6.4% of women with UI was before reaching the toilet, 1.2% was permanent, 19.4% was related to cough and sneezing, and 2.7% of women did not indicate a specific time. In evaluating the relationship between each of the variables and UI, three factors were identified to be completely related to UI, i.e., morbid obesity (P < /em>=0.038), gestational age between 32 to 37 weeks (P < /em>=0.012), and age ≥ 35 years old (P < /em>=0.009).Conclusion: It seems that one-third of pregnant women in the third trimester of pregnancy have UI, which is a multifactorial issue and therefore requires multidisciplinary programs to prevent it.
General surgery
Atefeh Moridi; Sudabeh Mahmoodi; Nayereh Rahmati; Marzieh Fathi; Zahra Naeiji
Volume 6, Issue 4 , August 2021, , Pages 188-194
Abstract
Background & Objective: Awareness of breast cancer risk factors, clinical presentations and screening rules and methods may encourage women to use preventive measures more commonly. Materials & Methods: A total of 691 women from general population were interviewed using a standardized ...
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Background & Objective: Awareness of breast cancer risk factors, clinical presentations and screening rules and methods may encourage women to use preventive measures more commonly. Materials & Methods: A total of 691 women from general population were interviewed using a standardized questionnaire. Demographic data, level of awareness about risk factors, presentations and screening the breast cancer and their general perception about the treatment’s efficacy were evaluated.Results: Of the participants, 45.7% had “good” knowledge about the presentations of breast cancer while the level of awareness was “good” in 19.2% of them in field of risk factors (statistically significant difference). As only about 16% of them knew that women should perform breast self-examination once a month and about 15% of them were aware of the screening role of the annual clinician performed breast examination.Conclusion: Most of our participants had statistically significant lower level of knowledge about the risk factors and screening rules and tools of breast cancer than its clinical presentation.
Obstetrics and Gynecology
Leila Asadi; Zahra Behboodi-Moghadam; Mahboobeh Shirazi; Fateme Moshirenia; Behjat Khorsandi
Volume 8, Issue 3 , May and June 2023, , Pages 223-232
Abstract
Background & Objective: Understanding the reproductive and sexual needs of pregnant women seems to be crucial in increasing the effectiveness of services and addressing their needs and expectations. Therefore, the aim of this study was to explain the needs and concerns of reproductive and sexual ...
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Background & Objective: Understanding the reproductive and sexual needs of pregnant women seems to be crucial in increasing the effectiveness of services and addressing their needs and expectations. Therefore, the aim of this study was to explain the needs and concerns of reproductive and sexual health of pregnant women during the COVID-19 pandemic.Materials & Methods: This is a qualitative study with a content analysis approach. In this probe, 16 interviews were accomplished with 15 pregnant women who had been referred to pregnancy care centers. Data analysis was performed predicated on the content analysis approach using MAXQDA software version 12.Results: Based on 17 interviews conducted with pregnant women during the COVID-19 pandemic, pregnant women were found to be suffering from mental disorders, fears, disrupting prenatal care, and sexual problems.Conclusion: Reproductive and sexual health of pregnant women in the Covid-19 epidemic should not be neglected and considered in health planning.
General Gynecology and Pelvic Floor
Arvin Arian; Zinat Ghanbari; Seyedeh Nooshin Miratashi Yazdi; Maryam Deldar Pesikhani; Majid Yousefi
Volume 7, Issue 4 , March and April 2022, , Pages 296-303
Abstract
Background & Objective: Pelvic floor dysfunctions (PFD) are common disorders among women and affect about 50% of them over 50. About 400,000 American women undergo surgery due to the severity of these disorders. The aim of this study was to investigate the correlation of patients' symptoms with both ...
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Background & Objective: Pelvic floor dysfunctions (PFD) are common disorders among women and affect about 50% of them over 50. About 400,000 American women undergo surgery due to the severity of these disorders. The aim of this study was to investigate the correlation of patients' symptoms with both static and dynamic MRI findings.Materials & Methods: In this study, we performed MRI on 60 women suspected of pelvic floor disorders in the Imam Khomeini Hospital complex. Following rectal enema of 60-120 cc sonography gel and vaginal enema of 5-10 cc gel, we performed MRI with 3 Tesla equipment (Siemens Magnetom Trio) utilizing multichannel (16 rows) surface coil on the supine position. Static MRI was performed with high-resolution T2 FSE sequences in sagittal, axial, and coronal planes. Dynamic imaging was done using mid-sagittal T2 HASTE or true FISP in 3 different phases (rest, squeeze, strain and defecogram). The radiologists were blinded to the clinical data of patients.Results: Our study included 60 patients with a mean age of 52.7±14.3 years. Regarding the MRI findings in patients with urinary symptoms, except for the level I fascial defect, the other findings were not related to the patients' symptoms. Among patients with defecation symptoms, other MRI findings did not have a significant relationship with the patient's symptoms except for severe rectal descent. The association between endopelvic fascial defects and levator muscle injury with sexual complaints was not statistically significant.Conclusion: In conclusion, these results suggest that the patients' symptoms are not good predictors for MRI findings and are limited in reliability. Thus, MRI must be counted necessary to further evaluate patients with pelvic floor abnormalities. Other studies regarding MRI findings' correlation with different symptoms in these patients are required.
Gynecology Oncology
Mohammad Reza Javan; Bahareh Moghimian-Boroujeni; Hossein Ayatollahi; Amirali Ayatollahi; Nafise Amini; Elham Jafaei; Maryam Sheikhi; Narjes Soltani
Volume 8, Issue 4 , July and August 2023, , Pages 342-349
Abstract
Background & Objective: Recurrent pregnancy loss (RPL) is the occurrence of three or more miscarriages before the 20th week of pregnancy. Thrombophilia factors are one of the common causes of RPL.Materials & Methods: This retrospective study was performed on women with miscarriages. ...
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Background & Objective: Recurrent pregnancy loss (RPL) is the occurrence of three or more miscarriages before the 20th week of pregnancy. Thrombophilia factors are one of the common causes of RPL.Materials & Methods: This retrospective study was performed on women with miscarriages. 620 patients’ documents with pregnancy loss were investigated. Based on the number of pregnancy loss, the women were divided into a control group with less than three miscarriages (212) and RPL group (180). Cytogenetics analysis and thrombophilia factors polymorphism tests were performed for all patients.Results: In the analysis, none of the studied polymorphisms (MTHFR 677 C⁄T /Factor V Leiden /Prothrombin G20210A/ ACE I/D/ PAI-1) showed a significant relationship between Control and RPL groups (P-value ˃ 0.05). Cytogenetic analysis showed 2 numerical and 9 structural abnormalities among both groups. Statistical analysis indicated a significant association between the number of abortions and age (P value= 0.005, r= 0.139). We even realized that there was a significant relationship between polymorphism number and recurrent number of miscarriages (P value= 0.018, r= 0.6).Conclusion: We showed that polymorphisms analysis for thrombophilia factors is a more precious test than cytogenetics analysis (study of the banded pattern of chromosomes during metaphase of the cell cycle). We even indicated that no association was found between thrombophilia polymorphisms in the control and RPL groups. This means that screening for Factor V Leiden, prothrombin G20210A, MTHFR C677T, ACE I/D, and PAI-1 and cytogenetic analysis in patients with a history of RPL is not recommended.
Obstetrics and Gynecology
Shahnaz Ahmadi; Elnaz Salarifar; Kambiz Ahmadi; Maryam Rahimi; Mahshid Bahraini
Volume 7, Issue 5 , July and August 2022, , Pages 399-404
Abstract
Background & Objective: Preeclampsia is associated with the release of soluble endoglin (sENG) into the maternal circulation. It inhibits sENG secretion, inhibiting the complex I of the mitochondrial electron transport chain. Therefore, using metformin may be helpful in the prevention of preeclampsia. ...
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Background & Objective: Preeclampsia is associated with the release of soluble endoglin (sENG) into the maternal circulation. It inhibits sENG secretion, inhibiting the complex I of the mitochondrial electron transport chain. Therefore, using metformin may be helpful in the prevention of preeclampsia. The aim of this study was to evaluate the effect of metformin in preventing superimposed preeclampsia.Materials & Methods: This single-blind randomized clinical trial was conducted on 60 pregnant women 25-40 years old with chronic hypertension before the 20th week of pregnancy. The patients were randomized and divided into two groups (n=30). The first group received 1000 mg metformin (tablet metformin 500 mg bid), and the second group received a placebo (2 tablets daily). Then the incidence of preeclampsia and intrauterine retardation growth of the fetus were compared in the two groups.Results: The metformin consumption significantly reduced the incidence of preeclampsia (P < /i>=0.04) and intrauterine growth restriction (P < /i>=0.035) compared to the control group. Conclusion: Metformin effectively reduced the incidence of superimposed preeclampsia and related factors in a pregnant patient with chronic hypertension.
General surgery
Fakhrolmolouk Yassaee; Sima Habibi; Reza Shekarriz Foumani; Seyed Mehrdad Motiei Langroudi; Elena Ghotbi
Volume 8, Issue 5 , September and October 2023, , Pages 457-463
Abstract
Background & Objective: In all surgical interventions including cesarean section, pain is a challenging issue. The aim of this study was to identify the underlying causes that affect post-cesarean pain intensity.Materials & Methods: A total of 128 consecutive patients who underwent ...
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Background & Objective: In all surgical interventions including cesarean section, pain is a challenging issue. The aim of this study was to identify the underlying causes that affect post-cesarean pain intensity.Materials & Methods: A total of 128 consecutive patients who underwent cesarean section at Taleghani hospital were included in the study. A questionnaire was used to gather the patients’ demographic and clinical data. The length of the incision was measured with a ruler on the first day following the cesarean section. In addition, the pain intensity was assessed using a Likert scale at scales: 1, 2, 4, 8, 12, and 24, on the day after surgery and 48 hours and one week later. Descriptive statistics were calculated for all variables. Analyses were conducted using SPSS version 22 and a p-value < 0.05 was considered statistically significant.Results: The study showed that overall, patient age, BMI, level of education, type of surgical incision, duration of surgery, type of cesarean section, type of anesthesia, and breastfeeding were not predictors of postoperative pain intensity. However, the study found that “indication of the cesarean section” and the “stage of labor” in which the cesarean was performed are correlated with postoperative pain intensity. (P-value<0.05).Conclusion: In this study, we were able to identify 2 parameters that were independently associated to postoperative pain scores: “underlying indication of cesarean section” and the “stage of labor” in which cesarean section is performed. This information helps clinicians to identify high-risk patients in terms of postoperative pain and take early action.
Gynecology Oncology
Hakimeh Akbari; Hossein Forouzandeh; Tooraj Reza Mirshekari; Seyed Adnan Kashfi; Mehdi Ghavamizadeh
Volume 7, Issue 6 , September and October 2022, , Pages 507-512
Abstract
Background & Objective: Breast cancer has a pivotal role in many deaths caused by malignancies. Epidermal growth factor receptor-2 (EGFR-2 or HER-2) and estrogen receptor (ER) have immense predictive values as prognostic factors. Breast cancers that have steroid receptors and respond to hormone ...
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Background & Objective: Breast cancer has a pivotal role in many deaths caused by malignancies. Epidermal growth factor receptor-2 (EGFR-2 or HER-2) and estrogen receptor (ER) have immense predictive values as prognostic factors. Breast cancers that have steroid receptors and respond to hormone therapy show a better prognosis than cancers without steroid receptors.Materials & Methods: A retrospective cross-sectional study was performed on 500 pathology blocks of women with breast cancer sent to the pathology department of Amir-al-Momenin medical and educational center, Gerash, Iran, from 2016 to 2019. Data were analyzed by SPSS software (Version-16) via ANOVA test followed by Chi-square and t-tests. P-value <0.05 was considered as significant.Results: The utmost type of malignancy was invasive ductal carcinoma (IDC) at 35.03%. Among ER-positive patients 59.67% were HER-2-positive. Nonetheless, among the PR-positive patients 54.74% were HER-2-positive. ER-positive patients were correlated with p53 receptor, distant metastasis and HER-2 significantly (P < /i><0.01). However, PR-positive patients just correlated with p53 receptor significantly (P < /i><0.01).Conclusion: Investigated samples were more ER-negative and less PR-positive compared to similar studies. Meanwhile, ER-positive patients were HER-2-positive. Regarding the correlation with prognosis of breast cancer, especially in HER-2-positive patients, there is a need to perform profound screening programs for HER-2 in breast cancer patients, especially with histopathological characteristics of invasive ductal carcinoma.
Gynecology Oncology
Farah Farzaneh; Elnaz Ghaffari; Maryam Sadat Hosseini; Tahereh Ashraf Ghanjouee; Afsaneh Hosseini
Volume 8, Issue 6 , November and December 2023, , Pages 571-578
Abstract
Background & Objective: High-risk (HR) HPV infection is the major cause of cervical cancer, which is still one of the most common cancers among women. Based on some not-published results, it seems that some of the other HR HPVs might be as important as HPV 16, and 18 in developing high-grade ...
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Background & Objective: High-risk (HR) HPV infection is the major cause of cervical cancer, which is still one of the most common cancers among women. Based on some not-published results, it seems that some of the other HR HPVs might be as important as HPV 16, and 18 in developing high-grade CIN. This study was conducted to determine the relationship between Other HPV and high-grade CIN.Materials & Methods: In this prospective study from 2019 to 2022 (approved by the ethics committee), all women with positive HPV based on the COBAS method were invited to participate in the study (N=646). For all the patients, colposcopy was done, and then the liquid-based samples of women with Other HPV positives were reanalyzed by HPV typing.Results: All the patients who were infected with HPV18 were involved in CIN1. On the other hand, 50% of patients who were infected with HPV18 were involved in CIN2. 50% of patients with HPV45 were involved in CIN2. There is also a significant relationship between HPV31 and CIN3.Conclusion: Because in our study there was a significant relationship between CIN3 and HPV31; and CIN2 with HPV45, and in the COBAS method, HPV31 and HPV45 are only reported under the general title of Other HPV, because of the possibility of the importance of other HPV with high-grade neoplasias, it is recommended to analyze the other HPV with HPV typing. Further studies are needed to confirm our findings.
Farah Farzaneh; Zahra Vahedpour; Tahereh Ashrafganjoei; Mitra Rafizadeh; Hajar Ale Bouyeh; Maryamsadat Hosseini
Volume 1, Issue 1 , May and June 2016
Abstract
Background and Objective: Most gestational trophoblastic neoplasias (GTN) develop following hydatidiform mole; but may occur after abortion, normal pregnancy or even ectopic pregnancy.
Objectives: The aim of this study was to assess the importance of six-month follow-up of uncomplicated molar pregnancy ...
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Background and Objective: Most gestational trophoblastic neoplasias (GTN) develop following hydatidiform mole; but may occur after abortion, normal pregnancy or even ectopic pregnancy.
Objectives: The aim of this study was to assess the importance of six-month follow-up of uncomplicated molar pregnancy after achieving undetectable β-human chorionic gonadotropin (β-hCG) levels.
Methods: In this retrospective study, molar pregnancies with negative β-hCG were compared with those with positive β-hCG during a six-month follow-up.
Results: A total of 279 women with molar pregnancy, treated at two referral university hospitals in Tehran were analyzed and 86 patients (31%) who had completed their follow-up period were included. Of the evaluated patients (n = 86), the pathology report indicated complete mole for 66 patients (77%) and partial mole for 20 patients (23%). All 86 patients had achieved at least one undetectable β-hCG level during their follow up, and none showed evidence of relapse.
Conclusions: We found that in patients with uncomplicated molar pregnancy, relapse is unlikely after achieving undetectable serum β-hCG levels. Further investigations with larger sample sizes and preferably prospective design are needed to make a definite conclusion.
Soghra Khazardoost; Fahimeh Ghotbizadeh; Sahar Latifi; Maryam Tahani; Mohammad Ali Ali Rezaei; Masoomeh Shafaat
Volume 1, Issue 2 , September and October 2016
Abstract
Objectives: Determining the necessity of cesarean section (C/S) due to failure of induction of labor (IOL) is essential to avoid fetus distress. In this study, the performance of the Bishop score and trans-vaginal ultrasound measurements were compared to predict successful IOL, and the most useful cut-off ...
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Objectives: Determining the necessity of cesarean section (C/S) due to failure of induction of labor (IOL) is essential to avoid fetus distress. In this study, the performance of the Bishop score and trans-vaginal ultrasound measurements were compared to predict successful IOL, and the most useful cut-off points were estimated.
Methods: Nulliparous women with gestation age of > 37 weeks with a live fetus in cephalic presentation were invited to participate in this study. Bishop score was assessed by digital examination, and trans-vaginal ultrasound was used to measure cervical length. Trans-abdominal ultrasound was utilized to determine the fetal head position.
Results: One hundred women entered the study. Multiple regression analysis revealed that the Bishop score and cervical length had a reliable predictive value in determining successful IOL. The cut-off points for predicting successful induction were 16 mm for cervical length and 5 for the Bishop score, using receiver operating characteristic curves (ROC). Both cervical length and Bishop score were good predictors for vaginal delivery (sensitivity and specificity of 85% and 67%, respectively for cervical length; and 84% and 70%, respectively for Bishop score).
Conclusions: Cervical length is a good predictor of successful IOL. Considering the painful process of digital exam, implementing trans-vaginal ultrasound is preferred.
Mahboobeh Shirazi; Fatemeh Shahbazi; Setareh Akhavan; Mohadeseh Sharifi Taskooh; Fatemah Azadi
Volume 1, Issue 3 , November and December 2016
Abstract
Backgroung: Given the importance of natural childbirth and emphasis on the normal vaginal delivery, and since important causes of having a C-section are lack of response to induction of labor with Syntocinon® injection and the fact that the cervix is unfavorable for labor.
Objective: The present ...
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Backgroung: Given the importance of natural childbirth and emphasis on the normal vaginal delivery, and since important causes of having a C-section are lack of response to induction of labor with Syntocinon® injection and the fact that the cervix is unfavorable for labor.
Objective: The present study aims at achieving the best method of cervical ripening for pregnancy termination to reduce the C-section rate, labor duration, economic burden, and labor pain.
Methods: In this regard, the current study examined the effect of hyoscine-N-butylbromide (HBB) on the progression of cervical ripening in normal vaginal delivery. In the current prospective double-blind controlled clinical trial, 60 pregnant females referred to Valiasr hospital (with the mean age of 27.2 years) were randomly divided into 2 groups of experimental and control; HBB and normal saline (placebo) were intravenously administered in the active phase of labor.
Results: The pain reduction in the patients, the duration of drug action until the cervical dilatation, the number of drug use for the full cervical dilatation, the time of the onset of the first, second, and third stages of labor, the length of hospitalization until the delivery, the drug effect on the fetus and mother, and the delivery method were evaluated in both groups. HBB significantly reduced the duration of the first stage of labor; however, it did not affect the second and third stages. Moreover, no negative effects were observed on the mother and fetus health.
Conclusion: According to the obtained results, it can be concluded that the intravenous injection of HBB can be applied as an effective drug for labor progress; however, further clinical studies with larger sample sizes are required to confirm these findings.
Fatemeh Azadi; Maryam Moshfeghi; Narges Bahrami; Mohammad Hossein Eftekhari
Volume 2, Issue 1 , March and April 2017
Abstract
Background: Pelvic infections are among the most prevalent and serious postpartum complications. Over the past several decades, these infections, along with preeclampsia and hemorrhage, have constituted the triad of death among mothers. The presence of meconium in the amniotic fluid has been considered ...
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Background: Pelvic infections are among the most prevalent and serious postpartum complications. Over the past several decades, these infections, along with preeclampsia and hemorrhage, have constituted the triad of death among mothers. The presence of meconium in the amniotic fluid has been considered as one of the risk factors for postpartum infections. This study aimed to investigate the association of meconium-stained amniotic fluid with postpartum infection and fever.
Methods: This prospective cohort study included 200 singleton term pregnant women, referred for childbirth to Imam Khomeini and Razi hospitals of Ahvaz in 2014. The women were assigned to two groups, ie, subjects with meconium-stained amniotic fluid (exposure group) and subjects with clear amniotic fluid (control group). The participants in the two groups were identical in terms of maternal age, gestational age, parity, and duration of ruptured membranes. Pregnant women who had underlying medical problems were excluded from the study. Both groups received intravenous ampicillin half an hour before the surgery until 48 hours after the surgery, based on the protocol introduced by the hospital for women planning cesarean section. The two groups were compared regarding post-C. Section infection. The exposure group consisted of 100 subjects with meconium-stained amniotic fluid, while the control group included 100 subjects with clear amniotic fluid. The participants were observed for maternal prognosis, based on postpartum infections.
Results: Both groups underwent C-section. In the exposure and control groups, 14 (14%) and 12 (12%) women had fever after C-section, respectively. Moreover, 6 (6%) and 3 (3%) women in the exposure and control groups had post-C. section wound infections, respectively.
Conclusions: No significant difference was found in post-C. Section fever and wound infection between the two groups, which might be related to the duration of intravenous antibiotic administration. To examine the effects of intravenous antibiotics, further studies should be conducted. In both groups, the highest incidence of fever was observed among women younger than 20 years; this result was statistically significant.
Soheila Aminimoghaddam; Ghazal Kamyabi; Fariba Yarandi; Soghra Zarei
Volume 2, Issue 2 , May and June 2017
Abstract
Background: Endometrial carcinoma is the most common cancer of the female genitalia and its prevalence is 2% to 3% along the females’ lifetime. This adenocarcinoma is diagnosed in the early stages because the patients become symptomatic early in the course of disease. The correlation of the lower ...
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Background: Endometrial carcinoma is the most common cancer of the female genitalia and its prevalence is 2% to 3% along the females’ lifetime. This adenocarcinoma is diagnosed in the early stages because the patients become symptomatic early in the course of disease. The correlation of the lower uterine segment involvement (LUSI) with the recurrence, and the survival rates in patients with endometrial adenocarcinoma are always questionable. Confirming the prognostic significance of LUSI can fundamentally improve the current state of patients’ surveillance. The current study aimed at investigating the association of lower uterine segment involvement with deep myometrial invasion in endometrial adenocarcinoma.
Methods: In the current retrospective cohort study, 54 patients with stage I endometrial endometrioid adenocarcinoma who underwent surgery in Mirza-Koochak-Khan Hospital, Tehran, Iran, from 2004 to 2014 were divided into 2 groups according to the presence of LUSI. In the current cohort study, the data from the patients exposed to LUSI were obtained by questionnaires to measure deep myometrial invasion besides post-operative adjuvant radiotherapy. The median of follow-up period was 48 months for all of the patients, which started after their surgery, and the measurement period for variables were similar to those of the follow-up period, which was 48 months. They were compared regarding to age, tumor grade, depth of myometrial invasion, lymphovascular involvement, extra uterine diseases, the extent of lymphadenectomy, adjuvant therapy, recurrence rate, time, and location. The data analysis was conducted by the SPSS v.16 statistical software (Chicago, IL, USA) at the significance level of 5%. In the investigation, Chi-square, the Kolmogorov-Smirnov, t test, and the Mann-Whitney U tests were used.
Results: Group 1 consisted of 13 patients with LUSI and group 2 had 41 patients without LUSI divided by a non-random sampling method. According to the results of the Mann-Whitney U test, there was a significant difference between the mean age of patients with LUSI and that of the ones without LUSI (P = 0.03). It showed that the mean age in the former group was significantly higher than that of the latter. A Chi-square test showed no significant association between the lymphovascular involvement and the presence of LUSI (P = 0.1). The Fisher exact test showed that patients with LUSI had significantly higher rate of radiotherapy after surgery rather than the ones without LUSI (P < 0.001).
Conclusions: In conclusion, there was a significant association between the lower uterine segment involvements with deep my ometrial invasion in the endometrial endometrioid adenocarcinoma. In other words, there was a significant difference in the depth of myometrial invasion between the groups, and the patients with LUSI had deeper myometrial invasion (the Mann-Whitney U test, P < 0.001).
Zahra Rezaei; Zahra Shahraki; Mahboobeh Shirazi
Volume 2, Issue 3 , September and October 2017
Abstract
Introduction: Utero-cutaneousfistulaisarareconditionfollowinguterinesurgeriesespeciallycesareansection. Thiskindof fistula has various etiologies including drain use, iatrogenic trauma, endometriosis, multiple abdominal surgeries, incomplete closure of uterine wound during cesarean delivery, inflammatory ...
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Introduction: Utero-cutaneousfistulaisarareconditionfollowinguterinesurgeriesespeciallycesareansection. Thiskindof fistula has various etiologies including drain use, iatrogenic trauma, endometriosis, multiple abdominal surgeries, incomplete closure of uterine wound during cesarean delivery, inflammatory processes related to intra-abdominal sepsis or infectious, and dislocation of intrauterine devices.
Case Presentation: This report deals with two unusual cases of utero-cutaneous fistula. The patients referred with discharge from abdominal wall. The first one had vesico-cutaneous fistula simultaneously. Both of them had a second cesarean section. After four months of cesarean section, in fistulography report of the first case, it was found irregular fistula tract associated with vagina following cannulation and contrast injection. In the second case, ultrasonography revealed the attachment of uterus to abdominal wall as well as accumulation and communication of the small amounts of fluid from uterine cavity to abdomen wall. After confirming the diagnosis, the repairing surgery was successfully planned.
Conclusions: Cesarean has some rare morbidity such as uterocutaneous fistula that needs awareness of physician and patient. The early diagnosis and repairing of this abnormality is essential.
Fakhrolmolouk Yassaee; Reza Shekarriz-Foumani; Shima Sadeghi
Volume 2, Issue 4 , November and December 2017, , Pages 1-5
Abstract
Background: Women’s activity in many social and religious events necessitates them to have their menstruation suppressed, including in yearly Hajj rites for Muslim women. According to the Islamic religious set-ups, Muslim women must be physically and morally clean during the Hajj rites in Mecca. ...
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Background: Women’s activity in many social and religious events necessitates them to have their menstruation suppressed, including in yearly Hajj rites for Muslim women. According to the Islamic religious set-ups, Muslim women must be physically and morally clean during the Hajj rites in Mecca. In this research, the efficiency and side effects of extended consumption of hormonal agents in Iranian women during the Hajj rites in Mecca were examined.
Methods: The retrospective cross-sectional study involved a sum of 212 participants of pilgrim women recruited from 30 Sep. to 4 Nov. 2013, already prescribed with different types of hormonal agents for 35 - 36 days. Thereafter, they were assessed by questionnaires for the sake of success and side effects throughout the approach.
Results: Out of 212 subjects, 161 (75.9%) had experienced menstrual delay during Hajj rites with no spotting. Women taking combined oral contraceptives within the first half of their menstrual cycle had a significant postponement of menstrual bleeding.
Conclusions: Majority of the pilgrim women who completed the Hajj rites thoroughly with no spotting were satisfied with the extended consumption of hormonal agents.
Radiology
Mehnoosh Torkzaban; Nesa Rajabpoor Nikoo; Ateeh Kalateh; Mahboobeh Shirazi
Volume 5, Issue 1 , August 2020, , Pages 27-30
Abstract
Background and Objective: Conjoined twins (CTs) are rare complications of monozygotic twinning. Cephalothoracopagus is the rarest subtype of CTs and occurs once in every 58 sets of conjoined twins or once in every three million births. Here we present such a case and analyze the possible reasons for ...
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Background and Objective: Conjoined twins (CTs) are rare complications of monozygotic twinning. Cephalothoracopagus is the rarest subtype of CTs and occurs once in every 58 sets of conjoined twins or once in every three million births. Here we present such a case and analyze the possible reasons for ultrasonographic misdiagnosis and recommend solutions to avoid it.Case Report: In this article, we have reported a case of Cephalothoracopagus Janiceps twining. The ultrasonographic diagnosis was missed at 7 and 12 weeks scans. Increased thickness of nuchal translucency and absent nasal bone was observed alongside with suspected gastroschisis. The patient was referred for further evaluation at 13-14 weeks of pregnancy. Unexpectedly, two alive fetuses were reported fused in the head, thorax, and abdomen. Because of the poor prognosis, counseling was provided for parents and elective medical pregnancy termination was carried out. We have analyzed the possible reasons for ultrasonographic misdiagnosis.Conclusion: Without applying a standardized scanning of the entire uterus both in a longitudinal and transverse approach in early pregnancy, cephalothoracopagus twining may be misdiagnosed with a singleton pregnancy. A high level of concerns may raise for conjoined cephalothoracopagus twinning in case of finding a single fetal pole with an irregular body outline and a disproportionally large head in the presence of two separate fetal hearts in early pregnancy. Two fused heads with two brains and two sets of lower and upper extremities do confirm the diagnosis.
Khadigeh Mirzaiinajmabadi; Somayeh Makvandi; Masoumeh Mirteimoori; Ramin Sadeghi
Volume 3, Issue 1 , March and April 2018, , Pages 29-37
Abstract
Aims: Labor is a painful process. Managing and controlling labor pain is an essential aspect of midwifery services and is the main goal of childbirth care. One of the methods used in traditional medicine to relieve labor pain is aromatherapy. This systematic review and metaanalysis study was an update ...
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Aims: Labor is a painful process. Managing and controlling labor pain is an essential aspect of midwifery services and is the main goal of childbirth care. One of the methods used in traditional medicine to relieve labor pain is aromatherapy. This systematic review and metaanalysis study was an update conducted with the aim of critically evaluating and summarizing all available evidence obtained from randomized clinical trials on the effect of aromatherapy with lavender on labor pain relief.
Information and Methods: In this systematic review, searching a number of foreign databases, including MEDLINE/PubMed, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus, from the start date of these databases to December 2017 was independently conducted by two researchers, using symbols, i.e. Lavender* OR Lavandula* OR silexan AND labor OR labour OR birth OR childbirth. Comprehensive Metaanalysis (CMA) software version 2 was used for statistical analysis.
Findings: Based on the search strategy, 244 primary studies were found. Finally, 5 studies including 541 participants were examined in this systematic review. Three studies were subjected to meta-analysis. In general, the quality of clinical trials was moderate and combinatory. Aromatherapy with lavender reduced labor pain in the active phase. The mean difference of labor pain in the aromatherapy groups with lavender and control groups was 1.05 (0.552-1.548; p=0.000036).
Conclusion: Using aromatherapy with lavender among pregnant women reduces the labor pain. The availability of information obtained from this study can be useful for gynecologists, midwives, and nurses working in labor and delivery units.
Farah Farzaneh; Farzaneh Jamdar; Sarang Younesi; Mehdi Taheri Amin; Pourandokht Saadati; Fariba Navidpour; Payam Balvayeh; Robabeh Ghodssi-Ghasemabadi; Maryam Sadat Hosseini
Volume 4, Issue 1 , March and April 2019, , Pages 29-35
Abstract
Background: Cervical cancer is one of the common cancers in developing countries, which has a high rate of mortality. This study aimed to evaluate the prevalence of abnormal cervical cytology among Iranian women.
Methods: In this cross-sectional study, cervical cytological results of 137,484 Iranian ...
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Background: Cervical cancer is one of the common cancers in developing countries, which has a high rate of mortality. This study aimed to evaluate the prevalence of abnormal cervical cytology among Iranian women.
Methods: In this cross-sectional study, cervical cytological results of 137,484 Iranian women, who were screened for cervical cancer in Tehran and 12 other provinces of Iran from 2013 to 2016, were investigated. The Pap smear was prepared by a liquid-based method and evaluated by a pathologist.
Results: The overall prevalence of abnormal cervical cytology in the studied population was 3%. The mean age of the population was 35.77 ± 9.6. In this study, the prevalence of abnormal cytology in 2013, 2014, 2015, and 2016 was 2.10%, 2.68%, 3.47%, and 3.60%, respectively. The rate of the abnormal Pap smear has increased over the years, and this trend has been statistically significant (P < /em><0.001). In this population, atypical squamous cells of undetermined significance (ASCUS) cytology was the most common abnormal Pap smear (1.96%).
Conclusion: In this study, the prevalence of abnormal cervical cytology has been significantly increased in Iran in recent years. This increase requires careful monitoring of general education programs, strict cervical cancer screening, and routine vaccination against HPV infection.
Maternal Fetal Medicine
Maryam Saraei; Pegah Estakhrian Haghighi; Hamed Amirifard; Arezu Najafi
Volume 6, Issue 1 , January 2021, , Pages 29-34
Abstract
Background & Objective: Gestational hypertension (GH) is considered as one of the important health-related issues of pregnant women. One of the raised problems in the pathogenesis of GH is obstructive sleep apnea (OSA). This study aimed to evaluate associated factors of OSA among an employed pregnant ...
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Background & Objective: Gestational hypertension (GH) is considered as one of the important health-related issues of pregnant women. One of the raised problems in the pathogenesis of GH is obstructive sleep apnea (OSA). This study aimed to evaluate associated factors of OSA among an employed pregnant population.Materials and Methods: In this study, 200 employed pregnant women with GH as the case group and 200 healthy pregnant ones as the control group were enrolled. Blood pressure >140/90 after 20 weeks of gestational age without proteinuria was defined as GH. Chi-square and Mann-Whitney tests were applied for statistical analysis.Results: Mean ± SD of age and body mass index (BMI) were 32.85 ± 5.45 (years) and 31.85±5.97 (kg/m2) among the case group, respectively. Participants with GH had higher mean BMI, neck circumference, and more frequency of snoring than the control group, which was statistically significant (P < /em><0.012, P < /em><0.025, and P < /em><0.007, respectively). Sales and service occupations consisted the group with the highest frequency of GH.Conclusion: Participants with GH had higher BMI, snoring, observed apnea, and neck circumference. This observation warrants comprehensive assessment of OSA and related risk factors among patients with GH.
Gynecology Oncology
Fariba Behnamfar; Safoura Rouholamin; Taj Sadat Allameh; Fahimeh Sabet; Leila Mousavi Seresht; Maryam Nazemi
Volume 7, Issue 1 , September and October 2021, , Pages 32-37
Abstract
Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated ...
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Background & Objective: Comparative study between laparoscopic and laparotomy scoring in patients with advanced ovarian cancer.Materials & Methods: This prospective study included 27 patients with advanced ovarian cancer who underwent laparoscopy and laparotomy scoring at hospitals affiliated with Isfahan University of Medical Sciences (IUMS) during 2020 and 2021. The laparoscopic predictive index value (PIV) score (range: 0-14) was calculated for all patients. In patients with PIV scores <8, primary cytoreductive surgery (PCS) was performed, and patients with scores ≥8 were candidates for neoadjuvant chemotherapy (NACT). In the PCS group, laparotomy scoring and surgical findings for each anatomical area were registered for all patients, and concordance between laparoscopy and laparotomy findings was compared. Residual disease following PCS was documented for all patients.Results: A total of 27 patients underwent laparoscopic scoring surgery; 25 patients (92/5%) had a PIV score <8, and two patients (7/5%) had a PIV score ≥8. There was 92% agreement between PIV scores at laparoscopy and laparotomy. Agreements in different anatomical regions in laparoscopy and laparotomy were as follows: involvement of the bowel 76%, mesenteric 92%, liver 96%, omental 92%, diaphragm 96%, stomach 100%, peritoneal carcinomatosis 96%. A laparoscopic PIV score of <8 had a PPV of 84% at predicting R0 at PCS.Conclusion: Laparoscopic scoring is a precise approach in the management of patients with advanced ovarian cancer. Laparoscopic scoring is a screening method of selecting patients for primary surgery or NACT and improved R0 resection at PCS. The present study was designed to assess patients who would gain the maximum benefits from primary surgery.
Obstetrics and Gynecology
Soheila Dabiran; Shahla Khosravi; Leila Pourali; Sedigheh Ayati; Zahra Mohaddes Ardebili; Shamim Delavari
Volume 8, Issue 1 , January and February 2023, , Pages 35-40
Abstract
Background & Objective: Delayed childbearing has become a worldwide phenomenon, yet the association between advanced maternal age (AMA ≥35 years) and pregnancy outcomes remains unclear. This issue has also been inadequately explored in Iran. To assess the relationship between pregnancy complications ...
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Background & Objective: Delayed childbearing has become a worldwide phenomenon, yet the association between advanced maternal age (AMA ≥35 years) and pregnancy outcomes remains unclear. This issue has also been inadequately explored in Iran. To assess the relationship between pregnancy complications and AMA in the Iranian context.Materials & Methods: This cross-sectional study involved 891 women who had consecutive pregnancies and were referred for delivery to an academic hospital at Mashhad university of medical sciences, Mashhad , Iran, from March 2015 to March 2019 for The women were considered into the two age groups, namely, a 20 to 34year group and an AMA group, who were then assessed in terms of complications of late childbearing, such as preeclampsia, gestational hypertension, and gestational diabetes mellitus (GDM); mode of delivery; and five-minute Apgar score. The data were analyzed using the chi-square test and the Mann–Whitney U test in SPSS version 9. The P<0.05 was considered statistically significant.Results: The AMA group exhibited lower five-minute Apgar scores and a significantly higher prevalence of preeclampsia, gestational hypertension, and GDM (p < 0.05). The two groups also substantially differed concerningquality of prenatal care (p < 0.001). Regarding the mode of delivery, cesarean section was more prevalent in the AMA group, whereas vaginal delivery was more common in the younger group (p < 0.001).Conclusion: With regard to trend to pregnancy in higher maternal age and higher pregnancy complication in this population, precise preconception counseling is crucial to educating couples for early childbearing at younger age.
Maternal Fetal Medicine
Azam Jafari Fard; Sonia Sadeghpour; Fatemeh Bahadori; Javad Rasouli
Volume 9, Issue 1 , January and February 2024, , Pages 36-44
Abstract
Background & Objective: Preeclampsia is a perinatal and maternal morbidity and mortality-related pregnancy disease. A diagnostic challenge is frequently presented by the finding of a small femur length, especially below the fifth percentile. When the ultrasound was performed, it can be related ...
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Background & Objective: Preeclampsia is a perinatal and maternal morbidity and mortality-related pregnancy disease. A diagnostic challenge is frequently presented by the finding of a small femur length, especially below the fifth percentile. When the ultrasound was performed, it can be related to fetal growth restriction. This study sought to determine how short femur diaphysis length (FDL) during 32–37 weeks of gestation affected preeclampsia.Materials & Methods: Between February 2021 and February 2022, pregnant women who received a regular abnormality scan at the Shahid Motahari University Hospital in Urmia, Iran, between 32 and 37 weeks of gestation were included in the study. As part of the abnormality scan, fetal biometry and uterine artery Doppler ultrasound were evaluated, and the mean pulsatility index of the two uterine arteries was noted. From our database system, we gathered information on maternal obstetric features such as ethnicity, age, weight, parity, smoking, and medical history including hypertension and diabetes mellitus.Results: The present study's findings showed that preeclampsia, maternal age, and the number of prior pregnancies were all connected with multivariate analysis of the fetal femoral length percentile. Additionally, the 50th percentile femoral's sensitivity and specificity for the diagnosis of preeclampsia were 96.88 and 81.88, respectively.Conclusion: According to our findings, there is a substantial association between PE and short FLduring 32–37 weeks of gestation.
Marzieh Talebian; Zohreh Talebi Mazreshahi; Elham Khosravi Mashizi; Nafiseh Khalili
Articles in Press, Accepted Manuscript, Available Online from 14 November 2022
Abstract
Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There ...
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Introduction: Although 1% to 2% of all pregnancies are ectopic, ectopic pregnancy (EP) is the most frequent obstetrical disease leads to maternal mortality and morbidity at first trimester. The basic diagnostic method of EP is the human chorionic gonadotropin (HCG) test and transvaginal ultrasound. There are some rare EP cases with negative HCG blood test. Case presentation: A 31-years old woman referred to the emergency department with hypogastric, periumbilical, and right upper quadrant intermittent pain and vaginal bleeding and prior history of EP 7-months ago that treated with methotrexate and her intra uterine device had been removed at that time. Her last menstrual period was undetermined. Although HCG blood test-qualitative was negative (2.08 IU /ml),ultrasound examination showed an 43×53 mm echogenic, heterogenic complex solid mass in the left adnexa and a large amount of echogenic fluid demonstrating hemoperitoneum. Taken surgery because of the exceeded abdominal pain revealed active bleeding in the left salpinx due to ruptured EP. Conclusion: Management of patients suspected of EP with negative HCG-blood test is difficult. In this uncommon cases in emergency, computed tomography, ultrasound and diagnostic laparoscopy or laparotomy can improve prognosis of patient.
Obstetrics and Gynecology
Madhubala Manickavasagam
Volume 5, Issue 2 , October 2020, , Pages 57-60
Abstract
Background and Objective: Management of caesarean myomectomy (CM) in lower uterine segment obstruction is a hard process. Here I present a pregnant woman with multiple fibroid pregnancy and an obstructing intramural fibroid in the lower segment. The CM procedure was modified here with initially excision ...
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Background and Objective: Management of caesarean myomectomy (CM) in lower uterine segment obstruction is a hard process. Here I present a pregnant woman with multiple fibroid pregnancy and an obstructing intramural fibroid in the lower segment. The CM procedure was modified here with initially excision of obstructing myoma and delivery of baby.Case Presentation: A primigravida woman visited emergency room with abdominal pain at 22 week gestation, receiving antenatal care elsewhere. The emergency abdomen USG showed multiple fibroids in pregnancy with a huge obstructing fibroid in lower segment and a breech presentation with no anomalies. Comparing earlier USG reports exposed that the multiple fibroids were growing across the gestation weeks along the developing fetus. The mother was followed for watchful expectancy till 37 weeks gestation and delivery was planned as elective LSCS. Cesarean myomectomy was carried out through initial excision of lower uterine segment myoma to remove the obstruction, and then deliver the baby through the same incision.Conclusion: Here the cesarean myomectomy procedure was altered from a regular one, featuring preliminary myomectomy of uterine fibroid in the lower segment, and then delivering the baby and myomectomies again. The outcome was delivering a live baby with hemostasis in a case, with multiple and large fibroids.
