International Journal of Reproductive BioMedicine
Year:2017 | Volume:15 | Issue:9|Papers Count:8

Background: Pseudocyesis is a psychopathological clinical syndrome in which a non-pregnant woman firmly believes herself to be pregnant and manifests many symptoms and signs of pregnancy. Although the exact etiology of pseudocyesis has not been determined. Objective: This study was conducted with the aim of assessing the biopsychosocial view to pseudocyesis. Materials and Methods: A comprehensive search in electronic databases such as Google Scholar, PubMed, ScienceDirect, Web of Science, and Scopus was conducted between 1943-2016 to retrieve pseudocyesis related articles. For this purpose, 1149 articles were collected and 66 items were used. Results: Findings were classified into 2 main categories: a) pseudocyesis etiology, which could include (biological psychological factors and psychiatric disorders, and social factors); and b) pseudocyesis management. Conclusion: Pseudocyesis results from a multidimensional group of factors, and a holistic and comprehensive approach should be taken to its treatment. Cooperation between gynecologists and psychiatrists would likely be useful in addressing the condition.

Background: The clinical consequences of hypothyroidism and hypothyroxinemia during pregnancy such as preterm birth are not still clear. Objective: The aim of this meta-analysis was to estimate the relation of clinical and subclinical hypothyroidism and hypothyroxinemia during pregnancy and preterm birth. Materials and Methods: In this meta-analysis, Preferred Reporting Items for Systematic review and Meta-Analysis were utilized. Searching the 83Tcohort studies83T were done by two researchers independently without any restrictions on Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO and Google Scholar databases up to 2017. The heterogeneity of the studies was checked by the Cochran's Q test and IP2P index. Both random and fixed-effects models were used for combining the relative risk and 95% confidence intervals. Data were analyzed using Comprehensive Meta-Analysis software version 2. Results: Twenty-three studies were included in the meta-analysis. The relative risks of the clinical hypothyroidism, subclinical hypothyroidism and hypothyroxinemia during pregnancy on preterm birth was estimated 1. 30 (95% CI: 1. 05-1. 61, p=0. 013, involving 20079 cases and 2452817 controls), 1. 36 (95% CI: 1. 09-1. 68, p=0. 005, involving 3580 cases and 64885 controls) and 1. 31 (95% CI: 1. 04-1. 66, p=0. 020, involving 1078 cases and 44377 controls), respectively. Conclusion: The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, 83Tgynecologists and endocrinologists83T should manage these patients to control the incidence of 83Tadverse pregnancy outcomes83T such as preterm birth.

Background: Adherence issues in polycystic ovary syndrome (PCOS) patients have not been examined thoroughly. Patients report prolonged periods of treatment and side effects of the drug as the most common reason for withdrawal from treatment. To improve the effective management of PCOS patients, it is fundamental to understand facilitating and inhibiting factors to treatment adherence. Objective: To explore facilitating/inhibiting factors related to treatment adherence among PCOS patients. Materials and Methods: This was a qualitative study with a purposive sample of women with confirmed diagnosis of PCOS. The data were collected via 20 in-depth semi-structured interviews with women aged between 21-34 yr. A qualitative content analysis was used to analyze the data. Results: Five themes were identified which described different types of facilitating/ inhibiting factors to treatment adherence. Inhibiting factors included financial issues, patient-related, disease-related, and health care provider-related factors; while social factors were found to be both facilitating and inhibiting. Conclusion: The findings suggest that successful adherence to PCOS treatment is highly dependent on patients recognizing and adapting to financial, social, and health care related inhibiting factors. It is also crucial for clinicians and policy makers to recognize these key inhibiting factors in order to improve treatment outcomes.

Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women which affect fertility. Clomiphene citrate is used as first-line treatment for this disorder, which is associated with some complications and therapeutic resistance. Objective: In this research, we compare the effectiveness of ginger with clomiphene on sexual hormones such as Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), estrogen and progesterone in order to treat PCOS effectively with fewer side effects. Materials and Methods: In this experimental study, 63 adult female rats (170-200 gr) were studied and divided randomly into 9 groups as control (not received any interventional substance for 60 and 89 days), sham (were given distilled water and ethyl alcohol intraperitoneally daily for 60 and 89 days), and 7 experimental groups receiving estradiol valerate (PCOS inducing agent, intramuscular) alone and with 100 mg/kg clomiphene or different doses of ginger extract (175 and 350 mg/kg) orally daily for 60 and 89 days. Sexual hormones were analyzed and compared in different groups. Results: Our results showed that in the PCOS-induced group, LH and estrogen concentration increased while progesterone and FSH concentration decreased remarkably (p<0. 05) as compared to control group. Furthermore, in groups receiving clomiphene and ginger extract, we demonstrated significant (p<0. 05) improvement in hormonal secretion as compared to the PCOS-induced group. Clomiphene, compared with the lower dose of ginger extract, had a better improving effect on balancing sexual hormones in PCOS. Moreover, ginger extract at higher doses has better effects in improving PCOS. Conclusion: As the long-term administration of clomiphene citrate has some side effects, the use of ginger as a herbal medicine without any side effects at high doses can be an effective and good alternative in improving PCOS.

Background: Preeclampsia is a condition associated with systemic disorders in the mother and the fetus. However, the exact causes of preeclampsia are unknown, but several genetics and environmental factors play role in development of this disease. Major histocompatibility complex role is very important during pregnancy through which the fetus is not rejected by mother’ s immune system. Objective: In this study, we investigated the relationship of the human leukocyte antigen (HLA)-DQA1*0102/HLA-DQB1*0602 polymorphism with preeclampsia. Materials and Methods: Genomic DNA of 181 pregnant women with a history of preeclampsia as the case group and 228 pregnant women with no history of preeclampsia as the controls were extracted. The HLA-DQA1*0102/HLA-DQB1*0602 polymorphisms of all DNA samples were identified by the SSP-PCR method. Frequencies difference of variables between case and control groups were calculated by Chi-square test. The ethnic origin of the participants in this study was extracted from their medical records. Results: There was a significant association between preeclampsia and Sistani ethnic group (p=0. 031). Moreover, there was a significant association between preeclampsia and frequencies of allele HLA-DQB1*0602 (p<0. 001), and genotypes of heterozygote (+0102/-0602) (p<0. 001) and negative homozygote (-0102/-0602) (p=0. 005). There also was an association between allele HLA-DQB1*0602 and preeclampsia in Fars ethnic group (p=0. 028). Conclusion: It seems that immune incompatibility may have an important role in preeclampsia predisposition. According to our results, the lack of locus HLA-DQB1*0602 may be a risk factor for preeclampsia.

Background: Despite many effort to identify and control the factors involved in polycystic ovary syndrome (PCOS), there are no available reports indicating the association of healthy eating index (HEI) and PCOS. Objective: The present study has been conducted to examine the relationship between HEI and PCOS. Materials and Methods: In this case-control study, the study population comprised 297 women aged 20-40 yr referred to Baqiyatallah Hospital Clinics, Tehran, Iran in two groups: case group (n=99) and control group (n=198). The usual dietary data were collected using a validated 168-item semi-quantitative food frequency questionnaire. Standard anthropometric measurements (height, weight, and waist circumference) were also taken. Unconditional logistic regression was used to analyze the relationship between the PCOS and the HEI. Results: The mean age and body mass index of case and control groups were 29± 5. 5 vs. 29. 5± 6 yr and 26. 6± 4. 8 vs. 26± 4. 2 kg/m² , respectively (p=0. 752, p=0. 822). Mean HEI scores for the case and control groups were found to be 61 and 65, respectively. In final model and after adjustment for confounders, the prevalence of PCOS in subjects in the highest tertile HEI score was significantly (50%) less than those in the lowest tertile HEI score (OR=0. 50; 95% CI: 0. 25-0. 74, p=0. 001). Conclusion: Our results suggest that HEI score is inversely associated with the risk of PCOS in adult women.

Background: Preeclampsia is associated with maternal and neonatal complications. It has been indicated that increased uric acid might have a predictive role on preeclampsia. Objective: We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia. Materials and Methods: In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included. Hemoglobin, hematocrit, platelet count, liver and uric acid tests, and maternal and neonatal complications were assessed. The severity of preeclampsia, placental abruption, preterm labor, thrombocytopenia, elevated alanine aminotransferase and aspartate aminotransferase (ALT and AST), HELLP syndrome, eclampsia and required hospitalization in the ICU was considered as the maternal complication. Fetal complications were: small for gestational age (SGA), intrauterine fetal death, hospitalization in the neonatal intensive care unit, and Apgar score <7 at five minutes. Results: Of our participants, 38 women had severe preeclampsia (23. 8%). The mean level of uric acid in women with severe preeclampsia was significantly higher than non-severe preeclampsia (p=0. 031), also in those with an abnormal liver test (p=0. 009). The mean level of uric acid in women with preterm delivery was significantly higher than women with term delivery (p=0. 0001). Also, the level of uric acid had no effect on neonatal hospitalization in neonate invasive care unit. Based on logistic regression, the incidence of severe preeclampsia not affected by decreased or increased serum levels of uric acid. Conclusion: With higher level of uric acid in server preeclampsia we can expected more complications such as hepatic dysfunction and preterm delivery. Thus serum uric acid measurement can be helpful marker for severe preeclampsia.

Background: Perineural cysts formed within the nerve-root sheath at the dorsal root ganglion. They are most commonly located in the arachnoid covering the junction of the dorsal ganglion and nerve root. They are usually asymptomatic, incidental findings, usually located in the lumbar and sacral region of the spinal canal. It is important to consolidate the imaging findings of this rare disease so clinicians can become more clinically relevant in the evaluation of these cysts. Case: Herein we report a case of perineural cyst misdiagnosed with hydrosalpinx by pelvic ultrasonography and finally diagnosed with magnetic resonance image. Conclusion: Perineural cyst should be considered, in the presence of bilateral adnexal masses separated from the ovaries in pelvic sonography.