International Journal of Women's Health and Reproduction Sciences
Year:2014 | Volume:2 | Issue:5|Papers Count:14

Although acute myocardial infarction (AMI) in pregnancy is rare, can result in maternal and/or fetal death and should be carefully managed. The aim of this study is to collect and review the data on the management from numerous articles published since 2000.For literature review we performed a literature search on PubMed that were based on diagnoses and management of myocardial infarction on pregnancy. Atherosclerosis appears to be the most common cause of AMI. Although there are some differences related to pregnancy stage such as thrombosis, coronary artery spasm or dissection that seen more frequently in pregnant women than age-matched nonpregnant women. In addition to traditional risk factors of atherosclerosis in general population, some other risk factors due to physiological or pathological changes in pregnancy and also some drugs can cause AMI. The Presentation and diagnosis of AMI in pregnancy usually is the same as nonpregnant patients but there are some important points. Regardless of some differences, therapeutic option of AMI in pregnant women is the same of nonpregnant patients. Probably primary percutaneous coronary intervention is the optimal medical management of AMI during pregnancy. Use of thrombolytic therapy in pregnancy is prohibited and is very limited. Although there have been many reports of cardiopulmonary bypass surgery during pregnancy, most knowledge is based on anecdotal and old reports. Early detection and multidisciplinary approach and timely delivery can minimize the serious consequences of AMI in pregnancy.

Objectives: To report the authors’ experience in suction and evacuation with cannula followed by maintenance of negative pressure in the uterine cavity by keeping the cannula inside for 20-30 minutes, which was performed for controlling intractable postpartum hemorrhage (PPH) in a tertiary care hospital.Materials and Methods: This is a retrospective observational study carried out from July 2011 to December 2012 at Batra Hospital and Medical Research Centre, New Delhi, India. Nine patients who delivered either vaginally or via caesarian section and developed primary PPH refractory to conventional medical treatment, were included in the study. Suction and evacuation of the uterine cavity was done and then the cannula was kept inside the uterine cavity for 20-30 minutes thereby maintaining negative pressure (400-600 mmHg) in the cavity. Data were retrieved from patients’ hospital records.Results: Intractable primary hemorrhage was encountered in 9 patients of whom 6 had bleeding after caesarian section and 3 after vaginal deliveries. Uterine atony due to prolonged labour was the commonest cause. Hemorrhage was effectively controlled in 8 out of 9 cases (88.9%) and hysterectomy was avoided. In one patient (11.1%) the procedure failed and life saving hysterectomy was done to control the bleeding. This approach not only controls PPH but also preserves the woman’s reproductive functions and avoids hysterectomy and its related complications and consequences.Conclusion: This is a simple conservative surgical method to treat PPH in low resource settings. It requires minimal training, conserves the uterus, and is technically less challenging and associated with less blood loss than hysterectomy.

Objectives: To assess the awareness and practices regarding breastfeeding and weaning among female healthcare providers working in tertiary care hospital of Karachi.Materials and Methods: This descriptive cross-sectional study was conducted among married female healthcare professionals who have at least one child under the age of five years. A sample of 94 study participants working in a private tertiary care hospital was selected through convenience sampling technique. Data collected using structured and self administered questionnaire. Data analysis was done by SPSS version 20 and Chi-square was applied with P-value<0.05 was considered significant.Results: Of the 94 female healthcare providers questioned, 90 (95.7%) recognized breast feeding as the preferred mode of feeding however, only 74 (78.7%) practiced it while 28 (29.8%) did not.15 (15.9%) of these cited workplace related issues as an important reason for hindrance. Although healthcare providers were aware of the hazards of bottle feeding yet majority i.e.80 (85.1%) practiced it. The most appropriate age for weaning was considered to be six months by 73 (77.7%) of the participants, however, only 50 (53.2%) practiced it. Homemade meals were used by 80 (85.1%) of the participants for hygienic reasons.Conclusion: Healthcare providers were found to have the right knowledge regarding the practices of breast feeding and weaning, however there was a significant gap between their knowledge and practice. Workplace related hindrances were found to be the main reason for this gap. So it is recommended to empower working mothers in order for them to be able to carry out the best feeding practices.

Objectives: Oral Contraceptive Pills (OCPs) are one of the most important and efficient methods of contraception, although their efficacy depends on correct and continual use. Women who discontinue to use OCPs, almost use a less effective method of contraception or do not replace use of OCPs with another method which results in unwanted pregnancy. Therefore, this study was carried out to determine the Continuation and Discontinuation Reasons of LD Contraceptives among Iranian Women.Materials and Methods: This cohort study was conducted from 2003 to 2006. Samples were 462 women presenting to one of 13 randomly selected health centers at Tabriz, a metropolis in the northwest of Iran. For data analyses inferential statistical tests were used.Results: In this study duration of OCPs usage rate of 1, 6, 12, 18, 24, 36, 48, and 54 months were as 88.96, 58.01, 44.59, 37.59, 30.52, 19.06, 9.99, and 2.78% respectively. The most common reasons for discontinuation were anger (35.5%), nausea (16.2%), and trend to pregnancy (22%). The relations was significant between continuation and variables including: use of OCPs as first method, having a strong information source, satisfaction of method (p=0.000), women (p=0.0096) & husbands’ job (p=0.032) and their literacy level (p=0.0155).Conclusion: Some demographic factors had influence on the continued use of OCPs. Positive effects of the user’s satisfaction and their level of education on continuation, requires more counseling policies of health for women especially during their first months of using OCPs.

Objectives: Infertility is threatening and stressful as a big crisis in life psychologically. Since there still are many ambiguities about the infertility’s being stressful. This study is done for defining the perceived stress among infertile couples and its social-individual predictors.Materials and Methods: This study is a sectional one which was done on 322 infertile couples referring to the infertility center at Alzahra Hospital in Tabriz. Sampling method was available. The gathering data instruments included social-individual particulars questionnaire and perceived stress scale (PSS) questionnaire which was completed as self-completion by the participants. The multivariate linear regression analysis method was used for defining the social-individual predictors of perceived stress.Results: The findings of the research showed that mean (standard deviation) of perceived stress among women was 27.4 (6.0) and 25.9 (5.3) among men out of 0-56 grade range and there was statistically significant difference between men and women due to perceived stress (P<0.001). The variable of monthly income sufficiency for living expenses, occupation, type of current treatment, Method of treatment, Etiology of infertility, methods of contraception were the predictors of perceived stress.Conclusion: The results of this research showed higher perceived stress among women compared to men; therefore it is necessary to provide approaches for reducing the perceived stress focusing on its predictive variables for recovering the couples’ mental status.

Objectives: Approximately 48% of all pregnancies in the US are unintentional, unplanned, or mistimed and most unplanned pregnancies result from non-continuous, incorrect use or not using a contraceptive method. Choice of a method should be based on the effectiveness and protection provide against unwanted pregnancy. Aim of this study was determining reasons for choosing the traditional method (withdrawal) as contraception.Materials and Methods: This is a cross-sectional descriptive study. The participants in this study consisted of 387 married women who used withdrawal method. Samples were selected randomly. A questionnaire was used for data collection. Descriptive statistics, Chi square, independent-samples t-test, Pearson test and one-way ANOVA were used for data analysis through SPSS 18.Results: Findings indicated that 121 (31.3%) women chose this method because they were sure that, it has same influences as other contraceptive methods, 114 (29.5%) ones chose it due to fearing of infertility by other contraceptive methods and 64 (16.5%) women said that their husbands are reluctant to use other methods.Conclusion: The results showed that the wrong believes or lack of information cause women to choose this unsafe method. So providing women with necessary information in this field by health care providers can be most effective way for replacing effective methods and preventing unwanted pregnancy.

Objectives: Trichomonas vaginalis which is flagellated unicellular organism is the causative agent of vaginitis. Medications used to treat trichomoniasis often have unpleasant side effects or are not effective. Given the prevalence of this disease, the production of safe, effective and affordable medicines is necessary. Various species of ferula are antibacterial and anti-fungal and anti- protozoan. So far, no study has been done on the effect of Ferula szowitsiana on trophozoite of Trichomonas vaginalis.Materials and Methods: Coma (Ferula), native to Eastern Azerbaijan province, was collected and methanol extracts were prepared. Trophozoite of Trichomonas vaginalis was cultured in vitro in CPLM medium and the effect of the mentioned extracts on the growth and survival of Trichomonas vaginalis trophozoite was measured by Mack-master slide.Results: Concentrations of 2 and 3 mg/ml in Methanol extracts of F. szowitsiana and could inhibit the growth of Trichomonas vaginalis trophozoite completely after 72-hour incubation. Trichomonas vaginalis trophozoite survived at concentrations of 0.5 and 0.375 and 0.25 mg/ml and methanol extract of F. szowitsiana were 42, 52 and 68%, respectively. The reduction of the number of parasites was visible 48 hours after incubation which was statistically significant (P<0.05).Conclusion: Ferula extract in different concentrations inhibited the growth of the dose-dependent trophozoite of Trichomonas vaginalis. The results of this study showed that native species of F. szowitsiana is suitable for the study of anti-trichomonas nature of it in vitro. Therefore, further study and identification of effective components in the methanol extract in the studied species are required.

Objectives: Although sport has many advantages, it sometimes causes disorders on women’s menstrual cycles. One of these can be delaying the menarche age and creating disorder in the menstrual cycle. On the other hand, sport is effective on dysmenorrhea and the pain resulted from it. This research aims at comparing the menarche age, menstrual regularity, dysmenorrhea and analgesic consumption among athletic and non-athletic students at the universities of Tabriz.Materials and Methods: This study is a causal comparative one which was done in 2010 on 360 girl students in 18-28 years old majoring in medicine and non-medicine at the universities of Tabriz. Samples were chosen selectively and completed the questionnaires, visual analogue scale (VAS), sport and menstrual record. The data were analyzed by SPSS 16 statistical software via descriptive and inferential statistical tests (Mann-Whitney U and Chi-square). P<0.05 was considered as significant.Results: In studying data, menarche age (P=0.001) and menstrual disorder (P=0.026) had significant difference which was higher in athletic group. The frequency of dysmenorrhea in athletic and non-athletic group did not have significant statistical difference (P=0.39) while the analgesic consumption was significantly lower in the athletic group (P=0.001).Conclusion: This study showed that sport can improve dysmenorrhea and decrease the need for analgesic for improving the dysmenorrhea among the people. Meanwhile, it is necessary to pay more attention to nutrition which is one of the important reasons of delayed menarche and menstrual disorder.

Objectives: To compare the Performing and not-performing of prophylactic surgery for urinary incontinence in women with pelvic organ prolapse.Materials and Methods: In a randomized controlled clinical trial that performed in department of Gynecology and Obstetrics of Tabriz University of Medical Sciences on women with advanced pelvic organ prolapse without history of urinary incontinence. The effects of performing and not-performing of prophylactic surgery for urinary incontinence in women with advance pelvic organ prolapse evaluated.Results: Mean age of patients was 53.83±5.52 years in the range of 41-66 years. Mean ICIQ-SF questionnaire scores at the first three questions in patients with pelvic organ prolapse with prophylactic surgery was 0.50±1.54 and in patients with pelvic organ prolapse without prophylactic surgery was 0.86±2.02. Significant difference was not found at the answers to the first question (P=0.507), the second question (P=0.415) and to the third question (P=0.445) ICIQ-SF questionnaire of in the patients advance pelvic organ prolapse underwent surgery for pelvic organ prolapse with and without prophylactic surgery.Conclusion: As regards, a significant difference was not found in the prevention of urinary incontinence between groups with and without prophylactic surgery. Therefore, prophylactic surgery is not recommended routinely for all patients and only we will attempt to do this surgery in symptomatic patients and reduced the additional costs and complications associated with prophylactic surgery in other patients who actually did not need to do this surgery.

Objectives: Busulfan is one of the anti-cancer drugs, despite of the tremendous usefulness in biotechnology and therapy of chronic diseases such as leukemia, lymphoma, ovarian cancer and it can lead to impaired spermatogenesis. The aim of this study was to seen body and testicular weight and serum Malondialdehyde (MDA) enzyme in rat was performed following the use of busulfan.Material and Methods: This study was conducted on 20 adult male rats ranging in age from 6 to 8 weeks, Animals in the two group includes a control group and the experimental group that received 50 mg/ kg busulfan as a single intra peritoneal injection and after 8 weeks, body and testis weight and serum MDA levels were measured. Then Data were analyzed with SPSS 16. P<0.05 was considered significant, and results were compared between the two groups.Results: single dose of busulfan, induced its effects on body, testis weights and serum MDA levels. Body weight in experimental and control groups, was respectively, 297.40 gr and 301.00 gr, Body weight of rats in the experimental group than the control group was decreased, but the difference was not significant (P>0.05). Testicular weight in both control and experimental groups, respectively, were 1.45 gr and gr 0.960. Difference between the two groups was significant decreased (P>0.05). Comparison of serum MDA of control and experimental groups, were showed 3.81±1.5 and 6.9±1.1 nmol/lit. No difference between the two groups was significant increased (P>0.05).Conclusion: It can be concluded that the use of busulfan can reduced body weight and testicular weight, and increased serum MDA and could be side effects in reproduction process.

The incidence of the placental invasion anomalies are increasing, mainly due to repeat cesarean deliveries. Placenta percreta occurs if these villi perforate the serosa and also sometimes into adjacent organs such as the bladder. The prenatal diagnosis is very important because of the high maternal morbidity and mortality rates without the appropriate surgical planning. The adherent placentas will result in severe early postpartum bleeding, just after the delivery of the fetus. Severe hemorrhage usually results rapidly in disseminated intravascular coagulation (DIC), shock, multiorgan failure or death. The surgery is also challenging due to the risk of the adjacent tissue damage, such as bladder or ureteral injury. Approximately 1 in every 3 cases need intensive care. We present here a prenatally diagnosed, 31-year-old gravida 7 para 2 abortus 4 pregnant case with placenta percreta and rewiev the relevant literature about the key aspects in the ultrasonograhic diagnosis and underlie the key points in the diagnosis.

Ectopia cordis (EC) is the presence of a live, beating heart outside the thorax and is one of the most unique congenital anomalies. EC has been a weak association noted with trisomy 18 and a few cases have been associated with other chromosomal abnormalities. Pentalogy of cantrell (PC) is a rare congenital syndrome of abdominal wall defect, lower sternal defect, diaphragmatic pericardial defect, anterior diaphragmatic defect, and intracardiac abnormalities. It has a rare frequency of about 1/100, 000 births. The hallmark of this syndrome is an omphalocele associated with EC. Only a few patients with the full spectrum of the pentalogy have been described. Only very few patients survive attempts at surgical repair, the main causes of death being tachyarrhythmias, bradycardia, low blood pressure, rupture of the diverticulum, and heart failure. Early diagnosis is important about discuss the option of elective termination with the parents if intracardiac anomalies of incompatible with life are noted. We report two cases of PC diagnosed in early second trimester.

CADASIL (cerebral arteriopathy, autosomal dominant, with subcortical infarcts and leukoencephalopathy) is an infrequent inherited small artery disease that could have anesthetic implications. However these have rarely been reported. We present an anesthetic experience of a female patient previously diagnosed with CADASIL, who had suffered an ischemic vascular cerebral accident with a MRI compatible with leukoencephalopathy, and who was dependent for daily activities, mood alterations, apathy, and urine incontinence. We discuss anesthetic management of CADASIL patient, considering protection from further cerebral ischemia.

Objectives: Homeopathy is an alternative medicine which reacts based on the principal as ‘likes cures likes’. Small amount and much diluted medicine of original substance that produces signs and symptoms in healthy individuals can treat disease with similar signs and symptoms. Many studies have confirmed the positive effects of homeopathic medicines. Homeopathy is a perfect complement to the science of midwifery. Many women’s health problems are easily treated with homeopathic medicines. The objective of current study is to visualize and analyze the scientific activities by leading countries in the field of Homeopathy and Midwifery.Materials and Methods: All papers entitled Homeopathy in the database of Web of Science were extracted and went under contain analysis. Databases of Science Citation Index Expanded SCI-E) and Social Science Citation Index SSCI) from Web of Science were used to obtain all row data.Results: Retrieving of data led a total number of 1830 papers entitled homeopathy. The contain analysis of extracted papers showed that only 2% of them was in the subject area of Obstetrics & Gynecology. England was the leading country regarding to producing and publishing papers in the field of homeopathy followed by USA and Germany respectively.Conclusion: Regarding to the effective role of homeopathy on Obstetrics & Gynecology, the portion of performed research activities in the subject area of homeopathy seems to be very redundant and small.