International Journal of Women's Health and Reproduction Sciences
Year:2015 | Volume:3 | Issue:4|Papers Count:11

Through my research, I have come to understand that women who have undergone a significant body change due to trauma, surgery, or disease find viewing their bodies in a mirror is an emotionally charged, distressing experience. In this editorial, I focus on the experience of viewing self in the mirror postmastectomy, a nursing education intervention gleaned from an understanding of this experience, and this debate: Should we wait on randomized control trials (RCTs) prior to implementing interventions for the mirror experience for those women who will have a mastectomy OR is this a case in which we should abandon the hierarchy of evidence?

Due to its potential harmful effects on the general health and reproductive life of the women, in the light of available literature, it was aimed to review the effect of human brucellosis on women’s health and reproduction. Data from 75 reports belonging to the years 1917 through 2015, obtained via a search on various internet sources by the words “Brucella”, “brucellosis,” “women’s health,” “human pregnancy,” “human reproduction,” “abortion,” “preterm birth,” “intrauterine fetal demise,” and “intrauterine fetal death” were used to characterize basic microbiological features together with the risk factors, clinical presentations and complications of the human brucellosis related to various aspects of reproductive well-being. A high rate of spontaneous abortion was a more consistent finding rather than high rates of preterm delivery and intrauterine fetal death in pregnant women with brucellosis. The occurrence of abortion was not associated with the magnitude of serum agglutination titre or the clinical type of disease. The novel replication profiles of Brucella in human trophoblasts give insights into the pathogenesis of infectious abortion. Brucellosis is a risk factor for women’s general health and reproduction as well as for many obstetric complications during pregnancy, of which spontaneous abortion is the mostly known. In order to prevent the disease and these complications, education of the women, especially the poor ones of childbearing age with low educational level is strongly advised. When the infected women present for medical care, an appropriate antimicrobial therapy should be started promptly.

Objectives: Partner violence affects one in three women worldwide and is linked to higher rates of women’s cancers with increased utilization of health care services. However, evidence of the association between severity of violence and health screening behaviors (i.e., Pap testing, mammography, & clinical/self-breast exams [SBEs]) is scant. The purpose of this study was to identify engagement of abused women in preventive health screening behaviors.Materials and Methods: This was a cross-sectional study of 284 abused women with children. Participants were part of a 7-year prospective study to examine the treatment efficacy of the 2 models most often offered to abused women. At the 24th month interview, data on health promotion behaviors were collected via investigator designed instrument. Both descriptive and chi square analysis were used for data analysis.Results: Abused women were more likely to engage in preventative health behaviors than the general US female population but had a higher incidence of sexually transmitted infections (STIs) and abnormal Pap test results with variance based on race, ethnicity, immigration status, language, and the type of intimate partner violence (IPV) services initiated. Preventative screening was adequate, but there was poor follow-up care for abused women who received abnormal results.Conclusion: Findings suggest urgent need to maintain high rates of screening and initiate better follow-up care. Recognition of the potential co-existence of gynecological infections or cervical cellular irregularities with the experience of partner abuse may lead health care providers to improved diagnosis and treatment for both IPV and abnormal gender-specific health care outcomes.

Objectives: ower genital tract injuries are associated with high maternal morbidity or mortality if severe, poorly managed or delayed in repair. It is a frequent complication of vaginal delivery. The aim of the present study was to determine the prevalence, demographic characteristics and pattern of spontaneous lower genital tract injuries and its relation to parity and place of delivery. Also, to determine the complications of lower genital tract injuries following vaginal delivery managed in UCTH, Calabar.Materials and Methods: This was a retrospective study of women managed for lower genital tract injuries at UCTH from 1 January, 2009 to 31 December, 2014. All women who sustained spontaneous lower genital tract trauma following vaginal delivery were studied.Results: Out of 15 526 total deliveries over the study period, 1413 women sustained lower genital tract injuries, giving a prevalence rate of 9.1%. The most frequent lower genital tract injuries include first degree perineal tear 40.2%, second degree perineal tear 18.3%, peri-urethral tear 14.5% and cervical laceration 11.9%. The prevalence of vaginal lacerations and third/fourth degree perineal tear were highest among primigravida, while cervical laceration was highest among primiparous. The most frequent morbidity observed were anemia (44.8%) and postpartum hemorrhage (31.6%). The maternal mortality of 0.68% was recorded and all were unbooked women who delivered outside UCTH. Conclusion: The associated morbidity and mortality following lower genital tract injury in this study were high mostly among unbooked women who delivered outside the hospital. This can be reduced by health education, uptake of antenatal care and skilled attendance in labor.

Objectives: The aim of this study is to examine the change in body image perception (BIP) and evaluate self-esteem levels during pregnancy.Material and Methods: This study includes totally 180 females having similar demographic features, i.e. 30 non-pregnant (control group) and 50 pregnant women from each trimester (first, second and third trimester groups) at an Obstetrics Outpatient Department of a university hospital. BIP and self-esteem scores have been compared among the groups. Data relating to all participants have been obtained by using socio-demographic data form, body image scale and Rosenberg Self-Esteem Scale (RSES).Results: All demographic features have been found to be similar among the groups. The body mass index (BMI) was higher in the third trimester of pregnancy compared to other groups; whereas BIP was significantly worse in the third trimester group compared to the first trimester and control groups (P<.05). There was a negative correlation between trimesters of pregnancy and BIP (Rho=-0.221; P=.003). Self-esteem was detected at a relatively higher level in first trimester group compared to the second and third trimester groups (P<.05).Conclusion: BIP levels have declined during the pregnancy period and self-esteem has been observed at a higher level in the first trimester compared to the advanced trimesters of pregnancy.

Objectives: Defining the educational needs of women concerning vaginitis and self-care methods aiming at disease treatment is a necessity. This study aimed to determine the educational needs among women at reproductive age with vaginitis in order to design a training program.Materials and Methods: In a descriptive cross sectional study using purposive sampling, 224 non-pregnant, premenopausal, 15-49 years old, and sexually active females complaining from vaginitis were admitted in the 3 gynecology clinics in Tehran, Iran in 2014. Data on educational needs was collected through a questionnaire containing demographic and disease characteristics and the needs assessment sections, which includes 13 topics of educational needs related to vaginitis based on five score in likert scale.Results: The mean age of patients was 32±(6.9). The average of vaginal infection episodes in the preceding year was 2.8±(2.6). The foremost educational need was sexual self-care of vaginitis. Educational needs averages of the disease information and self-care domains showed a significant statistical difference (P<.001). A total of 115 individuals (51.4%) highly needed education based on the total score.Conclusion: Education is highly needed regarding self-care of vaginitis. The educational need regarding sexual relationship self care is more critical than other topics. The needs in the domain of self care are more important than the domain of disease information. We suggest preparing self-care educational package based on needs assessment as a useful tool to help treatment and prevention of disease recurrence.

Objectives: Ovarian cancer is one of the most common causes of cancer related death in women. Diagnostic techniques to detect ovarian cancer in the earlier stages are likely to improve prognosis. The aim of this study is to evaluate a novel serum tumor marker HE4 in comparison with CA125 and the risk of ovarian malignancy algorithm (ROMA) in patient with ovarian malignancy and benign tumors.Materials and Methods: CA125, HE4, ROMA were determined in 33 patients with ovarian cancer and in 67 patients with benign tumors. CA125, HE4 cut offs were 35 U/ml and 70 pM, respectively. ROMA algorithm cut off was 13.1% and 27.7% for pre-menopausal or post-menopausal women, respectively. Data were analyzed by SPSS19 software; and P<0.05 was considered significant.Results: In this study, serum level of CA125, HE4 and ROMA were higher in patients with ovarian cancer than benign tumors (P<.001). Area under the ROC curve for CA125, HE4 and ROMA were 82.4%, 84.01% and 82.4%, respectively. The differences were not significant.Conclusion: The median CA125, HE4 and ROMA serum levels differed significantly between benign and malignant cases. Although the initial reports were promising, measurement of HE4 and ROMA did not increase the detection of malignant diseases compared with CA125 alone.

Objectives: Systemic fungal infection (SFI) is one of the most common causes of mortality, especially in preterm neonates. This fact necessitates the need to pay more attention to the prophylactic role of antifungal therapy in these neonates. The aim of this study was to evaluate the effect of intravenous fluconazole prophylaxis on the clinical outcome of preterm neonates during hospitalization.Materials and Methods: In a randomized, double-blind clinical trial, 93 preterm neonates with birth weight less than 1250 g without any major congenital anomalies were divided into control and case groups. Gestational week, birth weight, history of antenatal antibiotics and steroids administration and central venous catheter usage were recorded. During hospitalization, 3 mg/kg dose of fluconazole was administered for the case group for 6 weeks: in the first 2 weeks every 3 days, in the second 2 weeks every 2 days, and in the third 2 weeks every day; however, the control group did not receive fluconazole. The outcomes, including duration of mechanical ventilation, in-hospital mortality, and duration of oxygen requirement were ultimately recorded. The data from both groups were analyzed using statistical tests and compared to each other.Results: There were not significant differences in both groups in terms of gestational week of childbirth (P=.059), birth weight (P=.342) and antenatal steroids administration (P=.221); while duration of mechanical ventilation, duration of hospitalization and the mortality rate were significantly higher in the control group compared with the case group (P=.002), (P=.011) and (P=.045), respectively.Conclusion: The results show IV fluconazole administration for very low birth weight preterm neonates can improve the prognosis of fungal infection and reduce mortality.

Introduction: Primary hyperparathyroidism (PHP) a rare condition that leads to severe maternal and fetal complications in pregnancy. In this report, we aimed to present the successful conservative medical treatment of PHP diagnosed during pregnancy.Case Presentation: A 32-year-old pregnant woman was referred to our clinic at 14 weeks of gestation with severe vomiting, chronic constipation and proximal muscle weakness. According to the clinical presentation, PHP was diagnosed on the basis of biochemical and ultrasonographic findings. The patient was treated with high fluid intake, low calcium diet, oral phosphate supplementation and intramuscular injection of calcitonin. At 38 weeks of gestation, healthy infant was delivered by cesarean section with mild preeclampsia.Conclusion: Treatment options of PHP, including medical and surgical therapy are debated in the literature. Early diagnosis and effective management may reduce perinatal mortality and morbidity. Although surgical treatment in the second trimester is the definitive therapy, conservative management can be preferred in mild cases of PHP in pregnancy.

Introduction: We describe a patient who had ovarian and endometrial cancer which metastasized to sigmoid colon one year after surgery.Case Presentation: A 53-year-old woman was admitted with the complaints of abdominal pain, abdominal distension and postmenopausal bleeding. Her transvaginal ultrasound scan revealed a cystic mass containing papillary projections with the dimensions of 6.5×5×4 cm on the right ovary. Level of (carbohydrate antigen) (CA) 125 was 223 IU. Dilation and curettage revealed endometrioid adenocarcinoma. Debulking surgerywas carried out. Histopathological diagnosis was grade 2 adenocarcinoma with squamous differentiation for endometrial cancer and grade 2 endometrioid adenocarcinoma with squamous and mucinous differentiation for ovarian cancer. The stage was 1A for endometrial cancer and 1A for ovarian cancer. 12 months after the operation CA 125 level was 112 IU. Positron emission tomography (PET) scan showed a small lesion (1.5×1.5 cm) in the pelvic cavity with increased fluorodeoxyglucose (FDG) uptake. Five months after the chemotherapy, CA 125 level elevated from 10 to 60 IU and subsequent magnetic resonance imaging (MRI) revealed a tumoral mass with the dimensions of 3×2.2 cm. A second laparotomy was performed and the metastasis was excited. The tumor was endometrioid adenocarcinoma with infiltration in the serosa and muscularis propria of sigmoid colon.Conclusion: It is needed to consider the possibility of double cancer in the diagnosis and treatment of gynecological malignancies.

Dear Editor: Infertility has many causes and different pathogenesis, and there are some critical controversies against most of its therapeutic protocols. Some researchers showed that low-dose aspirin (LDA) has positive effect on ovary, fertilization and implantation for users of assisted reproductive technology (ART) such as in-vitro fertilization (IVF); but such researches are not enough and need to be investigated further. As opposed to the mentioned hypothesis, Akhtar et al (1) announced that: “Adjuvant treatment with aspirin and heparin do not improve IVF outcome.”