International Journal of Women's Health and Reproduction Sciences
Year:2018 | Volume:6 | Issue:1|Papers Count:16

Editorial:Over the next few years, it is anticipated that the number of operations for pelvic organ prolapse (POP) and related pelvic floor disorders will increase substantially as a result of aging of the population (1). Nowadays, roughly, 1 out of every 10 women undergoes surgery for urinary incontinence or prolapse. When we also consider 30% risk of reoperation during their lifetime, it is obvious that surgical treatment of POP has an important impact on a women’ s health...

As a unique preventable cancer, invasive cervical carcinoma is the second most common cancer among the women in developing countries. Change in women’ s lifestyle, worldwide spread of HPV infection and women’ s lack of effective education and screening programs in less developed countries constitute the most important factors for its high incidence and mortality rate. From a diagnostic perspective, atrophic smears may be interpreted as positive malignant smears in postmenopausal and occasionally in premenopausal women. However, rarely a high grade or malignant smear might be rendered as the atrophic smear. For this reason acquaintance with atrophic smears and their diagnostic challenges should be included in pathology and cytotechnology training courses. In this review, usual pattern of atrophic smears and differential diagnosis of atrophic smears along with mimics will be presented for decision making and particularly avoiding overdiagnosis.

Objectives: The failure of oocyte morphological assessment to predict in vitro fertilization (IVF) outcome has led the researchers to examine biochemical criteria of follicular fluid (FF). Anti-Mullerian hormone (AMH), an important marker of ovarian reserve, is secreted by the granulosa cells. The aim of this study is to investigate the relationship between the FF (AMH) levels and oocyte, embryo quality, fertilization, and clinical pregnancy. Materials and Methods: The FF (AMH) levels of 61 patients (mean age: 33. 72 ± 4. 82 years; range: 21 to 42 years) were analyzed. The FF (AMH) levels were measured by the quantitative auto-analyzer with an electro-chemiluminescence assay. Results: The FF (AMH) levels in patients under 35 years of age were higher in pregnant women than non-pregnant ones (P<0. 01). Conclusion: Our study results showed that the FF (AMH) levels were correlated with the quality of oocyte and embryo and were the predictors of clinical pregnancy in patients younger than 35 years of age.

Objectives: Despite significant global decline in neonatal mortality, the rates are still unacceptably high in sub-Saharan African countries. One of the common and preventable causes of neonatal mortality is neonatal infection with group B streptococcus (GBS) microorganism. This study aims to determine the prevalence of anogenital colonization by GBS bacteria among HIV positive women, factors influencing colonization and the antimicrobial sensitivity in women attending antenatal clinic in our center. Materials and Methods: This was a prospective study conducted at the antenatal clinics of University of Calabar Teaching Hospital (UCTH), Calabar. A total of 84 eligible and consented HIV positive women and 84 HIV negative women that were within 35 to 37 weeks of gestational age matched for age and parity were studied. Results: Eighteen subjects tested positive to GBS infection with overall prevalence of 10. 7%. However, 13 (15. 5%) subjects with HIV infection tested positive to GBS infection and that was significantly higher compared with 5 (6. 0%) among women without HIV infection. The prevalence of GBS infection was significantly higher among subjects with primary education (54. 5%). Among HIV positive subject, there was significantly higher prevalence of GBS infection among concordant couples compared to discordant couples (P = 0. 04). Most of the subjects were sensitive to ceftriaxone (88. 9%) and erythromycin (72. 2%), and drug sensitivity was least with ampicillin (16. 7%). Conclusion: Anogenital colonization with GBS is high among pregnant women in our center and significantly higher among HIV infected subjects. Preventive approach to GBS colonization is a worthy measure and there is need to institute GBS screening among high risk pregnancies such as HIV infected women.

Objectives: Premenstrual syndrome (PMS) is one of the psychosomatic problems related to women› s reproductive function, which is associated with emotional and mood symptoms such as anger, anxiety and irritability. The current study aimed to compare the effect of Melissa officinalis capsule and care educational programs on the intensity of physical, mental and social aspects of PMS in high school girls. Materials and Methods: This study was a randomized, placebo-controlled trial which was conducted on 200 high school girls with PMS who were randomly allocated into 4 groups in Shiraz. The first group received 600 mg of M. officinalis essence daily from the first to the end day of their menstrual cycle for 3 consecutive cycles; the second and third groups received care educational program and placebo respectively, and the last one was the control group. The data were analyzed using paired t test and Repeated measures analysis of variance (ANOVA). Results: The results of repeated measures ANOVA test revealed a significant reduction in 3 determined times, pre-intervention, one and 2 consecutive months after the intervention (P < 0. 001), in the intensity of physical, psychological and social aspects of PMS symptoms, and this varied in different groups (P < 0. 001). The extent of changes varied over time and in different groups, so, the control and placebo groups had the least symptom changes over the time Conclusion: Melissa officinalis capsule and care educational programs were much more effective in reduction of the severity of physical, mental and social symptoms of PMS compared to the control and placebo groups.

Objectives: This study was done to explore the sexual experience of women after hysterectomy. Materials and Methods: This is a qualitative study done by the use of content analysis method. The research community includes women with the experience of hysterectomy who were admitted to the treatment centers or private clinics in the west of Mazandaran province, Iran in 2016. Purposeful sampling was applied and the single face-to-face interview with 20 participants was the method for data gathering. Interview guide was used as the research tool; then the interviews were analyzed according to the Granheim and Lundman method. Results: The data has been classified into 4 main categories of “ hysterectomy as a decaying or renewing process in sexual relationship” , “ sexual ability with no womb” , “ limitations of seeking help” and “ perceiving the need for comprehensive supports” . Conclusion: Psychological interviews for exploring the fear of sexual behavior and consulting with peer groups or psychological consultation for couples before hysterectomy can help in clarifying the surgery side-effects and decreasing the fear. Mental and economical support from family members, following the treatment up and advanced supports like exploring sexual needs, screening the problems, educating couples on sexual affairs and rebuilding the self-image can be helpful in creating a stress-free sexual life for this group; besides, presenting treatment solutions like vaginoplasty or on time appropriate treatment of sexual problems is also recommended.

Objectives: Since pain management is an important concern in childbirth. This study was designed to evaluate the effects of nitrous oxide in comparison with lidocaine in terms of pain relief, during episiotomy repair in primiparous women. Materials and Methods: In this prospective randomized controlled trial, 120 pregnant women were recruited. The intervention group received nitrous oxide 2 minutes before starting episiotomy repair, until the end of the procedure. The control group received 5 mL of lidocaine (2%) before starting the episiotomy. The results of 2 groups were compared with regard to the pain intensity using a visual analog scale (VAS). Mann-Whitney, student’ s t test, and chi square test were used to analyze the data. Results: Sixty women were studied in each group. Nine participants (15%) in nitrous oxide group, as opposed to 23 (38. 4%) in lidocaine group, had moderate, severe or extremely severe pain (P = 0. 005). In terms of satisfaction level, there was no significant difference between 2 groups (P = 0. 713). Conclusion: The results of this study showed that pain intensity in the nitrous oxide group was significantly lower than that in the lidocaine infiltration group. Application of nitrous oxide at least 2 minutes before repair may be an effective method for pain management in episiotomy repair.

Objectives: Mother’ s milk is very complex biologic liquid for babies. It is strongly recommended that babies be fed exclusively by mother’ s milk for the first 6 months of baby’ s life and be continued until she is 2 years old. The mothers’ self-efficiency is the main factor to predict the breastfeeding duration. Therefore, regarding the significance of instructing mothers and its effects on breastfeeding efficiency, this research was conducted to investigate the effects of pregnancy care instruction at home on the breast-feeding efficiency of first-time pregnant women. Materials and Methods: In this clinical proficiency research, 65 first-time pregnant women, in their last 3 months of pregnancy, who referred to the clinics related to Shiraz medical school, were studied in 2 groups of treatment and control. The research instruments were 2 questionnaires, one of which contained demographic characteristics and the other one was Breastfeeding Self-Efficacy Questionnaire developed by Dennis. Six sessions of educational programs were conducted for the treatment group at home (3 sessions in the last 3 months of pregnancy and 3 sessions in the first, second, and sixth weeks after delivery). Meanwhile, a questionnaire on breast-feeding self-efficacy was filled out and analyzed in both groups. Results: Both groups were the same in demographic variables. Variance analysis test showed that there was a significant difference in the mean scores of breastfeeding self-efficacy between the 2 groups (P < 0. 001). Conclusion: Instruction of pregnancy care (at home), focusing on feeding by mother’ s milk, is effective in increasing the efficacy of mother’ s breast-feeding.

Objectives: Infertility is a stressful condition influencing interpersonal and social relationships among infertile couples. Various strategies have been suggested for coping with infertility. This study examined the effect of the collaborative infertility counseling model on coping strategies in infertile women undergoing in vitro fertilization (IVF) in an urban area of Iran. Materials and Methods: This clinical controlled trial was conducted on 60 women with primary infertility selected from Milad Infertility Center in Mashhad, Iran. They were randomly allocated to the intervention and control groups with 29 and 31 samples in each group. The intervention group received individual counseling based on the collaborative reproductive healthcare model. The counseling was provided with the collaboration of a midwife, a gynecologist and a clinical psychologist in 5 sessions during a 2-month period. The control group received only routine care. The fertility problem inventory (FPI) and general health questionnaire were used to measure perceived fertility-related stress and general health, respectively. Moreover, the ways of coping-revised questionnaire was used to collect data regarding the women’ s coping strategies at the beginning of the study and at the day of the embryo transfer. The student t test, Fisher exact test, Mann-Whitney U test and analysis of variance (ANOVA) were used for data analysis. Results: A statistically significant difference was reported between the two groups in terms of problem-focused coping strategies (P = 0. 037). However, no statistically significant difference was reported between the groups with regard to emotion-focused coping strategies (P = 0. 947). There were statistically significant differences between the 2 groups in the mean scores of seeking social support (P = 0. 022) and planful problem-solving strategies (P = 0. 045) as the subscales of problem-focused coping strategies. Conclusion: The collaborative reproductive healthcare model promoted the use of problem-focused coping strategies. Therefore, the use of collaborative counseling approaches by healthcare professionals is suggested for assisting infertile women to cope with infertility.

Objectives: This study intended to compare the serum magnesium level in women with preterm labor, with its level in women with normal pregnancy of the same age, and assess the relationship between serum magnesium level and response to magnesium sulfate (MgSO4). Materials and Methods: Forty women aged 18-40, with gestational age of 26-32 weeks and signs of preterm labor, and 40 women in similar age and gestational age with normal pregnancy were included in this study. Case group received betamethasone 12 mg in 2 separate doses with 24-hour interval. MgSO4 was administrated (in dose of 4 mg), and continued by 2 mg/h. Once the tocolytic therapy goal was achieved, the administration of MgSO4 continued for an additional 12-hour. Results: The mean age, gestational age, gravidity, parity, number of live born children, number of dead children, miscarriage, and molar pregnancy were similar in 2 groups. The mean of serum magnesium level showed a significant difference between 2 groups. In the case group, 27 patients showed positive therapeutic response to MgSO4; the difference between the mean of serum magnesium level in these 27 patients and the other 13 patients who did not respond well was significant. The serum magnesium level < 1. 85 mg/dL as a cut-off point had 85% sensitivity and 78% specificity with CI = 0. 75-0. 97 in predicting response to MgSO4 in the case group. Conclusion: Serum magnesium level can be used as a predictive tool for preterm labor. It can help in preterm labor in selecting patients who benefit from MgSO4 as a tocolytic agent. Magnesium supplementation may be helpful in patients with decreased serum magnesium level to prevent preterm labor.

Objectives: This study intended to evaluate the effect of 3 exercise programs on reducing symptoms of primary dysmenorrhea among some Iranian school girls. Materials and Methods: This randomized clinical trial study was conducted on 70 students aged 15-18 years with primary dysmenorrhea. They were randomly assigned into 4 different groups: stretch group (n = 19), massage group (n = 19), combined group (n = 21), and control group (n = 19). To evaluate the effect, the treatment was applied as 8 weeks of physical activity, 3 sessions a week, twice a day, 10 minutes for massage group, 20 minutes for stretching group and 20 minutes for combination group and without exercise for control group on primary dysmenorrhea. Moreover, to measure the intensity and severity of pain McGill’ s questionnaire were used. Results: The results revealed that performing a regular physical activity led to a significant reduction in the severity of dysmenorrhea pain (P < 0. 05), Pain Rate Index (PRI ) (P < 0. 05), visual analog scale (VAS) (P < 0. 05), present pain intensity (PPI) and total pain according to McGill’ s short form questionnaire (TP) (P < 0. 05), and volume of bleeding (P < 0. 05) in the 3 groups. Conclusion: The results of this study indicated that lifestyle modifications including some physical activities would decrease the quality and quantity of pain in primary dysmenorrhea such as duration and intensity of pain.

Objectives: Pregnancy-related anxiety is a risk factor for poor outcomes. The aim of this study was to validate the Farsi version of the Anxiety Scale for Pregnancy (ASP) in a sample of Iranian women. Materials and Methods: After translation and back-translation of the ASP, the content validity ratio (CVR) and the content validity index (CVI) of each item were calculated based on the opinions of a panel of 10 experts. Four hundred pregnant women in the third trimester of pregnancy completed the Farsi version of the ASP. For discriminant validity, we compared the ASP mean scores of women with low and high levels of childbirth fear. Confirmatory factor analysis (CFA) was performed to investigate construct validity of the scale. Results: No item had CVR and CVI scores less than 0. 62 and 0. 8, respectively. The results of the CFA for the ASP were unsatisfactory for the proposed 5-factor model (RMSEA = 0. 087, SRMR = 0. 092, chi-square/df = 4. 03, CFI = 0. 87, and GFI = 0. 91). After removing item 9, satisfactory CFA results were obtained and the structural model fit was confirmed (RMSEA = 0. 066 (CI [0. 053, 0. 078]), SRMR = 0. 069, chi-square/df = 2. 71, CFI = 0. 93, GFI = 0. 95). Cronbach α coefficient for the 13-item ASP was 0. 703. The scale showed moderate correlations with the Spielberger State-Trait Anxiety Inventory (STAI) and Childbirth Attitudes Questionnaire (CAQ) scores (0. 61, 0. 59, and 0. 57, respectively) and could differentiate well between women who preferred cesarean and those requesting vaginal delivery. Conclusion: The present study confirmed the content validity and construct validity of the Farsi version of the 13-item ASP for women in the third trimester of pregnancy.

Objectives: Introduction: Review of articles point out that the route of delivery may cause oxidative stress. Since management of labor is of great importance for healthy childbearing, the present study was performed to compare cesarean section (CS) and normal vaginal delivery (NVD) through Entonox inhalation in terms of oxidative stress indices in mode of delivery. Materials and Methods: Sixty women undergoing CS and 60 women undergoing painless labor using Entonox gas were included in the study after obtaining a written informed consent. Three tests including lipid peroxidation, total thiol molecules (TTMs), and ferric reducing ability of plasma (FRAP) assay were performed. To this end, venous blood samples (5 mL) were obtained from the mothers at the end of the second stage of labor or after surgery. The same indices were measured for 5 mL of blood sample taken from the umbilical artery of the infants. Descriptive (means) and analytical (independent t test) tests were employed for data analysis. Results: Mean maternal lipid peroxidation level in the CS and Entonox groups were 5. 798 ± 4. 210 and 5. 105 ± 2. 892 nmol/mm, respectively (P = 0. 544). TTMs were 0. 2846 ± 0. 2632 and 0. 2656 ± 0. 2437 mmol/mm in the CS and Entonox groups (P = 0. 687). Moreover, mean scores of FRAP were 0. 766 ± 0. 516 and 1. 057 ± 0. 626 nmol/mm in the CS and Entonox groups, respectively (P = 0. 007). However, oxidative stress indices of the infants were not different between 2 groups (P > 0. 05). Conclusion: Since total antioxidant capacity in the CS group was lower compared to the Entonox group, it seems that maternal antioxidant defense decreases. Thus, Entonox can be used safely from the perspective of oxidative stress indices.

Objectives: Heart diseases are among the most common diseases, subjecting the maternal and fetal life to risks, causing complications for both mothers and babies. Despite medical and surgical progress made in the heart diseases, coronary artery diseases are still the second cause of the mortality and significant disability, as well as the low efficiency in the women over 40 years of age; also, they are the leading cause of mortality in the women over 65 years old. This study was conducted to investigate the prevalence of heart diseases in the pregnant women. Materials and Methods: This study was a descriptive cross-sectional conducted on the pregnant women with heart problems using the census method from September 2015 until September 2017. After data collection, they were analyzed using SPSS version 17. Results: The findings of the present study showed that dyspnea (28. 1%), cardiac palpation (32. 7%) and hypertension (11. 7%) were the most common causes of pregnant women’ s referral to obstetrics clinics. Also, most cardiac problems were associated with valvular problems (24. 3%) and heart failure (18%). The average age of the patients was 28 ± 9 years. Conclusion: Heart diseases are very dangerous during pregnancy, but its progression and complications in the mother and the fetus can be prevented by treatment and continuous, as well as, a complete care during pregnancy and before delivery.

Objectives: Considering the importance of breastfeeding and positive role of the quality of life (QoL) of mothers in it, we intended to investigate QoL predictors. Materials and Methods: This cross-sectional study was conducted on 547 eligible breastfeeding mothers with infants, aged between 2 and 6 months, referred to health centers in Falavarjan, a city in Iran. Participants were selected randomly. The socio-demographic questionnaire and QOL Inventory of the World Health Organization (WHO) were completed through interview. The multivariate linear regression analysis was carried out to investigate the relationship of QoL with socio-demographic characteristics. Results: The mean score (standard deviation) of QoL was 67. 6 (13. 7) from a range between 0 and 100. According to the multivariate linear regression analysis, the variables of mother’ s age, spouse’ s age and job, economic status, gestational age at delivery, gravidity, tendency towards pregnancy, breastfeeding history, and breastfeeding training had relationship with QoL. Conclusion: Considering that the effects of socio-demographic factors on QOL in breastfeeding mothers can be moderated, it seems that the QOL of such mothers can be improved through extensive planning and supportive strategies by family and society.

Objectives: Premature birth and subsequent admission to the neonatal intensive care unit impair the mother-infant attachment process. The present study aimed to determine the impact of developmental care on the mother-child attachment at the adjusted age of 1 year. Materials and Methods: In a quasi-experimental study, 105 premature infants born in Al-Zahra hospital of Tabriz at a gestational age of 26 to 32 weeks and a weight of 1500 g or less were assigned to three groups of 35. The control group, intervention group 1, and 2 received routine care, developmental care in the neonatal intensive care unit (NICU) and neonatal unit, developmental care in the delivery room or operation room, respectively. The mother-child attachment at the adjusted age of 1 year was measured using Maternal Postnatal Attachment Scale. Results: The mean (standard deviation) score of the mother-child attachment at the adjusted age of 1 year in the control group, intervention group 1 and 2 was determined to be 83. 8 (6. 9), 81. 7 (5. 7), and 81. 4 (6. 7), respectively. The results indicated no significant difference between the three groups in terms of the score of mother-child attachment and its subscales. Conclusion: In this study, high score of the mother-child attachment was observed in all three groups. Given the importance of developmental care and support to mothers of premature infants as well as the newness of developmental care in Iran, it seems necessary for authorities to pay more attention to this type of care and conduct further research on this subject.