International Journal of Women's Health and Reproduction Sciences
Year:2019 | Volume:7 | Issue:4|Papers Count:18

Pre-eclampsia is a major risk factor for maternal and perinatal mortality with an incidence of about 2-8%. Its diagnosis is based on new-onset hypertension and raised urinary protein excretion after 20 weeks of gestation. In the absence of proteinuria, the diagnosis can be made with hypertension together with the accompanying signs or symptoms of significant end-organ dysfunction (1). Therefore, the diagnosis may be difficult and complicated in some cases...

Objectives: Chlamydia trachomatis is globally reported as a pathogenic infection and is the most common bacterial cause of sexually transmitted infection (STI) in most countries. In addition, chlamydial cervicitis and the adverse complications of the first line treatment, namely, azithromycin failure are highly prevalent. Thus, the present study will be conducted to determine and compare the effects of single-dose azithromycin and its combination with moxifloxacin based on syndromic and etiologic methods in the diagnosis and treatment of chlamydial cervicitis. Materials and Methods: This is a study protocol for a randomized clinical trial which will be performed at the Women’ s Clinics and Health Centers in Amol, Iran during 2018. Further, the study will evaluate women with cervicitis complaints, who have a proven case of chlamydial cervicitis through syndromic or etiologic diagnostic methods and meet the inclusion criteria for the study population. Discussion: To the best of our knowledge, this trial will be the first study to explore the effects of single-dose azithromycin in combination with moxifloxacin in the treatment of chlamydial cervicitis. The results of this trial will further reveal the diagnostic value of syndromic and etiologic methods in the diagnosis of chlamydial cervicitis.

Objectives: The aim of this study is to assess the impact of Cinnamomum verum, Mentha spicata, Zingiberene officinal on polycystic ovary syndrome (PCOS) treatment. Materials and Methods: MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Scopus, Web of Science, Google Scholar, ProQuest, Clinicaltrial. gov, and for Persian articles SID, Magiran, Irandoc, and Iranmedex were searched without any time limitation. Results: Thirteen randomized controlled trials (RCTs) consisting 668 women were entered in the meta-analysis. Significant differences in fasting blood sugar (FBS; weighted mean difference (WMD)=-3. 69 mg/dL, 95% CI:-6. 67 to-0. 7, P = 0. 02; 241 participants), fasting insulin (WMD =-4. 53 μ IU/mL, 95% CI:-6. 45 to-2. 61, P < 0. 001; 183 participants), triglyceride (TG; WMD =-17. 97 mg/ dL, 95% CI:-30. 51 to-5. 43, P = 0. 005; 183 participants), total cholesterol (TC; WMD=-14. 60 mg/dL, 95% CI:-22. 93 to-6. 26, P = 0. 0006; 183 participants), low-density lipoprotein cholesterol (LDL; WMD =-16. 58 mg/dL, 95% CI-23. 91 to-9. 24, P < 0. 001; 183 participants), malondialdehyde (MDA; WMD =-0. 25 nmol/ml, 95% CI-0. 41 to-0. 09, P < 0. 002; 124 participants), total testosterone (TT; WMD =-0. 18 ng/mL, 95% CI-0. 27 to-0. 09, P < 0. 001; 116 participants), free testosterone (FT; WMD =-5. 47 pg/mL, 95% CI-8. 34 to-2. 61, P = 0. 0002; 78 participants) were obtained by using cinnamon alone and herbal mixture containing cinnamon in comparison to control. Conclusions: This meta-analysis showed that cinnamon alone and herbal mixture containing cinnamon improve level of FBS, fasting insulin, TG, TC, LDL, MDA, TT, and FT serum level.

Objectives: Breast cancer is known as one of the most common women’ s neoplasms and the Diagnosis and Treatment of cancer has a great effect on women’ s sexual function. Considering the high survival rates of breast cancer, attention to sexual function is very important as a domain in the quality of life. Therefore, this research aimed to review studies on women’ s sexual function using the female sexual function index (FSFI). Materials and Methods: To this end, PubMed, Web of Science, Scopus, and ProQuest databases were considered and Iranian studies on sexual function in breast cancer, which were in Persian or English and used the FSFI tool, were selected in this regard. In addition, these studies were methodologically evaluated and the keywords included “ breast cancer” and “ sexual function” , along with their synonyms. Results: A total of 128 studies were identified out of which 5 cases having the inclusion criteria were selected after reviewing the title, abstract, and quality assessment. The rate of sexual dysfunction in the survivors of breast cancer varied between 52. 5% and 100%. Based on the domains of FSFI, the lack of desire and lubrication dysfunction were the most common disorders while satisfaction with sexual life obtained the highest score. Conclusions: Overall, it is necessary to systemically measure sexual dysfunction after cancer diagnosis and treatment employing an appropriate tool. Finally, effective interventions are required to improve sexual function.

Objectives: The present study focused on tobacco smoke and its effect on semen parameters, sperm DNA quality (compaction and fragmentation) and clinical outcomes after intracytoplasmic sperm injection (ICSI) therapy Materials and Methods: The semen samples were divided according to smoking status into the following 2 groups, 98 heavy-smokers (G1) and 43 non-smokers (G2). Semen was prepared and purified using the PureSperm gradients according to the WHO guidelines 2010. Protamine deficiency (CMA3 positivity) was assessed by chromomycin CMA3 staining and sperm DNA fragmentation (sDF) by TUNEL assay. Results: The mean concentration and the total motility were significantly higher in G2 in comparison to G1 (P = 0. 014, and P = 0. 026 respectively) and the results were similar for the mean percent of the progressive motility and normal morphology (P = 0. 0001). CMA3+ and sDF in G2 were significantly lower in comparison to G1 (20. 35 ± 13. 34% vs. 33. 30 ± 22. 33%, P = 0. 001; 14. 23 ± 13. 07% vs. 26. 68 ± 19. 77%, P = 0. 0001). Meanwhile, there were no significant differences in the ICSI outcomes, except for the pregnancy rate, which was significantly higher in G2 than in G1 (0. 60 ± 0. 49% vs. 0. 38 ± 0. 48%; P = 0. 013). In G1, CMA3+ correlated negatively with sperm concentration (r =-0. 233, P = 0. 021) but positively with sDF (r = 0. 484, P = 0. 0001). In G2, sDF correlated negatively with progressive motility and morphologically normal spermatozoa (r =-0. 304, p=0. 047; r =-0. 361, P = 0. 017 respectively). Conclusions: The findings of this study revealed that tobacco smoking altered sperm parameters and later affected the pregnancy results in ICSI therapy. CMA3 and TUNEL tests are therefore useful as a supplementary test before any ART treatment to ensure a good prognosis.

Objectives: For decades, scholars have debated the benefits of exercise during pregnancy. Birthing ball exercise is the latest among the antenatal exercises which pregnant women commonly perform in Indonesia. Therefore, the current study aimed to investigate whether pelvic rocking exercise using the birth ball is effective in correcting the fetal lie, presentation, and attitude in the late third trimester of pregnancy. Materials and Methods: To this end, pregnant women (n=114) enjoying the inclusion criteria were randomly divided into intervention (who were assigned to perform pelvic rocking using the birth ball) and control (without exercise) groups. Fetal lie, attitude, and presentation before and after the trials were determined in both groups by performing the abdominal palpation of Leopold’ s maneuver. Results: Based on the results, the intervention group showed a higher proportion of fetus with flexed attitude (P < 0. 001) as compared to the control group. In addition, 49. 1% of women in the intervention group indicated longitudinal lie compared to 29. 8% of those in the control groups (P < 0. 001). Finally, 56 out of 57 women in the intervention group demonstrated head presentation whereas only 45 out of 57 women in the control group showed the same presentation (P < 0. 01). Conclusions: Overall, it is suggested that pelvic rocking exercises using the birth balls are useful for maintaining lies, fetal attitudes, and presentations and thus it is worth recommending for pregnant women.

Objectives: Assessment of glycodelin (GD) as a marker for unruptured ectopic pregnancy (EP) in the first trimester of pregnancy. Materials and Methods: This case-control study was conducted during June 2016 to May 2017 in the Obstetrics and Gynecological Department of Baghdad University at Baghdad teaching hospital/medical city complex. In this study, 100 pregnant women in their first trimester of pregnancy were included after clinical and ultrasonic findings. Results: Based on the results, GD levels in EP were significantly lower than those with normal intrauterine pregnancy (1. 58 ± 1. 18 vs. 30. 1 ± 11. 9). In addition, using receiver operator curve analysis, the cut-off GD level of 9. 5 and less had acceptable validity results (100% sensitivity, 100% specificity, 95% positive predictive value, 100% negative predictive value, and accuracy 100%) to predict EP. Conclusions: In general, serum GD is considered as an excellent predictor of unruptured EP.

Objectives: Maternal nutritional behavior before and during pregnancy contributes significantly to improving the outcomes of pregnancy and the health of the newborns after birth. In addition, the theory of planned behavior (TPB) is a proper model for use during pre-pregnancy and pregnancy. Therefore, the present study evaluated the effect of TPB education on nutritional behaviors of overweight and obese women before pregnancy. Materials and Methods: This randomized controlled trial was conducted on 100 overweight and obese women who attended a nutrition unit in Khansar during April-August 2017. A convenient sampling method was used and the samples were randomly divided into intervention and control groups. The intervention group participated in five nutritional training sessions based on the TPB in addition to routine care. Data were collected with TPB and nutritional behaviors questionnaires before, after, and 2 months after education. Finally, the Student’ s t test, Fisher exact test, as well as Mann-Whitney U test, chi-square and repeated-measure tests were utilized for data analysis. Results: Based on the result of the repeated measure test, the overall score of the TPB changed (P = 0. 002) over time and a significant difference was observed between the 2 groups (P = 0. 002). In addition, the result of the repeated measure test indicated that the length of time affects the nutritional behavior score (P = 0. 000) and there was a significant difference between the 2 groups in this regard (P = 0. 000). Conclusions: Considering the effect of training, based on the TPB, on nutritional behavior, the content of this training is suggested to be included in the pre-pregnancy program.

Objectives: The identification of at-risk fetus is considered as one of the most difficult challenges for clinicians and researchers although the clinical significance of placental calcifications (PCs) and its relation to adverse pregnancy outcome are controversial. Therefore, the present study aimed to evaluate the relationship between PC and estimated fetal weight (EFW) percentile at 30-34 weeks of pregnancy. Materials and Methods: This prospective cross-sectional study was carried out on all pregnant women except for multiple pregnancy subjects who were admitted to an outpatient perinatal center from October 2016 to September 2018. Several parameters were measured at 30-34 weeks of pregnancy, including EFW, umbilical artery pulsatility index (PI), middle cerebral artery PI, cerebroplacental ratio (CPR), right and left uterine artery PI, along with right and left uterine artery notch. Finally, the calcification of the placenta with any shape and degree was determined as well. Results: In this study, 739 pregnant women were evaluated for PC, including patients with PC (9. 87%), small-for-gestational age (SGA, 3. 65%), and those with at least one abnormal Doppler index (23. 95%). Patients with PC and those with at least one abnormal Doppler index had significantly higher SGA (29. 62% and 12. 42%, respectively). In addition, there were 55. 55% and 30. 13% patients with SGA and PC in the group with at least one abnormality in terms of Doppler indices. Conclusions: In general, the findings showed that PC is more common in SGA. Based on the results, at least one abnormality in Doppler indices was more common in PC and SGA, and uterine artery Doppler abnormality was the most prevalent abnormal findings in the arterial Doppler. Thus, PC may be an important marker for adverse pregnancy outcomes.

Objectives: The present study aimed to investigate the effect of acceptance and commitment therapy (ACT) on the quality of life of infertile women during the treatment. Materials and Methods: This study was a randomized clinical trial that was conducted on 40 infertile women admitted to the clinics of Arak, Iran. They were selected through a convenience sampling technique and were randomly assigned to intervention (n=20) and control (n=20) groups. The Fertility Quality of Life (FertiQoL) Questionnaire was used as a data collection tool, which was completed before and one month after the intervention. The counseling group was provided with eleven 90-minute sessions of ACT twice a week. Then, the data were analyzed using SPSS 23 through the chi-square test and independent samples test. Results: Based on the results, there was a statistically significant difference between the mean scores of the quality of life in ACT and control groups before and one month after the intervention (P < 0. 05). Conclusions: In general, it seems that ACT improves the infertile women’ s quality of life and this treatment can be used for alleviating the quality of life of these women taking into account the high incidence of infertility.

Objectives: Giving birth is a unique experience that requires a pregnant woman’ s ability to cope with labor pain. Using happiness, this potential can be given to a pregnant woman. This study was performed to compare the effect of muscle relaxation and guided imagery on the happiness and fear of delivery in primiparous women. Materials and Methods: This quasi-experimental study was carried out on a sample 0f 180 primiparous women who referred to healthcare centers in Zahedan during 2017. The subjects were selected by the available sampling method. Then, Brislin’ s and Oxford Questionnaires were used to evaluate the fear of childbirth (FOC) and happiness, respectively. Through simple randomization, people who were qualified were included in relaxation, guided imagery, and control groups. Finally, a four-week training program was implemented for individual training. Results: Before the intervention, the mean scores for the FOC in relaxation, guided imagery, and control groups were 39. 51 ± 6. 91, 44. 00 ± 9. 30, and 41. 56 ± 9. 37, respectively, and after the intervention, they were 30. 45 ± 6. 56, 34. 78 ± 9. 36 and 41. 78 ± 8. 69, respectively. Based on the results, the mean scores of the FOC after the intervention showed a significant difference among the groups (P = 0. 0001). In addition, the mean scores for happiness were 37. 5 ± 15. 54, 34. 54 ± 17. 72, and 36. 78 ± 18. 97, as well as 54. 66 ± 14, 49. 63 ± 17. 05, and 36. 65 ± 18. 28 before and after the intervention in relaxation, guided imagery, and control groups, respectively (P = 0. 0001). Conclusions: To prevent unnecessary cesarean sections, the current study confirmed the effect of muscle relaxation and guided imagery techniques for reducing the fear of delivery while increasing happiness in pregnant women.

Objectives: The aim of this study was to determine the 3-year overall survival among the epithelial ovarian cancer patients based on the histology, age, and the stage of the disease in Iran during 2011-2017. Materials and Methods: This study was a cross-sectional retrospective study that was conducted on 179 newly diagnosed patients with epithelial ovarian cancer, who had referred to the gynecologic cancers clinic in a referral training hospital in Tehran during 2011-2017. The patients’ data including the demographic characteristics of the patients, the stage of the disease, and the treatment type were analyzed based on the pathologic responses. Results: Among 220 newly diagnosed patients with epithelial ovarian cancer, 179 of them were suitable for the follow-up. There were 93 death and 85 living cases among these patients and the mean age of the patients was 50. 5 ± 11. 3. In addition, most of the patients were in stage 3 (60. 9%) and 6. 7% of them were in stage 4. The most common pathology was serous adenocarcinoma (70. 9%). In this study, the overall survival rate had no connection with the type of tumor histology but it was related to the stage of the disease (P = 0. 05). Finally, there was no mortality in stage one and among the mucinous adenocarcinoma cases. Conclusions: The survival in the epithelial ovarian cancer was related to the stage of the disease and among all the pathologies, mucinous adenocarcinoma and clear cell carcinoma had the best survival rate.

Objectives: Cervical cancer can be prevented by identifying the lifestyle and diet. The purpose of this research was to compare lifestyle and nutritional risk in Iranian women with cervical cancer and healthy women who referred to hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran during 2015-2016. Materials and Methods: This descriptive-comparative study was conducted on 120 women referring to hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran during 2015-2016. The data collection tool was a questionnaire that covered data on health-promoting lifestyle profile (HPLP), diet, and demographic characteristics. Finally, data were analyzed by SPSS software, using an independent t test, as well as chi-square and Mann-Whitney tests. Results: Statistical differences were observed between the number of delivery, smoking, and the smoking of the spouse although the difference in HPLP between the 2 groups was insignificant. However, healthy women could better manage their stress and interpersonal relations compared to women who had cervical cancer. As regards diet, fat was statistically different between the two groups (P < 0. 05). Conclusions: In general, a change in lifestyle, diet, reduced smoking can decrease the incidence of cervical cancer in women.

Objectives: The present study aimed to compare the antifungal activities of Teucrium Polium smoke product and nystatin in the treatment of Candida vaginitis in vitro. Materials and Methods: In this quasi-experimental study, 105 subjects were diagnosed with Candida vaginitis. The data were collected through a collection form and the species were isolated by the germ tube, as well as CHROMagar chromogenic and chlamydospore formation tests. Results: Based on the results of the germ tube, chlamydospore formation, and CHROMagar tests, 70. 5%, 23. 8%, and 66. 6% of the species were Candida albicans, respectively. In addition, 99% of the samples were sensitive to nystatin. A significant relationship was also observed between the antifungal drug and the type of organism (P<0. 02). Finally, all the 15 standard clinical samples were sensitive to T. polium smoke. Conclusions: In general, the results confirmed the antifungal effects of T. polium and nystatin on the species isolated from 10 clinical samples obtained from Candida vaginitis as well as on five standard strains.

Objectives: Stress replication to laryngoscopy and intubation are exaggerated in the patient with severe preeclampsia and this stress can lead to an increased risk of maternal mortality and morbidity. The aim of this study was to compare the efficacies of remifentanil and labetalol in attenuating these responses in women with violent preeclampsia undergoing cesarean section (C-section) with general anesthesia. Materials and Methods: In this double-blind study, 70 women with violent preeclampsia undergoing cesarean delivery were randomly assigned to two groups to receive either remifentanil 1 μ g/kg or labetalol 0. 25 mg/kg before the induction of anesthesia. Then, blood pressure (BP) and heart rate (HR) were measured before and 1, 3, and 5 minutes after the intubation. The first and 5th-minute Apgar scores were evaluated as well. Results: All hemodynamic variables decreased in both groups after the administration of remifentanil or labetalol. Labetalol significantly attenuated the rise in BP and HR during laryngoscopy and intubation compared to remifentanil (P < 0. 001). Eventually, no significant difference was found between the Apgar scores of the two groups (P = 0. 97 and P = 0. 19, respectively). Conclusion: Overall, the administration of labetalol before the inspiration of anesthesia can control stress replication to laryngoscopy and shows better intubation and more stability than remifentanil in patients with severe preeclampsia undergoing C-section.

Objectives: Controlling the complications of anesthetics (e. g., succinylcholine) seems necessary since they are greater for nulliparous women who undergo elective cesarean section (C-section). The present study aimed to investigate the effects of magnesium sulfate on the complications of succinylcholine administration in nulliparous women undergoing elective C-section. Materials and Methods: This double-blind clinical trial was conducted on 60 nulliparous women during 2012-2013. The women were randomly assigned to A and B groups. Before inducing the rapid anesthesia with succinylcholine, patients in the intervention group received 30 mg/kg of magnesium sulfate within 10 minutes and then the hemodynamic status and the side effects of succinylcholine were recorded in a special form. Statistical tests were performed using repeated-measures ANOVA, chi-square test, and one-way ANOVA tests and the level of significance was determined to be P < 0. 05. Results: There was no significant difference between the two groups in terms of demographic data (P > 0. 059). However, the results indicated that there was a significant difference between the 2 groups regarding the myoglobin level (P = 0. 010). Contrarily, the results showed that most patients in the intervention (n=23) and control (n=15) groups experienced no or mild and severe fasciculation, respectively (P < 0. 001). Conclusions: In general, magnesium sulfate can greatly control and reduce the complications of succinylcholine administration, including fasciculation.

Objectives: Chlamydia trachomatis, as the main cause of bacterial sexually transmitted disease (STD), can lead to serious complications such as spontaneous abortion. Therefore, the aim of this study was to determine the frequency of C. trachomatis infection in spontaneous abortion of infertile women who referred to Tabriz University of Medical Sciences during the first pregnancy by means of nested polymerase chain reaction (PCR) method in 2015. Materials and Methods: The present descriptive, cross-sectional study was performed in the infertility clinics of Tabriz University of Medical Sciences from March 21, 2015 to March 19, 2016. A total of 120 infertile women were selected by the convenience sampling method. The specimens were prepared by the Dacron swab after four rotations in the endocervix and discharged into the specific transport medium of C. trachomatis. The DNA extraction was then performed by AccuPrep genomic DNA kit and the DNA was extracted until performing the PCR at-20° C. Next, nested PCR was conducted in 2 rounds and the final product of PCR was agar-2% gel electrophoresis. After entering the data in SPSS, the chi-square test was used to examine the role of factors influencing C. trachomatis infection and a P value less than 0. 05 was considered significant. Results: The incidence of C. trachomatis infection in women with spontaneous abortion was 16. 66%. In addition, there was a significant difference between the infected and non-infected groups regarding employment (P < 0. 04), birth control method (P < 0. 03), and the number of sexual intercourses per week (P < 0. 001). Conclusions: The prevalence of C. trachomatis in women who became pregnant with infertility treatment and spontaneous abortion was high in this study. Thus, nested PCR is considered an appropriate method for the diagnosis of C. trachomatis and it is essential for pregnant women who experience pregnancy with infertility treatment.

Objectives: The current study presented a fertility-preserving laparoscopic approach combined with hysteroscopy for the treatment of a uterine arteriovenous malformation (AVM) after a failed uterine artery embolization (UAE). Case Presentation: The patient was diagnosed with acquired uterine AVM and underwent a UAE, followed with the recurrence of massive vaginal bleeding. The computed tomography angiography (CTA) demonstrated AVM neovascularization and the patient profoundly desired to preserve her fertility. Results: The patient underwent a laparoscopic surgery combined with hysteroscopy during which the supply vessels of the AVM were obliterated and a 3-month GnRHa regimen was prescribed accordingly. The follow-up CTA was performed at postoperative day 3 and month 5. Both of the obtained images indicated the remission of the AVM. Thus, the patient remained asymptomatic during a 18-month follow-up after the operation. Conclusions: In general, the laparoscopic obliteration of the supply vessels of the uterine AVM could provide an alternative to hysterectomy in patients whose embolization attempt failed and thus had a fertility-preserving desire.