Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2020 | Volume:23 | Issue:5|Papers Count:12

Introduction Polycystic ovary syndrome is a common endocrine disorder in women of reproductive age. This syndrome may affect cognitive function and impair spatial memory. Therefore, this study was performed with aim to evaluate spatial memory in women with polycystic ovary syndrome. Methods This correlation descriptive study was performed in 2013 on 50 women with polycystic syndrome and 50 women without polycystic syndrome who were selected among those referring to specialized obstetrics and gynecology clinics. PCO criterion was used to diagnose polycystic ovary syndrome and Computer Spatial Working Memory Test was used to assess spatial memory. Then the score of spatial memory of the two groups were analyzed by SPSS software (version 21) and independent t-test, Chi-square and Pearson correlation test. p < 0. 05 was considered statistically significant. Results Mean scores of spatial memory test in case and control groups were 0. 52± 0. 88± 0. 39± 06 and, respectively. The difference in cognitive performance between the case and control groups was statistically significant (P <0. 0001) and women with this syndrome had better performance than the control group. Also, spatial memory scores were significantly correlated with age (p = 0. 002), but not significantly correlated with education level (p = 0. 99) and body mass index (p = 0. 38). Conclusion Patients with polycystic ovary syndrome had better spatial memory, but since this capability originates from a pathological process, it does not imply an overall improvement in cognitive function, so, comprehensive follow up of these patients and possible complications of the disease may be necessary.

Introduction Endometriosis is one of the most common chronic diseases in women that can cause infertility. Surgical removal of endometrioma can reduce pain and improve the quality of life of patients, while its effect on fertility is still controversial. This study was performed with aim to evaluate the effect of endometriosis surgery on fertility rate and outcomes in women with endometrioma. Methods This randomized controlled clinical trial was performed in 2017 on 64 women with endometrioma ≥ 4 cm. After random allocation, the intervention group received endometrioma surgery and the control group received expectant treatment. The two groups were followed for six months in terms of fertility. Data were collected using a researcher-made checklist. Data were analyzed by SPSS software (version 20) and independent t-test and Chi-square test. p < 0. 05 was considered statistically significant Results Frequency of pregnancy in the intervention group (76. 6%) was significantly different from the control group (46. 6%) (p =0. 023). Also, the frequency of spontaneous pregnancy was significantly different in the intervention and control groups (95. 7%, N=22 vs. 42. 9%, N=6) (P=0. 001). Conclusion Surgery of endometrium ≥ 4 cm is effective in infertile women and increases the chance of spontaneous pregnancy without other infertility treatments.

Introduction Human Papilloma Virus (HPV) is one of the most common sexually transmitted viruses and the main cause of urogenital tract cancers. Cervical cancer is the fourth common cause of cancer death in women and in more than 90% is associated with a persistent infection with one of the High-Risk HPV types. This study was performed with aim to determine HPV genotypes in DNAs extracted from tissue samples of people suspected to HPV infection. Methods In this cross-sectional epidemiological study, 201 tissue samples were obtained from people suspected to HPV infection that had referred to Dr. Mozaffari pathobiology laboratory for diagnosis in Tabriz from 2016-2019. Viral DNA was extracted using high pure viral nucleic acid extraction kit and genotyping was studied using HPV Direct Flow CHIP Kit. Data were analyzed by Excel software. Results Viral DNA amplification was observed in 45 samples (73%) and considered as HPV-positive. Among them, 8 samples (6%) were infected by high-risk types, 36 samples (34%) by both high & low-risk types and 56 samples (60%) by low-risk types. HPV types 6, 11 and 43 with frequency f 107, 23 and 10, respectively out of 145 people were identified as the most common low-risk types and HPV-18, 39 and 16 with frequency of 23, 11 and 10, respectively were identified as the common high-risk types. Most of the infected women were in the age range of 25-35 years and the age range for men was 35-40 years. Conclusion This study showed that determining the genotypes of HPV is considered as an important step in the management of HPV-infected people, especially people with persistent infection by High-risk types.

Introduction Letrozole and raloxifene are used in female reproductive disease. They have special properties and side-effects. This study was performed with aim to compare the in vitro effects of letrozole and raloxifene on human endometrial stromal cells. Methods This experimental study was performed in 2019 on 16 samples of endometrial biopsy of women with normal menstrual cycles in secretory phase. Endometrial biopsies were digested by collagenase type I. Stromal cells were harvested by using serial filtration of cell suspension through cell strainer (70 and 40 µ m) and ficoll layering. The cells were confirmed by immunohistochemical staining for vimentin. The cells of each biopsy were divided into: control and letrozole, or control and raloxifene. After 15 day, morphological changes and cell viability were determined. Data were analyzed by one way ANOVA and Tukey test. Results Cell viability in control and letrozole 0. 1, 1 and 10 µ M concentration was 14. 7, 7. 8, 5. 6 and 4. 2 ×104 cells, respectively. Cell viability in control and raloxifene 0. 1, 1 and 10 µ M was 21. 8, 12. 9, 9. 1 and 3×104 cells, respectively; the difference was significant (P<0. 05). The morphological changes score of cells were 3. 86, 3. 38, 2. 68 and 2. 08 in control and letrozole groups, and were 3. 98, 3. 77, 3. 72, 1. 18 in control and raloxifene; the difference was significant (P<0. 05). The effect of letrozole and raloxifene on the bioavailability and morphology of endometrial stromal cells was different. Conclusion Letrozole and raloxifene showed anti-proliferative and dose-dependent effects on in vitro human endometrial stromal cells and raloxifene effect was more potent than letrozole.

Introduction Nausea and vomiting and pelvic girdle pain are the most common complaints during pregnancy with unknown causes and similar risk factors. The study in this filed may indicate common features which express their understanding of nature. Therefore, this study was performed with aim to investigate the relationship between nausea and vomiting with pelvic girdle pain during pregnancy. Methods This descriptive study was performed on 148 pregnant women who referred to the clinics covered by Shahid Beheshti University in the northern, eastern and Shemiranat areas of Tehran in 2019. Data collection tools included demographic characteristics form, pelvic girdle pain questionnaire, and Pregnancy-Unique Quantification of Emesis and nausea questionnaire. Data were analyzed by SPSS software (version 24) and descriptive statistical tests and one-way analysis and t-test. P<0. 05 was considered statistically significant. Results Mean score of pelvic girdle pain was 26. 86 ± 13. 30. The results of one-way ANOVA test showed a significant relationship between mean pelvic pain scores at different severity of nausea and vomiting (mild, moderate and severe) (P <0. 003). Conclusion The severity of nausea and vomiting varies with the severity of pelvic girdle pain and as the severity of nausea and vomiting increases, the pelvic pain score increases; there is a synergistic relationship between these two variables. It is recommended that attention be given to this synergistic effect with aim of life quality improvement in planning for prevention, treatment and providing services in prenatal care.

Introduction BATF2 (Basic leucine zipper transcription factor 2) is related to some cancer types, and dysregulation of BATF2 expression is frequently detected in aggressive and metastatic cancers. The expression of BATF2 was revealed to inhibit the development of malignant tumor cells and decreased expression of BATF2 has been correlated to poor prognosis in different cancer. However, the role of BATF2 in breast cancer has been less known. Therefore, this study was performed with aim to investigate the BATF2 gene expression in breast cancer. Methods In this case-control study which was performed in 2016-2018, 40 formalin-fixed paraffin-embedded breast cancer tissues and 40 adjacent non-tumor tissues were evaluated. After total RNA extraction and cDNA synthesis, relative gene expression was accomplished by Real-Time PCR and evaluated by method. Also, the association of gene expression with clinical factors and survival rate was evaluated. Data were analyzed by SPSS statistical software (version 22) and T and ANOVA tests. p < 0. 05 was considered statistically significant. Results BATF2 expression was significantly decreased in the breast tumor tissues compared with the non-tumor tissues (P=0. 0001). Consistent with these results, BATF2 expression was correlated with metastasis and high tumor grade (P= 0. 008 and P=0. 01, respectively). As well as, decreased BATF2 expression showed reduced overall survival when compared to those with high expression (P=0. 03). Conclusion BATF2 plays a tumor-suppressor role in the development of breast cancer. Also, decreased BATF2 expression is associated with the metastasis as well as poor prognosis of cancer. Therefore, BATF2 may serve as a prognostic biomarker and potential therapeutic target for this disease. However, further investigation is needed to validate this claim.

Introduction Increasing natural childbirth and decreasing cesarean section is one of the strategies for improving maternal and neonatal health to achieve the millennium development goals. In order to achieve this goal, health transformation plan and program for promotion of natural childbirth have been developed and implemented in Iran. Therefore, this study was performed with aim to analyze the trend of natural childbirth and cesarean section indicators in order to realize the goals of the health transformation plan in Madaen Hospital, Tehran. Methods In this cross-sectional study, the data of delivery and cesarean section were collected from 2013 to 2017. Changes in the level and trend of natural childbirth and cesarean sections before and after transformation plan were evaluated by independent t-test and regression model of cut-off in STATA software (version 15). Results The trend of natural childbirth after implementation of the plan increased by 0. 685% per month (p=0. 020) and the trend of cesarean section decreased by 0. 749% per month (p=0. 011). In the 3-year period after the health transformation plan, the percentage of natural childbirth increased by 0. 680 per month (p<0. 001) and the percentage of cesarean section decreased by 0. 744 per month (p<0. 001). Conclusion According to the results of the study, implementation of adoption policies was effective in reducing the rate of cesarean section in the private hospital. Therefore, the promotion of natural childbirth in order to implement the transformation plan leads to achieve the goals of improving maternal and neonatal health.

Introduction Cesarean section is the most common surgery in obstetrics and gynecology. Post-cesarean surgical wound infection has irreversible complications. Lack of knowledge about its prevalence has prevented the adoption of preventive decisions in general policies of the health system. Therefore, this study was performed with aim to evaluate the rate of post-cesarean surgical wound infection and its related factors in women referred to Tabriz hospitals. Methods This descriptive cross-sectional study was performed on 315 women candidate for cesarean section in public and private hospitals of Tabriz from 2018 to 2019. Symptoms of surgical wound infection were recorded in post-cesarean section infection questionnaire. Data were analyzed by SPSS software (version 20) and Chi-square, Independent t-test and logistic regression. p < 0. 05 was considered statistically significant. Results 79 participants (25. 08%) had symptoms of surgical wound infection. Investigation of specific and effective risk factors on surgical wound infection indicated that variables such as gestational age (P=0. 041), number of pregnancies (P=0. 019), previous cesarean section (P=0. 009), premature rupture of membrane (P=0. 008), type of cesarean section (P=0. 003), gestational diabetes (P=0. 008) and body mass index (P=0. 005) were significantly different between the two groups. Conclusion Post-cesarean surgical wound infection was observed in 25% of women and its risk factors included gestational age, number of pregnancies and previous cesarean section, premature rupture of membrane, emergency cesarean section, gestational diabetes, and high BMI.

Introduction Cesarean section is considered as one of the most common gynecological surgeries. Pain after cesarean section can cause adverse effects to the mother. This shows the need to pay more attention to complementary therapies to reduce pain. Since prioritizing and evaluating the effectiveness of complementary therapies is of great importance, so this study was performed with aim to compare the effects of foot reflexology and auriculotherapy on pain after selective cesarean section. Methods This randomized controlled clinical trial was performed on 168 cesarean candidates referred to teaching health centers of Rafsanjan University of Medical Sciences in 2018. The subjects were randomly assigned into 3 groups of reflexology, Auriclotherapy and control. Reflexology was performed twice in 24-hour interval and Auriculothera was performed continuously for 24 hours. In the control group, only the researcher was present without intervention. Data collection tools were demographic data form and VAS. Data were analyzed by SPSS software (version 21), and using one-way ANOVA and Tukey Multiple Comparison Test. p < 0. 05 was considered statistically significant. Results Mean pain intensity changes in the foot reflexology group (1. 86± 1. 62) immediately after each intervention were lower than uriclotherapy group (1. 45 ± 1. 98) and the control group (0. 64 ± 2. 08) )p < 0. 001). But in the uriclotherapy group, pain severity in the interval between the interventions was significantly decreased compared to the reflexology group. Conclusion Foot reflexology was effective on immediate and short-term pain after cesarean section, and the effect of uriclotherapy with continuous stimulation of the shenmen point is more gradual and lasting. This reduced the need for analgesic use in the uriclotherapy group compared to other groups. Therefore, these two methods can be recommended to relieve pain in post-cesarean care.

Introduction Delay in episiotomy wound healing is associated with an increased risk of infection; prevention of perineal wound infection is a major component of daily care for mothers. For more quickly healing of episiotomy wounds, low cost, effective, convenient, accessible and acceptable methods are considered by women; medicinal plants are of these methods. Therefore, this systematic review was performed with aim to investigate the effects of medicinal plants on the episiotomy wound healing in Iran. Methods Electronic search was done in databases of Iranmedex, Magiran, SID, Web of Science, Science Direct, Scopus, Pubmed, as well as Google Scholar search engine with Persian and English keywords including: Episiotomy, Wound healing, Perineum, Herbal Medicine, and Medicinal Plants. Combined searches of the keywords was performed using OR and boolean AND operators. The search period was from observation to December 2019. According to the CONSORT 2010 checklist, the studies with a score of ≥ 18 were included in the study. Data analysis was performed qualitatively. Results In this study, 28 clinical trials including 19 types of medicinal plants were studied. According to the results of the studies, most plants were effective in episiotomy wound healing. Conclusion Plants such as as Aloe Vera, Turmeric and Lavender that have anti-inflammatory, antibacterial and antioxidant properties are desirable options for wound healing. Due to insufficient number of articles in some cases and inconsistency in the results of some other articles, we can't definitively comment about these plants. Therefore, for definitive effectiveness of these interventions, further studies with larger sample size are recommended.

Introduction Hydatidiform mole is one of the emergency risks in pregnancy that can threaten the life of women of childbearing age with risk of death. Various studies have reported different risk factors for this disease. One of these factors is nutritional deficiency, especially vitamin deficiencies, which can lead to this condition. Therefore, this study was performed with aim to systematic review of the relationship between the blood level of vitamins in women and hydatidiform mole. Methods In this systematic review study, for finding the related articles, the international databases such as: Web of Science, Scopus, PubMed and Embase, Google Scholar and national databases such as: MagIran, SID, IranDoc and IranMedex were evaluated using the keywords of: "Hydatidiform Mole", "Gestational Trophoblastic Disease", "Molar Pregnancy" and "Vitamin" which were combined with the OR and AND Boolean operators without time limitation. Finally, two researchers independently reviewed the articles for assessment of the quality (by using NOS checklist) and data extraction. Results Finally, 10 articles were included with total sample size of 1134 women. The publication¢ s year of papers was from 1988 to 2018 and all studies were case-control. The findings showed that level of vitamins A, D, E, C, B9 and B12 are associated with hydatidiform mole, so that decreasing of these vitamins leads to molar pregnancy. In most of the studies, there was decreased level of these vitamins in both complete and incomplete molar pregnancy. Conclusion Decreased level of vitamins A, D, E, C, B9 and B12 can increase the risk of molar pregnancy. Therefore, by examining and determining the nutritional deficiencies in women with history of molar pregnancy, we can evaluate the effect and administration of vitamin supplements on recurrence of hydatidiform mole can by designing clinical trials.

Introduction Uterine myoma is a benign uterine mass that its prevalence in pregnancy is 1. 6-10. 7% and is associated with increased risk of obstetric complications and increased rate of cesarean and postpartum hemorrhage. Case presentation The patient was a 34 years old woman, G4L2Ab1, with gestational age of 22 weeks who was hospitalized due to premature preterm rupture of membrane and uterine fibromatosis and large fibroid in cervix which blocked the birth channel. She was candidate for cesarean section and tubectomyand at the time of operation, after opening the abdomen, because possibility of massive hemorrhage, we decided hysterectomy with fetus insitu without incision on the uterus in order to prevention of massive hemorrhage and maternal morbidity (due to the complete parity and the patient's desire to remove the uterus). Conclusion Hysterectomy with fetus insituis one of the methods in cases that uterus has multiple myoma and fetus is nonviable and parity is complete and there is indication for pregnancy termination by cesarean section. This method can be performed to prevent massive hemorrhage, transfusion and maternal morbidity.