Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2020 | Volume:22 | Issue:11|Papers Count:11

Introduction: Lack of knowledge about the prevalence of placenta accreta causes unintended complications in susceptible women. Awareness of its prevalence can guarantee the diagnostic and therapeutic methods in susceptible women in future studies. This study was performed with aim to evaluate the prevalence rate of placenta accreta in women candidate for non-emergency cesarean section with previous cesarean section referred to Tabriz women's hospitals. Methods: This descriptive-analytical study was performed during 2012-2016 at Tabriz two hospitals of Al-Zahra and Taleghani with the participation of 310 women candidate for non-emergency cesarean. The individual information including demographic characteristics and disease-related information was included in the researcher-made checklist. Data were analyzed using SPSS software (version 20) and Spearman correlation and regression tests. PResults: 55 patients (17. 74%) had placenta accreta; the variables such as age (P=0. 001), BMI (P=0. 003), number of previous cesarean section (P=0. 002), cigarette smoking (P=0. 036), number of previous pregnancies (P=0. 002), history of myomectomy (P=0. 001), third trimester hemorrhage (P=0. 003), and number of baby during delivery (P=0. 003) were significantly associated with placenta accreta. Conclusion: The prevalence of placenta accreta was 17. 74% in the present study, which necessitates doing precise diagnostic measures to be aware of this complication.

Introduction: Increasing age and receiving chemotherapy are among the risk factors for deep vein thrombosis that have not been studied so far in Iranian society. Therefore, this study was performed with aim to investigate the frequencyof deep vein thrombosis in women over 40 years with breast cancer undergoing chemotherapy referred to Tabriz chemotherapy clinics in 2018. Methods: This cross-sectional descriptive study was performed on 165 women in Tabriz chemotherapy clinics in 2018. Deep vein thrombosis was assessed by the criteria for diagnosis of deep vein thrombosis and those who were at high risk of developing deep vein thrombosis were examined by Doppler ultrasound. Data were analyzed by SPSS software (version 21) and Spearman correlation coefficient and regression. PResults: The mean of deep vein thrombosis was 13. 69± 2. 20 that based on the available checklist, 19 patients (11. 52%) were at high risk for this complication that after Doppler ultrasound analysis, deep vein thrombosis was confirmed in 17 patients (10. 30%). The results of Chi-square test showed a statistically significant difference between the number of chemotherapy sessions and developing deep vein thrombosis (p=0. 001). Conclusion: The prevalence of deep vein thrombosis in the present study was 10. 30% in patients with breast cancer undergoing chemotherapy, which was related to the number of chemotherapy sessions.

Introduction Nausea and vomiting is one of the most common and undesirable side effects of cisplatin and due to the effects of ginger in the treatment and prevention of nausea and vomiting, this study was performed with aim to evaluate the effect of ginger capsule on treatment of nausea and vomiting in patients receiving cisplatin undergoing mastectomy. Methods This randomized clinical trial study was performed on 60 cancer patients in the chemotherapy clinic of Tabriz Shahid Madani Hospital in 2018-2019. The intervention group received ginger tablet 500 mg twice daily from 10th days after chemotherapy and one week before mastectomy. The control group received placebo tablet. Rhodes nausea and vomiting assessment tool was used before the intervention and the day after mastectomy. Data were analyzed by SPSS software (version 21) and Shapiro-Wilk and t-test. P<0. 05 was considered statistically significant. Results The intra-group comparison showed the control group had no significant difference in terms of nausea severity after the intervention (p=0. 119), whereas a significant difference was observed in the intervention group after the intervention (p=0. 001). There was no significant change in vomiting severity in the control group (p=0. 229), while this score was significantly decreased in the intervention group (p=0. 004). Conclusion Ginger capsule is effective in treatment nausea and vomiting in women who have used cisplatin and are going to undergo mastectomy.

Introduction: Regarding to the prevalence of polycystic ovarian syndrome and its complication in women at reproductive age, this study was performed with aim to evaluate the relationship between total testosterone and sonographic findings in two groups of married hirsute women with normal and oligomenohrric mensturation in order to find it as a predictor and diagnostic factor to replace with current methods. Methods: This case control study was performed on 93 hirsute patients in two groups of normal and oligomennohric menstruation in 2017-2018. Ferriman-Gallwey checklist was completed after clinical examination by gynecologist and then the patients were evaluated by vaginal ultrasonography and serum testosterone test. Data were analyzed by SPSS software (version 22) and t-test, Chi-square, Correlation, and regression tests. P<0. 05 was considered statistically significant. Results: The level of total was 0. 02-2. 8 nmol/lit, the mean of testosterone in regular menstruation group was 0. 85 and in irregular menstruation group was 1. 52. In regular menstrual hirsute group, there was significant relationship between hirsutism score in lower abdominal and thigh, and in irregular menstruation group, in lower abdominal and thigh and arm (p<0. 05). In oligomennohric group, direct linear significant relationship was found between Gallwey score and sonographic findings (p<0. 05). In addition, every quantified sonographic markers were checked with age, finally reverse linear relationship was found between mean number of follicles< 6 mm and age which indicates that the number of follicles< 6 mm will decrease with increasing age (p=0. 01) Conclusion: In both groups, the relationship between total testosterone and lower abdominal, thigh and arm hair growth is clear that can be as a predictor factor for total testosterone level. However the sonographic findings are as predictor factor in irregular mensturation patients group.

Introduction: Cardiovascular adaptation in pregnancy is the most important changes related to aerobic training. Heart rate variability is one of the most important cardiovascular health parameters. Pregnancy and training as a kind of stress affect cardiovascular system. However, appropriate research regarding this issue is not enough. Therefore, this study was performed with aim to evaluate the effect of aerobic training on heart rate variability in pregnant women. Methods: This randomized clinical trial was performed on 22 healthy pregnant women in Shahid Akbarabadi hospital of Tehran in 2019. There were 12 healthy pregnant women with gestational age of 24-26 week in the intervention group and 10 healthy pregnant women in the control group. The intervention group participated in 8 week aerobic training with moderate intensity. Time and frequency parameters of heart rate variability were monitored in pregnant women with electrocardiogram lead two and AST3000 Avicenna software. data were analyzed by SPSS software (version 24) and Mann Whitney U, Wilcoxon, fisher, paired t, independent t, and Shapiro-Wilk tests. P<0. 05 was considered statistically significant. Results: Mean of time domain and low frequency parameters were significantly higher in pregnant women who had trained at 34th week of pregnancy than pregnant women in the control group (p<0. 05). While, no significant changes were observed in mean of time domain and low frequency parameters in control group (P>0. 05). Conclusion: Aerobic training improves autonomic nervous system and parasympathetic nervous system superiority.

Introduction: Vasomotor symptoms such as hot flashes and night sweats occur in the near-menopausal stage and thereafter and affect women's quality of life. This study was performed with aim to determine the factors related to the severity of vasomotor symptoms using structural equation modeling in women of Mashhad. Methods: This cross-sectional, descriptive-analytical study was performed in 2017 on 664 women aged 42-60 years old in Mashhad. Information about hot flashes, night sweats, depression, anxiety and cognitive impairment were measured through MSSI-38 questionnaire. Demographic data as well as nutrition and life events questionnaires were completed for participants. Data were analyzed with weighted least squares estimation method in Structural Equation Modeling using SPSS software (version 16) and Mplus (version 6. 12). P Results: The frequency of hot flashes was moderate in 109 women (%16. 40), severe in 84 (%12. 70) and very severe in 98 (%14. 80). The frequency of night sweats was moderate in 88 women (%13. 30), severe in 72 women (%10. 80) and very severe in 93 women (%14. 00). There was significant relationship between life events (p=0. 025), anxiety (p=0. 013), disease (p=0. 005) and menopause status (p<0. 001) with vasomotor symptoms. Conclusion: Participation in training and counseling sessions on reducing stress and increasing women's self-efficacy, controlling underlying diseases by early visiting a specialist, exercising, mobility and improving economic status can be effective in reducing vasomotor symptoms.

Introduction: Breast pain is one of the most common complaints of mothers in postpartum period. Breast engorgement is a major cause of breast pain in the first days after delivery. Reflexology induces deep muscle relaxation, thereby stimulating blood and lymph circulation in cells, releasing endorphins and controlling pain. This study was performed with aim to evaluate the effect of foot reflexology on the severity of breast pain due to breast engorgement in lactating mothers. Methods: This clinical trial study was performed in 2018 on 80 lactating mothers during the first to fifth days after delivery who had breast engorgement in Mashhad Health Center No. 1. Subjects were divided into two groups of foot reflexology and routine care. The severity of breast pain was determined by visual analogue scale and the subjects who scored 2 out of 10 on this scale entered to the study. The intervention group received foot reflexology once a day for 3 days and control group received routine care. Data were analyzed using SPSS software (version 24) and paired t-test, independent t-test, Mann-Whitney, Chi-square and ANOVA tests. P <0. 05 was considered statistically significant. Results: Mean severity of pain after the intervention decreased in both reflexology and control groups. There was a significant difference between the two groups in mean of pain intensity. So that pain severity was significantly decreased in the reflexology group than the control group (p <0. 001). Conclusion: Foot reflexology leads to more reduction in the severity of postpartum breast pain than routine care. Therefore, reflexology is recommended in the management of postpartum breast pain.

Introduction: Vaginitis is the most common problem of gynecological diseases. Among the types of vaginitis, Candida is the second most common cause of vaginitis in women. Diabetes is known to be a leading cause of vaginal fungal disease. Conventional treatment of Candida infection is clotrimazole vaginal cream. But this drug has the side effects including redness, burning, vaginal irritation and rash. Antifungal and hypoglycemic effects of Salvia Officinalis extract have been demonstrated in laboratory and clinical studies. This study was performed with aim to compare the effect of Salvia Officinalis vaginal cream with clotrimazole vaginal cream on treatment of Candida vaginitis in diabetic women. Methods: This randomized clinical trial study was performed on 68 patients with vaginal candidiasis in Mashhad in 2018-2019. 34 patients were placed in Salvia Officinalis and 34 in clotrimazole group. Vulvovaginal candidiasis was diagnosed by clinical symptoms and wet test, and culture in Sabrouraud dextrose agar. Vaginal Salvia officinalis cream and the Vaginal Cream Clotrimazole were administered one applicator every night for 7 nights. Follow-up was done 1 ± 7 days later. Data collection was done by the checklist of individual information and recording the signs and observations. Data were analyzed using SPSS software (version 21), and independent t-test, Chi-square, Mann-Whitney, McNemar and Wilcoxon tests. P<0. 05 was considered statistically significant. Results: There was statistically significant difference in Salvia Officinalis discharge in the salvia group compared to clotrimazole group (p <0. 001). Whereas the other improving symptoms such as irritation of the vulva (P = 0. 0317), itching (P = 0. 093), burning (P = 0. 383), post-couital pain (P = 0. 067) were not significantly different between two groups. Conclusion: Both Salvia Officinalis and clotrimazole cream improved clinical symptoms of Vulvovaginal candidiasis, and treatment effects of these two drugs are similar.

Introduction: Hemorrhoids is one of the most common problems during pregnancy. Lifestyle modification recommendations are associated with patients' noncompliance. The potential therapeutic properties of coconut oil on hemorrhoids have been suggested, but its scientific evidence has not been reported, therefore this study was performed with aim to determine the effect of coconut oil ointment on hemorrhoids symptoms in pregnant women. Methods: This randomized clinical trial was performed on 60 pregnant women referred to comprehensive health services centers in Mashhad in 2018-2019. The subjects were randomly divided into intervention and control groups. In the intervention group, one applicator of coconut oil ointment was applied twice a day for two weeks; they also received lifestyle modification recommendations. The control group only received lifestyle modification recommendations based on national guidelines. The improvement of hemorrhoids symptoms was measured on the first, seventh and fourteenth days using Visual Analog Scale (pain, prolapse, itching and overall score of hemorrhoid symptom). Data were analyzed using SPSS software (version 16) and Mann-Whitney, Independent T and Friedman tests. P<0. 05 was considered statistically significant. Results: The mean score of pain, prolapse, itching and overall score of hemorrhoid symptoms in coconut oil ointment group significantly decreased compared to the control group (p<0. 05). In the intra-group evaluation, in the coconut oil ointment group, the pain score measured by day was significantly different (p<0. 001) but in control group this difference was not significant (p=0. 050). Conclusion: Coconut oil ointment is effective in improving the hemorrhoids symptoms, therefore it is recommended for pregnant women with hemorrhoids grade 1 and 2.

Introduction: Although virginity has been accepted as an undeniable value in most societies, however, self-request virginity testing is skeptical, so this review study was performed with aim to investigate the attitudes, approaches and consequences towards this test. Methods: In this review study, databases of SID, Iranmedex, Magiran, ProQuest, Pubmed, Ovide, ScienceDirect, EBSCO, MD Consult, Cochrane library, Scirus, Google scholar and WHO, UNFPA websites were searched by using the keywords of virginity testing, Self request, Ethical aspect since 1970-2018. The language for search was English and Persian. Results: Self-request virginity testing is generally done due to social and cultural pressures and has been criticized by many human rights associations following personal, social, and political consequence. The World Health Organization (WHO) has recognized it as violence against women. In Iran, virginity test is religiously prohibited (Haram), and self-request virginity testing is in contrary with providing services with respect and few clauses of Iranian patient’ s right charter. Self-request virginity testing is performed despite of all these mentioned. Conclusion: Virginity testingis more social outcome than being a medical examination, and along with the policies of WHO, not only virginity test is contrary with professional behaviors, Iran patients’ rights charter, and Iranian constitute, but also it is prohibited according to Shiaat religious leaders. However, the dominant approach is a sort of negligence policy in this regard. According to the findings of this study, proper approach to virginity testing needs cooperation among responsible organizations and specialist in medical, judicial, law, religious, and social affairs.

Introduction: Sclerosing stromal tumor (SST) is a rare tumor of sex cord stromal tumor. Regarding to specific clinical, historical and hormonal feature, it has been differentiated from sex cord stromal tumor. In this study, a rare case of ovary sclerosing stromal tumor is reported. Case presentation: A 37-years-old woman with history of one pregnancy, one normal delivery and 3 months amenorrhea referred to physician and was evaluated. Sonography showed a solid cystic mass in right adnexa, intraperitoneal free fluid and normal tumor marker, and was admitted in Emam khomeini hospital, Tehran university of medical sciences with possible diagnosis of malignancy and underwent open surgery. The mass was released from the tissue around the ovary and was sent to frozen section pathology. She underwent right salpingo oophorectomy according to the possibility of stromal sclerosing tumor. Conclusion: Solid masses with intraperitoneal free fluid are considered as the cases of differential diagnosis of ovary malignant tumor, but some benign tumors such as SST could present with malignant feature in sonographic pattern, it is suggested to do limited surgery with preserving ovary before excessive surgery and sending the sample to frozen section and pathology confirming of benign tumor based on ovary sclerosing stromal tumor.