Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2021 | Volume:23 | Issue:9|Papers Count:13

Introduction: Non-Hodgkin's lymphoma in the genital system is uncommon and ovary is one of the most common sites of involvement. Ovarian involvement in non-hodgkin's lymphoma is often secondary and is a part of the systemic involvement. Primary and localized ovarian involvement is uncommon and occurs in less than 10% of cases. In this study, a rare case of primary ovarian non-Hodgkin's lymphoma is presented. Case presentation: The patient was a 64-year-old woman with a history of hysterectomy and postmenopausal bleeding that referred to the academic hospital of Mashhad University of Medical Sciences. On ultrasound and CT scans, solid cystic foci were found between the bladder and rectum, consistent with the location of the cervix and uterus. Subsequent evaluations confirmed histological and immunohistochemical diagnosis of ovarian non-Hodgkin's lymphoma. Conclusion: Ovarian lymphoma is one of the differential diagnoses that should be considered in the pelvic masses.

Introduction: Human chorionic gonadotropin for the final maturation of eggs in the In-vitro fertilization cycle was associated with the possibility of a negative effect on endometrial acceptance, fetal quality and ovarian hyper stimulation syndrome. Replacing it with a gonadotropin-releasing hormone agonist to trigger final ovulation is expected to reduce these effects. Therefore, this study was performed with aim to evaluate the outcome of triggering in in vitro fertilization with antagonist protocol by gonadotropin-releasing hormone agonist, human chorionic gonadotropin simultaneously with human gonadotropin-releasing hormone agonist and human chorionic gonadotropin. Methods: In this randomized clinical trial study conducted in 2015 and 2016, women were divided into three random groups after preparing the follicles for triggering and ovum retrieval. One group received 0. 2 mg of dipherline, the second group received 10, 000 units of human chorionic gonadotropin and the other group received 0. 2 mg of dipherline along with 1500 units of human chorionic gonadotropin. The number and quality of eggs and embryos were the outcomes of the study. Data were analyzed by SPSS software (version 17) and Leven tests and one-way analysis of variance. P < 0. 05 was considered statistically significant. Results: The number of retrieved oocytes in the group receiving gonadotropin-releasing agonist was significantly higher than the other groups (p = 0. 001). More embryos were produced in the gonadotropin-releasing hormone agonist group compared to the other two groups (p = 0. 009). However, the number of high quality embryos produced in the groups was similar. Conclusion: The onset of final oocyte maturation with gonadotropin-releasing hormone agonist significantly increases the number of retrieved oocytes and obtained embryos. However, dual stimulation using low-dose human chorionic gonadotropin (IU1500) and gonadotropin-releasing hormone agonist did not alter quality of embryo compared to the standard dose of human chorionic gonadotropin (IU10000).

Introduction: Mastectomy results in damage to the nerves of chest, also inappropriate long-term positioning during surgery leads to upper cross syndrome. Stretching exercise can be effective in treating this syndrome that there is consensus in the type of exercise; therefore, this study was performed with aim to investigate the effects of eight weeks of stretching exercise on upper cross syndrome in mastectomized women. Methods: This randomized controlled clinical trial study was performed in 2018 on 30 women after mastectomy in Imam Reza Hospital. The subjects were divided into two groups of intervention (performing 24-hour stretching sessions) and control (without any intervention). Frontal, kyphosis, shoulder, and pain angles were measured before and after the intervention. Data were analyzed by SPSS software (version 20) and the ANCOVA and T-test. p < 0. 05 was considered statistically significant. Results: Intervention led to positive and significant effects in the variables of kyphosis (P=0. 003-Control group=39. 01± 03. 41-Intervention group=43. 51± 03. 90), head forward (P=0. 041-Control group=32. 13± 03. 25-Intervention group=29. 91± 02. 98) and pain (P=0. 00001-Control group=65. 02± 11. 93-Intervention group=30. 14± 06. 13) between the two groups. According to the results of ANCOVA, there was a significant difference between the two groups in kyphosis angle (P=0. 003), head forward angle (P=0. 019) and pain (P=0. 003) after exercise. Conclusion: The variables of pain, head angle and kyphosis, which are disabling variables following upper transverse syndrome, were improved by eight weeks of stretching exercises, and the intervention in this study could be useful.

Introduction: Abortion is a common complication of pregnancy. Understanding the factors affecting abortion plays an important role in preventing and improving pregnancy outcomes. Since the relationship between parents' blood group and RH in the incidence of abortion is controversial, this study was performed with aim to investigate the relationship between parents' blood group and abortion in pregnant mothers in Gonabad. Methods: This case-control study was performed in 2019 on 450 pregnant women referring to the sonography clinics of Gonabad in two groups of abortion and healthy pregnancy less than 20 weeks. Blood groups of the subjects and their spouses were evaluated. The tools included a checklist of personal and midwifery information and the use of cell type method (tube method) to determine the blood group of individuals. Data were analyzed by SPSS statistical software (version 20) and Chi-square, independent t-test, one-way analysis of variance and logistic regression. P < 0. 05 was considered statistically significant. Results: According to the findings, the most common blood type in all women was O (case group 30% and control group 63. 33%) and the most common blood type in their husbands (case group 21. 33% and control group 32. 33%). Blood group AB was the lowest blood group in mothers (case group 14% and control group 32. 66%) and fathers (case group 14% and control group 16%) The risk of spontaneous abortion was higher in women with blood type A than other ABO blood groups (p <0. 05). The most common Rh blood group in women was Rh positive (77. 3% in mothers in the case group and 82. 33% in the control group). Also, the most common Rh blood group in fathers was Rh-positive (88% in the fathers of the case group and 6% in the control group). No association was found between abortion and parental RH. ABO blood incompatibility between parents was associated with the risk of spontaneous abortion (p <0. 001). Conclusion: ABO blood incompatibility between parents is associated with the risk of spontaneous abortion. The risk of spontaneous abortion in women with blood group A is higher than in other ABO blood groups. Parental RH is not associated with abortion.

Introduction: Cesarean is one of the most common surgeries in the world. This surgical procedure has complications such as anxiety and intraoperative hemorrhage. Various methods have been suggested to reduce anxiety and intraoperative hemorrhage. One of these methods is music therapy. This study was performed with aims to evaluate the effects of music therapy on intraoperative hemorrhage in patients undergoing cesarean with spinal anesthesia. Methods: This randomized clinical trial research with control group was conducted on 90 patients undergoing cesarean in 2019. The research subjects were divided into the intervention and control groups. Iguana music was played for patients in the intervention group for 15 minutes before and during surgery; then, hemorrhage and hemodynamic parameters were evaluated. Data were analyzed by SPSS software (version 16), and Kolmogorov-Smirnov, Paired t-test, Independent t-test and Chi-square test. P<0. 05 was considered statistically significant. Results: Based on the results, in the intervention group, systolic and diastolic blood pressure, also heart rate significantly decreased compare to before the intervention (p<0. 05). The results also indicated that intraoperative hemorrhage in the intervention group was significantly less than that in the control group (p<0. 05). Conclusion: Music has positive effect on the reduction of intraoperative hemorrhage, systolic and diastolic blood pressure, and heart rate in patients undergoing cesarean. Therefore, music can be suggested as a complementary treatment for the reduction of hemorrhage in cesarean patients to alleviate anxiety.

Introduction: Coronavirus 2019 is an emerging infectious disease. During an outbreak of infectious diseases, pregnant women and their fetuses are at high-risk populations. This study was performed with aim to investigate the maternal and neonatal consequences of pregnant women with COVID-19. Methods: In this descriptive case-series study, all pregnant women referred to Tehran Amir Al-Momenin Hospital for delivery and were suspicious for COVID 19 were examined during March to May 2020. The subjects were sampled, and the maternal and neonatal complications diagnosed by clinical or laboratory symptoms were evaluated. Data were analyzed by SPSS software (version 21) and descriptive statistical methods (mean, standard deviation, number and percentage). Results: The most common symptom of COVID19 in 7 women (100%) in this study was fever. Only 2 women (28. 57%) needed nasal oxygen after delivery, and none of the pregnant women needed assisted breathing device. All patients had high CRP and pulmonary involvement in CT scans. Five pregnant women delivered their infants by vaginal delivery, one of them was preterm labor and one infant had low birth weight. One male infant had asphyxia, and one male infant was dead 5 hours after birth, and two infants were hospitalized with symptoms of COVID 19, although their PCR tests were reported negative. Conclusion: According to the results of the present study, COVID 19 is associated with maternal and neonatal complications.

Introduction: Endometriosis is an estrogen-dependent inflammatory disease. Studies show that in women with endometriosis, the activity of macrophages in the peritoneal cavity increases, resulting in inflammatory reactions and stabilization of endometriosis. This study was performed with aim to investigate the effect of a period of swimming exercise and vitamin E intake on catalase and superoxide dismutase activity, and malondialdehyde levels in ovarian tissue of endometriosis model rats. Methods: In this experimental study, 25 rats were randomly divided into 5 groups; healthy-control, endometriosis, endometriosis+exercise, endometriosis+vitaminE, endometriosis+vitaminE+exercise. To induce endometriosis, ovarian tissue was removed along with part of the fallopian tube tissue and the tissue pieces were grafted to the area of the right pelvic wall. Vitamin E intake was 200 mg / kg. Swimming training was eight weeks and 30 minutes each day. Data were analyzed by SPSS software (version 23) and one-way ANOVA and Tukey's post hoc tests. P < 0. 05 was considered statistically significant. Results: The groups of endometriosis+exercise, endometriosis+vitamin E and endometriosis+exercise+vitamin E showed a significant increase in Superoxide dismutase activity compared to the endometriosis group (P<0. 0001) and endometriosis+exercise+vitamin E group compared to the endometriosis+exercise (P=0. 0013) and endometriosis+vitamin E groups (P=0. 0257). Also, a significant increase in Catalase activity was observed in endometriosis+exercise (P=0. 0036), endometriosis+vitamin E (P=0. 0006) and endometriosis+exercise+vitamin (P<0. 0001) groups compared to the endometriosis group. However, the concentration of Malondialdehyde showed a significant decrease in endometriosis+exercise, endometriosis+vitamin E and endometriosis+exercise+vitamin E compared to the endometriosis group (P<0. 0001). Conclusion: The desired changes in the catalase and superoxide dismutase activity and malondialdehydelevels in the endometriosis process can improve the relative oxidative status of the disease in the animal model; performing the swimming exercises as well as the simultaneous use of vitamin E will help to improve oxidation indices in the animal model.

Introduction: Episiotomy is the most common incision in midwifery to increase the diameter of pelvic outlet. Anzaroot contain flavonoid, saponin, tryptophanes, tannins and other polyphenolic compounds. So it has analgesic properties. This study was performed with aim to determine the effect of Astragalus fasciculifolius (Anzaroot) gel on episiotomy pain severity in primiparous mothers. Methods: This three-blind clinical trial study was conducted on 72 primiparous women referred to Shahid beheshti hospital in Isfahan in 2019. They were randomly divided into two equal groups of experiment (Anzaroot) and control (Placebo gel). Severity of pain was assessed using the visual pain scale (VAS). Data were analyzed by SPSS software (version 16) and Independent Samples T Test, covariance analysis and repeated Measures analysis. P˂ 0. 05 was considered statistically significant. Results: There was no significant difference between two groups in demographic features and obstetric variables (P˃ 0. 05). Before the intervention, no significant difference was observed between two groups in the severity of pain (P=0. 16(. After the intervention, severity of pain in the experiment group was significantly less than the control group (p < 0. 05). Conclusion: Anzaroot gel is more effective than placebo in relieving of episiotomy pain.

Introduction: Early diagnosis of preeclampsia as one of the complications of pregnancy is very important in controlling this disease and preventing further risks for the mother and fetus. Neutrophils to lymphocytes ratio (NLR) and platelets to lymphocytes ratio (PLR) are both inflammatory ratios which can be easily calculated. NLR and PLR were previously tested as predictors of common pregnancy complications, but the results were inconsistent. Therefore, this study was performed with aim to compare neutrophils to lymphocytes ratio and platelets to lymphocytes ratio in women with preeclampsia and normal pregnant women. Methods: This case-control study was performed on 153 pregnant women referred to Ali Ibne Abitaleb Hospital of Zahedan in 2018. Patients were divided into three groups: control, mild preeclampsia and severe preeclampsia. Data were collected using pre-designed information forms. Data were analyzed by SPSS software (version 22) and ANOVA and Tukey tests. p < 0. 05 was considered statistically significant. Results: The ratio of neutrophils to lymphocytes in the preeclampsia group was significantly higher than the control group (P = 0. 008), but the ratio of platelet to lymphocyte was not significantly different between the two groups (P=0. 236). Conclusion: Since the ratio of neutrophils to lymphocytes in the preeclampsia group was significantly higher than the control group, it seems that neutrophils to lymphocytes ratio can be used to predict preeclampsia.

Introduction: Sexual dysfunction is one of the most common disorders in women. So far, researchers have examined various treatments to promote women's sexual health. This study was performed with aim to review the modern pharmacological treatments of female sexual dysfunction in women. Methods: In this narrative review, databases of PubMed, Scopus, Web of Science, SID, Magiran, and Google Scholar were searched up to December 2019 without time limitation using the related keywords. Inclusion criteria were observational, interventional, and review studies that provided the content appropriate to the objectives of this narrative study. Findings were discussed according to thematic classification (treatment of interest / sexual desire disorders, genito-pelvic pain-penetration disorder, and orgasmic disorder). Results: In this study, after the evaluation of 865 studies, finally 63 studies were included in this review. According to the findings of the studies, the existing therapeutic approaches for the treatment of interest / sexual desire disorders including (US Food and Drug Administration-approved: Bremelanotide and Flibanserin, unapproved drugs including Phosphodiesterase 5 Inhibitors, Testosterone) and treatment option for genito-pelvic pain-penetration disorder including (approved by the US Food and Drug Administration: Lubricants, Ospemifene, Prosterone, Elagolix and Botox injection in the research phase), but for orgasmic disorders in women, no drug has been approved. Conclusion: Currently, several drugs approved/unapproved have been used for treatment of sexual dysfunction in women that through different mechanisms such as increased genital blood flow, affecting androgen levels, or the central nervous system's function contributes to improving sexual dysfunction. Furture studies on the field of treatment of female sexual dysfunction are recommended.

Introduction: Demand for egg donors is growing worldwide. Due to the acute shortage of egg donors worldwide and since donors' satisfaction affect their willingness to re-donate, therefore, this study was conducted with aim of a systematic review of studies on donors' satisfaction with egg donation and willingness to re-donate in Iran and the world. Methods: Comprehensive searches were performed in databases of Magiran, SID, Irandoc, Scopus, Pubmed, ISI as well as Google Scholar search engine from 1990 to 2020. To search the studies, Persian and English keywords including: egg, ovum, oocyte, satisfaction, donor, Re-donation and combining these words with AND and OR operators were used. According to STROBE criteria, the studies which scored above 15 were included in the study. Data analysis was performed qualitatively. Results: Out of 63 articles found in the databases, 7 articles which met the inclusion criteria were reviewed. All of these articles were of good or average quality. The results of the studies showed that egg donors evaluated the donation experience positively, so that the level of satisfaction was high and many of them were willing to donate eggs again. Conclusion: Despite the high satisfaction of donors, determining and implementing the methods to improve donor satisfaction leads to better selection and retention of donors.

Introduction: The effects of air pollution on gestational hypertension and preeclampsia have been reported in a number of studies. Exposure to air pollutants is associated with adverse maternal and fetal consequences. In the present study, we conducted a systematic review on the relevant studies with the aim of determining the relationship between air pollution and gestational hypertension or preeclampsia. Methods: In this study, a review systematic was conducted to obtain relevant studies from the English databases Pubmed, Scopus, Web of science, , Cochrane library, Embase from the beginning of 2014 to the end of31 december 2019 with English keywords air pollution, hypertension during pregnancy and preeclampsia with all possible search combinations. Inclusion criteria: Cohort or case control articles, the target population of pregnant women, is considered one of the air pollutants and its relationship with preeclampsia or gestational hypertension. Exclusion criteria: review and meta-analysis, animal and genetic studies The quality of the articles was evaluated using the Strobe checklist. Results: out of 581 articles, 21 articles that had inclusion criteria were examined. 8 studies considered gestational hypertension only, 5 studies considered preeclampsia, and 8 studies both considered outcome. Each of these studies has considered a range of pollutants to be exposed and their relationship to pregnancy inducted hypertension or preeclampsia were investigated. Which had 18 articles good and excellent quality and 3 articles poor quality. 8 studies reported gestational hypertension as outcome, 4 studies reported preeclampsia alone, and nine studies examined both outcomes. Conclusion: The results ofmost studies showned association between gestational hypertension or preeclampsia. While a number of studies have reported conflicting results on the effect of some air pollutants with preeclampsia or hypertension during pregnancy(HDP). Therefore, it is suggested that further cohort or case control studies be conducted in this area, in different countries around the world.