JOURNAL OF OBSTETRICS GYNECOLOGY AND CANCER RESEARCH
Year:2025 | Volume:10 | Issue:4|Papers Count:12

Background & Objective: Clear cell carcinoma (CCC) is an uncommon subtype of ovarian cancer, with inherent resistance to common chemotherapy agents. Glutathione peroxidase 3 (GPX3) is one of the important mechanisms of cell defense against cell damage signals. Recent studies have suggested that suppression of the GPX3 gene increases sensitivity to Cisplatin chemotherapy drugs against ovarian clear cell carcinoma (OCCC). The present study was conducted with aim to evaluate glutathione peroxidase 3 protein expression in clear cells and other ovarian carcinomas by immunohistochemistry. Materials & Methods: Patients with the diagnosis of ovarian carcinoma, who were referred to the pathology department of Imam Khomeini Hospital, were included. Immunohistochemical staining for GPX3 was performed on the paraffin blocks. The intensity and percentage of the marker were evaluated. Results: A total of 76 patients, including 31 CCC, 33 high-grade serous carcinomas (HGSC), 10 endometrioid carcinomas, and 2 low-grade serous carcinomas were examined. The mean age of the patients was 52.06 ± 11.4 years. The mean age in the CCC group (49.9±9.6 years) and in the non-clear cell carcinoma (NCCC) group (53.5±12.5 years) was not significantly different (P=0.1). Most of the patients in the CCC group were stage 1 (63%), while in the NCCC group, most of the patients (61%) were in stage 3 (P=0.000). After immunohistochemical staining, no protein expression was seen in any of the CCC and NCCC tumoral samples. Conclusion: Immunohistochemistry is not a sensitive method to evaluate GPX3 protein expression. Studies in this field should be done by molecular or serologic evaluations.

Background & Objective: Clinical use of uterine artery (UtA) Doppler ultrasound imaging requires reference values, however despite the common use of UtA Doppler examination during pregnancy, to the best of our knowledge, there is no such range for Iranian pregnant women. Therefore, the present study was conducted aimed to investigate uterine artery Doppler indices in Iranian normal pregnancies. Materials & Methods: This observational longitudinal study was conducted on 486 low-risk pregnant women. The amount of plausibility index (PI) and resistance index (RI), as well as the presence of diastolic notch was assessed in weeks 11 to 14, 17 to 24, and 27 to 32 through Doppler ultrasound. Results: The bilateral notch for gestational age of 11 to 14 weeks was detected at about 6%, for gestational age of 17 to 24 weeks was 4.2% and for gestational age of 27 to 32 weeks was 3.6%. Reference intervals for mean uterine artery PI according to gestational ages showed a significant difference between different percentages (p<0.001). Also, there is a significant relationship between the mean uterine arteries PI/RI and the presence or absence of pregnancy complications (IUGR, premature birth, IUFD) among the participants. Conclusion: The results of this research showed a significant relationship between PI and pregnancy complications, while this was not detected in RI and diastolic notch. These results are relatively consistent with the findings of researchers in other countries.

Background & Objective: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy. Materials & Methods: This study used a cross-sectional design on 81 eligible patients with ovarian neoplasms who were undergoing surgery at the Dr. Wahidin Sudirohusodo Hospital and its networking hospital from October 2021 to June 2022. The ELISA technique was used to measure serum IL-6 from the peripheral vein. In addition, the CA-125 levels, risk of malignancy (RMI) index, and proportion of blood cells were analyzed. Chi-square analysis of the data had been used. Results: Most of the subjects were presented as malignant ovarian neoplasms (66.7%), followed by benign ovarian neoplasms (33.3%). IL-6 level ≥ 3.75 pg/mL was found in 72.8% of patients. In individuals with epithelial ovarian neoplasms, IL-6 levels did not significantly differ between malignant and benign types (p > 0.05). CA-125 levels, RMI, ascites, and tumor size differed significantly in patients with ovarian epithelial neoplasms between malignant and benign types (p <0.05). Leukocyte levels, hemoglobin levels, platelet levels, age, parity, and age of menarche were not significantly different in epithelial ovarian neoplasm patients between malignant and benign types (p > 0.05). Conclusion: The preoperative serum IL-6 level cannot be used as a marker of ovarian malignancy. However, this study confirms the relationship between the CA-125 level, RMI, ascites, and tumor size with the malignancy of ovarian tumors.

Background & Objective: The objective of this research was to investigate the influence of post-surgical vaginal radiofrequency on life quality and sexual function, using a control group for comparison. Materials & Methods: This clinical trial enrolled women with recurrent POP who underwent surgery at Imam Khomeini Hospital in Tehran, Iran, between November 2022 and July 2023. Patients were divided into an intervention group, which received vaginal radiofrequency treatment post-surgery, and a control group, which received radiofrequency treatment in silent mode. Both groups completed the Pelvic Floor Distress Inventory-20 (PFDI-20) and Female Sexual Function Index (FSFI) before surgery and five months post-surgery. Data analysis was performed using SPSS software, with a p-value of less than 0.05 indicating statistical significance. Results: The research encompassed a total of 60 participants, evenly split between the control group (age 56.16 ± 9.94 years) and the intervention group (50.70 ± 10.57 years). Statistical analysis showed no significant differences between the two groups in terms of demographic data, cough test results, and POP-Q test results, indicating similarity (P > 0.05). However, the intervention group, which received post-surgery radiofrequency treatment, showed a significantly greater reduction in PFDI-20 scores and a higher increase in FSFI scores than the control group (P<0.001). Conclusion: The results suggest that the application of radiofrequency treatment post-surgery led to more pronounced enhancements in PFDI-20 and FSFI scores compared to the group that was not subjected to this treatment. Consequently, it can be inferred that radiofrequency is a secure and efficacious approach for the repair of the pelvic floor.

Background & Objective: Women with multiple sclerosis (MS) suffer from a wide range of complications. The present study was conducted with aim to compare sexual dysfunction (SD), depression, and sexual quality of life in women with MS and women without MS. Materials & Methods: This cross-sectional study was conducted on 54 women with MS and 108 women without MS in Sina hospital affiliated to Tehran University of Medical Sciences in 2019. All participants were asked to fill valid and reliable versions of BDI (Beck Depression Inventory), FSFI (Female Sexual Function Index), and SQOL (sexual quality of life) questionnaires. Data were analyzed using SPSS software (version 23). P<0.05 was considered statistically significant. Results: The two groups of women with MS and those without MS were significantly different regarding the mean scores for BDI, SQOL, and orgasm and satisfaction domains of FSFI. Sexual quality of life (SQOL) had a significant positive correlation with FSFI (r=0.568, P<0.001) and a significant negative correlation with BDI scores (r=-0.528, P<0.001).  Considering SQOL as a dependent variable and age, education level, marriage duration, husband’s age, and BDI and FSFI scores as independent variables, linear regression analysis showed that education level, BDI score, and FSFI score were independent predictors of SQOL in all participants; while among MS patients, only BDI and FSFI were significant predictors of SQOL. Conclusion: Sexual quality of life and sexual function should be considered in women with MS, and depression should be assessed and treated as a possible risk factor.

Background & Objective: Melatonin plays a role in pubertal development and reproductive function through the hypothalamus-hypophysis-gonadal axis. In addition, melatonin production decreases with aging, so that indolamine could be an anti-ageing agent. The present study was conducted with aim to investigate the role of intra follicular melatonin level in ovarian reserve and IVF cycle outcomes. Materials & Methods: This prospective and cross-sectional study was conducted from April 2022 to April 2023. Patients on a mini-long agonist, short agonist, and antagonist protocols were enrolled in the study. Using ultrasound, follicle development was observed from the stimulation day until the hCG day (done every 2 or 3 days). Results: Melatonin levels were positively correlated with oocyte retrieved (r=0.705, P<0.001), number of fertilized oocyte (r=0.68, P<0.001), number of zygotes cleaved (r=0.660, P<0.001), high quality embryos (r=0.591, P<0.001), embryos for transplantation (r=0.604, P<0.001), percent of high quality embryos (r=0.58, P<0.001), and percent of blastocyst rate. Conclusion: Melatonin mean levels in follicular fluid significantly decreased in poor response than in standard and high response. The follicular fluid melatonin levels were associated with each oocyte quantity and quality and can expect ICSI consequences and act as highly important biochemical indicators of ovarian reserve.

Background & Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH). This study was conducted with aim to assess the impact of enoxaparin, an LMWH, and its outcomes in women with URPL. Materials & Methods: This single-blinded randomized clinical trial study was performed on 80 women with URPL and no history of thrombophilia. The participants were referred to the Infertility Clinic at Imam Reza Hospital (Milad Center) between March 2018 and February 2019. At the sixth week of gestation, the participants were assigned randomly to two groups (n=40 in each group). The treatment group received a daily subcutaneous injection of 40 mg of enoxaparin, while the control group received routine pregnancy care. Maternal and neonatal demographic data, pregnancy outcomes, complications, and live birth rates were recorded and subsequently compared between the two groups. Results: There was no significant difference between the two groups in previous pregnancies or miscarriages, and the live birth rate was about 85% in both groups. The occurrence of pregnancy complications was significantly higher in the treatment group compared to the control group (38.2% vs. 5.7%; P=0.021). Conclusion: Treatment with enoxaparin in women with unexplained recurrent pregnancy loss and no history of thrombophilia did not improve the pregnancy outcome nor decrease pregnancy complications.

Background & Objective: Platelets are an important component of the body’s hemostatic mechanism and play a vital role at every stage of pregnancy, including, placentation, pregnancy maintenance, and control of bleeding after parturition. Thrombocytopenia, defined as a platelet count lower than 150,000/mcl, is the second most common hematological condition after anemia, which complicates 10% of pregnancies. Gestational thrombocytopenia often found in the third trimester as an incidental finding is a self-limiting condition without any clinical presentation and recovers after delivery. Pathological thrombocytopenia as seen in preeclampsia, HELLP syndrome, acute fatty liver of pregnancy, DIC, drugs, etc. is associated with adverse pregnancy outcomes. This study is aimed to assess feto-maternal complications in pregnancies complicated by thrombocytopenia according to etiology. Materials & Methods: This study was done prospectively for one year in 100 pregnant women with thrombocytopenia. Clinical course: Mode of delivery along with perinatal and maternal complications were noted. Results: We found 66% of women with low platelets have gestational thrombocytopenia, 20% with pre-eclampsia and HELLP syndrome, 7 % with chronic hypertension, 5% with dengue and 2% with AFLP. The maternal complications were postpartum hemorrhage, placental abruption, and wound hematoma. Fetal complications were low birth weight, stillbirth and NICU admission. Most complications were seen with preeclamptic women. Conclusion: The most common cause of low platelet count in pregnancy is gestational thrombocytopenia. Feto-maternal complication rates in Gestational thrombocytopenia are significantly low when compared to the groups where thrombocytopenia is associated with Pre-Eclampsia, Eclampsia, HELLP Syndrome, AFLP, Dengue Fever and Chronic hypertension.

Background & Objective: Antiemetic that prevents nausea and vomiting for ovarian cancer patients during chemotherapy, have major effects on the quality of life and adherence to patients’ treatment. This study aims to study the effectiveness of antiemetic in improving ovarian cancer patient’s quality of life using Functional Living Index Emesis (FLIE) scale.Materials & Methods: A cross-sectional study, data collection by total sampling method from 31 patients who received chemotherapy with emetogenic level 5 and were given antiemetic as Chemotherapy Induced Nausea and Vomiting (CINV) in the obstetrics and gynecology ward and one daycare service room at tertiary referral hospital X in Padang city, West Sumatra Indonesia. FLIE score was measured at 3 different measurement times, before chemotherapy administration, acute phase, and delayed phase.Results: The FLIE score before chemotherapy administration was 6.94, acute phase 6.09, and delayed phase 4.88.  The highest FLIE score is 7 which indicates no nausea or vomiting, while the lower FLIE score suggests the more severe nausea and vomiting experienced by the patient. Bivariate test with a Kruskal-Wallis in the acute phase obtained a value of P>0.05, implying there is no difference in the average FLIE score of patients in the acute phase and in the delayed phase obtained a value of p≤0.05 which means there is a difference in the average FLIE score in the delayed phase among patients based on the antiemetic given.Conclusion: The antiemetic given has not been effective in maintaining a good patient quality of life, especially in the delayed phase.

Background & Objective: Breast cancer is the leading cause of female cancer death in Iraq, where participation in screening is low despite awareness programs. Female primary care providers do promote breast cancer screening even with minimal training, time, and cultural limits. These challenges should be overcome to enhance screening and improve public health. This study was conducted with aim to examine the attitudes and behaviors of primary care female physicians regarding breast cancer screening. Materials & Methods: This cross-sectional study was conducted among 100 female physicians in Babylon Province, Iraq, at primary care centers from November 1 to December 1, 2024. We collected the three-part questionnaire, which included socio-demographics, attitudes, and habits, through personal interviews and Google forms. A 15-doctor pilot study clarified the questions. Results: In this study, 69% of female primary health care physicians had a "poor to average" attitude related to breast cancer screening, with statistical significance related to their age, experience, marital status, and number of pregnancies. Younger and single physicians who tend to have fewer pregnancies and less experience and had a better attitude and practice, showing a significant correlation between positive attitudes and better screening practices. MBChB physicians had better screening attitudes than family medicine specialists, and there was a need for targeted interventions to improve attitudes and practices. Conclusion: The current study found substantial differences in breast cancer screening attitudes and behaviours among female primary care providers. Younger, less experienced and single physicians and those with an MBChB had better screening attitudes. Targeted training and awareness initiatives can improve attitudes and practices.

Uterine myoma is benign tumor of the uterus enlarges during pregnancy, with incidence   0.1 – 10.7%. Uterine myoma in pregnancy is always interesting to learn, in terms of the effect of myoma in pregnancy or the effect of pregnancy on myoma. Reporting  24-year-old  woman with a large intramural uterine myoma  was referred to hospital at 36 weeks of gestation  and  the baby's head haven’t entered the pelvic inlet because it was blocked by that  large myoma , then  decided to  do a cesarean section. We also did a myomectomy after a cesarean section due to a large myoma that could block the uterine subinvolution with the risk of postpartum hemorrhage. An elective cesarean myomectomy was performed at 38 gestational ; the outcome was  baby boy  3340 g and a large fibroid (12 cm) followed by insertion of IUD intra uterine cavity to prevent adhesion. With proper examination and planning during pregnancy, myomectomy after cesarean section will give safe.

Necrotizing fasciitis, a rare and potentially lethal infection, is characterized by rapid and progressive involvement of the fascia and subcutaneous tissues. Here, we reported a 55-year-old woman with a history of recent surgery with complaints of erythema and foul-smelling discharge from the surgical incision site. The surgical incision site was opened, and cleaned with a sizable sterile normal saline, and the patient underwent ceftazidime, levofloxacin, metronidazole, and vancomycin. According to the results of microbiological cultures, non-albicans candida and its resistance to fluconazole, caspofungin, were substituted. However, necrotizing fasciitis increased. The rapid recognition, aggressive surgical intervention, and targeted antimicrobial therapy collectively played a pivotal role in successful recovery. The rapid recognition, aggressive surgical intervention, and targeted antimicrobial therapy collectively played a pivotal role in successful recovery. This case underscores the importance of vigilance in monitoring postoperative patients, particularly those with risk factors, and highlights the need for a multidisciplinary approach.