Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2020 | Volume:23 | Issue:7|Papers Count:12

Introduction: Given the high prevalence of low back pain in pregnancy and the increase in pain intensity in women with a history of low back pain in previous pregnancies and the recommendation of not to use analgesics in pregnancy, this study was performed with aim to investigate the effect of four weeks of physical exercise in water on the severity of low back pain in pregnant women with previous history of pregnancy low back pain. Methods: This randomized controlled clinical trial study was conducted with participation of 80 pregnant women with pregnancy low back pain and previous history of pregnancy low back pain at Tabriz University of Medical Sciences in 2019. In addition to lifestyle modification, the intervention group performed stretching and strengthening exercises for 16 session of 1 hour in the water, and the control group was only encouraged to improve their lifestyle. The Qubak questionnaire and demographic information were used before and after the intervention for all participants. Data was analyzed by SPSS software (version 20) and Clomogrov-Smirnov and dependent T-test. P <0. 05 was considered statistically significant. Results: At the end of the intervention, the intensity of pain in the intervention group (23. 45± 03. 56) was significantly lower than the control group (77. 15± 13. 03) (P=0. 001); on the other hand, in the intervention group, the intensity of pain at the end of the study (23. 45± 03. 56) was significantly reduced compared to the beginning of the study (73. 19± 11. 42) (P=0. 001). While in the control group, no significant changes occur after the intervention (77. 15± 13. 03) compared to before it (74. 36± 12. 23) (P=0. 419). Conclusion: Four weeks of physical exercise in the water could reduce the severity of low back pain in pregnant women with a history of low back pain; these movements are recommended for pregnant women.

Introduction: Production of science is the most rational and credible index of countries' scientific rank and position. This study was performed with aim to evaluate the scientific products of the abortion field among the organization of Islamic cooperation countries. Methods: This descriptive-analytical study was performed with scientometrics approach. By searching the Web of Science, all documents (n=4028) on abortion field was extracted from1973 to 2018. Through the Global Innovation Index, data needed to measure the development index and evaluate the scientific progress of Islamic countries were obtained. Excel software was used for data analysis. Results: Based on the results, Turkey, Iran and Egypt ranked first to third based on the number of scientific products, frequency of citations and Hirsch index among Islamic countries. Nigeria, Kazakhstan and Iran rank first to third in terms of self-citation. Iran, Turkey and Tunisia ranked first to third in the ranking of Islamic countries on the basis of scientific progress index. Conclusion: Iran's scientific products in the field of abortion among Islamic countries is favorable in terms of the number of scientific papers, scientific products growth, number of citations, Hirsch index and scientific progress index, but in terms of self-citation and citation per document, it requires more effort by researchers to achieve the desired position.

Introduction: Frozen section (FS) is a valuable method with high sensitivity and specificity which allows the surgeon to choose a suitable therapeutic plan in a short time. High cost and inaccessibility are the most important limitations of this method in many pathology laboratories. Touch imprint (TI) is a rapid and inexpensive method in this field. This study was performed with aim to compare the frozen section and touch imprint methods for intra-operative differentiation of benign and malignant ovarian tissues. Methods: In this cross-sectional study which was performed in 2012, 45 ovarian tissue samples which had been sent to the pathology department of Mashhad Ghaem hospital were evaluated by three methods of frozen section, touch imprint and permanent paraffin. Data analysis was performed using SPSS statistical software (version 16) and cross tab test. P less than 0. 05 was considered significant. Results: Accuracy of FS and TI were 97. 8% and 84. 4%, respectively. Sensitivity and specificity was 95. 7% and 100% for FS and was 69. 6% and 100% for TI. Moreover, Positive and negative predictive value was 100% and 96. 6% for FS and was 72. 7%% and 75. 9% for TI. Conclusion: FS is a sensitive and specific method for evaluation of malignancy tissues. TI alone cannot be replaced by this method, but if FS was not accessible, IT could be used as a rapid method for intraoperative evaluation of tissue samples.

Introduction: Aneuploidy screening before birth is essential prenatal care for all pregnant women, regardless of maternal age. Prenatal screening allows prenatal treatment of the fetus and proper pregnancy management. This study was performed with aim to determine the adverse pregnancy in pregnant women with positive aneuploidy screening at first and second trimester or combination of them. Methods: This cohort study was performed on 423 pregnant women from April 2017 to June 2019. Demographic, fertility, and laboratory data were recorded from the prenatal file or maternal self-report during prenatal care receiving, and then, the pregnant women were placed in two groups of women with positive and negative serum aneuploidy screening in terms of adverse pregnancy outcomes. Data were analyzed by SPSS software (version 23), and Chi-square, T-test and crude and adjusted logistic regression. P < 0. 05 was considered statistically significant. Results: In this study, 423 pregnant women in terms of adverse pregnancy outcomes were placed in two groups of pregnant women with positive and negative serum aneuploidy screening. Mean age in the positive and negative serum aneuploidy screening groups were 33. 08 ± 5. 77 and 29. 54 ± 5. 85, respectively (P = 0. 001). The incidence of abortion, preeclampsia, intrauterine growth restriction and NICU admission was higher in screen-positive group compared to screen-negative group. The crude odds risk ratio of adverse pregnancy outcomes in screen-positive women (OR = 1. 87 (1/15-3/03) P = 0. 04 and adjusted risk odds after controlling for maternal age, body mass index and parity was OR = 1. 79 (1. 09-2. 96) P = 0. 02. Conclusion: Adverse pregnancy outcomes are higher in women with positive aneuploidy screening. Further studies are needed to determine the sensitivity and specificity and accuracy of positive aneuploidy screening.

Introduction: Intra Uterine Device (IUD) and Depo-medroxy Progesterone Acetate (DMPA) are effective contraceptive methods that their usage may not be continued due to the occurrence of side effects. This study was performed with aim to evaluate the weight changes in DMPA compared to IUD users. Method: This retrospective cohort study was performed in 2017 on 150 IUD consumers and 150 DMPA users. Samples were collected from 34 health centers in Tehran by simple random sampling. Baseline weight) W1), 6 months (W2) and then 12 to 18 months (W3) after IUD and DMPA usage was measured. Data were analyzed by SPSS software (version 20). Independent t-test was used to compare the weight difference between the two time stages and repeated measures test was used in three time stages. p < 0. 05 was considered statistically significant. Results: Baseline weight in IUD group was significantly higher than DMPA group (P=0. 003). After 6 months, weight gain reversed in two groups and mean difference between W2-W1 showed significant increases in DMPA group in comparison of IUD users (P˂ 0. 001). Also, 12-18 months later, mean difference between W3-W1 indicated significant weight gain in DMPA users than IUD consumers (P˂ 0. 001). Weight gain during 12-18 months in DMPA users was about 2 Kg. Repeated measure analysis showed significant differences between two groups during time (P˂ 0. 001). DMPA usage (P= 0. 0001, B=2. 39) and Cesarean delivery (P= 0. 029, B=0. 72) were two significant factors on weight gain. Conclusion: Weight gain, albeit small is one of the complications of DMPA usage that should be considered.

Introduction: Pregnancy is associated with mental and physical changes in fathers expecting a child. Being aware of the signs and early diagnosis of the syndrome is essential for accepting fatherhood role and appropriate support of the wife during pregnancy. This study was performed with aim of psychometrics analysis of the Persian version of Couvade Brennan Syndrome questionnaire in fathers expecting a child. Methods: This methodological study was conducted in 2018. The Couvade-Brennan Syndrome questionnaire was translated into Persian using forward-backward translation after obtaining permission from its designer. After confirming the face and content validity, the final Persian version was filled by 200 fathers expecting child who met the inclusion criteria referred for antenatal care of their pregnant wives. Confirmatory and exploratory factor analysis was used to confirm construct validity of the tool. Its reliability was confirmed via Cronbach’ s alpha and test-retest. Results: The results of exploratory factor analysis revealed two factors of physical signs and mental signs with 13 items for each factor. These factors explained 49% of the whole variance of answers. Goodness of fit indices in confirmatory factor analysis suggested the two-factor model had the best goodness of fit for the data. Given the cut-off point of 1. 5 for item impact, face validity of all items was confirmed. Content validity ratio and Content validity inde were 0. 64 and 0. 92, respectively. Cronbach’ s alpha of whole questionnaire was measured as 0. 85 and the intraclass correlation coefficient was 0. 88. Conclusion: The results of psychometrics analysis of Persian version of Couvade-Brennan syndrome questionnaire showed acceptable reliability and validity of this tool for diagnosing of Couvade syndrome in father expecting a child.

Introduction: According to the protective role of Nesfatin-1’ s in obesity, this study was performed with aim to investigate the relationship between serum Nesfatin-1 with mothers' anthropometric indices at 18-24 months postpartum in terms of mode of delivery. Methods: This nested case-control study was performed on 42 pregnant women with gestational age of 28-32 weeks who had referred to the Mahdieh hospital in Tehran for prenatal care in 2014. Serum Nesfatine-1 levels were measured during 28-32 weeks of gestation and 24 hours after delivery using ELISA method. Then, the subjects were divided in two groups of case (natural vaginal delivery) and control (cesarean section). Anthropometric indices were measured two times in the third trimester of pregnancy and then 18-24 months after delivery. Data were analyzed by SPSS software (version 20) and Chi– Square, linear regression, Spearman, Wilcoxon Signed-Rank Test, and Mann-Whitney U test. P<0. 05 was considered statistically significant. Results: Serum level of nsafatin-1 after cesarean delivery had negative significant correlations with BMI at third trimester of pregnancy (P = 0. 001, r =-0. 66), postpartum follow-up BMI (P = 0. 004, r =-0. 59) and postpartum weight retention (P = 0. 05, r =-0. 42). Serum nesfatin-1 was a significant independent predictor of postpartum follow-up BMI (P <0. 01). Serum nsafatin-1 had no significant relationship with weight gain during pregnancy and anthropometric indices in NVD group (P> 0. 05). Conclusion: It seems that lack of increase of Nesfatin-1 after elective cesarean section will predispose the mother to obesity in the distant future in postpartum period.

Introduction: Recurrent pregnancy loss (RPL) is defined as the repeated occurrence of 2 or more miscarriages before 20th week of gestation. RPL is a multifactorial disorder and genetic defects are considered as one of the major risk factors for recurrent miscarriage. Regarding to the effective role of p73 gene in the process of primary blastocyst division and protection of germ cells, it seems that rs4648551 polymorphism in this p73 gene be associated with the occurrence of spontaneous abortion symptoms. This study was performed with aim to evaluate the frequency of this polymorphism between two groups of Iranian women with idiopathic recurrent miscarriage and healthy women. Methods: This descriptive case-control study was performed in 2015-2016 on 90 patients with history of 2 consecutive idiopathic recurrent spontaneous miscarriages compared to 110 healthy women who had at least two successful pregnancies as controls. DNA was extracted by RGDE procedure and genotyping was performed by Tetra ARMS technique. Data were analyzed by SPSS software (version 22) and Chi-square test. p < 0. 05 was considered statistically significant. Results: In SNP rs4648551(A

Introduction: Genital wart virus (HPV) is the most common sexually transmitted disease. The need to develop preventive education to avoid HPV in different communities has been considered. Due to the need to develop comprehensive health promotion programs for vulnerable women, including prevention programs, vaccination inoculation and early diagnosis, the present study was conducted to determine the effect of perceived benefits and barriers to HPV vaccination in vulnerable women. Methods: This randomized controlled clinical trial study was performed as a pretest-posttest in 1397 on 64 vulnerable women in welfare centers in Isfahan. Women were divided into intervention and control groups. Training on perceived benefit structures and barriers (using the Health Belief Model) regarding the intention to inoculate human papilloma vaccine was performed during 4 training sessions in the intervention group. Research units were evaluated before, immediately and 6 weeks after the test with a researcher-made questionnaire. Data analysis was performed using independent t-test, Mann-Whitney and Chi-square. The tests were performed at an error level of 5% using SPSS software (version 22). Results: The analysis of data showed that in the intervention group, the implementation of the intervention caused a significant increase in perceived benefits and a significant decrease in perceived barriers immediately after the test (p <0. 001). 6 weeks after the test, perceived benefits were stable (p = 0. 840) and perceived barriers were significantly reduced (p = 0. 017). Also, the intention of vaccine inoculation behavior immediately after the test and 6 weeks after the test increased significantly (p = 0. 001), while in the control group, changes in benefit scores, barriers and intention to behave in three stages of measurement were not significant. Conclusion: According to the results of the study, the educational program based on the constructs of benefits and perceived barriers of women is effective in increasing their intention to inoculate human papillomavirus vaccine.

Introduction: Cervical cancer is one of the most common cancers among women. Early diagnosis of this disease can reduce mortality among patients. So, women's screening is very important. One of the most common screening methods in this field is Pap smear screening and human papillomavirus test. Therefore, this study was performed with aim to compare these two methods in cervical cancer screening. Methods: In this systematic review of systematic review research, for finding the systematic review and meta-analysis articles about cervical cancer screening, the databases of pubmed, Scopus, science direct and Cochrane were searched using the keywords of " Cervical cancer screening", " Pap Test", "HPV Test " and " cotest " from 2015 to 2018. The quality of the included studies was assessment by the AMSTAR checklist. Results: sensitivity of HPV in two studied researches was 94% and 89. 9%, and its specificity was 90% and 89. 9%, while the sensitivity of Pap smear was 70% and 72. 9% and its specifity was 95 % and 95. 3 %. In the Cotest experiment in comparison to the cytology test, false positives results ranged 5. 8 to 19. 9 versus 6. 2 to 10. 9. Conclusion: According to the results of the studies, it seems that HPV test had more sensitivity, less specificity and more false positive results than Pap smear. However, regarding the great importance of this issue in clinical decisions, the final conclusion needs to more evaluation.

Introduction: Human cytomegalovirus (HCMV) is a major cause of congenital infection worldwide. HCMV seroprevalence is higher in Asian regions than in European societies. Pregnant women can transmit the virus to their fetuses depending on the type of infection (primary or non-primary). Congenital HCMV infection is the leading cause of sensorineural hearing loss in children. Given the importance of HCMV, this narrative-review study was performed with aim to determine the role of HCMV in congenital infection. Methods: In this narrative-review study, to find the related articles, the English and Persian databases including Google Scholar, PubMed and Magiran were searched from 2002 to 2019. The keywords of cytomegalovirus, congenital cytomegalovirus infection, diagnosis and prevalence both in Persian and English and also their combination used. Results: Developing countries estimated that the incidence of HCMV congenital infection is 6%-14%. While in developed countries such as Western Europe, United States, Canada and Australia, the incidence rate is 0. 5-0. 7%. Although HCMV infection is a significant cause of hearing loss and disability in children, there is still little awareness among general population and some physicians in this field. Several European countries routinely screen the pregnant women for HCMV but this screening is not currently performed in Iran. Conclusion: The studies in different societies highlighted the importance of congenital HCMV infection and its long-term complications in infants.

Introduction: Ogilvie syndrome is a non-mechanical and acute colon obstruction that can occur in women after pelvic surgery and can lead to cecal perforation if not be early diagnosed. Therefore, familiarity with this syndrome and its symptoms can help to prevent its complications. In this study, we report a case of ogilvie syndrome which resulted in perforation of the cecum and underwent right hemicolectomy. Case presentation: A 42-year-old woman after 72 hours of cesarean section (second turn) progressively had abdominal distension, obstipation flatulence and abdominal pain. At admission, there were signs of peritoneal stimulation, leukopenia, and electrolyte imbalance. The patient underwent laparotomy and the finding was cecal perforation. Right hemiclectomy was performed. Due to the severe contamination of the abdominal cavity, double barrel ileostomy was done. The patient was sent to surgical intensive care unit and treated with broad-spectrum antibiotics for 3 days. Subsequently, she was transferred to the ward and after the defication, the fluids regimen was started for the patient and discharged from the hospital 12 days after the surgery. And 3 months later she underwent ileostomy closure and did not have any particular medical problems in the subsequent follow-ups. Conclusion: Familiarity with ogilvie syndrome symptoms, including distension and bloating and obstipation, should always be considered by the physicians and personnel. It may be important especially in the presence of a recent history of pelvic surgery, because early diagnosis of this syndrome can be helpful in preventing its complications and mortality.