Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2018 | Volume:20 | Issue:11 |Papers Count:17

Introduction: Back pain is one of the most common musculoskeletal disorders that most women experience it for the first time during pregnancy. Back pain during pregnancy can cause disability or reduced quality of life. Sport exercise is one of the choices in treatment and prevention of back pain during pregnancy and seems that doesn’t have the limitations and complications of other treatment methods. This study was performed with aim to compare the effects of 12 weeks body balance and pelvic floor muscles exercise on back pain intensity during pregnancy.Methods: This semi-experimental study was performed on 60 primigravida women with pregnancy pack pain in 2015. The Participants were placed in four groups of 15 cases: body balance, Kegel exercise, combination of body balance and Kegel exercises, and control, they performed these exercises for 12 weeks. Data collection tool was VAS 10 marks, and the patient’s pain score was recorded before doing the exercises and also at last month of the pregnancy. Data was analyzed by SPSS software (version 16) and Kolmogrov-Smirnov, paired-t and ANOVA tests. P£0.05 was considered significant.Results: At the end of the intervention, mean of pregnancy back pain significantly reduced in the groups of body balance and combination of exercise (p<0.05), although the mean of pregnancy back pain in Kegel group reduced after exercise, but was not significant (P=0.138). The mean of pregnancy back pain significantly increased in control group (P=0.0001). There was significant difference between Kegel exercise and combination of body balance and Kegel exercises on pregnancy back pain (P=0.0006). Also, 12 weeks body balance, Kegel exercise and combination of body balance and Kegel exercises had significant effects on reduction of pregnancy back pain intensity (P=0.0001).Conclusion: Exercise protocol based on the body balance and Kegel improves pregnancy back pain, but body balance exercise causes more reduction in pregnancy back pain.

Introduction: Cervical ripening is essential in vaginal delivery, so, a safe and suitable method should be considered for cervical ripening. Nowadays, different methods are used for cervical ripening, including estrogen gels, prostaglandins and TNGs that their preference is unclear. This study was performed with aim to compare vaginal misoprostol and trinitroglycerin (TNG) on cervical ripening at term pregnancy.Methods: This randomized clinical trial was performed in 2011 on 148 primigravida patients with term pregnancy and unfavorable cervix (Bishop score £ 4) who were candidate for induced vaginal delivery and referred to Zahedan Ali Ebne Abi Talib hospital. The patients were divided into two groups: group A (400 µg vaginal TNG) and group B (25 µg vaginal misoprostol). The outcomes in two groups were recorded in the forms by observation. Data was analyzed by SPSS software (version 11.5) and Chi-square and T-test. P<0.05 was considered significant.Results: After administration of the drugs, cervical ripening (P<0.001) and Bishop score (P<0.001) were significantly higher in vaginal misoprostol group than TNG group. Also, time duration from drug administration to delivery was significantly shorter in vaginal misoprostol group than TNG group (P<0.001). 1 and 5 minutes Apgar Scores were similar in two groups. The side-effects of drugs before delivery in misoprostol group were 11 cases (14.9%) and in TNG group were 29 cases (39.2%), two groups were significantly different in terms of the incidence of these side-effects (P<0.001).Conclusion: Misoprostol compared to TNG causes more effective and rapid cervical ripening and also has less side-effect.

Introduction: Asymptomatic bacteriuria is a common problem during pregnancy. Delayed diagnosis and treatment may end up in harmful events for both mother and fetus. Physiological changes of urinary system during pregnancy facilitate the growth of microorganisms and cause this infection. This study was performed with aim to evaluate the prevalence of asymptomatic bacteriuria and determine the antibiotic susceptibility and its risk factors in pregnant women.Methods: This cross-sectional study was performed on 220 pregnant women referred to Shahidan Mobini Hospital in Sabzevar in 2014-2015. Sterile urine sample of pregnant women was analyzed in terms of Full urine test and culture. Antibiogram of isolated bacteria was done with colony count greater than 100000 by Bauer-Kirby Disk Diffusion. Individual characteristics of the subjects were recorded in the checklist. Data were analyzed by SPSS software (version 19) and Chi-square test. P<0.05 was considered significant.Results: In this study which was performed on 220 pregnant women, 7% of pregnant women had asymptomatic bacteriuria. Significant relationship was found between asymptomatic bacteriuria and education level (p<0.001), socioeconomic status (p=0.002), regional living area (p=0.004), history of previous urinary tract infection (p<0.001), and history of renal complications (p=0.028). However, no significant relationship was observed between asymptomatic bacteriuria and mode of last delivery, number of pregnancies and systemic underlying diseases (P>0.05). Most common isolated organisms were Escherichia coli and staphylococcus ureus. Antibiogram results showed that cotrimoxasol, nitroforantoin, ciproflouxasin and nalidixic acide are appropriate antibiotics for treatment of patients.Conclusion: Asymptomatic bacteriuria has favorable prevalence in Sabzevar city. In the screening of this situation, considering individual and social characteristics seems to be necessary.

Introduction: Regarding to the high prevalence of Down syndrome (1 per 700 births) different prenatal screening methods have been developed to identify high risk pregnant women. If the screening results were positive, prenatal genetic tests are recommended. This study was performed with aim to evaluate screening tests and comparison with fetal karyotype results.Methods: In this cross-sectional, descriptive and analytical study, the results of screening tests and genetic tests of 1009 pregnant women who underwent aneuploidy screening test in the years2015-2016, was examined. The information includes demographic data, familial history of previous child affected with Down syndrome, consanguineous marriage was obtained and then the results of screening and genetic test were recorded in a designed questionnaire. Data were analyzed using SPSS software (version 19), P value less than 0.05 was considered significant.Results: Based on the results of genetic tests, 59 cases (6%) of the studied fetuses had aneuploidy that 41 cases had Down syndrome. There was a significant relationship between screening tests and aneuploidy (P<0.05), but there was no significant association between the risk of neural tube defect (NTD) and aneuploidy (p>0.05). Also, significant relationship was found between NT>3mm and aneuploidy (P<0.001). The sensitivity and specificity of NT test to aneuploidy detection obtained as 47% and 90%, respectively.Conclusion: Fetal screening tests can help in finding pregnant women at risk for a child with chromosomal abnormalities. Further studies are recommended to determine the sensitivity of screening tests.

Introduction: To better control of pregnancy period and appropriate decision for termination of pregnancy, especially in high-risk cases, estimation of fetal weight is important. This study was performed with aim to evaluate fetal weight by fundal height measurement to access an easy, inexpensive and practical method in deprived areas.Methods: This analytical epidemiological study was performed on 220 pregnant women with special conditions who had referred Ahwaz Imam Khomeini Hospital for delivery in 2014. The uterine height was measured using a tape meter by a midwife and estimated fetal weight was obtained using Ben Johnson formula. The birth weight was measured immediately after birth with standard Seca scale and other factors affecting birth weight were studied. Then, data were studied by Regression and Decision Tree. Data were analyzed by SPSS software (version 17) and Chi-square and ANOVA regression tests. P<0.05 was considered significant.Results: Mean of real birth weight was 3244.52 gr and mean of estimated birth weight was 3304.18 gr. There was a direct and significant relationship between mean of birth weight and fundal height (P=0.01). The formula obtained from the regression was "W= 80.6 ´Fundal Height (cm) + 48.94 ´ number of delivery". Moreover, the well-estimated birth weight was obtained using the modeling with the decision tree based on the fundal height.Conclusion: Measuring the fundal height can be used as an appropriate criteria to predict the fetal weight. This feature can be used to predict some of the problems related to low birth weight and abnormal fetal growth before delivery.

Introduction: Multiple Sclerosis (MS) is one of the most common diseases of the central nervous system and is one of the causes of progressive disability in young people who may be sexually active. This disability can be associated with sexual-urinary problems that affect all aspects of their lives. This study was performed with aim to evaluate the association between disability and urinary-sexual dysfunction in women with MS.Methods: This descriptive-correlation study was performed on 78 women with MS referred to Neurology clinic of Ghaem Hospital in 2013. Data collection tools included individual characteristics form with the questions related to urinary problems, Krutzke disability scale, and female sexual function index (FSFI). Data were analyzed by SPSS software (version 19) and descriptive and analytic statistics. P<0.05 was considered statistically significant.Results: Patients had participated with mild (52.6%) and moderate (47.4%) disability. The highest and least frequency were satisfaction domain (43.6%) and sexual pain (10.3%), respectively. 30 patients (38.5%) had problems in more than three domains of sexual dysfunction. Regarding to the prevalence of urinary disorders, the highest and least frequency were urgency in urination (30%) and urinary incontinence (2.5%), respectively. Pearson’s correlation coefficient reported significant reverse relationship between disability level with sexual dysfunction (r=-0.61, P=0.001). Based on regression analysis, it was determined that disability level, high age, the years of diagnosing disease and the type of relapsing-remitting disease had the greatest effect on sexual dysfunction.Conclusion: The incidence of urinary – sexual dysfunction in multiple sclerosis affects all aspects of life, so the evaluation of patients should focus more on these disorders and provide context for the implementation of rehabilitation programs for patients.

Introduction: Different actions are performed today to reduce labor anxiety, among them medicinal herbs may provide a safer and more effective treatment option. Based on anxiolytic effects of saffron in previous studies, this study was conducted with aim to determine the effect of saffron capsule on labor anxiety in primiparous women.Methods: This clinical double-blind randomized controlled trial with parallel groups was performed in 2016 on 60 primiparous women referred to a selected hospital in Isfahan. The subjects were divided into two groups (n=30) of saffron capsules and placebo. The two groups received saffron or placebo capsule 250mg per night for 3 nights. Anxiety level was measured in two stages (at entering the study before start of taking capsules and at the time of admission in the ward). The study's tools included demographic and midwifery questionnaire and Spielberger Anxiety Inventory. Data were analyzed by SPSS software (version 23) and Independent t-test, paired t-test, Mann-Whitney, Fisher exact and Chi-square test. P<0.05 was considered significant.Results: Mean of anxiety scores before intervention was 30.2±10.01 in saffron group and 30.1±14.6 in control group, and no significant difference was found between two groups (P>0.05). The mean score of anxiety before start of taking capsule (P=0.99) and at admission (P=0.83) was not significantly different between the two groups. In both groups, there was no significant difference in mean anxiety score between pre-initiation of capsule and admission in maternity ward (P>0.05).Conclusion: In this study, there was no evidence of reducing effect of saffron capsule on anxiety during labor admission in primiparous women. Perhaps, it can be said that Saffron has anti-anxiety effect close to consumption. Pharmacological studies are suggested in this regard.

Introduction: Considering the development of nanotechnology and extensive use of nano-materials are in different fields of industry, it is necessary to investigate their destructive effects on biological systems. Titanium dioxide (TiO2) is used in the production of different dyes, cosmetics, ceramics, photocatalysts, water and sewage treatment and a lot of other products. This study was performed with aim to evaluate the Teratogenic effect of TiO2 in different gestational weeks of NMRI mice.Methods: This experimental study was performed on 30 female NMRI mice (25-30 gr, 8-12 weeks of pregnancy) in 2017. The mice were randomly assigned into 2 control groups and 4 case groups). Pregnancy was confirmed with vaginal plaque (GD0). The doses of 5 mg/kg of tio2 solution were orally gavage to pregnant mice from the first to 18th days of pregnancy. The first group, the first week of pregnancy, the second group, the second week of pregnancy and the third group received nanoparticles only in the third week of pregnancy and the fourth case group were treated during all period of pregnancy. The Sham group was gavage with solvent and control group received city water without gavage. In the 18th day of pregnancy, the fetuses were removed from the uterine tubes and their weight and height, Head circumference and morphologic disorders were recorded, their skeletal disorders were checked by alizarin red and painting. Data were analyzed by SPSS software (version 21). P<0.05 was considered significant.Results: Totally, significant reduction in body weight and CR length was observed in all four experimental groups in comparison with control group (P<0.05). Also, significant increasing was observed in appearance abnormalities such as fetal absorption, bleeding, organs abnormalities, and skeletal disorders in experimental groups in comparison with control group. The observations showed more incidence of Teratogenic effect in the group which was exposed to nanoparticles in second week.Conclusion: The results of present study prove the toxicity and teratogenicity effects of TiO2 nanoparticles on living organisms. So, further studies are recommended to predict the toxicity effect of TiO2.

Introduction: Evening primrose is one of the medicinal herbs with good effects which has been used in the treatment of multiple physical and mental problems and no side effects of its oral consumption has not been reported so far, therefore this study was performed with aim to evaluate the effects of evening primrose oilon prevention of postpartum grief in primiparous women referred to Ahvaz health centers.Methods: This clinical double-blind randomized trial was conducted on 132 primiparous women referred to Ahvaz health centers in 2012-2013. The subjects were randomly divided into two groups of 66 cases to receive a daily dose of 1 gr of evening primrose oil capsule or similar placebo gelatin capsule from the beginning of 37th weeks of pregnancy up to two weeks after delivery. The samples were assessed by Edinburg standard questionnaire on days of 4, 10 and 14 after delivery. Data were analyzed by SPSS software (version 20), and independent t-test, Chi-square and repeated measures analysis test. P<0.05 was considered significant.Results: There was statistically significant difference between the two groups regarding the risk of the postpartum grief, so that the risk of postpartum grief was lower in the intervention group than the placebo group (P=0.0001). The mean score of Edinburgh test in intervention group was significantly less compared to the control group on postpartum 4th day (p = 0.0001), 10th day (p = 0.001), and 14th day (p = 0.08).Conclusion: The use of evening primrose oil is effective to prevent postpartum grief.

Introduction: Obesity is known as a chronic inflammatory state in which anti-inflammatory adipokines level such as Omentin-1 decreases and this is directly linked with cardiovascular diseases. Therefore, this study was performed with aim to investigate the effect of eight weeks of circuit resistance training and cinnamon supplement on body composition and omentin-1 in overweight women.Methods: This clinical trial study was performed on all overweight female students at Zahedan Farhangian University in 2015-16. The subjects were randomly divided into four groups: exercise+placebo, exercise+Cinnamon, Cinnamon and control. Resistance training was three times a week and each session for 50 minutes. Supplement group consumed one capsule containing 0.5 g Cinnamon, one hour before breakfast and one hour before dinner for eight weeks. Seca height and weighing scales (model 220 made in Germany) was used to measure height and weight, BMI was measured as dividing weight (kg) on square height (m), the bondor kit made by East Biopharm Co. was used to measure Omentin-1 through ELISA method, and the HOMA-IR index was used to evaluate the insulin-resistance index. Data was analyzed by SPSS software (version 16) and Shapiro-Wilk test, Levene, dependent-t and ANOVA tests. P<0.05 was considered significant.Results: Omentin-1 values significantly increased in the groups of exercise+Cinnamon (p=0.001) and Cinnamon (p=0.001). Significant decrease was observed in body weight in three groups of exercise (p=0.030), exercise+Cinnamon (p=0.021) and Cinnamon (p=0.036). BMI was also significantly declined in three groups of exercise (p=0.038), exercise+Cinnamon (p=0.02) and Cinnamon (p=0.046). Changes in waist to hip rate were not significant in any of the groups. Also, no significant difference was found between the groups in none of the variables (P= 0.93).Conclusion: Resistance training as non-invasive intervention along with cinnamon consumption as well as cinnamon consumption alone increase Omentin-1 serum level (anti-inflammatory agent) and improve the body composition.

Introduction: The Mycoplasma Hominis bacterium lives on in the female reproductive system. Recent studies have shown that the presence of this bacterium is associated with disorders such as vaginosis, infertility, abortion and preterm labor. This study was performed with aim to determine the frequency of Mycoplasma hominis in women referred to Infertility Clinic of Hamadan Fatemieh Hospital.Methods: This epidemiologic-descriptive study was performed on 234 patients referred to the infertility clinic of Hamadan Fatemieh Hospital in 2016. Screening was performed using swabs from the endocervix of 234 female patients who had at least one of the symptoms of vaginosis, infertility, abortion and preterm labor. The culture medium was removed by filtration and the PCR molecular technique was used to trace the 16s rRNA gene as two methods for detection of bacteria. Data was analyzed by SPSS software and McNemar's test. P<0.05 was considered significant.Results: The frequency of Mycoplasma hominis in both methods was 13.7%. The correlation coefficient between culture and PCR methods was relatively desirable for detection of this bacterium (k=0.5). 41 patients (24.4%) with history of at least one abortion and 148 (14.2%) with vaginosis were diagnosed as positive Mycoplasma agar. The highest prevalence of Mycoplasma hominis was observed in the age range of 30-39 years.Conclusion: Although the PCR molecular technique has high sensitivity to diagnose Mycoplasma hominis, but the modified culture method has an acceptable sensitivity to detect this bacterium.

Introduction: According to the role of nutrition in physical and mental health, this study was performed with aim to evaluate the effect of maternal nutrition during pregnancy and breastfeeding, especially eating frankincense, dates and quince on the child's mind, mood and behavior according to the Quran, Hadith and Medical Sciences.Methods: In this interdisciplinary study which was performed based on attributive method, some scientific databases such as Google scholar, PubMed, Scopus, and SID were searched for published scientific articles from 1980 to 2016. Also, with using Noor Comprehensive Commentary Collection and Jami’ al-Ahadith softwares, Interpretations of Quran's verses: Al-Moamenoon, 51 & Al-Bagharah 172, 233 & Maryam, 25-26 as well as Hadiths of Ahl al-Bayt (AS) were searched. The effects of using frankincense, dates and quince during pregnancy and breastfeeding on the child's mind, mood and behavior was evaluated.Results: According to the Islamic texts, eating quince during pregnancy increases the intelligence, courage and morality of the child, eating frankincense increases intelligence, brave and good-nature of the children, and eating dates enhances the child's patience. Scientific researchers have proven the antidepressant effect of quince and its compounds' mental-physical effects, and the effect of frankincense to enhance memory and concentration and to reduce anxiety and depression, and the role of dates compounds to decrease and eliminate fatigue, depression and irritability. Moreover, maternal nutrition has a vital role in the composition of her milk and intelligence growth, calmness, confidence, mood and good behavior of the child.Conclusion: Eating frankincense, dates and quince during pregnancy and lactation, in addition to positive physical effects, has a good role in the personality, ethics and behavior of the child.

Introduction: Choriocarcinoma is one of the rare diseases of gestational trophoblastic tumor with various and sometimes misleading clinical presentations. Clinical suggestion of the disease and timely diagnosis can be useful. The aim of this study is to report a case of diagnostic medical error in postpartum choriocarcinoma.Case report: A 25-year-old woman with prolonged postpartum hemorrhage referred to the hospital in one of the cities around Mashhad. Despite frequent referring of the patient due to bleeding, and not considering laboratory signs and sonography and increased levels of bhCG, gestational trophoblastic tumor was not diagnosed. It led to uterus rupture. Then, with emergency situation due to uterus rupture, multiple lung and brain metastases, she was referred to the gynecologic oncology ward in 2017. Currently, she is under chemotherapy without need to surgery.Conclusion: The possibility of choriocarcinoma should be considered in every woman of reproductive age with postpartum abnormal uterine bleeding and also bleeding from other organs or diagnosis of metastasis with unknown etiology.