Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2017 | Volume:20 | Issue:6|Papers Count:16

Introduction: Preeclampsia is a multisystem disorder with unknown etiology which raises the risk of developing cardiovascular diseases in later life. On the other hand, recent studies have shown that increase in Carotid intima-media thickness (IMT) could be an independent predictor for early detection of atherosclerotic cardiovascular Diseases. According to Endothelial dysfunction as a common pathogenetic mechanism in preeclampsia and atherosclerotic process, we compared the carotid IMT of women with preeclampsia to healthy controls.Methods and Materials: In this cross-sectional study in the years 1394-95, IMT of common carotid artery was measured by ultrasonography in 30 pregnant women who admitted due to preeclampsia, 30 healthy pregnant women and 30 healthy non-pregnant women who were matched for age and gestational age. Then the data were coded and imputed to the software.Statistical analysis was done using SPSS software (version 11.5) and appropriate statistical tests. The level of statistical significance considerate as lower than 0.05.Results: The Mean IMT of carotid arteries was 0.77±0.29 mm in pregnant women with preeclampsia, 0.52±0.09 mm in healthy normotensive pregnant women and 0.55±0.07 mm in healthy non-pregnant women with significant statistical difference among three groups.p value:<0.001).Conclusion: The results of this study showed that IMT as an important and independent marker in the early prediction of atherosclerotic cardiovascular disease in women with preeclampsia is significantly higher than the control groups. Considering the association between increased IMT and higher risk of atherosclerotic diseases, we suggest that women with preeclampsia should be assessed for early detection of atherosclerotic cardiovascular diseases as a high risk group.

Introduction: Physical and psychological changes during pregnancy lead to changes in pregnant mother's health behaviors and life style and has effects on physical, psychological and social health and eventually on her quality of life in different stages of pregnancy. This study was done with aim to determine the relationship between quality of life and minor ailments of pregnancy.Methods: This cross-sectional study was performed on 199 pregnant women referred to health centers of Birjand University of Medical Sciences in 2014.Data collection tools included: researcher-made questionnaire consisting of demographic and midwifery information, minor ailments of pregnancy questionnaire, and shorted version of the quality of life standard questionnaire (SF-26). Data were analyzed by SPSS software (version 16) and using Pearson correlation coefficient and multiple linear regression analysis. P<0.05 was considered significant.Results: The mean of overall satisfaction of life was 68.84±16.75 and the mean score of pregnant mothers' common complaints was 38.12±9.1. The most common complaint was related to fatigue (82.3%). Also, the results of Pearson correlation coefficient showed significant reverse correlation between minor ailments of pregnancy and the score of overall satisfaction of life (r=-0.34, p< 0.001), the score of physical (r= -0.425, p<0.001), mental (r=-0.239, p< 0.001), social (r=-0.228, p=0.002) and environmental (r=-0.161, p=0.04) areas. The results of linear regression model showed that social support had positive effect on quality of life. So that mean score of quality of life in a group with average support was about 8 unit and in a group with high support was 11 unit more than a group with low level of support (p<0.001). Also, with increasing pregnant mothers' common complaints, the mean score of quality of life decreased as 0.57 unit that was statistically significant (p<0.001).Conclusion: The incidence of ailments during pregnancy has a remarkable effect on pregnant women's quality of life. So, the health workers' attention to these complaints and planning for care and health measurements for control and support of others can be effective on pregnant women's quality of life.

Introduction: Children are important component of future society and providing their health care is a national investment. With regard to close contact between mother and child, so, improving the mothers’ knowledge about neonatal care and the risk factors can be effective to prevent neonatal mortality and morbidity. This study was performed with aim to evaluate mothers’ knowledge about neonatal care in three educational hospitals of Mashhad University of Medical Sciences.Methods: This cross-sectional study was conducted in 2014 on 784 pregnant women referred to maternity wards of Omolbanin, Emam reza and Ghaem hospitals. The data collection tool was a researcher-made questionnaire on neonatal care. Data were analyzed by SPSS software (version 16) and using t-tests, Chi-square and ANOVA. P<0.05 was considered significant.Results: The knowledge of 50 mothers (6.4%) about neonatal care was poor, 430 (54.8%) moderate and 295 (37.6%) good. The mothers with diploma level education had the highest level of knowledge than other mothers. There was significant relationship between mother's level of education, job and mode of delivery with mothers' knowledge about neonatal care (P=0.005).Conclusion: Due to the effect of mothers' knowledge in the prevention of neonatal disease and mortality, it is better to focus more on educating mothers, especially in the field of mother’s diet and exercise, nipple cracking, and safe drugs during breastfeeding for all mothers.

Introduction: Embryo cryopreservation is potentially the best method to increase pregnancy rate for the women at risk of OHSS (Ovarian Hyper stimulation Syndrome) and the women at risk of losing ovarian function. With regard to the importance of issue and increasing development in the world regarding to Embryo cryopreservation and following pregnancy, this study was performed with aim to compare pregnancy rate and effective factors following fresh and frozen embryos transfer in women undergoing Assisted Reproductive Techniques (ART) in Milad Infertility Center (Montaserieh).Methods: This cohort study was performed on 200 infertile women who had referred to Mashhad Montaserieh Infertility Center during 2009-2010 for infertility treatment and were candidate for IVF/ICSI. Mature embryos of the patients were used in frozen and fresh groups for embryo transfer to uterus.Data was analyzed by SPSS software (version 11.5) and using Chi-square, independent t, and Kruskal Wallis test. P<0.05 was considered significant.Results: From 200 infertile women, 80 cases (42%) had pregnancy which 43 (43%) were in fresh embryo group and 37 (37%) in frozen embryo group; the difference was not significant (P=0.38). Infertility causes, number of embryo cells and grading of transferred embryos, delivery complications, method of embryo transfer, number of fetuses obtained from delivery, and endometrial thickness were not statistically different between two groups (P=0.61). But, mean number of transferred embryo was statistically different between fresh embryo group and frozen embryo group (P<0.05), but this difference was not significant when non pregnant women were deleted and comparison among pregnant women was not significant (P=0.22).Conclusion: There was no significant difference between fresh and frozen groups in terms of pregnancy rate and pregnancy complications (P=0.53).

Objective: Menopausal is one of the crisis’s of women life and the signs women experience in this period is one of important care challenges and one of its most important consequences could be known as the concealed anxiety came out the menopausal. So the present study is aimed to evaluate the effect of valerian on the anxiety of menopause women.Methods: This study is the kind of observational and clinical random traits studies. Sample cases of this study divided into two 72 individual groups of treatment and control randomly and a cross over design was done between two groups in the second phase of study. In the each period of experiment the treatment group received 530 mg valerian contained capsules two times per day and the control group received placebo capsules with the same apparent features. To measure the females’ anxiety, Espiell Berger concealed anxiety questionnaire was used and the paired sample mean compare test and repeated measure tests were used to analyze data in the statistical software SPSS.Results: Results showed that using valerian has no significant effect on decreasing anxiety but its effect in the second test level and after receiving placebo was found significant that shows the effective role of cure period time on the efficiency of this drug.Conclusion: It seems that the cure period has elementary role in valerian effectiveness on the decrease of postmenopausal women’s anxiety.

Introduction: Abnormal uterine bleeding (AUB) is a common gynecological problem in peri-menopausal women which needs proper evaluation. Diagnostic procedures for detection of uterine pathological lesions include endometrial biopsy, Transvaginal ultrasonography, diagnostic hysteroscopy and dilation and curettage (D& C). Regarding to the importance of uterine bleeding for proper treatment, this study was performed with aim to compare diagnostic value of Transvaginal ultrasonography with dilation and curettage (D& C).to determine the causes of abnormal uterine bleeding in perimenopausal women.Methods: This descriptive-analytic study was performed on 94 women with abnormal uterine bleeding referred to Ardabil Alavi hospital from 2013 to 2015. After completing the demographic questionnaire, pelvic examination and Pap smear, transvaginal sonography (TVS) and dilatation and curettage (D& C) were performed for all patients. Data analysis was done using SPSS software (version18) and Cochrane test, determination of sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV). P<0.05 was considered significant.Results: Myoma was the most common pathological lesion in both TVS and D& C methods (65.9% and 60.6 %, respectively). Sensitivity of TVS for detecting of myoma and endometrial polyp were 59.5% and %51.2, respectively and the specificity was 83.2% and 72/5%, respectively. PPV and NPV of TVS for diagnosis of myoma were 42.2%, 57.4% and for diagnosis of endometrial polyp were 61.4% and 39.9%, respectively. Sensitivity and specificity of TVS in the diagnosis of normal and abnormal bleeding) was 59.5% and 65.4%, respectively. PPV and NPV was 12.4% and 84.58%, respectively. The sensitivity and specificity of TVS in the correct diagnosis of patients with abnormal bleeding was 87.5% and 94.5%, respectively. PPV and NPV of TVS was 26.5% and 37.86%, respectively.Conclusion: Due to the high sensitivity and specificity of transvaginal sonography in the correct diagnosis of abnormal bleeding and non-invasiveness and low cost of this method, it is suggested as the first step in the evaluation of patients with abnormal bleeding.

Introduction: Post-cesarean anxiety is associated with increased pain, using analgesics and increased hospitalization time. Auriculotherapy may be useful as a complementary medicine to reduce anxiety. So, this study was performed with aim to evaluate the effects of auriculotherapy on anxiety in patients after cesarean section.Methods: This two-group randomized clinical trial study was performed on 66 pregnant women who referred to Mashhad Omolbanin hospital for caesarean section in 2015. In the intervention group, 2-3 hours after the operation, Auriculotherapy (in shenmen, subcortex, uterus, pelvic and abdominal points) was performed for 20 minutes. Before, one and two hours after the intervention, anxiety was measured by Spielberger anxiety questionnaire and blood pressure and pulse rate were evaluated. Data were analyzed by SPSS software (version 16) and statistical tests of independent t-test, paired t-test, Chi-square and Fisher test. P<0.05 was considered significant.Results: There were no significant differences between two groups in terms of demographic characteristics, mean of state and trait anxiety before cesarean and state anxiety before the intervention (after cesarean) (P>0.05). No significant difference was observed between two groups in terms of mean anxiety one hour after the intervention (P=0.332). Two hours after the intervention, anxiety reduced in auriculotherapy group, but increased in control group, although the difference was not significant (P=0.876). Also, no significant difference was found between two groups in terms of systolic and diastolic blood pressure and pulse rate (P>0.05).Conclusion: The use of auriculotherapy has no effect on reducing maternal anxiety after cesarean up to two hours after the intervention; therefore, it is recommended to perform further studies regarding the effects of auriculotherapy on anxiety after cesarean for longer time follow-up.

Introduction: Childbirth causes increasing weight between 0.4 to 1.8 kg according woman's age. Changes in life as a result of pregnancy and childbirth result in shifting in mothers operations and some can' t handle taking care of their infant even in third month and don’t start housework and social activities. According to the results of researches about activity subtraction of fat people, aim of this study is to consider weight retention and its relation with mothers' functional state in 6 months after childbirth.Methods: This cross sectional research has been done 6 months after delivery on 307 in Ardabil, 2016. Weight retention was measured by minus weight in 10th-12th week of pregnancy and weight in 6 month after childbirth. Weighting process was done by a similar person in each time. Data gathering tools in this research were included socio demographic and functional status questionnaire.Results: three hundred seven women participated in this study from May to August 2016. The mean (SD) Body Mass Index was 25.58 (4.47). The mean (SD) weight retention 6 months after delivery was 0.5 (9.99) kg. Out of job subdomain of functional status, others, including household activities (p=0.05), social and community activities (p=0.042), infant care activities (p=0.009) and self-care activities (p<0.001) had significant correlation with weight retention.Conclusion: Studied women had acceptable weight retention 6 months after delivery. In present study there is a significant and inverse correlation between all functional status subdomains (except job). In the way that more weight retention caused less points in each four subdomains.

Introduction: postpartum blues is a complication which affects mother's health and her relation with newborn and her physical and psychological health. Therefore, health team should consider early interventions to prevent postpartum blues. This study was performed with aim to determine the effect of infant massage on postpartum blues in primiparous women.Methods: This clinical trial study was performed on 54 primiparous women with natural delivery who referred to Mashhad Imam Reza and Omolbanin hospitals in 2016. The mothers in intervention group massaged their newborn 15 minutes daily for 10 days and no intervention was done for control group. Severity of postpartum blues was evaluated on the 1st, 4th and 10th days after birth in case and control groups. Data was analyzed by SPSS software (version 16) and using Mann-Whitney, Fisher exact and Chi-square tests.Results: There was not statistically significant difference between two groups in terms of postpartum blues at 1st day after delivery (P=0.084). While mean of postpartum blues had significant difference in case and control groups on the 4th (P=0.001) and 10th (P=0.034) after delivery, meaning that mean of postpartum blues on the 4th and 10th after delivery was lower in case group than control group.Conclusion: The infant massage was effective for decreasing postpartum blues severity. Since infant massage it is useful and cost free method to decrease postpartum blues, it is recommended to mothers that perform it after delivery to improve maternal psychological health.

Introduction: Widowhood is a stressful event for women that is often associated with loss of health, human relations, and financial support. This study was conducted with aim to explain the experiences of Iranian widows about their effort to meet emotional and sexual needs.Methods: This study was performed with descriptive phenomenology approach. Data were collected through semi-structured interviews with 10 widows who were selected by purpose-based method. Colaizzi's method was used for analysis of data.Results: After analyzing of interviews, three main concepts along with sub-concepts were identified that main concepts included: Motherhood vs. Femininity, Sexual needs: apparent but not spoken issue, and ambiguous future of the second marriage.Conclusion: The results demonstrated a close-up shot of Iranian widows' problems regarding unsuitable cultural and social beliefs about their emotional and sexual needs. Widows described their sexual needs as obvious but inexpressible regarding to the limitations of society. They faced a dilemma of need and fear to meet their sexual needs which is aggravated during the time after their spouses' death. They described unmet emotional needs as mothering role vs. femininity and explained how their need for nonsexual touch and emotional support by men faced them with the hesitancy about their role as a mother. The results showed that how the social norms force widows toward a nonsexual life to support their children.

Introduction: Chlamydia trachomatis is mainly transmited by sexusal contact and similar to other STDs (sexually transmitted diseases) affect primarily young and sexually active persons which due to its undesirable effects in pregnancy is of great importance. The aim of this study is review the role of different C. trachomatis serovars and their relaition with infection consequents.Methods: This study was a review of data collected from scientific databases including Web of science, Google scholar, PubMed, Sciencedirect, ISC and magiran using the following key word Chlamydia trachomatis, serovar, STD, prevalence and infertility. After initial search with emphasis on the published English papers over the last 5 years, 66 articles were included.Results: The distribution of different strains of this intracellular bacterium in different parts of the world can be a suitable clue for planning epidemiologic programs for control of this infection and consequently other STDs. All studies on this subject nearly revealed that E serovar is the dominant serovar in the infection of cervix, vagina and uro-genital system but its prevalence varies between 20-50% in different researches.Conclusion: The distribution of serological groups of C. trachomatis around the wolrd is very similar at national scale but are different between cities. The most prevalent serovars are E, D and F. Various studies have shown the relation of serovars involved in urogenital infections with clinical symptoms severity and the duration of C. trachomatis infection; however contradictory data have been reported.

Introduction: Necrotizing Fasciitis is one type of necrotizing soft tissue infections involving fascia and overlying subcutaneous fat, it has fast development and results in fulminant tissue destruction, toxicity, sepsis and high mortality. "Fournier's gangrene" is another name for "Necrotizing fasciitis of perineum". Signs and symptoms are seveer pain, swelling, erythema and induration of major labia that spreads rapidly to the anterior abdominal wall and gluteal region. Clinical manifestations of early stage of "Fournier's gangrene" are similar to "Bartholine abscess". Since Bartholin abscess is common and "Fournier's gangrene" is rare, gynecologist, usually does not consider this diagnosis.Case presentation: A 52 year – old woman with fever and pain, erythema and swelling of valva was admitted to the hospital. Initially, her diagnosis was bartholine abscess and drainage and marsupialization was done to her. Since fever continued, pain and mal- odor discharge didn’t improve, erythema and swelling progressed to mons of pubis and RLQ [S1], thus with diagnosis of Fournier's gangrene, she underwent surgical exploration and debridement together with broad spectrum antibiotic therapy; she discharged two weeks later with good condition and no fever.Conclusion: Since early stages of "fournier's gangrene" can be mistaken with "Batholine abscess", gynecologist should consider fournier's gangrene in women with underlying medical conditions such as diabetes and immunodeficiency with urogenital infection."Fourneir's gangrene" is a surgical emergency, therefore early diagnosis and treatment can prevent morbidity and mortality.