Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2011 | Volume:13 | Issue:6|Papers Count:12

Introduction: Supporting the luteal phase in patients undergoing Induction of ovulation together with intra uterine insemination (IUI) is routinely performed in some centers in Iran. This study was performed with the aim of comparing the effect of intra muscular progesterone injection and suppository progesterone for luteal phase support in these patients.Methods: This random prospective clinical trial was performed on 225 patients referred to Montaserieh infertility center affiliated to Mashhad university of medical sciences in year 2007. Patients undergoing induction of ovulation and IUI were randomly divided into two groups of treatment with 50 mg muscular progesterone injection (114 patients) and 400 mg vaginal suppository progesterone (111 patients) for luteal phase support. In patients whose serum bhCG was positive, their treatment course continued up to 12 weeks of gestation. Pregnancy rate, abortion and continuing of pregnancy were evaluated after 20th week of gestation. Data was analyzed using student t-test, exact Fisher, Mann-Whitney ad Chi square tests by SPSS 11.5 software.Results: Pregnancy outcome were better in suppository progesterone treatment group (p=0.0008). In addition, low drug complications and abortions were reported in this group (p=0.000). Patient satisfaction was significantly higher in suppository progesterone treatment group (p=0.0000).Conclusion: The effect of suppository progesterone treatment was better in supporting luteal phase in patients with induction of ovulation and IUI, and it can be used due to lower complications and more patient satisfaction rate.

Introduction: In the few studies were done on magnesium sulfate therapy, resulted that short-term magnesium sulfate therapy for prevention seizures in preeclampsia is effective as long term prescribed it. This study compared impact of two methods of therapy on improvement of preeclamptic patients.Methods: This clinical trial study was done on 148 pregnant women with preeclampsia who received magnesium sulfate (2005-2006) in Mahdieh hospital affiliated to Beheshti University of medical sciences. Preeclamptic patients after delivery were divided into two groups. The first group treated with magnesium sulfate for 24 hours and second group treated based on clinical recovery time, between 6-12 hours. Data collected with interview, filling the questioners and care of patients. Data were analyzed with descriptive statistical methods, t-test and using SPSS10.Results: Age, hypertension, urinary protein excretion, nationality (Afghan Persian), number of pregnancies was without significant differences in both groups. None of patients did not seizures.Conclusion: Due to limited studies in this area we advise to do more studies for making conclusion that short-term administration of magnesium sulfate in addition of safety and cost-effectiveness to be effective as long-term administration of it.

Introduction: Dysmenorrhea is a common gynecologic disorder that at least half of women experience it during their reproductive period. Treatments, which are based on prostaglandin reduction, can be used to treat dysmenorrhea. Levonorgestrel-releasing intra uterine device (IUD) known as Mirena is one of these treatments that decrease the synthesis of endometrial prostaglandins. This study was performed in order to assess the frequency of dysmenorrhea in women using copper IUDs compared to those using Mirena IUDs.Methods: This double-blind randomized clinical trial was performed on 160 women aged between 20 to 35 years who referred to Shahid Ayat Health Center (2006 and 2007) and decided to use IUDs as contraceptive method. Subjects were randomly divided into two groups of 80 cases, group A (insertion Mirena IUD) and group B (insertion copper 380-A IUD). Dysmenorrhea was assessed by designed questionnaires at first, and then 1, 3 and 6 months after insertion. Data were analyzed using Chi square, student t-test and repeated measure variance analysis by SPSS11.5.Results: Dysmenorrhea significantly decreased in both groups six months after IUD insertion compared to the first month (P<0.001). However, statistically, Mirena IUD reduced dysmenorrhea faster and earlier compared to cupper IUD (P<0.003).Conclusion: Levonorgestrel-releasing IUD can be used in young women to treat drug resistant dysmenorrhea, not only as a means of preventing dysmenorrhea, but also as a contraceptive method. 

Introduction: Chlamydia trachomatis can contaminate Genital tract and cause a broad spectrum of clinical manifestations in women, which vary from asymptomatic infections to complicated, ascending infections such as pelvic inflammatory disease, tubal infertility and ectopic pregnancy. Also in men, Chlamydia is the most common cause of urethral discharge. Present study was performed with the aim of determining the Chlamydia infection frequency in cervical and urethral samples of women referred to Ghaem Hospital of Mashhad.Methods: This descriptive study was carried out on 861 cervical and urethral samples of women having genital tract infection symptoms, who referred to Ghaem hospital of Mashhad during 3 years. Samples were cultured in cyclohexamide treated McCoy cell line and stained by Giemsa method. Samples were evaluated for cytoplasmic inclusion bodies. Data was analyzed using descriptive statistics.Results: Of all the samples, 588 cases (68.3%) were cervical and 273 cases (31.7%) were urethral samples. 408 cervical samples (69.39%) and 189 urethral samples (69.23%) were positive for Chlamydia in cell culture system.Conclusion: Chlamydia prevalence is very high among samples of patients who refer to laboratories. Considering the role of Chlamydia trachomatis in infertility, all infertile patients should be evaluate for Chlamydia infection at the first step.

Introduction: Cervical cancer is one of most common female genital tract malignancies leading to death. With detection and controlling the risk factors, both the incidence and mortality can be decreased. Because of socioeconomic and sexual behavior differences between Iranian society and other countries, this study was conducted to assess the role of demographic and economic factors on cervical cancer. Methods: This cross-sectional study was performed on 50 inpatients of Al-Zahra hospital with cervical cancer and 200 healthy women as control group in Tabriz city between years 2001 and 2008. Socioeconomic and demographic factors were collected by a form and data was analyzed by using U Mann-Whitney, Chi square, t-test and multivariate logistic regression by SPSS 16 software.Results: Cervical cancer risk increased among more than 50 years old women, (OR=1.33), women whom their husbands were smokers (OR= 1.46) and women who had husbands with low income (OR=1.32). Low aged at marriage (p=0.004), low aged at first delivery (p=0.003), parity number³5 (p=0.000) and increased marriage number in both women and their husbands (p=0.000) were associated with increased risk of cervical cancer. History of using condom and Pap smear respectively 70% and 90%, had protective effect on cervical cancer.Conclusion: Considering socioeconomic and demographic characteristics, which are major risk factors for cervical cancer, it is desirable to provide health and wellbeing education programs for women, particularly those in the lower socioeconomic status, to encourage them to participate in cervical cancer screening programs.

Introduction: Perineal lacerations are common perineal injuries in primiparous women and episiotomy is the most common surgical incision in obstetrics. There is no reliable evidence for confirming the routine use of episiotomy and it is recommended to perform selective episiotomy for fetal and maternal indications. This study was performed in order to compare perineal trauma in primiparous women with routine and selective episiotomy in Modarres Hospital of Kashmar.Methods: This clinical randomized trial was performed on 100 primiparous women aged between 17-35 years with spontaneous delivery in Modarres hospital of Kashmar in year 2003. Cases were selected by aims of study and were randomly divided into two groups of routine and selective episiotomy. All deliveries were done by researcher but evaluation of perineal outcome after delivery was done by another researcher who did not know about types of groups. Data were obtained from interviewing, observation forms and measurement of pelvic muscle strength and analyzed with student t-test, chi-square, and Mann Whitney and Fisher test by SPSS 11.5 software.Results: 12(24%) of women in selective group and 50(100%) in routine group had episiotomy (p<0/0001). Perineal injury happened in 62% of selected group and 100% of routine group, which was statistically different (p<0/0001). The two groups were similar in terms of variables effective on perineal trauma.Conclusion: Selective episiotomy can reduce perineal injuries; therefore, it can be replaced routine episiotomy as a safe and time saving method.

Introduction: Hysterectomy is one of the most frequently performed major surgical procedures, which is non emergent in 90% of cases and is performed in order to enhance women’s quality of life rather than to save life. Recent studies in this field have manifested different outcomes. This research was conducted with the aim of determining the quality of life after hysterectomy in women with natural menopause and women who had undergone surgery.Methods: This cross-sectional study was performed at least 3 months after hysterectomy, on180 women who were selected by random sampling. Quality of life was measured with Ferrans and Powers Quality of Life Index, which contained 66 items. Data was analyzed using descriptive statistical methods and Chi square test, Pearson correlation and variance analysis by SPSS14 software.Results: Mean of quality of life was 11.93 ± 2.55 (min 8.5, Max 21.5). Mean of quality of life score in pre-hysterectomy menopause, post-hysterectomy menopause and non menopause were respectively (12.54±2.73), (11.4±2.31) and (11.58±2.251), and was significantly different in three groups (P=0.003). Social psychological subscales of life quality showed a significant difference in three groups.Conclusion: Low qualities of life were seen after hysterectomy particularly for social and psychological aspects in premenopausal women. Use of alternative treatments for relief of symptoms is recommended as an important component of treatment for these women.

Introduction: Breast cancer is the most common cancer in women (not considering skin cancer). Its prevalence increases about 2% annually and its modifiable risk factors have been determined in various studies. The aim of this study was to evaluate the risk factors of breast cancer in women of Golestan province in Iran.Methods: In this case-control study all breast cancer cases recorded in cancer registry system of Golestan province during years 2004 and 2006 (case group) and their age-matched healthy neighbors (control group) were included (134 cases and 133 controls). Data was collected by interviews based on prepared questionnaire. Data Analysis was done with Chi-square and independent t-test by SPSS 13 software.Results: In cases who married before 19.29 years old, the risk of breast cancer was 0.76 folds, in menarche before 13.37 years old it was 1.3 folds, in women with menopausal age before 46.6 years old, it was 2.91-folds (p=0.021), in who become pregnant before 20.51 years old it was 0.87 folds, in cases who had breast feeding more than 64.35 months it was 0.73 folds, 1.33 folds in singles and in cases who educated under diploma it was 1.2 folds. In patients with a positive family history of breast cancer in grade one and two relatives, it was 0.53 and 0.67 folds, respectively.Conclusion: Results didn’t show a significant relationship between variables and risk of breast cancer (except for menopausal age). Some large cohort studies are suggested in this field.