Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2009 | Volume:12 | Issue:3|Papers Count:10

Introduction: Premenstrual syndrome (PMS) has various effects on the life style of women. Our aim was to study the effect of PMS on long term, short term and prospective memory of affected individuals.Methods: This experimental and field study enrolled 60 women suffering from PMS who were tested before and after menstrual cycle. The mean age of participants was 33 years old. For the test of long and short term memory we used 30 word learning task (30-WLT). The prospective memory was tested by performing a specified action. The obtained results were analyzed with t-test and covariance analysis.Results: The obtained results in this research showed that PMS decreased short and long term memory functions (p<0.001), but it did not affect the prospective memory.Conclusion: PMS is not only a kind of mood disorder that results in memory dysfunction but also may be accompanied by diseases as its background. So, the control and treatment of the various psychological and physical complications of PMS, as one of the most common conditions affecting women, are recommended to improve the achievements in the fields of work, education and social interactions.

Introduction: Postpartum blues is a mild mood disorder that may progress to postpartum depression which could be life threatening to both mother and infant. So prediction and recognition of this mood disorder could be an important contribution to mothers in postpartum period. The goal of this study was evaluation of the correlation between postpartum depression, maternal blues and premenstrual syndrome in women referred to the health centers affiliated to Bushehr University of Medical Sciences, Bushehr, Iran.Methods: This descriptive analytical study was performed to assess the correlation between premenstrual syndrome, maternal blues and postpartum depression in women referred to health centers affiliated to the Bushehr University of Medical Sciences. 400 women in the first trimester of pregnancy were enrolled in the study by simple sampling. Data were collected from the questionnaires of demographic characteristics and two questionnaires of premenstrual syndrome, maternal blues and postpartum depression, the latter was filled 10 days following labor. The gathered data were analyzed by descriptive analytical parameters. Results: The incidence of premenstrual syndrome was 35.5% while maternal blues was shown in 29% of participating women. Postpartum depression was seen in 15.5% of women in our study. There was no significant correlation between premenstrual syndrome and factors such as age, age at marriage, occupation, level of education, number of pregnancy, intake of psychotic drugs and level of satisfaction with marriage. However, there were a significant relationship between premenstrual syndrome of enrolled women with low parity (p=0.023) and history of gynecologic disease (p=0.013). There was no significant correlation between the incidence of maternal blues and postpartum depression with the above mentioned factors studied. Correlation tests of Pierson and Chi square indicated a positive and significant relationship between premenstrual syndrome with maternal blues and postpartum depression (p<0.001).Conclusion: Premenstrual syndrome and postpartum blues were relatively prevalent among the women enrolled in our study. The premenstrual syndrome could be a predictive factor in maternal blues and postpartum depression. The consideration of premenstrual syndrome could be useful in recognition of women at higher risk of maternal blues and postpartum depression.

Introduction: Bacterial vaginosis (BV) is the most common cause of abnormal vaginal discharge in fertile women. Although the gram staining of vaginal discharge (Nugent score) is believed to be the gold standard for diagnosis BV but Amsel's criteria are recommended for the clinical diagnosis of BV. The aim of this study was to determine the role of each of Amsel's criteria in the diagnosis of BV.Methods: This descriptive cross-sectional study was performed on 69 women with abnormal vaginal discharge. Samples of vaginal discharge were tested for BV infection using both Amsel's criteria and Nugent score. Considering Nugent score as the gold standard sensitivity, specificity, positive and negative likelihood ratio, positive and negative predictive value, area under curve of each Amsel's criteria and combinations of two criteria were estimated.Results: The prevalence of BV was 42% in our study. Vaginal pH and clue cell were the criteria with the highest sensitivity (83%) and specificity (84%), respectively. Also the sensitivity and specificity of combination of any two criteria ranged from 24% to 62% and 70% to 87%, respectively. The sensitivity and specificity of Amsel's criteria was 55% and 73% respectively.Conclusion: In this study we compared the results of combination of two of Amsel's criteria for diagnosis of BV while the Nugent score was considered as the gold standard. The findings of the present study showed that we can use pH of vaginal discharge for the diagnosis of bacterial vaginosis at first and if the result is negative, the diagnosis can be ruled out. If the pH test becomes positive, another component of Amsel should be tried while two positive components confirm the diagnosis of BV and specific treatment could be started. If the second component is negative we should use another component of Amsel for diagnosis or ruling out of the disease.

Introduction: Colon cancer is one of the cancers which are strongly influenced by environmental factors. In 1980, "feminine sex hormones" were suggested as factors that might be related with colon cancer and many studies have been performed since then. The present case-control study investigated the correlation of menstrual, reproductive and oral contraceptive (OCP) factors with colon cancer in women older than 45 years old who had colon cancer.Methods: This case-control study was conducted in two major hospitals of Mashhad. It enrolled 83 women with colon cancer in the study group and 99 women who were admitted to Ghaem and Imam Reza hospitals for the conditions unrelated to gastrointestinal and gynecological diseases in the control group. The median age of the participants was at least 45 years old.Factors such as parity, age at first full-term pregnancy, number of abortions, age at menopause and duration of OCP usage (in years) were compared between the two groups.Results: There was a significant trend of decreasing colon cancer risk with increased parity (p=0.01). Age at first pregnancy was directly associated with the risk of development of colon cancer (p<0.01). There was no significant difference in number of abortions between those two groups of our study. (p>0.1) Also there was no significant correlation of the age at menopause of older than 50 years and OCP usage with the risk of development of colon cancer (p>0.1, p>0.1, respectively).Conclusion: Based on the findings of the present study, it seems that the relationship between reproductive factors and colon cancer is more prominent than menstrual factors and OCP usage, but verification or rejection of this conclusion needs stronger and more consistent evidences.

Introduction: Menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity which is recognized to have occurred after 12 consecutive months of amenorrhea, for which there is no other obvious pathological or physiological cause. It leads to changes in the quality of life, osteoporosis and heart diseases in affected women. In this paper the pattern of age of natural menopause in Shahrood (in Semnan province, Iran) was studied.Methods: This cross-sectional study enrolled 1392 women who were 30 years old or older. They were randomly selected using a cluster sampling method and interviewed to fill out a questionnaire including required data. An exclusion criterion was the presence of abnormal menopause due to surgery. Finally 1338 women remained in the study and the pattern of the age of menopause was estimated for them calculating the prevalence of menopause in each age group.Results: Mean and median ages at natural menopause were 53.2±5.7 and 50.7 years respectively. The prevalence of menopause was low from age 30 to 42, but it showed a steady increase to the age of 54 years old. The prevalence of natural menopause slowed down after the age of 54 in our study.Conclusion: Findings of our study showed that mean age at natural menopause in Shahrood is higher than other regions of Iran. However, careful estimation of age at natural menopause needs further studies using appropriate methodology in other regions of Iran.

Introduction: Polycystic ovarian syndrome (PCOS) is one of the causes of anovulation, oligoovulation and infertility. There are two categories of treatment for these patients: 1) medical treatments such as Metformin, Clomiphene citrate, Gonadotropins; 2) surgical treatments such as cauterization of ovaries and laparoscopic ovarian drilling (LOD). The aim of this study was to evaluate the efficacy and successful rate of LOD in PCOS with infertility that was irresponsive to medical therapy. Methods: This Semi-experimental (before-after) study was done in 45 infertile women with PCOS who were resistant to medical treatment by Clomiphene citrate in Besat hospital in Sanandaj, Iran. LOD was performed in all patients. The patients were followed up to 12 months after LOD for regularity of menses, pregnancy rate, outcome of pregnancy, and complications after surgery. Data were collected by SPSS software and were analyzed by Chi square, McNemar and T-test. Results: Before surgery 40 patients (88.9%) had irregular menses. After surgery this rate was reduced to 15 patients (31.1%). 28 patients (60%) became pregnant during 12 months. The average time for the patients to become pregnant after ovarian cauterization was 5 months. Complication after surgery was seen in only one patient as adhesion of sigmoid colon to ovary. There was no hyperstimulation (OHSS) or multiple gestations after induction ovulation. 21 of the 28 pregnant patients (75%) delivered healthy infants. There was no significant correlation between body mass index, FSH/LH ratio before operation and the rate of regularity of menses in our patients. Conclusion: LOD is an effective treatment for infertile women with PCOS resistant to Clomiphene citrate and it could be the first line of treatment for the infertile women with PCOS.

Introduction: Induced abortion is defined as medical or surgical termination of pregnancy before fetal viability is achieved either due to maternal or fetal causes. Considering the potential complications of surgery and anesthesia, hospitalization, costs and time spent, medical induced abortion has replaced surgical treatment in the past two decades. The aim of this study was to evaluate the efficacy of vaginal Misoprostol (Prostaglandin E1) in medical termination of first trimester pregnancy. Methods: This descriptive analytic study was done on 100 women in first trimester of pregnancy that referred for termination of their pregnancies to hospitals affiliated to Mashhad University of Medical Sciences in 2006. Vaginal Misoprostol (800  mg) was prescribed and in cases of failure of induced abortion, a second dose followed 24 hours later. Control sonography was performed in all patients to detect any residue of pregnancy one week later. In failed cases of induced abortion or the presence of residue, dilatation and curettage (D & C) was done. Data were analyzed by Chi square test and p value of <0.05 was considered significant. Results: In our study 83 women (83%) had successful complete abortion. Medical abortion was achieved by first dose of vaginal Misoprostol in 55 patients (62%) while in 28 enrolled women (34%) a second dose of vaginal Misoprostol was needed. D & C was done in 17 cases. No side effects were noted due to vaginal Misoprostol treatment in our study.Conclusion: Medical abortion in first trimester pregnancy with vaginal Misoprostol showed a safe and cost-effective treatment modality.

Introduction: Exercise could play an important role in health keeping during pregnancy. Few studies have been done to elucidate the causes of these effects of exercise in pregnancy outcomes in women. Due to the probability of poor outcomes of pregnancy accompanied by economic, physical and psychological consequences this research was carried out in order to investigate the effects of some simple exercises and proper daily activity on the outcome of pregnancy.Methods: This experimental study was conducted on 138 of pregnant women that were in eighth to twelfth weeks of their pregnancy who referred to the either health centers or the clinics of gynecologists for control of pregnancy. They were selected by block sampling methods. After thorough explanation of the goals of the study and obtaining the written consent, the enrolled women were randomly attributed into two study and control groups. The study group included 66 women and control group included 72 women. The research had four stages: 1) taking history, 2) a teaching program for study group, 3) collecting data, 4) assessment and analyzing data using Chi-square and T tests.The enrolled women in the study group did 60 minutes of light aerobic exercises for every other day for 30 weeks.Results: The enrolled women in the study and control groups had normal labor in 98.4% and 61.1%, respectively. The Chi-square test showed significant differences between both groups based on parturition sort ( c2=14.5, p<0.05). Odd ratio of natural parturition in the study group was 5.36. The T test showed the significant statistical difference between both groups on the first minute Apgar score (P<0.009, t=0.85) and the fifth minute Apgar score (P<0.001; t=2.80). But there was no significant difference of the average weight gain of enrolled women during pregnancy between two groups.Conclusion: Findings of our study showed that doing exercises during pregnancy period not only resulted in no harm to the mother and fetus but also improved outcome of pregnancy.