Journal of Family and Reproductive Health
Volume:7 Issue: 4, Dec 2013

To evaluate the plasma creatine phosphokinase (CPK) level after a single injection of methotrexate (MTX) as a predictor of treatment success in ectopic pregnancy (EP). In this prospective study, seventy nine women older than 18 years treated with methotrexate for ectopic pregnancy were evaluated for CPK and β-subunit of human chorionic gonadotropin (βhCG) levels, while they received intramuscular MTX at a dose of 50 mg/m2. The day of injection was considered as day 1 (D1). CPK level on D1 was compared between the group 1(as treatment success group), treated by a single MTX injection, and the group 2, treated by two or three MTX injections or by surgery. The success rate of MTX treatment was 58 (73.3%). The mean of CPK was higher in treatment success group (group1) than failure group (group 2) (71.98 ± 15.711 vs. 64.43 ± 15.898), but the difference was not significant (p=0.06).The mean of βhCG was significantly lower in treatment success group (group 1) than failure group (group 2) (1187.52±631.45 vs. 1663.87±1096.845; p=0.01). Ultrasonographic findings of EP were seen in 63 patients, while the means of βHCG and CPK were higher in these patients than those with normal ultrasonography, but difference was not significant (p=0.37 and p=0.24, respectively). The sample was not large enough to indicate a significant difference in the CPK level, which can be considered as an indicator for differentiating between the successful and unsuccessful treatment groups. Moreover, the present study did not show any relation between initial β-hCG and CPK serum levels, so our findings indicate that they are not possibly considered as two independent biomarkers in ectopic pregnancy.

The aim of this study was to estimate the prevalence of sexual intimate partner violence (SIPV) and to investigate its associated factors among women attending public obstetrics, genecology, and family planning health services of the city of Marivan, Iran. This multistage cluster sampling study recruited 770 women attending the public obstetrics, gynecology and family planning health services of the city of Marivan from May to November, 2009. Our findings confirmed that about one-third of the women experienced SIPV (32.9%). Statistically significant differences were found (p <. 001) in SIPV by almost all demographic and characteristic variables. Woman’s circumcision, forced marriage, spouse’s infidelity, level of sexual desire, woman’s pleasure from intercourse, and spouse’s inattention to woman’s sexual satisfaction during intercourse were statistically significant predictors of SIPV, and also, were accounted for 61.8% of the participants. Public health centers and health-care providers should focus on both women and their spouses in order to participate in both national and community level of educational and promotional intervention programs. Without their participation, the likelihood of success in decreasing SIPV against women would be low.

The aim of this study is to determine if simvastatin pretreatment would change clomiphene response in clomiphene citrate-resistant (CC-R)women with (PCOS). This quasi experimental study included twenty five clomiphene resistant women with PCOS. All patients received cyclic oral contraceptives pills (OCP) (30µg of ethinyl estradiol and 150µg of desogestrol) from the 5th day of their spontaneous or progesterone (P) induced menstrual cycle; in addition, they received simvastatin (20mg/day) from the first day of cycle for two consecutive months. Then, patients were given 100 mg clomiphene citrate (CC) (Iran Hormone, Iran) for five days starting from day three of their menstrual cycles. The primary outcome measures were ovulation and pregnancy rates. The change in body mass index (BMI), the mean number of follicles ≥ 18 mm, the mean of follicular size and endometrial thickness on the day of human chorionic gonadotropin (HCG) administration were secondary outcome measures. Ovulation occurred in 5 out of 25 (20 %) patients, but none of the patients conceived in this study. No important change in BMI was observed after using simvastatin (0.28+1.13; p=0.228). In all patients with ovulation, the number of follicles ≥ 18mm was one. The mean follicular size and endometrial thickness on the day of HCG administration were 19.67 ± 2.04 and 7.00 ± 1.34, respectively. In this study, we did not observe the favorable effect on ovulation and pregnancy rates with CC following of simvastatin pretreatment in CC-resistant PCOS women. So, further studies with a larger number of patients, higher doses of CC and more cycles are necessary to make this obvious.

To evaluate sexual function and its relationship with quality of life, and mental and physical health in pregnant women. Obtained results showed that 59 (39/3%) pregnant women were «very dissatisfied», 25 (16/7%) women were «moderately dissatisfied», 64 (42/7 %) women were «both satisfied and unsatisfied», only 2 (1/3 %) women were relatively satisfied, and no one was «very satisfied». There is a significantly negative weak correlation between female sexual function with anxiety and depression, while there is a significantly positive weak correlation between female sexual function with the general quality of life, psychological health and environment dimensions. Only depression predicts female sexual function significantly. The women more than 10 years passed of their marriage showed more sexual satisfaction compared to those less than 10 years passed of their marriage (p< 0. 05). The roles of predictive variables in sexual dissatisfaction, as well as the limitations for the study are discussed in the article. Obtained results showed that 59 (39/3%) pregnant women were «very dissatisfied», 25 (16/7%) women were «moderately dissatisfied», 64 (42/7 %) women were «both satisfied and unsatisfied», only 2 (1/3 %) women were relatively satisfied, and no one was «very satisfied». There is a significantly negative weak correlation between female sexual function with anxiety and depression, while there is a significantly positive weak correlation between female sexual function with the general quality of life, psychological health and environment dimensions. Only depression predicts female sexual function significantly. The women more than 10 years passed of their marriage showed more sexual satisfaction compared to those less than 10 years passed of their marriage (p< 0. 05). The roles of predictive variables in sexual dissatisfaction, as well as the limitations for the study are discussed in the article. Depression as same as environment heath had an important effect on sexual satisfaction in pregnant women and so assessment of depression and environment health in medical program for pregnant women is necessary. Also considering decrease in sexual satisfaction in aging training new methods for sexuality can be useful.

To compare efficacy, safety and tolerance of combination of mifepristone and misoprostol versus misoprostol-only in induction of late intrauterine fetal death (IUFD). This prospective study included a consecutive series of 52 women gravid up to fourth with IUFD after 28 weeks of gestation between January 2008 and June 2011. Women were divided into two groups. First group of women received a single oral dose of 200mg mifepristone, and after 24 hours, 100ug of intravaginal misoprostol was administered, followed by intravaginal 100µg misoprostol at four hourly intervals if required. Second group of women received 100 µg misoprostol at four hourly interval per vaginally (maximum 600µg in 24 hours). Oxytocin was given for augmentation if needed. The induction-to-delivery time was shorter with the combination regimen (p < 0.001) group. The total dose of misoprostol needed was lower in the group pre-treated with mifepristone (p < 0.001). Oxytocin was required only in misoprostol group. The two groups did not differ as regards complications experienced during labor and delivery significantly. Both regimens, misoprostol-only and the combination of mifepristone and misoprostol are safe in induction of labor after intrauterine fetal death (IUFD). Pre-treatment with mifepristone is more effective in terms of reducing of induction delivery interval, requirement of lesser dose of misoprostol and no need of augmentation with oxytocin.

Nowadays, many infertile couples can have child by assistant reproductive technology (ART). Always the undesirable effects of these methods on newborn are considered and are evaluated. The aim of this study is to describe the impact of ART on ocular and visual performances of infants born by these methods. In a cross-sectional descriptive study, 479 infants aged three-nine months presented to an optometry clinic of Child Health and Development Research Department (CHDRD), Tehran, Iran. Static retinoscopy, qualitative fixation evaluation, Hirschberg test, red reflex assessment and external eye examination were carried out. Other information such as birth weight and maturity of the infants was recorded. It was possible to assess only 320 out of 479 infants due to general condition of some participants. Comparison of mean refractive error in infants’ right and left eyes did not show any significant difference. Our findings confirmed that 20.3% had poor fixation, while 2.9% revealed manifest strabismus. The results also revealed the prevalences of myopia, hyperopia and emmetropia are 2.9%, 87%, and 10.1%, respectively. Red reflex abnormalities were significantly found in boys and in preterm infants (p<0.05). Failure of fixation control was seen more frequently with increasing refractive error, which significantly developed in preterm infants (p<0.001). These results reflect the necessity of more comprehensive assessments and further follow-up of infants born by ART, especially for premature male ART infants. These results also suggest the probability of fixation condition and visual deficiencies in these infants. It is recommended to pay close attention to this preliminary report about the refractive and fixation condition of the infants born after ART.

We report a case of a woman presenting in a state of shock with classic symptoms of ruptured ectopic pregnancy. She had a history of tubal ligation done three years back. Exploratory laparotomy was done, and a diagnosis of ruptured ectopic ovarian pregnancy was made.Keywords: Ovarian Pregnancy, Ectopic Post Tubal Ligation

A 49 year old woman diagnosed as a cervical cancer patient, after receiving appropriate treatment experienced metastasis in her abdominopelvic cavity. After aggressive management, she was well for a while. However, she developed to a poor condition consisting of urologic, gastroenterological, hematologic and neurologic problems just in a short time. In the course of hospital she presented one sided passive bradykinesia, resting tremor, cogwheel rigidity with controlateral suspicious CT scan of brain. She passed away soon after that.