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Women’s Health and Reproduction Sciences - Volume:3 Issue: 1, Winter 2015

International Journal of Women’s Health and Reproduction Sciences
Volume:3 Issue: 1, Winter 2015

  • تاریخ انتشار: 1394/02/08
  • تعداد عناوین: 12
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  • Becky Spencer, Arash Khaki Page 75
  • Zafer Akan Page 77
  • Elizabeth Restrepo, Fuqin Liu Page 78
    Objectives
    Gestational weight gain is important for optimal maternal and neonatal outcomes. New Institute of Medicine (IOM) recommendations for gestational weight gain define obesity as body mass index (BMI) ≥30 and do not differentiate between maternal obesity classes. The recommended weight gain is 11-20 lbs. for obese women. The purpose of this study is to document prevalence of maternal obesity, excess gestational weight gain, and negative maternal and neonatal outcomes prior to 2009 IOM recommendations for gestational weight gain.
    Materials And Methods
    This was a retrospective cohort study using Texas birth/infant death certificate data for 2005 through 2009, inclusive. The study population included 419,028 women. Those with excess (>20 lbs.) gestational weight gain were compared with those who gained the recommended 11-20 lbs.
    Results
    Compared to the recommended weight-gain group, women in the excessive weight-gain group had lower percentage of gestational diabetes, across three obesity classes. Women with excessive weight gain had higher percentage of pre-eclampsia and Cesarean delivery (C-section) than women in the recommended weight-gain group. Babies of women with excessive weight gain in Obesity Class III had higher percentages of Neonatal Intensive Care Unit (NICU) admission, assisted ventilation >6 hours, surfactant therapy, and antibiotics for suspected sepsis than babies of women in Obesity Class III, gaining within the IOM recommendation.
    Conclusion
    Findings suggest that the relationships between maternal obesity classification, gestational weight gain, and maternal and neonatal outcomes are complex. Further evidence is needed to make recommendations on gestational weight gain for obese women, stratified by the severity of obesity.
    Keywords: Gestational weight gain, 2009 IOM Guidelines, Pre, pregnancy obesity
  • Irene Mora, HervÁs., EmÍ, Lia SÁ, Nchez, Francisco Carmona, Montserrat EspuÑa., Pons Page 84
    Objectives
    To estimate the incidence of perineal trauma in primiparous women with spontaneous vaginal delivery and to identify the factors associated with second-degree lacerations.
    Materials And Methods
    A subset analysis of women with spontaneous vaginal deliveries (n=489) from an institutional review board-approved parent study in healthy, nulliparous, continent pregnant women, attending the public health care system of Catalonia (northeast Spain). Primary outcome measure was perineal trauma according to the RCOG classification. For the bivariate analysis, the Student’s t-test, ANOVA and the chi-squared test, or the corresponding non-parametric tests were used. Rates, relative risks and odds ratios (multivariate analysis) were estimated along with 95% confidence intervals (CI).
    Results
    About 91% (95% CI: 88-93%) of women with vaginal deliveries showed some degree of perineal trauma. Nulliparous women with spontaneous deliveries who did not undergo an episiotomy were 9 times more likely to present a tear (any grade) than those who received an episiotomy [Relative risks (RR) = 9.6, 95% CI: 6.3%-14.6%, P<0.001]. Only episiotomy reached statistical significance in bivariate and multivariate analyses (P<0.0001), revealing the protective effect of episiotomy respect to second-degree tear.
    Conclusion
    The absence of episiotomy was the only variable independently associated with second degree perineal tears, showing a clear protective effect.
    Keywords: Episiotomy, Parity, Vaginal birth
  • Fatma Eskicioglu, Esra Bahar Gur Page 89
    Objectives
    Rupture of membranes prior to the onset of labor is known as Premature Rupture of Membranes (PROM). Early and correct diagnosis is crucial in order to prevent fetal and maternal risks that can be life threatening. We aimed to investigate the diagnostic ability of the tests in PROM.
    Materials And Methods
    Nitrazine test, fern test, amnio-dye test, biochemical tests (insulin-like growth factor binding protein-1 and placental alpha microglobulin-1) were evaluated in terms of effectiveness in diagnosis of PROM.
    Results
    A gold standard method has not yet been defined in PROM. Diagnostic tests (nitrazine test, fern test, Insulin-like Growth Factor Binding Protein-1 “IGFBP-1” and Placental Alpha Microglobulin-1 “PAMG-1”) should be used when the diagnosis is not certain following history, examination with sterile speculum and ultrasonography evaluation.
    Conclusion
    IGFBP-1 and PAMG-1 are tests based on bedside immunochromatographic method. Especially, PAMG-1 comes into prominence with its high sensitivity and specificity.
    Keywords: Fetal membranes, Insulin, like growth factor binding protein 1, Placental alpha, microglobulin 1, Premature rupture
  • Chidozie Emmanuel Mbada, Olubukayomi Ebunoluwa Adebayo, Taofeek Oluwole Awotidebe, Funmilola Adenike Faremi, Monisola Omoyemi Oginni, Abiola Oladele Ogundele, Anne Antonette I. Emechete Page 93
    Objectives
    The African culture seems to play a major prohibiting role in physical exercise during pregnancy and immediate postpartum. This study was designed to assess practice and pattern of antenatal and postnatal exercise among Nigerian women.
    Materials And Methods
    Three hundred and sixty-five women (189 pregnant women and 179 nursing mothers) from six selected hospitals in south-west Nigeria participated in this cross-sectional study. Data were obtained on socio-demographic and obstetric characteristics, and practice of antenatal and postnatal exercise. Descriptive and inferential statistics were used to analyze data at P<0.05 alpha level.
    Results
    The mean age of all the respondents was 28.9± 4.63 years. A majority of the pregnant women responders were nulliparous (39.2%) while the nursing mother responders were mostly multiparous (54.5%). Prevalence for engagement in physical exercise was 81.9% and mostly based on self-prescription (35.5%) and prescription by nurses (28.8%). Antenatal and postnatal exercise practice was 84.7% (160/189) and 79.0% (139/176), respectively. Aerobic (43.5%) and stretching (33.4%) were the most common type of physical exercises. Exercise frequency was mostly 1-2 times per week (40.8%). There was significant association between exercise practice and education level (χ2=18.795; P=0.001).
    Conclusion
    Engagement in antenatal and postnatal exercise among Nigerian pregnant and nursing women was high and mostly based on self-prescription. Education level significantly influence physical exercise practice among Nigerian women with aerobic and stretching as the predominant exercises in pregnancy and postpartum.
  • Elaheh Ouladsahebmadarek, Ali Dastranj Tabrizi, Manizheh Sayyah, Melli, Mehri Jafari, Shobeiri, Parvin Mostafa, Garabaghi, Fatemeh Nazari Page 99
    Objectives
    Making a decision on the extent of surgery for ovarian tumors depends on the intraoperative diagnosis. The aim of this study was to compare the intraoperative cytology and frozen section (FS) for diagnosis of ovarian masses.
    Materials And Methods
    One hundred and thirty-one patients with ovarian masses who underwent surgery for ovarian neoplasms were evaluated by intraoperative scrape and FS techniques and compared to final pathologic diagnoses.
    Results
    Scrape cytology for intraoperative diagnosis of benign ovarian tumors had sensitivity of 89.06% compared to 90.62% for FS. Specificity of both scrape and FS techniques for benign tumors was 94.91%. Sensitivity and specificity of scrape for malignant ovarian tumors were 94.91% and 89.06%, respectively. The related values for FS were 94.91% and 90.62%. The overall accuracy percentage of scrape and FS for diagnosis of ovarian neoplasms was 91.86% and 92.68%, respectively.
    Conclusion
    Intraoperative scrape cytology has high accuracy in diagnosis of ovarian tumors and is comparable with FS.
    Keywords: Frozen sections, Intraoperative, Cytology, Pregnancy outcome
  • Farhang Abed, Shahrzad Zadehmodarres Page 103
    Objectives
    Sperm cell preparation is an important step in the advanced treatment of infertility. Among the different methods introduced, none are considered to be ideal. The common methods are based on utilizing centrifugal separation which has been proven to be harmful to the sperm cell. We developed a method, based on the motion against the flow of sperm cell, which can successfully separate active sperm cells.
    Materials And Methods
    In this study, we investigated the efficacy of this approach with a randomized clinical trial. Fifty-one candidates for the intra uterine insemination (IUI) treatment participated in our study. Twenty-five cases were assigned to our test group, separating the sperm cells using the proposed method (upstream method), and the conventional swim-up method was applied to 26 cases in our control group. The entire process of IUI treatment in both groups was exactly the same except for the methods of separating sperm cells.
    Results
    Results showed that the pregnancy rate using the new method was 20%, while the common method of sperm cell preparation resulted in 15.3% pregnancy rate.
    Conclusion
    The new sperm preparation method (Upstream method) can be used as a simple, quick and effective method of sperm cell separation in fertility treatment especially in IUI procedure.
    Keywords: Intra Uterine Insemination, Sperm, Sperm preparation, Swim, up, Upstream
  • Masoumeh Mazandarani, Nargess Osia, Mohammad Ghafourian Page 107
    Objectives
    Achillea biebersteinii Afan. has been used as antispasmodic and sedative agent to treat dysmenorrhoea in traditional medicine of Golestan province. The present study was conducted to evaluate the antioxidant activity. It is also an ethno pharmacological survey of Achillea biebersteinii Afan., as antispasmodic and sedative agent in treating dysmenorrhoea in traditional medicine of Golestan province.
    Materials And Methods
    Ethno pharmacological data was obtained as field observation among well-known indigenous rural healers (68-82 ages) in southwest of Golestan province in August 2011. The data gathered evaluated the potential of Achillea biebersteinii in preventing or treating dysmenorrhoea. Flowers of the plant were collected in July 2012 at an altitude of 2600 meters, ethanol extract was obtained by Maceration and antioxidant capacity was obtained by 1,1-diphenyl-2-picryl hydrazyl radical scavenging (DPPH).
    Results
    Results showed that in traditional medicine of Golestan province, the flowers of Achillea biebersteinii has been used in combination with Peganum harmala, Mentha aquatica, Cuminum cyminum, Foeniculum vulgare and Nigella sativa as antispasmodic, anti-inflammation and sedative agent to treat stomach ache, dysmenorrhoea, facial flushing, cramps and menopause. Also the ethanol extract of the plant is a very good free radical scavenging with the highest antioxidant activity (IC50 = 1.27±0.1 μg/ml in dry weight).
    Conclusion
    These finding not only confirm the use of the plant in the traditional medicine of Golestan province, but also can serve as a basis for phytochemical and pharmaceutical researches to identify and produce effective herbal drugs in prevention or treatment of common dysmenorrhoea.
    Keywords: Achillea biebersteinii Afan., Antioxidant, Dysmenorrhoea, Ethno pharmacology
  • Sultan Qudah, Omar Abu Azzam, Tarek Athamneh, Sascha Baum, Erich, Franz Solomayer, Mohammad Hammadeh Page 111
    Objectives
    To review the role of trachelectomy as a method of fertility preservation instead of traditional radical hysterectomy in early cervical cancer.
    Materials And Methods
    We conducted our original study through research in PubMed for all original studies and reviews published in the last 10 years. We reviewed the data available on trachelectomy in early stage cervical cancer whether through abdominal route or vaginal route and laparoscopic lymphadenectomy. Moreover, we reviewed the oncologic outcome, recurrence rate and its effect on subsequent pregnancies.
    Results
    We found that recurrence and death rates seem to be comparable between radical trachelectomy (RT) and radical hysterectomy. Complications of RT include chronic vaginal discharge, abnormal uterine bleeding, dysmenorrhea, inflammation and ulcer due to cerclage, amenorrhea, and cervical stenosis. Although around 70% can get pregnant after RT, there are increased complications of pregnancy after this procedure mainly 2nd trimester miscarriages and preterm deliveries.
    Conclusion
    RT is a useful technique associated with an excellent pregnancy rate in fertility-preserving surgery to treat early stage cervical cancer. Selection of suitable patients for conservative treatment is the best important point for getting a good result without any recurrence or complication.
    Keywords: Fertility preservation, Radical hysterectomy, Trachelectomy, Uterine cervical neoplasms
  • Divya Pandey, Brajendra N. Tripathi, Pallav Mishra Page 115
    Introduction
    Rudimentary horn pregnancy (RHP), an entity with a diagnostic dilemma is known to rupture most commonly in second trimester, sometimes in early third trimester. This case of ectopic rudimentary horn (RH) presented acutely in the first trimester.
    Case Presentation
    A 30 years old G3P2L2 with previous two vaginal deliveries presented with acute abdominal pain and features of hemorrhagic shock at 8 weeks 5 days gestational age. With clinical diagnosis of ruptured ectopic pregnancy, the patient immediately underwent laparotomy, which revealed hemoperitoneum with a unicornuate uterus along with ruptured RHP. RH excision with ipsilateral salpingectomy and right tubal ligation was done and the maternal life salvaged.
    Conclusion
    High index of suspicion based on clinical history and examination complemented with diagnostic radiological modalities can help in prenatal and pre-rupture diagnosis of RHP, hence its prompt treatment to alleviate scope of any emergency situation and the disastrous consequences leading to maternal morbidity and mortality.
    Keywords: Ectopic pregnancy, First trimester, Rudimentary horn pregnancy, Rupture
  • Mertihan Kurdoglu, Zehra Kurdoglu Page 118
    The accumulated data related to the recently discovered functions of laminin receptor 1 (LR1) in the early stages of placentation[1-5] made us to think that it may also have an important role in human reproduction, which may be regarded as a very new job for this multifunctional protein overexpressed in many types of cancer and is very well known for its important roles in tumour-cell migration and invasion.