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Women’s Health and Reproduction Sciences - Volume:5 Issue: 3, Summer 2017

International Journal of Women’s Health and Reproduction Sciences
Volume:5 Issue: 3, Summer 2017

  • تاریخ انتشار: 1396/05/31
  • تعداد عناوین: 15
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  • Stephanie B. Mohammed, B. Shivananda Nayak Pages 153-157
    Objectives
    To identify the trend occurring in the diagnosis, prognosis, and therapy treatment of women diagnosed with polycystic ovarian syndrome (PCOS) and to highlight the importance of the accumulated and accepted decisions made.
    Methods
    To perform a quality assessment on the literature available from specific search engines throughout the years 1800-2017.
    Results
    PCOS affects women physically, psychologically, metabolically, endocrinologically and reproductively. Women are identified from the basic cardinal features classifiable with the condition from which they are then recommended to have diagnostic testing. To date, these involve the use of an ultrasound for the identification of immature follicles and biochemical testing of ovarian hormones and corresponding blood test in relation to the signs and symptoms exhibited. PCOS has shown to be present from the pre-adolescent stage throughout adolescent into adulthood and it is observed to affect women regardless of their ethnicities and demographics.
    Conclusion
    Presently there are various proposed treatments available for the management of PCOS which includes lifestyle modification, administration of pharmaceutical agents and surgical procedures.
    Keywords: PCOS, Symptoms, Diagnosis, Treatments
  • YÜce, Ouml, Zge, YÜce Tuncay, Ccedil, Amurdan Mahmut Orhun Pages 158-163
    Abnormal uterine bleeding (AUB) is a frequent cause of visits to health care provider during adolescent period and is characterized by irregular, excessively heavy, prolonged and/or frequent bleeding of uterine origin. Although many etiologies cause AUB, the one most likely cause among adolescents are dysfunctional uterine bleeding (DUB). DUB describes any kind of abnormal bleeding pattern that is not attributable to any structural or systemic disease. Anovulation due to immaturity of the hypothalamic-pituitary-ovarian (HPO) axis is the leading cause in the first 2-3 postmenarchal years. The primary goal of treatment is prevention of hemodynamic instability. Therefore, assessing the severity and cause of bleeding is important. Therapeutic approach in the acute period should be established according to the degree of anemia and amount of flow. Treatment options for medical care of DUB generally include: oral contraceptives, progestins, non-steroidal anti inflammatory drugs, anti-fibrinolytic agents, GnRH analogues and levonorgestrel releasing intrauterine system (LNG-IUS). Additionally, long-term management with hormonal therapy in patients with severe uterine bleeding is known to be safe for developing HPO axis.
    Keywords: Adolescent, Dysfunctional Uterine Bleeding, Therapeutics
  • Fatemeh Yari, Kamran Aeinfar, Saber Abbaszadeh, Khatereh Anbari, Seyyed Amir Yasin Ahmadi Pages 164-170
    Objectives
    Angiotensin converting enzyme (ACE) is an important enzyme involved in the physiopathology of renal, cardiovascular and ovarian systems. One of these ACE related diseases is polycystic ovary syndrome (PCOS).
    Materials And Methods
    We intend to update the only meta-analysis written by Jia et al in 2013 on the association of ACE gene polymorphism and risk of PCOS. The reason of our attempt to update this meta-analysis was that they found no significant relation in their meta-analysis. For this aim, we searched in databases for relevant documents.
    Results
    We found 8 relevant papers, 6 of which had been covered by Jia et al meta-analysis. In order to perform this meta-analysis, we used comprehensive meta-analysis software. The analysis was done through P value and sample size of each study based on fixed-effect model. Analyses were performed in 5 different groups of alleles and genotypes. Among these 5 analyses, 4 of them were statistically significant. Hereby, we concluded that DD genotype of ACE is a risk factor for PCOS (P value = 0.013; odds ratio [OR] = 1.195), while DI is the protecting genotype (P = 0.009; OR = 0.819).
    Conclusion
    Hence, it is suggested to use a very low dose of captopril as an ACE inhibitor in the PCOS patients having DD genotype in future as a clinical trial, just as a scientific model. Further investigation on ovary ACE system is needed.
    Keywords: Angiotensin converting enzyme inhibitors, Meta-analysis, Polycystic ovary syndrome
  • Aima Iram Batool, Syeda Humaira Jabeen, Naima Huma Naveed, Fayyaz Ur Rehman, Iram Inayat, Fareeha Idrees, Asma Noreen, Hakim Bibi Pages 171-174
    Objectives
    Lack of safety measures and unawareness about the harmful effects associated with pesticide exposure among cotton picking females contribute to poor health quality in this group of workers. The activity of butyrylcholinesterase (BChE) acts as potential biomarker of pesticide exposure among these females. Our study aimed to determine the relationship between decreasing activity of BChE level in serum with pesticide exposure in female cotton pickers that can lead towards health impairments.
    Materials And Methods
    The BChE level in serum samples of 50 female cotton pickers were compared to that of 50 controls using the t test. A questionnaire was prepared and asked from each female worker which was related to precautionary measures, work history and personal information.
    Results
    Serum BChE activity in exposed females was (6194.80 U/L) as compared to non-exposed females (7209.77 U/L). Our studies confirm and extend the association between educed BChE activity and pesticide exposure. BChE activity could be used as an assessment tool for pesticide poisoning among exposed workers. In regard to precautionary measures none of the females used gloves or eye glasses. Face mask was used by only 10% of the females for protection. 30% of the females did not take bath or wash their hands and face after picking, and almost all females were found to eat and drink during picking.
    Conclusion
    Pesticide exposure along with no safety measures decreased the BChE activity among exposed female workers that could be responsible for deranging the physiological responses of their body.
    Keywords: Acetylcholinesterase, Butyrylcholinesterase, Female, Pesticides
  • Nasrin Saharkhiz, Farnaz Ehdaeevand, Anahita Tavana, Zahra Majdfar, Masoumeh Fallahian Pages 175-180
    Objectives
    To evaluate and compare the efficacy of mefenamic acid and tranexamic acid in controlling menorrhagia induced by Copper T-380A intrauterine device (IUD).
    Materials And Methods
    Women aged 18-40 years with heavy menstrual bleeding, who were using TCu380A IUD, were randomised to receive tranexamic acid (group 1, n = 120) or mefenamic acid (group 2, n = 90), 500 mg three times daily for 3-5 days of three consecutive menstrual cycles. Changes in menstrual blood loss volume and duration were assessed using the questionnaire form filled out before the treatment and every month for 3 months. Method of calculation of blood loss volume was instructed to all participants at the first visit. Haemoglobin (Hb) concentration level of participants were also assessed before and after the treatment. Data were analysed using t test, paired sample t test, non-parametric Mann-Whitney test, chi-squared test, and analysis of covariance (ANCOVA).
    Results
    After the treatment, mean blood volume decreased significantly, by 42.3% in group 1 and by 44.5% in group 2, but their difference was not significant. Mean menstrual days decreased significantly, by 64% in group 1 and by 62% in group 2; however, their difference was not significant. Hb concentration level before and after the treatment was not significantly different between the 2 groups. The peak effect of both drugs was observed at the end of the second month of treatment.
    Conclusion
    Tranexamic acid and mefenamic acid have the same significant effect in reducing mean blood loss volume and duration of menstruation in TCu380A IUD users.
    Keywords: Intrauterine devices, Copper, Mefenamic acid, Menorrhagia, Tranexamic acid
  • Leila Ghahremani, Monireh Alipoor, Sedighe Amoee, Sareh Keshavarzi Pages 181-186
    Objectives
    Health-promoting behaviors during pregnancy are those that encourage or improve health-related quality of life, both maternal and foetal. They also decrease risk factors. The present study aims to investigate the effect of health education on health-promoting behaviors in pregnant women in Mahshahr, southern Iran
    Materials And Methods
    In this experimental study, 78 pregnant women were selected using multi-stage sampling and were randomly divided into 2 groups each including 39 subjects. The intervention group learned physical activity and health behaviors based on the constructs of self-efficacy through 6 sessions. However, no interventions were performed for the control group. The data were collected using a questionnaire containing demographic information, health-promoting lifestyle, and Exercise Self-Efficacy Scale (ESES) before and one month after the intervention. Then, the data were analyzed using t test, chi-square test, and regression analysis.
    Results
    After the intervention, the mean score of health-promoting behaviors, subscale and physical activity self-efficacy increased in the intervention group, which was significantly different from the control group (P
    Conclusion
    The results of current study supported the effectiveness of training and revealed that training based on self-efficacy theory led to an increase in the mean score of health-promoting behaviors, particularly physical activity and motivational skills (self-control and feeling of self-efficiency). Thus, by creating and maintaining regular health-promoting behaviors, maternal and fetal health and well-being can be guaranteed.
    Keywords: Pregnancy, Health-promoting behaviors, Self-efficacy
  • Malihe Soltani, Maryam Moghimian, Hosein Abtahi, Majid Shokoohi Pages 187-192
    Objectives
    This experimental study used a rat model to investigate the effect of Matricaria chamomilla (MC) extract on histological damage and oxidative stress induced by torsion/detorsion in adult rat ovary.
    Materials And Methods
    In our experimental study, 28 female Wistar rats were used. They were randomly divided into 4 groups; G1, Sham group; G2, Ovarian torsion for 3 hours followed by detorsion 10 days (TDO); G3, Ovarian torsion for 3 hours and then received 200 mg/kg hydroalcoholic extracts of MC, 30 minutes before detorsion, followed by detorsion (10 days) (TDOMC); G4, received 200 mg/kg of hydroalcoholic extracts of MC. After the 10-day reperfusion period, blood sampling was done and blood levels of estrogen, testosterone, some oxidative stress markers and anti-oxidant enzymes were assayed. Further assessment was carried out by histomorphometry on 10-day postprocedure.
    Results
    Comparison of the histological parameters showed a significant change in the G2 group as compared with other groups. The levels of estrogen, glutathione peroxidase (GPx), and superoxide dismutase (SOD) significantly decreased in G2 group, and increased in G3 and G4 groups, and the malondialdehyde level increased in the duration of ischemia. Treatment by MC decreased the malondialdehyde level in G3 and G4 groups.
    Conclusion
    The results of this study showed that MC could reduce oxidative stress and tissue damages following ovarian torsion/detorsion.
    Keywords: Matricaria chamomilla, Ovary, Oxidative stress, Tissues, Torsion
  • Sakineh Mohammad-Alizadeh, Toktam Dokhanchi, Sevil Hakimi, Yusef Javadzadeh, Lida Takallu, Parvin Mostafa Gharabaghi Pages 193-199
    Objectives
    Bacterial vaginosis (BV) is the most common vaginitis, which is derived from a reduction in vaginal lactobacilli and an increased growth of other anaerobic species of bacteria. Vitamin C can be effective in treatment of BV through the production of lactic acid. The aim of the present study was to determine the efficacy of adding vitamin C vaginal to metronidazole in treatment of BV.
    Materials And Methods
    This study was a triple-blind randomized clinical trial. The study was carried out from July 2015 to November 2015 on 160 women who referred to gynecologic clinic of Mashhad with pure BV. They randomized into intervention and control groups. The intervention group received 500 mg of oral metronidazole tablets twice a day along with 250 mg vitamin C vaginal tablets for 7 days and the control group received the same dose of oral metronidazole along with placebo for 7 days. Amsel and Nugent criteria were analyzed prior, 10 ± 3, and 30 ± 3 days after the treatment.
    Results
    The cure rate, based on Amsel and Nugent criteria was 85.9% in intervention group and 52.3% in control group on day 10 ± 3 (odds ratio [OR]: 5.3, 95% CI: 2.4 to 11.6) and 87.7% in intervention group and 41.9% in control group on day 30 ± 3 (OR: 9. 8, 95% CI: 4.2 to 22.4).
    Conclusion
    According to the results, it seems that the two-drug treatment of BV with oral metronidazole and vitamin C vaginal tablets is more effective than one-drug treatment of BV by oral metronidazole for recovery and non-recurrence.
    Keywords: Ascorbic ccid, Bacterial vaginosis, Metronidazole
  • Fahimeh Sehati Shafaie, Mojgan Mirghafourvand, Marzieh Bagherinia Pages 200-204
    Objectives
    Transition to motherhood, is a challenging and stressful process in postpartum period as the women not only face new tasks associated with the maternal role but also the dramatic changes in their bodies. This study was performed with the aim to determine the relationship between maternal self-confidence and functional status in postpartum period.
    Materials And Methods
    This cross-sectional study was conducted on 136 primiparous women at 2 weeks postpartum who were referred to 25 health centers of Tabriz, from December 2015 to April 2016. Data were collected using the socio-demographic characteristics questionnaire, Lips Maternal Self-confidence Score (LMSCS) and Inventory of Functional Status After Childbirth (IFSAC). The statistical tests including Pearson correlation, independent sample t test, one-way analysis of variance (ANOVA) and general linear model were used for data analysis through SPSS v. 21. The significance level was considered as P
    Results
    The mean (SD) of total functional status scores was 2.2 ± 0.4, with achievable scores ranging from 1 to 4 and maternal self-confidence scores was 105.6 ± 11.2, with achievable scores ranging from 24 to 144. Between functional status and maternal self-confidence there was significantly positive and strong correlations (P = 0.001, r = 0.271).
    Conclusion
    The results show that maternal self-confidence has a positive effect on functional status in postpartum period and increased self-confidence leads to improved functional status.
    Keywords: Postpartum period, Self-concept, Women
  • Mahin Kamalifard, Abbas Yavari, Mohammad Asghari-Jafarabadi, Ghafoureh Ghaffarilaleh, Ahmad Kasb-Khah Pages 205-211
    Objectives
    Women with premenstrual syndrome (PMS) show emotional, physical and behavioral symptoms regularly every month. Mild physiological symptoms of PMS appear in 95% of women at their reproductive age. We hypothesized to evaluate the effect of yoga exercise on PMS.
    Materials And Methods
    A randomized controlled clinical trial was conducted from April to October of 2015. Eligible women for inclusion were selected conveniently from women that had randomly referred to selected private obstetrics and gynecology clinics in Tabriz, Iran. Thereafter, 62 subjects were selected for the study. Subjects were randomly divided into 2 groups: 31 subjects for yoga and 31 subjects for control groups with blocks 4 and 6. The yoga group performed yoga for 10 weeks in 3 sessions with each session of 60 minutes duration. Subjects of control group did not do any yoga. Subjects completed the Premenstrual Symptoms Screening Tool (PSST) questionnaire for evaluation of the effect of yoga exercise on emotional, behavioral, physical symptoms and quality of life of subjects with PMS before and after the intervention. Data were analyzed by covariance.
    Results
    The mean ± standard deviation (SD) of emotional, physical, behavioral symptoms and impact of yoga exercise on quality of life in yoga were 26.28 ± 16.54, 32.69 ± 20.81, 10.90 ± 14.10, 22.8 ± 14.56, and in the control group were 54.91 ± 21.31, 72.01 ± 22.24, 44.05 ± 22.32, 54.00 ± 20.33, respectively (P
    Conclusion
    Results highlight that yoga significantly relieves the PMS symptoms and can be prescribed for treatment of PMS.
    Keywords: Premenstrual syndrome, Quality of life, Yoga
  • Niloofar Sattarzadeh, Azizeh Farshbaf-Khalili, Elaheh Khari Pages 212-217
    Objectives
    Preconception care focuses on spouses’ welfare and gestational health as well as related consequences before and after conception. The present paper was conducted in Tabriz health care centers, Iran in 2015-2016 in order to determine socio-demographic predictors of midwives’ practice and knowledge regarding preconception care.
    Materials And Methods
    This was a cross-sectional study implemented on all midwives (202) occupied in Tabriz health care centers, Iran, using socio-demographic, knowledge and practice questionnaires. The instrument validity was determined based on content validity index (CVI) and CVR methods while its reliability was determined from 2 aspects of repeatability (ICC) and internal consistency (Cronbach alpha coefficient). The socio-demographic and knowledge data questionnaires were completed by midwives while observational checklist of practice was completed by researcher. The data were statistically analyzed using descriptive and inferential methods.
    Results
    Mean (SD) score of midwives’ knowledge was 73.21 (± 11.83) and mean (SD) score of midwives’ practice was 80.31 (±12.25). According to Pearson test, the direct relation between knowledge and practice was not significant (P = 0.133, r= 0.238). According to multivariate linear regression analysis, age, educational level, employment status and work experience were defined as predictors of midwives’ knowledge and age, employment status and job responsibilities as predictors of midwives’ practice.
    Conclusion
    With regard to the direct correlation between knowledge and practice, improvement of midwives’ knowledge and so paying attention to the predictors of practice such as employment status and job responsibilities in order to promote midwife’s motivation and practice seems to be essential to improve the quality of preconception care.
    Keywords: Iran, Knowledge, Midwifery, Preconception care
  • Parastoo Abbasi, Sakineh Mohammad-Alizadeh Charandabi, Mojgan Mirghafourvand Pages 218-223
    Objectives
    In all parts of the world, education about pregnancy and childbirth are offered to women as part of routine care. This study aimed to compare the effect of software and booklet on knowledge regarding labor pain management.
    Materials And Methods
    This randomized controlled clinical trial was conducted on 153 pregnant women referring to healthcare centers of Miandoab city in West Azerbaijan province, Iran in 2015-2016. Participants were assigned into 2 intervention groups (educational software and educational booklet) and the control group. A single face-to-face session was held by the researcher for intervention group on the management of labor pain in 30-34 weeks of pregnancy and booklet and software were presented. The questionnaire of knowledge of labor pain management was completed by the participants before and four weeks after the intervention. Analysis of covariance (ANCOVA) with baseline score adjustment was used to compare the mean score of knowledge between the study groups.
    Results
    By adjusting the baseline score, the mean score of knowledge after the intervention in both software group (mean difference = 5.5; CI 95%: 4.6 to 6.3) and booklet group (3.4; 2.5 to 4.2) was significantly higher than the control group. Also, the increase in knowledge score in the software group (2.1; 1.2 to 9.2) was significantly higher than the booklet group.
    Conclusion
    The results show that both software and booklet are effective in improving maternal knowledge about managing the labor pain and the software is more effective than booklet, thus, it seems that e-learning can be used as replacement for traditional educational methods.
    Keywords: Knowledge, Labor pain, Pregnancy software
  • Mahin Kamalifard, Azizeh Farshbaf Khalili, Mahsa Namadian, Sepideh Herizchi, Yunes Ranjbar Pages 224-230
    Objectives
    Menopause is an inevitable milestone and an important stage in every woman’s life. This study aimed to compare the effects of lavender and bitter orange on depression in menopausal women.
    Materials And Methods
    This triple-blind randomized controlled clinical trial was conducted on 156 menopausal women in Urmia, Iran in 2015. Eligible women were allocated into 2 intervention groups and one control group with a ratio of 1:1:1 through the randomized block design. Intervention groups received 500 mg capsules containing only bitter orange or lavender flower’s powder and control group received 500 mg starch capsules, all groups used capsules twice daily after breakfast and dinner for 8 weeks. Capsules were in the same appearance. Beck Depression Inventory was completed by the participants before and 8-week after the commencement intervention. The analysis was performed based on intention to treat approach.
    Results
    The one-way analysis of variance (ANOVA) analysis showed no significant difference in mean depression score in the three groups before the intervention (P = 0.262); however, the general linear model test adjusted for base line and confounding factors such as menopausal age and women age showed significant differences between the groups in the mean depression score after 8 weeks of treatment (P
    Conclusion
    Considering the positive effect of bitter orange and lavender in reducing depression in menopausal women, they can be used as a complementary medicine in depressed patients.
    Keywords: Depression, Menopause, Lavender, Citrus aurantium, Bitter orange
  • Fereshte Salarinia, Soheila Bani, Mohammad Asghari Jafarabadi, Shirin Hasanpoor, Shamsi Abasalizadeh, Khalil Ansari Pages 231-236
    Objectives
    The present study aimed at determining the relationship between sleep quality and overweight and obesity in women of reproductive age referred to health centers and bases in Yazd in 2014-2015.
    Materials And Methods
    A total of 450 women of reproductive age with a body mass index (BMI) of >18.5 were participated in this study and divided into 3 equal groups (n = 150) of normal weight, overweight, and obese. Instruments used in this study were the Pittsburgh Sleep Quality Index (PSQI) and a socio-demographic questionnaire. Data from the questionnaires were completed by the participants and analyzed using statistical methods.
    Results
    In this study, 66% of normal weight women of reproductive age had an acceptable sleep quality, while 77% of overweight and 93% of obese women of reproductive age had poor sleep quality, respectively. The results of this study showed that a significant correlation existed between BMI of normal weight women of reproductive age and the components of sleep quality (P = 0.001). An inverse significant relationship was also found between BMI of overweight women of reproductive age and the components of sleep quality (P
    Conclusion
    The results of this study revealed that women of reproductive age with overweight and obesity have poor sleep quality. Among components of sleep quality, sleep disorder, impaired daily functioning, and consumption of hypnotic drugs have the most important role in reducing sleep quality. It seems that change in lifestyle can improve sleep quality and thus can reduce BMI
    Keywords: Obesity, Overweight, Sleep, Women
  • Zahra Fardiazar, Leila Soltanpour, Fatemeh Ghatrehsamani Pages 237-242
    Objectives
    Polyhydramnios is a condition that could be along with significant maternal, fetal and neonatal consequences. One of the most important complications of this condition is preterm labor and delivery of preterm neonates. Although in mild cases expectant conservative management is effective, in more severe cases, medications (such as indomethacin) and amnioreduction could be considered. Each one of these methods could be accompanied with complications. This study aims to examine the results of management of patients with polyhydramnios according to the fetal and maternal distress and preterm labor criteria.
    Materials And Methods
    In this descriptive-analytic setting, 26 pregnant mothers with polyhydramnios (amniotic fluid index [AFI] more than 30) were managed according to the fetal and maternal distress and preterm labor criteria. In cases under 32 gestational weeks, indomethacin was used with an initial dose of 25 mg every 6 hours and a maximum dose of 2-3 mg/kg that was tapered when the AFI diminished. In refractory cases, the flowchart of fetal and maternal distress and preterm labor was employed. In pregnancies aged over 32 weeks, in case of maternal distress amnioreduction was performed, and in asymptomatic patients, cervical length, funneling, color Doppler and placental thickness were evaluated and in normal cases controlling was carried every 1-2 weeks and abnormal cases amnioreduction was carried out.
    Results
    The mean age of studies patients was 28.12 ± 7.22 years and the mean pregnancy age was 232.23 ± 23.57 days. On this basis, there were 8 patients under 32 gestational weeks, in which indomethacin was administered and a response to treatment was seen in the week 1. All cases have increased amniotic fluid again in week 2. In 2 cases, re-administration was done. All patients including those aged over 32 weeks and those who reached 32 weeks by using indomethacin were managed according to the suggested algorithm. Symptoms indicating maternal distress was present in 3 patients (11.5%), 2 of them were treated with amnioreduction and the other one did not give consent and pregnancy termination was carried out at the age of 29 gestational weeks due to cord prolapse. In 2 cases with amnioreduction, the pregnancy reached to term. The mean cervical length was 32.38 ± 2.38 mm and dilatation or funneling was not present. Decreased placental thickness, placental malfunction and abnormal placental circulation were not detected. Except for the one mentioned case, all pregnancies were terminated over 34 gestational weeks, and besides a case with prolapse, no other maternal, fetal or neonatal complication was observed.
    Conclusion
    The effect of indomethacin was temporary and this medication could be used safely. The beginning of delivery is suddenly in these patients and is not predictable by cervical changes. The placenta was normal in all cases in the current study. In case of maternal distress, amnioreduction was along with good outcome. Color Doppler evaluation and placental thickness were not accompanied with good results.
    Keywords: Polyhydramnios, Indomethacin, Amnioreduction