shahla yazdani

 Anemia, thrombocytosis, and leukocytosis, are commonly found in a variety of malignancies. The prognostic role of preoperative leukocytosis, anemia, and thrombocytosis on stages and grades of endometrial cancer (EC) in women undergoing surgery was the subject of this study.

 In this cross-sectional study, 105 women suffering from EC at Babol Ayatollah Rouhani Hospital from 2011 to 2018 were considered. Anemia, thrombocytosis, and leukocytosis were defined as prognostic factors. Then, the patients were placed at stages I, II, III, and IV, and ECs were graded as well, moderately and poorly differentiated or undifferentiated.  SPSS 22 software, Chi-square, analysis of variance (ANOVA), and receiver operating characteristic (ROC) were used for statistical analysis (p < 0.05).

 Higher rates of leukocytosis (54.3%), anemia (47.4%), and thrombocytosis (66.7%) were detected in tumor grades III, II, and III, respectively. A higher rate of leucocytosis (51.4%), anemia (60.5%), and thrombocytosis (51.9%) were reported in tumor stages III, I, and III, respectively. The relationship between tumor grade and tumor stage with leucocytosis and thrombocytosis was statistically significant (p <0.001). The white blood cell (WBC) sensitivity (70%) and specificity (70%), Hb sensitivity (37%) and specificity (39%), and platelets sensitivity (73%) and specificity (74%) were determined. There was a significant relationship between levels below the 3-variable curve and tumor stage with WBC (p <0.001) and platelet (p <0.001).

 Preoperative leukocytosis and thrombocytosis are related to the severity, stages, and grades of EC. Both of them have a prognostic role in women suffering from EC.

The suitable BMI cut-off point in persons with endometrial cancer or hyperplasia with abnormal uterine bleeding was investigated in this study.

This case-control research was conducted on 1470 women with abnormal uterine bleeding in Ayatollah Rouhani Hospital,Babol between 2010 and 2012, with 312 participants included in the study. In terms of uterine biopsy results, patients were split into six groups: simple hyperplasia without atypia, simple hyperplasia with atypia, complicated hyperplasia with atypia, complex hyperplasia without atypia, endometrial cancer, and normal persons.

The mean age and BMI of patients in these three groups were not significantly different (P equal to 0.081 and 0.435, respectively). The kind of disease exhibited a strong relationship with menstruation (P 0.001). The body mass index (BMI) values ​​did not have significant levels under the curve to determine the appropriate cut-off point in the diagnosis of hyperplasia plus endometrial cancer and endometrial cancer alone (P 0.380 and 0.124, respectively) and hyperplasia alone (P = 0.920). Based on logistic regression, age 50 years and older and irregular menstruation were significant with OR equal to 2.36 and 2.09 (P = 0.011) and HTN with OR equal to 0.44 (P = 0.026), respectively.

BMI has little predictive value in the detection of endometrial cancer or hyperplasia, according to the findings, and other diagnostic and screening modalities should be utilized instead. The findings backed up the theory that old age and irregular menstruation are linked to an increased risk of endometrial cancer.

The present study aimed to compare the diagnostic values of glycosylated hemoglobin (HbA1c) and fasting blood sugar (FBS) using the glucose challenge test (GCT) in screening for gestational diabetes.

A total of 618 women at 24-28 weeks of pregnancy were selected, and their FBS and HbA1c were measured using the GCT. The obtained results were compared in terms of sensitivity, specificity, as well as positive and negative predictive values using the ROC curve.

At the cut-off point of 1.4, sensitivity was 69.74% and specificity was 69.05 for the FBS test; at the cut-off point of 6.6, sensitivity was 90.79% and specificity was 80.95% for the HbA1c test; the area under the ROC curve was 0.925 with a 95% confidence interval (0.979, 0.872).

The diagnostic values of the HbA1c test and GCT were favorable in screening for gestational diabetes; the HbA1c test also showed a high diagnostic value in women with positive OGCT and GCT results.

Ultrasound is performed to check the growth of endometrial cells outside the uterus and the pathology is performed to confirm endometriosis. A combination of diagnostic methods is important for summarizing and starting treatment of endometriosis. The present study was performed with aim to investigate and compare clinical and ultrasound diagnoses in patients with histopathological diagnoses of endometriosis.

This retrospective study was conducted in 2010-2021 on 140 women aged 18-65 years old suffering from endometriosis referred to Ayatollah Rouhani Hospital in Babol city. Confirmation of endometriosis was done based on tissue pathology and then comparing clinical history with ultrasound findings. The data collection tools were the patients' files and the researcher made checklist. Collected data included clinical manifestations, presence or absence of pain during menstruation, abdominal pain, pain during intercourse, pelvic pain, abnormal menstrual bleeding, backache, pain during defecation, and dysuria. Data were analyzed by SPSS software (version 22) and chi-square and independent t-tests. P<0.05 was considered statistically significant.

Dysmenorrhea (55.63%), abdominal pain (48.59%), and dyspareunia (31.69%) were the most common clinical symptoms. The state of uterine echogenicity was reported to be homogeneous in 99 patients (69.7%) and heterogeneous in 43 (30.3%). Echogenic status had a significant relationship with abdominal pain (p=0.004) and abnormal menstrual bleeding (p=0.032), adenomyosis with abdominal pain (p=0.004), ovarian adhesion with complaints of pain during intercourse (p=0.002) and status of fallopian tubes with complaints of pain during intercourse (p=0.015) and dysuria (p=0.049).

Dysmenorrhea, abdominal pain, dyspareunia, abnormal menstrual bleeding, and dysuria had significant difference with ultrasound findings. For definitive diagnosis and appropriate treatment, clinical manifestations, pathology, and ultrasound should be considered and treatment should be carried out based on that.

The aim of this study was to find the causes of failure of natural childbirth in late-term pregnancy that can be useful for managing childbirth in these pregnant mothers and to design a solution to increase natural childbirth.

This cross-sectional study was conducted in the community of pregnant women with a late-term pregnancy of more than 41 weeks. The studied sample includes 148 pregnant mothers who were referred to Ayatollah Rouhani Hospital in Babol from March 2018 to February 2020. Mother's age, Body Mass Index, gestational age, number of pregnancies, number of deliveries, length of hospitalization, the state of the cervix and preparation method of the cervix for termination of pregnancy were extracted and recorded from patients' files. Data were compared in two groups of pregnancy termination methods (natural childbirth and cesarean delivery). Statistical analysis was done using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and Chi-square test and Student’s t-test statistical tests and logistic regression model fitting. P-value less than 0.05 was considered significant.

In this study, 167 pregnant women with late-term pregnancy were studied. The age of pregnant women is reported with mean of 26.03 and standard deviation 5.98 of years. The high Bishop variable, with odds ratio of 0.44, is a variable protective factor for cesarean delivery (P=0.001). Higher body mass index with odds ratio of 1.09, is also known as a risk factor for cesarean delivery (P=0.01), so that for each unit of increase in Bishop score, the chance of cesarean delivery decreases by 56% and for each unit of increase in body mass index, the chance of cesarean delivery increases by 9%.

This study showed that nearly half of cases of late pregnancies lead to normal delivery. High body mass index reduces the chance of normal delivery in late term pregnancies. But a higher Bishop score can be effective in the success of natural delivery.

Anemia increases the risk of adverse pregnancy outcomes including preterm delivery and low birth weight. This study was performed with aim to determine the relationship between the severity of anemia with preterm delivery and low birth weight and the level of hemoglobin which causes these consequences.

This cross-sectional study was conducted in 2019-2020 on 737 pregnant women referred to Ayatollah Rouhani Hospital in Babol who underwent delivery. Demographic information, hemoglobin level of mothers, gestational age, type of delivery, weight, height, head circumference and Apgar of the newborn were recorded in the checklist. Data were analyzed by SPSS (version 25) and univariate ANOVA, t-test, Chi-square and correlation coefficient tests.

The prevalence of anemia in pregnant mothers was estimated at 24.15%. Gestational age, weight, height, head circumference, and Apgar of the newborn were significantly lower in the anemic group (p<0.001). By dividing the mothers into two groups of term and pre-term, there was no significant difference in their hemoglobin level (p=0.11); however, by dividing preterm mothers into early and late preterm groups, hemoglobin was reported to be lower in early preterm mothers (p=0.004). It was found that hemoglobin less than 11.7 g/dL in a pregnant mother increases the risk of preterm delivery (less than 34 weeks) and birth weight less than 2500 g.

It seems that despite reaching the hemoglobin to the minimum normal level, there is still a significant possibility of adverse outcomes in the newborn, so one should try to keep the hemoglobin level above the minimum normal level.

There are many studies on the health effects of dietary advice and physical activity in pregnancy while only a few reported the effects of simultaneous administration of motivational interviewing, dietary advice, and physical activity on neonatal outcome in pregnant women with metabolic syndrome (MetS). This study was designed to examine the effects of these interventions on fetal-neonatal outcome in pregnant women with MetS.

A randomized, single‑blind, controlled clinical trial was performed in 120 pregnant women with metabolic syndrome at 15- 20 weeks of gestation in two hospitals in Babol, north of Iran, 2018. The participants were allocated into two groups (n= 60 per group) using blocking randomization and were followed up until the end of pregnancy. Fetal-neonatal outcomes were compared between the two groups from week 32 of pregnancy. The interventional program included one motivational interview, two nutrition consultation sessions, and three sessions of physical activity (per week).  The control group received routine care. Demographic and fertility characteristics, anthropometric measurements, and biochemical and pregnancy outcomes were recorded. Data analysis was done applying independent t test, ANOVA, and logistic regression.

The incidence of respiratory distress syndrome was found to be significantly lower in intervention group (3.7%) compared with the control group (14.5%) at the end of the pregnancy (P=0.01).

Dietary recommendations, motivational interviewing, and physical activity in pregnant women with MetS during prenatal care can be used as safe and practical interventions to prevent respiratory distress syndrome.

Drug addiction causes complications such as preterm delivery, miscarriage, intrauterine growth retardation, prenatal mortality, placental abruption, preeclampsia, premature rupture of membranes, increased cesarean section and congenital anomalies. Therefore, this study was performed aimed to investigate the prevalence of substance abuse and pregnancy outcomes.

This study was conducted in two stages, initially a cross-sectional study was performed in all pregnant women referred to the maternity ward of Ayatollah Rouhani Hospital in Babol from April 2017 to March 2019. Then, a historical cohort study was conducted in which the subjects were divided into two groups: 112 addicted pregnant women and 224 non-addicted pregnant women. Data collection tool was a researcher-made checklist including: demographic information, maternal complications, and fetal-neonatal complications. Data were analyzed using SPSS software (version 21) and T-test and Chi-square test. P<0.05 was considered statistically significant.

The prevalence of addiction was 1.66% among 6713 pregnant women during these three years. Maternal, fetal and neonatal complications showed a significant increase among addicted mothers compared to the control group (P = 0.0001). Premature rupture of membranes in 44 women (39.28%) and preterm delivery in 32 (28.57%) were the most common complications. The chance of premature rupture of the amniotic sac was 9.09 times with a 95% confidence interval (0.058-0.211) and the chance of preterm delivery was 5 times higher with a 95% confidence interval (0.107-0.388) in addicted mothers. The chance of respiratory distress in infants born to addicted mothers was 10 times higher with a 95% confidence interval (0.058-0.227).

Addiction during pregnancy is associated with many maternal, fetal and neonatal complications, so it is recommended that a comprehensive and specific program be performed for diagnostic, treatment and rehabilitation measures, especially to reduce the damage caused by addiction for women.

Premature preterm rupture of membranes (PPROM) occurs in about 2-5% of singleton pregnancies and is known to cause one-third of preterm births. Our primary aim was to determine the maternal and neonatal outcomes in PPROM cases in mothers with a gestational age of less than 37 weeks.

In this prospective cross-sectional study, eligible singleton women between 24+0-37+6 weeks of gestation with the PPROM enrolled who had referred to Ayatollah Rouhani Hospital in Babol, Iran, during the years 2019-2020. Maternal and neonatal outcomes were obtained by the checklist.

The mean age of the studied mothers was 29.3± 6.19 years, and their mean body mass index was 30.6 ±5. The incidence of chorioamnionitis at the gestational age of >32 weeks was more than that in women at gestational age equal to or over 32 weeks (P≤0.0001). Vaginal bleeding was almost more than twice as high in women with a gestational age of less than 32 weeks compared to those with a gestational age equal to or over 32 weeks (P≤0.0001). Neonatal morbidity was higher in all cases at less than 32 weeks of gestation (P≤0.0001). The neonatal mortality rate was 5.35%, but it was 25% at less than 32 weeks of gestation (P≤0.0001). The latency period greater than 7 days had more odds ratio for neonatal morbidity.

Due to the high incidence of maternal and neonatal outcomes in gestational age less than 32 weeks, it is suggested that appropriate instructional materials and proper proceeding should be taken to prevent preterm labor and preterm rupture of the membranes.

Mature cystic teratoma of the ovary is one of the most common benign ovarian tumors, which may be confused with other adnexal lesions due to its extensive manifestations on ultrasound. Therefore, in this study, we tried to reduce the need for pathology frozen sections by examining more accurate preoperative ultrasound results and classifying ovarian lesions based on them.

In this study, 200 female patients with a definitive diagnosis of mature cystic teratoma of the ovary who have undergone surgery at Ayatollah Rouhani Hospital, February 2009 March 2019 were evaluated. After reviewing the files, demographic information, Ultrasound, intraoperative findings and final pathology were extracted and finally, the data were analyzed using statistical tests.

The age range of patients who were diagnosed with mature cystic teratoma of the ovary in the final pathology was 14-71 years. Most cysts were 5-10 cm in size. 86% of patients had unilateral right-sided ovarian involvement. The most common components of this cyst in the macroscopic report were hair (81%) and fat (80%). The diagnostic value of ultrasound for the diagnosis of mature teratoma of the ovary was 74.5%. The frozen section was used to diagnose and rule out the malignancy in 32.5% of patients.

The results of this study show that the prevalence of these tumors is higher in the reproductive age range. According to this study, these tumors have been seen in single people and pregnant women, Due to youth and fertility in the future, a good decision must be made about the surgical method. These tumors have a wide range of sizes. In addition, their most common complaint is abdominal pain, but it has been reported extensively in periodic ultrasounds for infertility. The diagnostic value of ultrasound for mature ovarian teratoma was high due to the presence of fat and hair in them. Therefore, the use of the frozen section (intraoperative pathology) can be reduced in more often unnecessary in cases.

The present study was performed to compare the analgesic effects of bupivacaine and magnesium sulfate combination on post-cesarean (C) section pain.

The present single-blind randomized clinical trial was conducted on 160 C-section candidates. The participants were randomly divided into four groups. When the fascia healed, the first group received 20 mL of 0.25% bupivacaine and the second group received 20 mL of 0.25% bupivacaine combined with subcutaneous adrenaline. In addition, both groups received 50 mL of intravenous normal saline. Further, the third group received subcutaneous bupivacaine and 50 mg/kg of magnesium sulfate and the fourth group received subcutaneous and intravenous normal saline as a placebo. The pain intensity was assessed 2, 6, 12, 18, and 24 hours after spinal anesthesia using the visual analogue scale (VAS) for pain. The dose of pethidine (as a standard analgesic) and hemodynamic parameters (i.e., heart rate [HR] and blood pressure [BP]) was recorded as well. The obtained data were then analyzed utilizing ANOVA, Tukey’s HSD, and repeated measures ANOVA tests.

The intensity of pain and the dose of pethidine decreased significantly in the combination of bupivacaine with magnesium compared to the other groups at all times (P < 0.001). However, diastolic BP significantly increased in the bupivacaine + adrenaline group in comparison with the other groups (P = 0.02).

Overall, bupivacaine combination with magnesium sulfate is suitable for controlling post-cesarean section pain.

The purpose of the study was to evaluate the effectiveness and safety of thermal balloon ablation in women with high anesthetic and surgical risk compared to invulnerable women according to the American Society of Anesthesia (ASA) physical status stratification.

This report was based on a retrospective cohort study of women with heavy menstrual bleeding (HMB) who were eligible for treatment with CavatermTM plus during 2012-2017. Women were classified as high-risk (HR) or low-risk (LR) cohorts based on ASA physical status stratification. The primary outcome includes amenorrhea in the twelfth months after the treatment. Risk adjustments were performed using regression models.

This research study consisted of 63 women with mean age 44.42±5.48. Mean of body mass index (BMI) in the HR cohort was higher than the LR cohort (31.48±6.22 vs 26.83± 3.51, P=0.005) and results were also similar considering the uterine length (mm) between HR and LR women (58.27±35.70 vs 30.92± 35.30, P=0.01). The primary outcome of treatment after a one-year follow-up in the two groups (HR and LR) was 31 (93.9%) and 15 (78.9%), respectively. After adjusting for known confounders including age, uterine length, parity, dysmenorrheal, the adjusted odds ratio was 0.94 (95% CI, 0.14– 2.5; P= 0.60).

For women with high anesthetic and surgical risks derived from serious underlying co morbidities, endometrial ablation can provide a minimally invasive, safe, and effective therapy for heavy menstrual bleeding.

Perinatal mortality rate (PMR) is one of the main indicators in evaluation of health community and healthcare systems. This study was performed to determine the perinatal mortality rate in the referral third level of maternal and infant care center affiliated to Babol University of Medical Sciences.

This descriptive-analytical study was performed on by cross-sectional method and 19234 births (9751 male and 9483 female) from 22 weeks gestation to 29 days after delivery Ayatollah Rouhani Hospital in Babol, northern Iran during 2011-18. Data on the cause of neonatal death, maternal age, type of delivery, malformations, maternal underlying disease, maternal pregnancy-related conditions, and diseases at the time of death in neonate were collected from website of the Ministry of Health. Then each of the indicators was calculated per 1000 live births.

In this study, the PMR was calculated per 1000 live births which was 29.01 (boys 16.17 and girls 12.84). The portion of vaginal delivery was 9.67 and cesarean section was 19.34. Out of 558 perinatal deaths, 59.9% died due to intrauterine death with an index of 17.37 and 40.1% of deaths were due to infant death with an index of 11.63. Most neonatal deaths (74%) occurred within the first 24 hours of birth and in terms of gestational age 86.02% were <37 weeks of gestation with an index of 24.95, and low birth weight were 83.8% with an index of 24.31. Underlying disease was found in 25.6% of mothers and pregnancy-related conditions in 74.4% of cases. Fetal distress in 14.4% with an index of 4.20 was the most common disease associated with infant death or cause of death in preterm infants. Other causes of perinatal death were specific disorders of perinatal origin, birth defects, chromosomal abnormalities, and accidents were 10.09, 4.06, and 0.58 per 1000 live births, respectively.

The most and important factors of prenatal mortality wrer prematurity and low birth weight that major causes include maternal pregnancy-related conditions and maternal underlying disease, Therefore, emphasis on adequate prenatal care, identification and follow-up of mothers with underlying diseases can be effective in reducing perinatal mortality.

Molar pregnancy is a type of abnormal pregnancy which is divided into complete and partial hydatiform mole. Its incidence varies in different countries and in different regions in every country. Its incidence is higher in Asia than elsewhere in the world, whereas occasionally its risk factors and clinical symptoms are different in various regions. Therefore, this study was performed with aim to evaluate the risk factors and clinical symptoms of hydatiform-mole in pregnant women referred to Ayatollah Rouhani hospital in Babol.

This retrospective descriptive study was performed on all pregnant women of hydatiforme mole with histopathologic definite diagnosis referred to the educational-therapeutic center of Ayatollah Rouhani Hospital in Babol from 2011-2017. Patients' information including demographic and clinical profiles was provided in a checklist format. Data were analyzed by SPSS software (version 18) and Chi-square and one-way ANOVA tests. P<0.05 was considered statistically significant.

In this study during 2011-2017, there were 19145 pregnancies in Babol Rouhani hospital. According to the pathology report, 70 cases of molar pregnancy were recorded. There were 41 (58.6%) of partial hydatidiform mole and 28 (40%) of complete hydatidiform mole. Most patients with molar pregnancy were in the age range of 20-35 years. 31 patients (44.3%) had O blood group. The most common symptom of the patients was bleeding 43 (61.4%).

The incidence of molar pregnancy was high compared with other parts of the world and the prevalence of partial hydatidiform mol was higher than other studies. The risk factors for molar pregnancy were: history of molar pregnancy, and O positive blood group. The most common clinical manifestation of molar pregnancy was bleeding.

Gestational diabetes mellitus (GDM) is defined as one of the three main types of diabetes mellitus (DM). It is established that GDM is associated with exceeding nutrient losses owing to glycosuria. Magnesium (Mg), as one of the essential micronutrients for fetus development, acts as the main cofactor in most enzymatic processes. The aim of this study was to measure serum and cellular levels of Mg, albumin, creatinine, and total protein to further clarify the relationship between these components and DM in pregnant women. Blood samples were obtained from 387 pregnant women. The participants were classified into four groups based on their type of diabetes, namely GDM (n=96), DM (n=44), at high-risk of DM (n=122), and healthy controls (n=125). All participants' fasting blood sugar (FBS), creatinine, albumin, Mg, and total protein in the serum levels and red blood cell Mg (RBC-Mg) were measured during 24-28 weeks of gestation. Groups were compared for a possible association between DM and abortion, gravidity, and parity. The serum levels of creatinine, FBS, albumin, Mg, and RBC-Mg were statistically different among the four groups (P = 0.001). Significant lower levels of RBC-Mg was observed in all studied groups in comparison with controls. Given a positive correlation between DM and abortion, it seems that decreased levels of RBC-Mg and serum albumin can increase the risk of abortion in pregnant women. Our data demonstrated significant alterations in albumin, Mg, and creatinine concentrations in women with DM or those at high risk of DM during their gestational age. It seems that the measurement of these biochemical parameters might be helpful for preventing the complications, and improving pregnancies outcomes complicated with DM.

Adenomyosis is a prevalent gynecological disorder among women with no specified causes. It is characterized by nonspecific symptoms, and can present itself as abnormal uterine bleeding, abdominal pain, menstrual disorders, and the like. Its diagnosis is made based on the pathologic histological examination of hysterectomized samples. This study aimed to evaluate the correlation of adenomyosis with other benign endometrial disorders in hysterectomized samples.

In this paper a total of 413 patients who referred to Rouhani Hospital of Babol, form 2012 to 2017, and underwent a hysterectomy surgery with pathological reports confirming the diagnosis of adenomyosis, were studied. After reviewing the medical records, the patients’ data, including their age, weight, number of deliveries, place of residence, and main complaints at the time of referral as well as benign endometrial pathologies correlated with adenomyosis, were examined. Finally, the obtained data were analyzed using statistical tests.

The prevalence of adenomyosis in this study was 21.7%. The patients’ most common complaints were abnormal uterine bleeding (86.4%), dysmenorrhea (39.2%), abdominal pain (31.2%), dyspareunia (21.1%), mass outflow (15%), and pelvic pain (9.4%). In the current study, the benign pathologies correlated with adenomyosis were leiomyoma (52.5%), uterine polyp (11.9%), adenomyoma (5.1%), and hyperplasia (0.5%).

 In the present study, the prevalence of adenomyosis was high and abnormal uterine bleeding was the patients’ most prevalent complaint. Moreover, leiomyoma had the highest correlation with adenomyosis.

Distinguishing between malignant and benign ovarian masses is necessary to refer patients to centers with experience in the surgical. The aim of this study was to analyze the diagnostic value of the tumor markers, including risk of malignancy index (RMI), human epididymis protein 4 (HE4), cancer antigen125 (CA125), and risk of ovarian malignancy algorithm (ROMA) in ovarian mass. One hundred patients with ovarian masses were assessed for the tumor markers ROMA, HE4, RMI, and CA125. The sensitivity and specificity of each parameter were calculated, using receiver-operating characteristic curves (ROCs) according to the area under the curve (AUC) for each method. The median CA125, HE4, RMI, and ROMA serum levels had significant difference between malignant and benign masses in the overall assessment (P < 0.001). The AUCs were 0.83 (CA125), 0.88 (HE4), 0.85 (RMI), and 0.92 (ROMA) for benign vs. malignant masses in all the patients. The comparison of ROC curves was carried out, using a pairwise comparison method, and no differences were found among 4 methods. The results based on the AUC markers of CA125, HE4, RMI, and ROMA revealed that the accuracy trend of ROMA was higher than that of CA125, HE4, and RMI in all the patients and each group of pre- and post-menopausal patients.

Medical management of miscarriage in the first trimester is performed with multiple-medication regimens. We aimed to compare the efficacy and complications of combined regimen of letrozole and misoprostol with misoprostol alone for first trimester medical abortion.

A retrospective cohort study was conducted at Babol University of Medical Sciences for medical abortion at gestational age less than 12 weeks. All pregnant women in the first trimester with indications for abortion between 2014 and 2015 and treated by the combined regimen of letrozole and misoprostol or misoprostol alone were included in this study. The successful complete abortion, the frequency need for curettage, the induction-abortion interval, drug complications, hemoglobin, and hematocrit ratio were all retrieved from the patients’ documents.

During the study period, 110 pregnant women were admitted to our hospital for medical abortion at the first trimester and were considered for medical management. Of these, 40 women received letrozole 7.5 mg for two days, followed by misoprostol 800 mcg vaginally. Seventy women received only misoprostol 800 mcg vaginally. Follow-up for abortion was usually done 24 hours after the medical management. The successful complete abortion rate in the combined regimen of letrozole and misoprostol was more than that of the misoprostol alone group (75.0% vs. 31.4%; P= 0.001). The frequency need for curettage (P=0.001) and the mean induction-abortion interval (P= 0.021) were lower in combined regimen of letrozole than misoprostol alone group. The drug complications, hemoglobin ratio and hematocrit ratio were similar between the groups.

Our study suggested that letrozole enhances the misoprostol effect in the first trimester of pregnancy termination and decreases some of its complications.

Given the prevalence of abnormal post-menopausal bleeding and the importance of its early examination for ensuring the timely diagnosis of any malignancies, the present study was conducted to investigate uterine pathologies in relation to post-menopausal bleeding patterns and endometrial thickness as observed in transvaginal ultrasounds and to offer models for predicting endometrial cancer.
The present descriptive-analytical cross sectional study was conducted on 112 post-menopausal women presenting to Ayatollah Rouhani Hospital in Babol, Iran. The patients underwent a transvaginal ultrasound and hysteroscopy and their samples were sent for pathological examination. The logistic regression model and the receiver operating characteristic (ROC) curve were used. This study presents 3 models for predicting endometrial cancer, including AM30 [which considers the subject’s amount of bleeding, Menopause age and BMI (Body Mass Index) for assessing her risk of endometrial cancer], AMD30 (which additionally considers the subject’s history of diabetes) and AMDI30 (which additionally considers the subject’s history of internal diseases).
Menopause age, amount of bleeding, BMI, and history of internal diseases were significantly linked to endometrial cancer in post-menopausal women with abnormal bleeding; that is, the variables were higher in this group than in those without cancer (P = 0.007, P = 0.004, P = 0.001, and P = 0.02). The three models defined, i.e. AM30, AMD30, and AMI30 had a high area under the ROC curve and could predict endometrial cancer with a proper sensitivity and specificity in post-menopausal women with vaginal bleeding. There were no statistically significant differences among these models, although the AMI30 model had a higher area under the ROC curve compared to the other two models (P = 0.29).
The present study recommends these three predictive models as alternatives for predicting endometrial cancer in post-menopausal women with vaginal bleeding.

Endometrial cancer is the most common type of malignancy in female reproductive system and is the fourth common cancer after breast, lungs and colorectal cancers. Our aim is to report epidemiology and frequency types of endometrial cancer and clinical staging and grading of this disease.
In this description and Cross-Sectional study, 75 patients with diagnosed endometrial cancer, being admitted to surgical ward of Rouhani Hospital or Shahid rajaii Hospital in Iran were enrolled to study. Demographic specification of patient, staging and grading and other variables related with endometrial cancer were collected and data was processed by SPSS version 18 software.
Disease of diabetes, hypertension and obesity had a frequency of 36%, 26.7% and 85.3% in orderly. The mean of abortion was 0.47, mean of delivery was 3.71, mean age of menarche was 13.73 and most frequent age of first delivery belonged to the range of 19-24 year old (47ones, 62.7%). A high percentage of patients had been menopause under 39 years of age (25 ones, 33.3%). 3 patients (4%) had a history of breast cancer and usage of Tamoxifen. Only 6 cases (8%) had a history of irregularities menstruation. 58 of patients were in stage1 and 17 were other stages. 77.2% of patients have endometrioid and 13 patients were suffered by sarcoma.
Most patients with endometrial cancer had endometrioid. Times of delivery and abortion, lower age of menarche and age of menopause and at the first delivery have been appeared to be associated with endometrial cancer.

Ovarian cancer is the most common cause of cancer death worldwide. Incidence of ovarian cancer is more common in postmenopausal women. Premenopausal onset is rare and the present study described two cases of ovarian clear cell tumors in young women.
The patients presented with pelvic mass which was confirmed by sonography and laparotomy and final diagnosis was made according to histologic examination. Both patients showed a solid mass with cystic components in adnexal areas and explorative laparotomy demonstrated extension of tumors to abdomen in both patients. The level of CA 125 increased in both patients. For both tumors, immunohistochemical stainings were positive for CK7 and CD15, but CK20 was negative.
Although ovarian clear cell tumor is usually diagnosed in postmenopausal women but its diagnosis should be suspected in young women with pelvic mass.

Despite the fact that many studies have been published about the risk factors associated with gestational diabetes mellitus, its prevalence remains high. The aim of this study was to examine the relationship between the history of irregular menses and gestational diabetes mellitus among pregnant women.
This case-control study was conducted on 51 pregnant women with gestational diabetes mellitus in prenatal clinics of Ayatollah Rouhani hospital in Babol, Mazandaran, from January 1, 2014 to December 31, 2015. At first, women with family history of diabetes mellitus, pre-pregnancy diabetes mellitus, previous gestational diabetes mellitus, age >35 years, weight >110 kg were excluded from the study. Then, one random control was systematically selected for each case, which was matched for age. All statistical analyses were performed through SPSS (Version 22). P-values less than 0.05 were considered statistically significant.
Irregular menses was not associated with gestational diabetes. The mean menarche at age was lower among the women with gestational diabetes (p=0.03). There was a significant association between menarche at age and gestational diabetes (OR, 6.74; 95% CI, 1.41-32.17). Dysmenorrhea did not differ between subjects with and without menstrual irregularities.
We concluded that early menarche at age (

Abnormal uterine bleeding (AUB) is the most common gynecological problems that many factors are involved in its creation. Two common methods used to diagnose uterine lesions are vaginal ultraultrasonography and hysteroscopy. The aim of this study was to evaluate the diagnostic value of transvaginal ultraultrasonography and hysteroscopy in the diagnosis of intrauterine lesions leading to the AUB.
A cross-sectional study was performed on 203 premenopausal post-menopausal women with complaints of abnormal uterine bleeding. A transvaginal ultraultrasonography was performed from the eligible subjects. In the second visit, a hysteroscopy was done and during the hysteroscopy procedure an endometrial biopsy was obtained from all the women. Pathology was considered as the gold standard and sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods using the Cat maker software.
The mean age of 203 patients who precipitated in this study was 43.1±2.7. Leiomyoma was the most common leading cause of abnormal uterine bleeding (36%). Sensitivity, specificity, positive predictive value and negative predictive value of ultraultrasonography in the diagnosis of intrauterine lesions were 74.2%, 49.75%, 71.9% 54.3%, respectively and for hysteroscopy were 91.67%, 86%, 85.9% and 88.7, respectively.
Hysteroscopy results were more consistent with the results of pathology and it was more accurate than transvaginal ultraultrasonography in the diagnosis of intrauterine lesions leading to the AUB.

Many women nowadays postpone their first pregnancy to the fourth or fifth decades of their lives, which could emanate from social, economic and educational factors. This study was an attempt to evaluate the pregnancy and neonatal outcomes in women at 40 years of age or above.
In this retrospective study, we compared the pregnancy outcomes for women over the aged 40 with those of age group under the age of 40 years. The maternal and obstetrical data, from August 2009 to August 2013, were all obtained from hospitals obstetrical documents. The Chi-square test and the T-Test were used to determine the relationship between the qualitative and the quantitative variables.
During the four years, a total number of 160 women, aged 40 or above gave birth, among which 25% was nulliparous. The mean age at delivery for the elderly group was 42.4 ± 2.1, which can be compared with the mean age of women (26.7± 4.7) under the age of 40. The gestational diabetes (p= 0.0001), gestational hypertension (p = 0.022), and polyhydramnios (p=0.010) occurred more often in women aged 40 or above. It is worth mentioning that the occurrence of anemia in the third trimester in the elderly group was lower than that of the younger group (8.8% vs. 23.1%) (p= 0.024). The preeclampsia, preterm labor, low birth weight, oligohydramnios, bleeding, emergency Cesarean section, and urinary tract infection were all similar in the two age groups.
This study showed that the adverse pregnancy outcomes were significantly higher in the women aged 40 years or above when compared with those of younger women. Therefore, there is an urgent need to provide more frequent prenatal care for the elderly women in primary health care centers.

Ovarian cancer is the most common cause of cancer death from gynecological tumors in Iran. Despite the fact that intra-operative frozen section, which is widely used in diagnosis of ovarian tumors, there are problems associated with the diagnostic procedure in this setting. The aim of this study was to compare the intra-operative frozen section with the permanent histo-pathological sections in the diagnosis of ovarian cancer at Rouhani Hospital in north of Iran.
The intra-operative frozen section diagnosis was conducted on 126 women with ovarian masses, who underwent surgery between January 2006 and July 2011. The results of the intra-operative frozen section were compared with those of the past histopathological diagnoses of permanent sections as the gold standard.
The overall accuracy of intra-operative frozen section diagnosis was 94.4%. There were 0.9% cases with false-positive as well as 1.8% cases with false-negative. The sensitivity and specificity values were 66.7% and 100% for malignant tumors, 80.0% and 95.9 % for borderline tumors, and 99.1% and 90.0% for benign tumors, respectively. All inaccurate diagnoses were for the epithelial tumors.
The intra-operative frozen section diagnosis is a reliable method for the surgical management of the patients with an ovarian mass. Diagnostic problems can occur during the intra-operative frozen section examination. The clinicians and pathologists must be aware of the pitfalls of this method therefore, there is an urgent need to establish a good communication among them in order to obtain more accurate results.