مجله زنان مامائی و نازائی ایران
سال هجدهم شماره 180 (هفته دوم بهمن 1394)

Tubal ectopic pregnancy is a common reason of death caused by pregnancy at third trimester. Methotrexate (MTX) is one of the common medical treatments in ectopic pregnancy (EP). This study was performed with aim to evaluate the result of treatment with multiple dose of MTX. This descriptive-analytic study was performed on 262 women with ectopic pregnancy who were treated with multiple dose MTX therapy in Imam Reza educating and treatment center in Kermanshah during 2008-2012. The findings related to initial β-hCG level, ectopic mass size, gestational age, the presence of the yolk sac, the need for surgical intervention, presence or absence of free fluid in the culdesac in ultrasound and gestational age were extracted from medical records of the patients and were recorded in the checklist. Data was analyzed by SPSS software (version 20), and Chi-square test. P Mean age of the patients was 29.11±4.87 years that most of them were gravid 1 and 2. Mean age of the patients, gestational age, gravidity and parity were not effective in the success rate of multiple dose methotrexate therapy (P>0.05). The success rate of multiple dose methotrexate therapy was 80.5%. There was relationship between response to therapy and mean β-hCG level. Regarding to high success rate of medical therapy with multiple dose methotrexate, it can be considered as an effective treatment option for patients with irrupted tubal EP. Also, attention to initial level of β-hCG is recommended in selection of patients for medical therapy in orde to reduce failure rate.

Polycystic ovary syndrome (PCOS) is one of the most common endocrinal disorders in women at reproductive age. In many cases, PCOS is associated with infertility and increased risk of metabolic syndrome. This study was performed with aim to investigate the effect of 8-week resistance exercise and calcium supplementation on anti-mullerian hormone (AMH) level and metabolic parameters in women with PCOS. This semi-experimental study was performed with pretest–posttest design on 30 women with PCOS who were referred to one of the medical centers of Arak in 2014. They were randomly assigned to three groups of resistance exercise and placebo, resistance exercise and calcium supplementation consumption (1000 mg/d), and control with 10 cases in each group. The protocol consisted of 3 sessions per week of exercise for 8 weeks, each session including 1-2 sets of 5–20 repetitions at 40–60% of 1RM(one repetition maximum). Serum levels of AMH and metabolic parameters were assessed before and after the training period. Data were analyzed using SPSS software (version 18), and two-way ANOVA and ANCOVA tests. P After 8 week total cholesterol resistance exercise, LDL-c, triglycerides and insulin resistance index were significantly decreased (P<0.05). Data analysis showed that calcium supplementation in conjunction with resistance exercise leads to more improvement in metabolic indices and serum level of AMH (P<0.05). Resistance training in conjunction with calcium supplementation for two months can have beneficial effects on metabolic indices and ovarian reserve in women with PCOS.

Episiotomy is the most common surgical incision during vaginal delivery and has the risks like any other surgical incision. One of the factors which have been recently considered is the use of herbs. Hypericum perforatum extract inhibits the arachidonic acid and Cyclooxygenase enzyme and reduces inflammation and pain. Also, the extract of this plant has been used as an antiseptic for surgical wounds. This study was performed with aim to determine the effects of Hypericum perforatum on Episiotomy wound healing. This double-blind randomized clinical trial was performed on 120 women who underwent episiotomy in Arak Taleghani educational hospital in 2015. The patients were randomly assigned into two groups: Intervention group (receiving Hypericum Perforatum ointment) and control group (receiving placebo ointment). Pain severity was assessed using VAS and wound healing was measured by REEDA before the intervention, 5 and 10 days after the intervention. Data was analyzed by SPSS software (version 16), and Chi-square and independent t tests. P There was no significant difference between two groups in terms of baseline pain and the primary appearance of the wound before the intervention (P=0.9 and P=0.97, respectively). In the intervention group, pain severity (P=0.1) and wound healing (P=0.9) after 5 days of intervention was not significantly different with control group. But, at 10th days of intervention, pain severity (P=0.004) and wound healing (P=0.02) was significantly different with control group. The subjects in the intervention group had less pain and more wound healing compared to control group. Hypericum Perforatum ointment is suggested for pain reduction and increasing wound healing in episiotomy.