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Women’s Health and Reproduction Sciences - Volume:5 Issue: 4, Autumn 2017

International Journal of Women’s Health and Reproduction Sciences
Volume:5 Issue: 4, Autumn 2017

  • تاریخ انتشار: 1396/07/29
  • تعداد عناوین: 16
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  • Ali Zeyad, Houda Amor, Mohammad Eid Hammadeh Pages 243-252
    Male urogenital tract infection (UTI) is one of the most important causes of male infertility, being associated with 8%-35% of male infertility. Pathogenic bacteria may interfere with infertility treatment involving the application of in vitro fertilization. Microorganisms might affect the spermatozoa function in different ways: (a) By direct contact on sperm cells; by the help of some organelles such as pili; causing agglutination of motile sperm, reducing ability of the acrosome reaction, and also causing alterations in cell morphology. (b) Trigger a local inflammatory reaction leading to increase in reactive oxygen species (ROS). (c) Induction of sperm autoantibodies. (d) Production of cytotoxic factors. (e) Infection treatment with antibiotics for long time may lead to defect in the sperm. The most frequently isolated bacteria from semen samples include Staphylococcus aureus, Escherichia coli, Streptococci, Klebsiella sp, Mycoplasma hominis, Chlamydia trachomatis and Enterococcus faecalis. The infection with these bacteria has significantly negative effect on sperm parameters and DNA integrity. DNA fragmentation may cause infertility, miscarriage, and birth defects in offspring. Therefore it may be a more objective marker of sperm function. The exact molecular mechanism of how bacteria affect chromatin and sperm nuclear protein still unknown. The bacterial infections lead to premature emergence of histone H3 methylation at lysine 79 (trimethylated H3K79) and hyperacetylated H4 which simultaneously occurred with transition protein TNP1. In mammals, reduced levels of histone H4 hyperacetylation correlates with impaired fertility. Further researches on this topic are necessary.
    Keywords: Bacterial Infection, Sperm proteins, PRM1, PRM2 ratios
  • Faezeh Kiani, Marzieh Saei Ghare Naz, Fatemeh Sayehmiri, Kourosh Sayehmiri, Hakimeh Zali Pages 253-263
    Objectives
    Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. If remains uncontrolled, it can cause lots of complications for both mother and fetus. The aim of this study is to investigate the risk factors of GDM in Iran using a meta-analysis study.
    Methods
    Different databases including all national scientific (Iranmedex, SID, Magiran, Irandoc, Medlib) and international (PubMed/Medline, Scopus, and ISI Web of Knowledge) databases were searched for published data on GDM risk factors in Iran. A total of 21 relevant articles from 2001 to 2015 were finally analyzed. Data synthesis was performed based on the random effects model. Data were analyzed using R software and STATA.
    Results
    A total of 1658 pregnant women with average age of 29.15 years old were investigated. The mean body mass index (BMI) of the subjects was 27.53. The most common risk factors for GDM were: high age 64% (95% CI: 53–76), excess weight and obesity 47% (95% CI: 40–54), family history of diabetes 31% (95% CI: 26–36), history of abortion 22% (95% CI:16–27), history of glycosuria 12% (95% CI: 4–19), history of macrosomia 10% (95% CI: 6 –13), delivery ≥5 case 10% (95% CI: 2–17), history of gestational hypertension 5% (95% CI: 1–8), history of preeclampsia 4% (95% CI:2 –7), history of diabetes in pregnancy 4% (95% CI:1–8), history of stillbirths 3% (95% CI: 2–5), delivery
    Conclusion
    Considering that approximately 40% of pregnancy diabetes cases will turn into diabetes over the coming years, controlling the risk factors can reduce the incidence of diabetes in pregnancy.
    Keywords: Gestational diabetes, risk factors, meta-analysis, Iran
  • Jehan Mahmoud Hamadneh, Zouhair Amarin, Shereen Hamadneh, Nail A. Obeidat, Manal Kassab, Mahmoud Bani Hani Pages 264-269
    Objectives
    To explore the prevalence rates of lifestyle practices linked to fertility disorders.
    Materials And Methods
    A cross-sectional descriptive study, using a validated questionnaire, was conducted among sub-fertile couples attending the fertility center at Jordan University of Science and Technology between February 2013 and August 2014.
    Results
    A total of 126 couples took part in the study. The average length of sub-fertility was 4.2 years. The mean age of the women was 31 years, of whom 70% were
    Conclusion
    Behavior-related fertility disorders are common in Jordan. Modifying lifestyle factors for better reproductive health is highly recommended.
    Keywords: Behavior, Fertility, Lifestyle
  • Durai Vanitha, Shanthi Edward, Suresh Varadharajan, Muthuthandavan Anita Rani Pages 270-276
    Objectives
    Menstrual health is fundamental to women’s sexual and reproductive health. Changes in normal menstrual patterns of women in reproductive age group may affect physical and psychological well being.
    Materials And Methods
    This cross-sectional study was conducted from August 2013 to January 2014 in rural villages of Poonamallee block, Thiruvallur district in Tamil Nadu. Ever married women of reproductive age group (15-49 years) were selected and interviewed on symptoms related to menstrual disorders using standard operational definition. Two stage cluster sampling was adopted.
    Results
    Mean age of 330 participants was 34.1 years and 61% had completed high school. More women (76%) belonged to upper and middle socio-economic class. It was observed that 44.8% of women had at least one menstrual disorder. Dysmenorrhoea (22.7%) and oligomenorrhoea (12.1%) were more common. Education acted as a protective factor for menstrual disorders (P = 0.0214). Low socio-economic status women had 1.8 times greater risk of dysmenorrhoea (P = 0.044). Old age (P = 0.035), anaemia (P = 0.002) and educational level (P = 0.032) were associated with oligomenorrhoea. Among women with menstrual disorders, 25.67% sought health care. Majority did not seek care due to personal reasons, 36% did not know they had disorders and 40% did not worry about it.
    Conclusion
    Almost half of rural women had menstrual disorders and very few sought health care. Majority of them did not seek care due to personnel reasons, this should be addressed.
    Keywords: Dysmenorrhoea, Health, Menstruation disturbances, Oligomenorrhoea
  • Marzieh Saei Ghare Naz, Giti Ozgoli, Fahimeh Hajizadeh, Zohre Sheikhan, Malihe Nasiri, Sharareh Jannesari Pages 277-282
    Objectives
    Changes in the fertility rate over the past 3 decades in Iran warn us of the reduced rate of the fertility and negative population growth and fear of population aging in coming years. Given the nationwide important role of the fertility behavior in the country’s economic and social growth, this study aimed to determine the relationship between the demographic factors and the religious orientation and the reproductive behavior of women working in Tehran city, Iran.
    Materials And Methods
    In this cross-sectional study, a total of 200 women working in the healthcare centers affiliated to Shahid Beheshti University of Medical Sciences and the selected education centers of Tehran and those who met the inclusion criteria, were selected using convenient sampling method. Moreover, the data were collected using reproductive behavior and religious attitude questionnaires developed by Golriz and Baraheni and the demographic questionnaire.
    Results
    The findings showed that a total of 63.5% and 36.5% of women were working in the healthcare centers and education centers, respectively. There was a meaningful and reverse correlation between the reproductive behavior and the religious orientation in the present study (r = -0.23, P > 0.05). There was also a statistically significant difference between the place of employment and the reproductive behavior score (P > 0.05), in such a way that the average score for the reproductive behavior of women working in the healthcare centers was higher than that of women working in the education centers.
    Conclusion
    The results of the present study indicated that the religious orientation affects the working women’s reproductive behavior. Thus, providing the perfect conditions to promote religious beliefs can play a prominent role in balancing individuals’ reproductive behavior.
    Keywords: Employment, Religion, Reproductive behavior, Women
  • Fahimeh Sehhatie Shafaie, Hamideh Mohaddesi, Mojgan Mirghafourvand, Fatemeh Ahadi Yulghunlu Pages 283-289
    Objectives
    According to the World Health Organization (WHO) statistics, the prevalence of C-section and unnecessary labor induction associated with adverse complications for the mother and baby is rising. This rate is higher in Iran, where many C-sections can be prevented by the proper management of labor and its duration. The present study was conducted to compare the effects of Ringer’s solution, dextrose solution 5% and oral intake on the delivery outcomes.
    Materials And Methods
    The present randomized clinical trial was conducted on 201 nulliparous women in labor assigned to 3 groups using a randomized block design, each receiving either Ringer’s solution plus oral fluids, dextrose solution 5% solution plus oral fluids or oral fluids alone. The solutions were intravenously administered at a rate of 125 mL/h in the groups receiving the solutions and the subjects in the oral fluids group could consume liquids of their choice (water, orange juice and apple juice). Delivery outcomes, including maternal outcomes (type of delivery, use of oxytocin and prolonged labor) and neonatal outcome (Apgar score) were recorded by the researcher. Data were analyzed using the one-way analysis of variance (ANOVA), the chi-square test and Fisher exact test.
    Results
    A significant difference was observed between the 3 groups in terms of administration of oxytocin (P
    Conclusion
    The results suggest that the consumption of dextrose solution by nulliparous women reduces the C-section rate, the need for oxytocin administration, the frequency of prolonged labor and improve neonatal outcome compared to when Ringer’s solution and oral fluids are used.
    Keywords: Type of delivery, nulliparous, dextrose, hydration, maternal outcome, Ringer's solution
  • Nahid Javadifar, Azam Honarmandpour, Zahra Abbaspoor, Amal Saki Malehi Pages 290-294
    Objectives
    Since pain reduction is an important concern in childbirth, this study was designed to evaluate the effects of nitrous oxide in comparison with lidocaine on pain relief, during episiotomy repair in primiparous women.
    Materials And Methods
    A prospective randomized controlled trial method was used in this study and 120 term pregnant women were recruited. The intervention group received nitrous oxide 2 minutes before starting episiotomy repair, until the end of the procedure. The control group received 5 mL of lidocaine (2%) before starting the episiotomy. The results of the 2 groups were compared with regard to pain intensity using a visual analogue scale (VAS). Mann-Whitney, student’s t test and chi-square test were used to analyze the data.
    Results
    Sixty women were studied in each group. Nine participants (15%) in nitrous oxide group, as opposed to 23 participants (38.4%) in lidocaine group had moderate, severe or extremely severe pain intensity (P value = 0.005). In terms of satisfaction level, there was no significant difference between 2 groups (P value = 0.713).
    Conclusion
    The results of this study showed that pain intensity in the nitrous oxide group was significantly lower than that in the lidocaine infiltration group. Application of nitrous oxide at least 2 minutes before repair may be an effective method for pain management in episiotomy repair.
    Keywords: Nitrous oxide, Episiotomy, Lidocaine, Pain
  • Mohammad Ghafourian, Masoumeh Mazandarani Pages 295-300
    Objectives
    Perovskia abrotanoides Karel. is an aromatic plant cultivated in North of Iran, which has been used as anti-inflammatory, sedative, and antiinfective. This work intended to determine the ecological requirements, antioxidant and antimicrobial activities of P. abrotanoides Karel. extract from Semnan province (North of Iran).
    Materials And Methods
    Aerial parts of plant in bloom were collected from Tash Mountain (2120 m) in September, 2014. Some ecological requirements and traditional data were obtained from rural people. Ethanol extracts of plant were obtained by maceration method; total flavonoid (TF) and total phenols (TP) were measured by spectrophotometry; antioxidant capacity was measured by TAC, RP, and DPPH; and the antimicrobial activity was studied against some microorganisms using well method and minimum inhibitory concentration (MIC)assay.
    Results
    Field observations showed that the P. abrotanoides Karel. is one of the wild growing herbs in the feet of the mountain in Semnan province (2000-2700 m). This area has dry cold climate type, with annual raining of 280 mm, temperature rate of 15.5 ̊C, and sandy clay loam soil (Ec=0.9 and pH= 7.1). Plant extract was rich source of TF (84.2 ± 0.4 mg QUE/g) and TP contents (143.4 ± 0.2 mgGAE/g) and had good antioxidant activity (IC50= 15.03 ± 1.2 mg/mL) especially in DPPH method. Candida albicans, Staphylococcus aureus, Staphylococcus epidermidis, Bacillus cereus, and Enterococcus faecalis were the most sensitive microorganisms with inhibition zones of 34, 32, 28, 21, 19 mm and MIC values of 58, 45, 53, 63, and 85 mg/mL, respectively.
    Conclusion
    Perovskia abrotanoides Karel. has the potential productivity of TP and TF constituents with suitable anti-Candida, antibacterial and antioxidant activities. Therefore it can be used as natural antiinfective to treat many infectious diseases such as vaginal infections.
    Keywords: Antioxidant, Antimicrobial, Vaginal infection, Ecology, Ethnopharmacology, Perovskia abrotanoides Karel, North of Iran
  • Fahimeh Sehhatie Shafaie, Mojgan Mirghafourvand, Kafiyeh Momeni Pages 301-305
    Objectives
    Health promoting behaviors and healthy lifestyle are the main ways to maintain health. Wrong lifestyle in menopausal women is the reason of many serious side-effects of this period. On the other hand, health is undoubtedly the most important aspect of human life; therefore, this study was conducted to determine the state of health promoting behaviors and their relationship with general health in menopausal women in Langroud city, Gilan province in 2013.
    Materials And Methods
    In this cross-sectional study, 400 menopausal women at the age range of 45-60 living in Langroud were randomly selected. The data were collected using demographic questionnaire, Health Promoting Lifestyle Profile (HPLP-II) and General Health Questionnaire (GHQ-28) by referring to the houses. Statistical tests of Pearson, t test, one-way analysis of variance (ANOVA) and multivariate linear regression were used to analyze data.
    Results
    Mean (standard deviation) of health promoting behaviors’ total score was 2.6 (0.3). The highest score of lifestyle was related to spiritual growth, 3.6 (0.4), and the lowest score was related to physical activity, 1.6 (0.3). Mean (standard deviation) of the total score of general health was 21.3 (6.9) and 26.7% of women were not in good health. There was a significant statistical relationship between health promoting behaviors and general health.
    Conclusion
    The results showed that health promoting behaviors in menopausal women were average; therefore, some solutions should be designed and performed for health promoting behaviors and general health in menopausal women in order to reach to favorable state.
    Keywords: Behavior, Health, Menopause, Women
  • Parvin Mostafa-Gharabaghi, Sakineh Alizadeh, Simin Atashkhoye, Manizheh Sayyah-Melli, Mehri Jafari-Shobeiri, Elaheh Ouladsahebmadarek, Laya Farzadi, Yashar Hashemi Aghdam Pages 306-311
    Objectives
    This study aimed to compare the effectiveness of a single preoperative dose of misoprostol with intraoperative oxytocin infusion in abdominal myomectomies.
    Materials And Methods
    Patients undergoing abdominal myomectomies were divided into 2 groups. An hour before the operation, women in the misoprostol group (n = 35) received a single dose of vaginal misoprostol (400 μg); those in the oxytocin group (n = 35) received oxytocin (intravenous infusion of normal saline solution [30 units in 1000 mL] during myomectomy).
    Results
    Blood loss, operation time, and need for blood transfusion were significantly reduced in the group administered with vaginal misoprostol. No difference was observed between patients in term of the period of hospitalization and complications. The results of oxytocin in abdominal myomectomy showed no significant difference.
    Conclusion
    Administration of a single preoperative dose of misoprostol could be a simple and reliable method for reducing intraoperative blood loss and need for postoperative blood transfusion in abdominal myomectomies.
    Keywords: Misoprostol, Oxytocin, Uterine myomectomy
  • Sepideh Herizchi, Mohammad Bagher Hosseini, Mahsa Ghoreishizadeh Pages 312-317
    Objectives
    Postpartum depression is a serious problem with considerable effect on the mother and infant’s health, being more common in mothers of preterm infants. Kangaroo mother care (KMC) method is a cheap and convenient way to take better care of premature neonates. This study aimed to evaluate the effect of KMC on the incidence of postpartum depression in mothers of preterm infants.
    Materials And Methods
    In this prospective cohort study, 60 mothers of premature infants who were hospitalized in neonatal intensive care unit (NICU) at Tabriz Al-Zahra hospital, were selected. All the mothers gave birth through caesarean section and carried out KMC. Mothers were divided in to 2 groups: mothers with 3 times or more/day KMC and those with less KMC. All mothers were required to complete the Edinburgh Postnatal Depression Scale (EPDS) on the 10th, 20th and 30th days after the delivery. The changes in mothers’ depression scale were evaluated.
    Results
    There was no obvious difference between the 2 groups in terms of EPDS scores on the 10th day (P = 0.07). However, there was significant difference on the 20th and 30th days (P
    Conclusion
    Considering the results of this study, it can be concluded that depression in mothers with KMC decreased during follow-up time. In fact, KMC is associated with a predictive effect on postpartum depression.
    Keywords: Kangaroo-mother care method, Postpartum depression, Premature Infant
  • Mojgan Mirghafourvand, Sakineh Mohammad-Alizadeh Charandabi, Tahereh Behroozi Lak, Fatemeh Aliasghari Pages 318-323
    Objectives
    Promoting the quality of life in women with polycystic ovarian syndrome (PCOS) is one of the most important goals of the medical community and the importance of lifestyle is more apparent in this area. This study aimed to determine the relationship between health-promoting lifestyle and quality of life in women with PCOS.
    Materials And Methods
    This study was conducted on 174 women with PCOS who attended public and private fertility clinics in Urmia (west Azerbaijan, Iran). The participants were selected by convenience sampling method. The data were collected through socio-demographic, health-promoting lifestyle (HPLP-II) and quality of life (PCOSQ) questionnaires. Multivariate linear regression was used to determine the relationship between the independent variables (health-promoting lifestyle and socio-demographic characteristics) and the dependent variable (quality of life).
    Results
    The mean (standard deviation) of total score of the quality of life was obtained 45.8 (11.3) in the range between 0 to 100. The highest and lowest mean scores were in the sub-domains of weight and hirsutism. The mean (SD) of total score of health-promoting lifestyle was 2.2 (0.3) out of 4. Based on multivariate linear regression, the variables of health responsibility, stress management, spiritual growth, body mass index (BMI), woman’s job and menstrual cycle intervals were predictors of the quality of life in women with PCOS.
    Conclusion
    Given the importance of lifestyle in women with PCOS to maintain and improve their quality of life, it is necessary to take serious strategies for changing and improving their lifestyle.
    Keywords: Health-promotion, Lifestyle, Polycystic Ovarian syndrome, Quality of life, Women
  • Farnaz Shokri, Parvin Mostafa Gharebaghi, Ali Esfahani, Manizheh Sayyah-Melli, Mehri Jafari Shobeiri, Elaheh Ouladsahebmadarek, Morteza Ghojazadeh Pages 324-331
    Objectives
    The principal treatment of ovarian cancer is surgery with or without chemotherapy. The chemotherapy, however, might be ineffective and long with serious side-effects. To obviate these shortcomings, more efficient and safer medications are required, among which ginger has recently gained popularity because of its anti-cancer properties. This study aims to compare outcomes and side-effects of adjuvant chemotherapy with and without ginger in ovarian cancer patients.
    Materials And Methods
    A total of 49 patients (20 patients in case group and 29 patients in control group) with stage I to III, histopathologically proved ovarian cancer underwent cytoreductive surgery followed by platinum-based adjuvant chemotherapy with and without investigator-prepared oral ginger capsules (2 g per day for 6 cycles). Potential side-effects, poor 12-month outcome (serum CA125 levels >35U, radiologic evidence of metastasis and recurrence, or death), and 12-month disease-free survival were documented and compared between the 2 groups.
    Results
    Poor outcome including serum CA125>35, metastasis, recurrence or death was documented more common in control group (69% versus 40%). metastasis frequency confirmed by computerized tomography (CT) scan 6 month after treatment was significantly lower in case group (P = 0.04). There was no significant difference regarding mortality and disease free survival during one year follow-up after treatment between 2 groups (P = 0.55). Chemotherapy complications such as nausea, vomiting, weight loss, and peripheral neuropathy were detected in case group less than control group but the difference was not significant.
    Conclusion
    Oral administration of ginger is along with a significantly better 12-month outcome in patients on chemotherapy because of ovarian cancer, and accordingly, considering its safety, its administration is recommended.
    Keywords: Ovarian Cancer, Ginger, Chemotherapy, Outcome
  • Sakineh Mohammad Alizadeh Charandabi, Mojgan Mirghafourvand, Salimeh Nezamivand Chegini, Yousef Javadzadeh Pages 332-338
    Objectives

    To assess the effect of co-administration of calcium and magnesium and calcium alone on pain intensity in primary dysmenorrhea.

    Materials And Methods

    In this study, 63 students with primary dysmenorrhea were randomly allocated into 2 intervention (receiving one tablet a day combined 600 mg calcium carbonate and 300 mg magnesium stearate, or only 600 mg calcium carbonate from 15th day of cycle until no pain day on the following cycle) and 1 placebo groups. The subjects filled in a diary including pain intensity (0-10 visual analog scale) and rest length for 2 cycles before intervention and 2 cycles under intervention. Univariate general linear model was used for data analysis.

    Results

    One from each intervention groups were lost to follow up. Both combined calcium- magnesium and calcium alone groups had better outcomes than the placebo group in pain intensity (adjusted difference -1.9, 95% CI -2.2 to -1.7 and -0.9, -1.2 to -0.6, respectively), rest length (-2.5 hours, -3.2 to -1.9 and -1.7, -2.4 to -1.1) and number of Ibuprofen taken (-2.6, -4.1 to -1.1 and -1.5, -2.9 to -0.1). The calcium-magnesium group had significantly better outcomes than the calcium group in pain relief and rest length but not in the Ibuprofen group. No side effect was reported.

    Conclusion

    Both combined calcium-magnesium and calcium alone are effective in relieving the pain and decreasing the rest length due to primary dysmenorrhea, but better efficacy was obtained from combined calcium and magnesium in comparison with its counterpart.

    Keywords: Calcium, Dysmenorrhea, Magnesium, Pain
  • Maryam Vaezi Pages 339-341
    Objectives
    Uterine rupture is an infrequent but serious event in pregnancy, which happens commonly in the second and third trimesters in scarred uteruses and labor phases. Uterine rupture during labor is very rare in the absence of scar and occurs mainly in multiparous women. This article introduces a very unusual case of unexpected rupture of an unscarred uterus in the 12th week of gestation.
    Case Presentation
    A 34 year old woman with a history of vaginal delivery, gravida 2, para 1, and gestational age of 12 weeks were admitted to Tabriz Taleghani hospital with abdominal pain. With increasing abdominal pain, the patient underwent ultrasound, which showed a lot of abdominal and pelvic free fluid, indicating urgent laparotomy, in which a bleeding rupture of about 5 cm was found on the posterior wall of the uterus. Placenta and fetus with an intact sac were bulging into the abdomen from the rupture site and hence were excised. The rupture was repaired and the patient was discharged on the third day in good conditions. The patient did not have any risk factors except multiparity.
    Conclusion
    Regardless of gestational age and history, uterine rupture should be kept in mind for all pregnant women with abdominal pain and signs of peritoneal irritation to timely and quickly detect and manage as a rare but life-threatening condition.
    Keywords: Unexpected rupture, Unscarred uterine, Early pregnancy, Case report
  • Ata Mahmoodpoor, Sarvin Sanaie Pages 342-343