International Journal of Women’s Health and Reproduction Sciences
Volume:8 Issue: 4, Oct 2020

While short-acting hormonal contraception (SAHC) remains the most popular form of modern contraception in most low and middle-income countries (LMICs), the use of long-acting reversible contraception (LARCs)—specifically implants—is rising globally. A better understanding is needed of the factors influencing users’ method selection and satisfaction. In this qualitative study we compared experiences, preferences, and needs of current LARC and SAHC users.

We administered a survey and semi-structured qualitative interview focusing on determinants of method choice to 12 current implant users and 12 current SAHC users from a rural Maya community in Guatemala.

Dissatisfaction with SAHC side effects was a major driver of method switching for current LARC users. SAHC users endured side effects of their methods to prevent pregnancy. The two groups held different perceptions of risks associated with LARCs. Neither group perceived LARC methods to be intrinsically more effective than SAHCs. Rather, women understood efficacy in terms of personal and individual experience with a method. Both groups valued user autonomy in method initiation, continuation, and termination.

We found important similarities and differences between LARC and SAHC users that can help family planning counselors in LMICs understand women’s method preferences. Future research should explore how to counsel women on method efficacy and how to ensure women’s autonomy within resource-poor service delivery environments

Spontaneous preterm birth is a leading cause of neonatal death. Fetal fibronectin (fFN) testing in cervical secretions between 22-34.6 weeks of gestation is used to predict non-delivery within the next 7 days in patients with symptoms of preterm labor. The objective of this study is to analyze fFN test performance in a group of patients with low risk for preterm delivery that presented with preterm labor symptoms, and to evaluate how the results of fFN testing influenced management decisions.

Patients after preterm delivery (gestational age 24.0-36.6 weeks) and patients who underwent fFN testing in Metropolitan Hospital, NYC Health+Hospitals, New York, NY, from January 1, 2015 to December 31, 2015 were identified and reviewed. Patients with positive fFN test results (fFN+; >50 ng/dL) were compared to patients with negative fFN test results (fFN-).

Among 77 patients identified, 66 (86%) were fFN- and 11 (14%) fFN+; 15 patients (78%) who delivered preterm were not tested with fFN. Preterm birth rate during the study period was 1.9%. There was no difference in maternal or neonatal characteristics between the two groups. Among fFN-, 4 patients (6%) delivered preterm, while among fFN+, none delivered preterm. In both groups, none delivered within 7 days of testing. Compared to fFN-, fFN+ had higher rates of admissions (36% vs 0%; P<0.001) and steroid administration (82% vs 0%; P<0.001).

In this retrospective analysis, use of fFN testing as an initial screening test for patients with symptoms of preterm labor in this low risk population did not result in improved clinical outcomes and was associated with a higher rates of hospital admissions and steroid administration.

Bangladesh is a country which is known for its flora and fauna in South Asia. Despite embracing safe motherhood and adhering to the advice of the International Community, with remarkable progress towards achieving the maternal mortality Millennium Development Goals (MDG) 5 goal, its development contrasts with the tribal people who reside in the remote hilly regions of the country. Therefore, this study was intended to identify the predictors that affect secure maternity practices among the tribal women of Chittagong Hill Tracts (CHT), Bangladesh.

This study adopted a cross-sectional approach and was performed with live births of 556 married tribal females aged 15 to 49 years from three districts of CHT when the age of their children was not more than 1 year. Semi-structured questionnaires were used to interview the subjects. Finally, the statistical analysis was conducted with SPSS20 to estimate the odds ratios and strength of the relationship between the variables at P<0.10.

The results of the study revealed that safe maternity practices are not the standard in CHT. Only 12.7% met the standard of maternity services in CHT. At the time of pregnancy, more than 2/3 of females received no prenatal care. The results further demonstrated that only 34% of the women gave birth to the baby at a hospital while 66% of the births occurred at home and over 50% were assisted by untrained traditional midwives.

In general, the results revealed that socioeconomic, demographic, cultural, and behavioral factors affected the adoption of maternal health care services (MHCS) by the women of CHT. Therefore, improving the economic conditions by introducing ‘ecofriendly’ industries can help enhance the uptake of safe motherhood practices

Maternal mortality is a crucial indicator of health care provision within a nation, particularly during the periods of instability. This study aimed to assess the maternal mortality ratio in one of the largest hospitals in Baghdad over eight years including the time of the threat of the so-called Islamic State of Syria and Iraq.

A cross-sectional study was undertaken by reviewing the records of mothers who passed away in the hospital from February 2011 to February 2018. The gathered data included the patients’ demographic features as well as obstetrical and medical conditions and causes of death each year.

During the eight years, the total live births numbered 95 800 while 52 mothers died for a maternal mortality ratio of 58.12 per 105 . Most of the deceased mothers aged between 30 and 39 years (P = 0.0015), were multiparous and from rural residence (P = 0.000), booked no antenatal care (P = 0.0014), and completed delivery via a cesarean section (P = 0.0184). The majority died in the postpartum period (P = 0.000) within the first 12 hours of admission (P = 0.000). Finally, the major presentation and cause of death were often obstetrical hemorrhage.

The maternal mortality was high and obstetrical hemorrhage was the main cause of death. In addition, the majority of patients died within the first 12 hours of admission, which is attributed to delays in access to the hospital and the lack of needed facilities during that critical period of time.

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder in reproductive age having a greater impact on health-related quality of life (HRQOL). The aim of this study was to find out PCOS demographics and its related HRQOL effects for improving psychological understanding in disease management.

A prospective questionnaire-based study was conducted for a period of twelve months at All India Institute of Medical Sciences, Patna, India. The data of 100 PCOS cases were collected about socio-demographic status, clinical history, and dietary intake. Then, a validated PCOS questionnaire (PCOSQ) was used to observe the impact of PCOS symptoms on patients’ HRQOL.

The overall 57% and 48% of PCOS cases belonged to the age range of 20-30 years and had a body mass index (BMI) of >25-30, respectively. Based on the results, a significant difference was observed in the mean score of PCOSQ vs. marital status in PCOS cases with respect to emotion (P=0.039), body weight (P=0.002), and infertility (P=0.001). Furthermore, the result showed a significant difference in the domain of emotion (P=0.008), body hair (P=0.035), body weight (P<0.001), and infertility (P=0.018) among BMI group, and a high score was observed in the BMI group <18 in comparison to the other groups of BMI.

In general, our findings indicated that infertility, emotions, and BMI had extremely higher impacts on the HRQOL of women suffering from PCOS although their educational status failed to affect HRQOL

Dysmenorrhea is one of several gynecological issues that occur among women of reproductive age. In addition, it appears as pain that forms in the pelvis or lower abdomen and spreads to the back and thighs. The peripheral blood among women with dysmenorrhea increases the synthesis and the concentration of oxytocin, F2α prostaglandin hormone, vasopressin, interleukin-6 (IL-6), and tumor necrosis factor-α (TNFα). In this regard, this study aimed to determine the effect of slow-stroke back massage (SSBM) on the levels of β-endorphins, IL-6, TNF-α, and menstrual pain intensity (MPI).

Based on the aim of the study, the posttest only quasi-experimental method with the control group design approach, pretest-posttest control group approach, and purposive sampling techniques were applied for sample selection. The samples were divided into SSBM and control groups each containing 20 subjects. The numeric rating scale (NRS), β-endorphin, IL-6, and TNFα levels were measured using the indirect enzyme-linked immunosorbent assay. Then, data were analyzed by paired sample t test and independent-samples t test with α ≤ 0.05.

The results revealed that SSBM had an effect on the intensity of menstrual pain (P<0.05), and differences were found between β-endorphin levels, IL-6, TNFα, and MPI among SSBM and control (P<0.05) groups. Accordingly, SSBM can stimulate releasing β-endorphin levels and reducing pro-inflammatory cytokines (IL-6 and TNFα).

In general, SSBM is a nonpharmacological action that is effective in primary dysmenorrhea

Breast cancer is the most common malignancy in women. In addition, it is the most mentally powerful cancer in women due to affecting the most important female sexual part. Patients with breast cancer experience problems in their marital relationship because of their disrupted mental image and sexual relations. In this regard, this study was conducted to investigate the relationship between sexual self-concept and mental body image in women with breast cancer.

This descriptive cross-sectional study was conducted on a sample of 120 women with breast cancer. Using a convenience sampling technique, patients were selected from among those hospitalized in the selected hospitals of Tehran in 2018. Data were collected using demographic details, the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ), and the Fisher’s Body Focus questionnaire. Finally, the data were statistically analyzed in SPSS-21.

According to the descriptive and analytical statistics, women with breast cancer obtained the highest scores in avoiding risky sex and sexual problem prevention while the lowest scores in terms of sexual preoccupation. Based on the results, there was no disruption in the body image of any of the examined women. Eventually, a significant correlation was observed between sexual self-concept and body image (P<0.001, r=0.4).

In general, body image has a positive relationship with sexual self-concept in women with breast cancer and is considered an important predictor of sexual health and behaviors of this group. Accordingly, psychological interventions, along with midwifery and sexual consultations offered by trained personnel can help empower these patients.

Endometrial receptivity is a complex event that occurs during the midluteal phase of the menstrual cycle known as the “window of implantation”. During this period, the endometrium develops characteristics that allow the adhesion and invasion of the embryo to the uterine epithelium. Accordingly, the expressions of miR-31 and its target gene were evaluated to study the effect of miR-31 on FOPX3 gene expression in recurrent implantation failure (RIF) patients and normal fertile women. More precisely, the aim of this study was to understand the expression of miR-31 as one of the important regulators of the FOXP3 gene in the endometrium of RIF patients versus receptive endometria from fertile patients.

This case-control study was conducted on 20 endometrial tissue samples of normal fertile women and RIF patients in order to evaluate miR-31 and its target gene expression.

According to the results of this study, a significant difference existed between RIF patients and normal fertile women (control group). The expression of the FOXP3 gene was more significant in the control group. miR-31 was also significantly expressed, which was due to the endometrial immunological disorder leading to the decreased expression of its target gene (FOXP3).

In general, implant abnormalities and recurrent abortions were observed in RIF patients due to the decreased expression of the FOXP3 gene resulting from the inhibitory effects of miR-31

This study was performed to investigate the relationship between the renal artery color Doppler with the umbilical artery and amniotic fluid index (AFI) in fetuses affected by intrauterine growth retardation (IUGR).

This was a descriptive cross-sectional diagnostic study and the target population included pregnant mothers who were diagnosed to have fetuses with IUGR referring to the Al-Zahra treatment center in Tabriz. At least 40 samples were referred between October 2019 and May 2020. The patients were evaluated using the transabdominal ultrasound of the umbilical artery and fetal renal artery, and then using the color Doppler values of the umbilical artery and fetal renal artery.

The present research was performed on 40 pregnant females with an IUGR fetus with umbilical artery percentile upper that 95% whose minimum to maximum age range was 22-38 years. There is no relationship between umbilical artery and renal artery color Doppler. In addition, umbilical artery color Doppler is not related to amniotic fluid, also renal artery color Doppler demonstrated no significant correlation with amniotic fluid index.

Based on our results, the PI of the umbilical artery had no significant correlation with that of the renal artery. In addition, there was no significant correlation with the PI of the renal artery and AFI.

Pregnancy is one of the pleasant periods of a woman’s life that turns into a bitter experience by common complications such as low back pain (LBP). Due to prevailing climatic conditions in Iran and the harmful social norms concerning Iranian women, the present study aimed to investigate the prevalence of pregnancy-related LBP and its influencing factors during different months of pregnancy.

This descriptive cross-sectional study was conducted in 2019 on 550 pregnant women for LBP who were eligible based on the inclusion criteria. The research instruments were a demographic questionnaire, a LBP examination, and the visual analog scale (VAS). The obtained data were analyzed using the chi-square test, the independent t test, and multiple logistic regression in SPSS 20, and a P<0.05 was considered statistically significant.

The prevalence of LBP was 67.27%, and the most important factors influencing pregnancy-related LBP were maternal age (OR=950, P<0.008), gestational age (OR=1.023, P=0.015), body mass index (OR=802, P=0.045), duration of sitting (OR=1.812, P=0.036), and the duration of standing (OR=1.625, P=0.042).

Overall, there was a high prevalence of pregnancy-related LBP in primiparous women in the present study and its predisposing risk factors included advanced maternal age, obesity, and low level of ability to sit and stand for a long time.

Oxidative stress indices are one of the factors that cause and exacerbate cardiovascular diseases in postpartum women, which can be changed with interval training. Therefore, the current study aimed at investigating the effect of interval training on oxidative stress indices among women in preterm labor undergoing the coronary artery bypass graft (CABG).

This randomized clinical trial was conducted on 21 participants (the sample size was determined based on a similar study) from December 2018 to May 2019 at Shahid Madani hospital of Tabriz, Iran. After the random allocation of subjects to the training (n=11) and control (n=10) groups, demographic information was collected and their physical activity level was assessed using the Kaiser physical activity survey before and after the intervention. In addition, the levels of oxidative stress indices were measured 24 hours before and after the intervention using the blood sample. The participants completed an eight-week invention including 24 one-hour sessions according to the available protocol. Finally, data were analyzed by means of statistical tests such as the Shapiro-Wilk, Leven, and Student’s t-test at a significant level of <0.05.

The effect of the aerobic exercise program on body weight loss, as well as body mass index (BMI) and body fat percentage changes was significant in the training group (P=0.011, P=0.004, and P=0.001, respectively). Based on the results, the serum and urine levels of 8-hydroxy-2-deoxyguanosine reduced significantly after the completion of the intervention (P=0.002 and P=0.001, respectively) in the training group.

In general, aerobic exercise after CABG decreased the fat percentile, BMI, and oxidative stress indices in the subjects. Thus, these trainings could reduce oxidative stress indices by increasing tissue metabolism and oxygen consumption.

Vulvovaginal candidiasis is the second most common gynecological infection in the world that can bring about unfavorable consequences for the health and life of the women of reproductive age. Accordingly, the purpose of this study was to determine the prevalence of vulvovaginal candidiasis and its relationship with the health-promoting lifestyle in Boukan, Iran.

This cross-sectional study was conducted with the participation of 320 married women aged 15-49 years who referred to all health centers of Boukan. The subjects were selected using a convenience sampling technique from October 2018 to March 2019. Written informed consent was obtained from the participants who were then asked to complete a demographic questionnaire and the Health Promoting Lifestyle Profile-II (HPLP-II). Finally, the data were analyzed in SPSS, version 24.

A total of 124 women (38.8%) had vulvovaginal candidiasis, and the total mean (standard deviation) score of healthpromoting lifestyle was 2.4 (0.2) from the possible range of 1-4. None of the demographic characteristics and vulvovaginal candidiasis were significantly related based on the results (P<0.05). The highest (2.8±0.3) and lowest (1.6±0.4) mean scores belonged to “nutrition” and “physical activity” subdomains, respectively. In addition, no statistically significant relationship was found between vulvovaginal candidiasis and the total mean score of health-promoting lifestyle and its subdomains (P>0.05).

In general, more than one-third of the participants had vulvovaginal candidiasis. Eventually, the infection had no statistically significant relationship with any of the characteristics of demographic information and health-promoting lifestyle.

The screening of chromosomal aberrations is one of the most common methods during pregnancy although this test is occasionally false-positive.

In this case-control study, 252 mothers with false-positive (n=126) and -negative (n=126) tests were evaluated respectively. Demographic data during pregnancy and postpartum included maternal and neonatal complications, and finally, perinatal variables were compared between the two groups.

The mean age of the case group was significantly higher than that of the control group (P < 0.001). In addition, lower smoking history in the spouse (P = 0.01), higher prevalence of preeclampsia (P = 0.33) and proteinuria (P = 0.03), preterm infant (P = 0.01), and low birth weight (P = 0.04) were observed in this group as well. Eventually, the shorter height P = 0.004) and lower 5-minute Apgar score (P = 0.03) were found in infants.

In general, mothers with positive screening results showed a higher risk of preeclampsia and preterm labor in comparison with those with false-negative screening results.

This study aimed to investigate the peculiarities of the uterine microbiome in the case of infertility and repeated in vitro fertilization (IVF) failures. Accordingly, the microbiome of the uteri of 22 women with 2 or more IVF failures (first group) and 20 healthy women (second group) was analyzed in this study.

The samples of uterine microbiomes were collected 7 days after the luteinizing hormone elevation, which was determined by the urine test. All measures were taken to avoid sample contamination. Finally, the massively parallel sequencing of the 16S ribosomal RNA gene was done in every uterine sample.

The analysis of the mean relative abundance of various microorganisms in the uterine microbiome showed that women with infertility had higher microbiological diversity and variability compared to healthy women. Eventually, the mean relative abundance of the Lactobacillus genus comprised 34.4% and 63.0% in the first and second groups, respectively.

In general, the presence of Lactobacillus in the uterine microbiome could be considered a favorable factor for good reproductive outcomes and successful IVF programs.