Journal of Obstetrics, Gynecology and Cancer Research
Volume:4 Issue: 1, Winter 2019

Laparoscopy is a surgical procedure which has been used in gynecologic cancer since 1994. With technology progressing during years, there are so many kinds of minimally invasive surgeries in gynecologic malignancies. Regarding the importance of overall survival and progression of free survival in cancerous patients, we should consider this type of surgery very wisely not to compromise patientchr('39')s prognosis. Considering all the points above, a review was performed to study the role of laparoscopy in gynecologic oncology including endometrial and cervical cancer. It can be concluded that laparoscopy is not safe in a disease with high risk of tumor spread. Also a good prognosis of cancer patients should not be jeopardized by doing incomplete laparoscopic surgery.

Vasomotor symptoms, also known as hot flashes, can be defined as a sensation of heat, intense sweating, and flushing, which are experienced episodically by many perimenopausal women. This sensation usually affects the face, neck, and chest. It is estimated that about 75% to 80% of women would suffer from hot flashes at some point during their perimenopausal years. A decline in oestrogen levels during menopause seems to be responsible for the appearance of hot flashes. This decline increases norepinephrine levels, leading to an up-regulation of serotonin receptors in the hypothalamus, which are involved in temperature regulation. The outcome of the activation of this norepinephrine serotonin pathway is believed to be the narrower thermoregulation zone, which in turn results in a greater risk of crossing the upper and lower thresholds of the thermoregulatory zone. Thus, it causes sweats and chills in this group of women. The most known effective treatment of hot flashes is hormone replacement therapy (HRT); however, in recent years, other non-hormonal options have become available for those women who cannot or do not want to take HRT.

Diagnosing fetal disorders and abnormalities in the early stages of pregnancy can prevent future adverse conditions for the infant and his/her family. This study aimed to evaluate the sensitivity and specificity of the first- and second-trimester screening tests for identifying fetal chromosomal disorders in pregnant women.

A total of 960 pregnant women participated in this retrospective cohort study that was performed at Yas Hospital. The participants’ mean age was 31.07±0.17 years. In the present study, all pregnant women, who referred to Yas Hospital for their first- and second-trimester screening tests, were studied from 2015 to 2017.

Most of the participants (43.4%) were primigravida. The sensitivity of the first-trimester screening test was 70%, and its specificity was 80.3%. The sensitivity and specificity of the second-trimester screening test were 45% and 94.5%, respectively.

Despite recent advances in the prenatal field, the accuracy of screening tests may still vary depending on maternal age and other existing characteristics. Consequently, in parents consulting, the possibility of false positives and negatives should be considered in the tests.

Pregnancy is one of the most important stages of a woman’s life. Although this is a pleasant period for most women, it is often considered as a stressful period accompanied by physiological and psychological changes. This study aimed to examine pregnant women’s attitude towards sexual desire and its relationship with quality of life and rumination in the last trimester of pregnancy.

The statistical population of this descriptive correlational study included all pregnant women in the last trimester of pregnancy. A total of 280 women were selected using a random sampling method. Data were collected using the Index of Sexual Desire, Rumination Scale, and Quality of Life Questionnaire. The data were analyzed by SPSS 11.5 using simultaneous regression analysis.

The results showed that rumination was significantly and negatively predicted by sexual desire. Moreover, the subscales of physical functioning, emotional problems, and general health were positively and significantly predicted by sexual desire. However, sexual desire could not significantly predict other subscales of quality of life, namely fatigue or vitality, emotional health, social functioning, pain, and physical health status.

Our finding revealed that, if guided and employed properly, sexual desire during pregnancy can moderate stress.

This prospective study aimed to determine the relationship between maternal and amniotic fluid (AF) lipid profiles in the second trimester with pregnancy outcomes.

One hundred-eighty singleton pregnant women, with a gestational age of 16-22 weeks, were enrolled in this study. All women underwent amniocentesis, and 2 mL of AF was investigated for AF lipid profile. Furthermore, the serum maternal lipid profile was evaluated simultaneously.  All participants were followed up until the delivery, and postnatal outcomes were recorded.

Mean maternal age and body mass index (BMI) of all participants were 5.8±33 years and 25.6±2.8 kg/m2, respectively. Mean maternal estriol, cholesterol, and triglyceride levels, as well as mean cholesterol and triglyceride levels of AF, were significantly different between term and preterm; intrauterine growth retardation (IUGR) and non-intrauterine growth retardation (non-IUGR); and low birth weight and normal weight neonates (P<0.001). The AF cholesterol level was an independent predictor of term or preterm delivery, while the maternal estriol level was an independent predictor of IUGR or normal growth.

Maternal and amniotic fluid lipid profiles could be good indicatives of fetus growth.

Cervical cancer is one of the common cancers in developing countries, which has a high rate of mortality. This study aimed to evaluate the prevalence of abnormal cervical cytology among Iranian women.

In this cross-sectional study, cervical cytological results of 137,484 Iranian women, who were screened for cervical cancer in Tehran and 12 other provinces of Iran from 2013 to 2016, were investigated. The Pap smear was prepared by a liquid-based method and evaluated by a pathologist.

The overall prevalence of abnormal cervical cytology in the studied population was 3%. The mean age of the population was 35.77 ± 9.6. In this study, the prevalence of abnormal cytology in 2013, 2014, 2015, and 2016 was 2.10%, 2.68%, 3.47%, and 3.60%, respectively. The rate of the abnormal Pap smear has increased over the years, and this trend has been statistically significant (P<0.001). In this population, atypical squamous cells of undetermined significance (ASCUS) cytology was the most common abnormal Pap smear (1.96%).

In this study, the prevalence of abnormal cervical cytology has been significantly increased in Iran in recent years. This increase requires careful monitoring of general education programs, strict cervical cancer screening, and routine vaccination against HPV infection.

Gestational trophoblastic neoplastic (GTN) as the one of curable malignancy all around the world has higher incidence rate in developing country, so study on its behavior, risk factor, and treatment failure reason is encouraging in such countries

This study was a descriptive, cross-sectional study which tries to examine the GTN cases medical record in referral university hospitals in Isfahan from 2011 to 2016 to examine the risk factor and the factor that affecting treatment response rate. The patients were studied in two divided group based on the FIGO scoring system.

70 GTN patients were identified over these 5 years. 59 patients were in the low-risk group and 11 patients were in the high-risk group. 100% of the patients in the low-risk group and 90.1% of the patients in the high-risk group responded to the first and second line treatment. In the follow-up one case of recurrence within the low risk patient and one case of mortality from the high-risk patients was reported. In the high-risk metastatic group, there was 1 case of unusual metastasis site at the kidney and the commonest site of distant metastasis was lung.

Response rate in the low-risk GTN patients was excellent (100%) and it was more than 90% in the high-risk GTN patients. Therefore, if GTN patients are treated in reference centers, the response rate will be favorable. Patients with brain metastases have good chances of recovery if treated timely.

Postpartum hemorrhage has different etiologies. One of the rare causes is inner myometrial laceration that makes the diagnosis more difficult. This report aimed to introduce a case of massive postpartum hemorrhage following an inner myometrial laceration.

Case Report: 

A 24-year-old primigravid woman referred to an academic Hospital due to hypertension of 140/90 and diagnosis of preeclampsia. Her pregnancy was terminated at 39th gestational week. She received two doses of 25 μg misoprostol sublingually. Subsequently, an induction was performed and normal vaginal delivery occurred. A 2800 gr infant was born. After the delivery, the patient suffered from massive postpartum hemorrhage which continued in spite of all medical treatments. With regard of unstable vital signs, laparotomy was done. By transverse uterine incision, a longitudinal inner myometrial laceration was found in the lower uterine segment, which was repaired, thus, hemorrhage was controlled.

An inner myometrial laceration is one of the differential diagnoses of postpartum hemorrhage which should be taken into consideration. Laparotomy and hysterotomy for repairing the inner myometrial laceration would control postpartum hemorrhage and could avoid hysterectomy.