Journal of Obstetrics, Gynecology and Cancer Research
Volume:3 Issue: 3, Summer 2018

Aims:

 Postpartum depression is a common event after delivery. Among some possible causes, pain is an important contributing factor which can play role in increasing psychiatric disease. The aim of the present study was to assess the effect of neuraxial analgesia methods on reducing incidence of postpartum depression.

Materials & Methods:

 280 pregnant women (140 cases, 140 controls) without depression history who referred for vaginal delivery in the maternity ward of Taleghani teaching hospital, from February 2016 until February 2017 were participated in this randomized clinical trial. Samples were selected by random sampling method. Depression risk was assessed by Edinburgh Postnatal Depression Scale (EPDS) and the pain was measured by Visual Analogue Scale (VAS). Data were analyzed by SPSS 22 using Mann-whitney test and independent t-test for comparing of quantitative mean values. The association between qualitative variables was assessed by Chi square and exact Fisher tests.

Findings :

Postpartum depression occurred in the painless delivery group and natural delivery group. There was statistically significant difference between them (p=0.04). It means that depression rate in painless delivery group was lower than natural delivery group. High Edinburg score was associated with high risk of depression.

Conclusion :

Postpartum depression in women with painless delivery is lower comparison to women with natural delivery.

Aims:

 Pain is the main concern after surgery. Gabapentin was recently suggested as a pain killer to be used after various surgeries. The purpose of the present study was to evaluate the effects of gabapentin on pain relief and need for opiates after total abdominal hysterectomy.

Materials & Methods:

 This randomized double-blind placebo-controlled clinical trial was performed on 85 women who underwent total abdominal hysterectomy from March 2014 to March 2016 in Akbarabadi teaching hospital and Firoozgar teaching hospital in Tehran, Iran. Samples were selected using consecutive sampling method and were randomly assigned into the 2 groups. In case group (n=44) gabapentin (800mg) was orally administered one hour before surgery and in the placebo group (n=41) placebo which was similar to gabapentin administered. The pain score was assessed in 2, 6, 12 and 24 hours after surgery. Nausea and vomiting were also compared between the 2 groups. Data were analyzed by SPSS 19 software using statistical tests.

Findings:

 The two groups did not have significant differences according to pain score in the recovery room (point 0). Mean score of pain was lower in the case group in 2, 6, 12 and 24 hours after surgery (p=0.005). Meperidine (pethidine) use was less in the case group (p=0.003). There was no difference between the 2 groups for nausea and vomiting.

Conclusion :

Using gabapentin before surgery can lower the pain after surgery and reduces the need for opiates. However, it doesn’t have an effect on nausea and vomiting.

Aims:

 Ovarian endometrioma is a prevalent gynecologic disease in women of reproductive age that is accompanied with a number of symptoms and has a high recurrence rate after hormone therapy and surgery. The aim of this study was to evaluate the effectiveness of sclerotherapy with 95% ethanol in patients with recurrent ovarian endometriomas.

Materials & Methods:

 In this pre-post clinical trial, 14 patients with infertility and recurrent ovarian endometriomas were examined during a period from December 2012 to December 2013 in Ghadir Mother and Child Hospital affiliated with Shiraz University of Medical Sciences. These subjects had undergone a laparotomy to remove their cysts at least once. They were selected using convenience sampling method. The patients underwent sclerotherapy with 95% ethanol and referred 1, 3, 6, and 12 months after the procedure for their periodic examinations and levels of FSH, AMH, CA125, E2, AFC, mass size, and pelvic pain were measured. The data were analyzed using repeated measures analysis of variance (ANOVA) by SPSS 14 software.

Findings:

 While the level of FSH significantly decreased (p=0.01), the AMH level began to increase after the treatment (p=0.17); however, this increase was not significant. The AFC level increased with the aid of the treatment (p=0.002). The mass size and the patients’ pain also significantly decreased (p<0.05). Four cases of pregnancy happened. In 2 of the patients, the cysts recurred and grew again.

Conclusion:

 Sclerotherapy with 95% ethanol can be used as an appropriate alternative therapy in patients with recurrent endometriomas.

Aims :

Preterm labors and abortions are among dangers that threaten mothers’ and infants’ lives. Several bacterial, viral, and parasitic agents can cause preterm labor and abortion. Among these bacterial agents, Chlamydia trachomatis plays a very key role. The aim of this study was to detect and isolate Chlamydia trachomatis from urine and its role in preterm labor.

Materials & Methods :

This cross sectional study was carried out from 2016 to 2017 in AlMahdi Clinic under the supervision of Tehran University of Medical Sciences. 119 pregnant women who were in the first trimester of pregnancy (between 12 and 14 weeks) referred to a health center for screening tests were selected using available sampling method and were collected their urine samples. The obtained samples were centrifuged and the DNA was extracted from urine sediment. Using specific PCR kits for detecting Chlamydia trachomatis, the presence or absence of this bacteria was investigated in the urine sediment. The data were analyzed using Chi square test.

Findings :

The rate of isolating Chlamydia trachomatis from the urine of these pregnant women was 6.72%. There was no significant relationship between chlamydia infection and history of abortion (p=0.93).

Conclusion:

 The level of the isolation of Chlamydia trachomatis from the urine of pregnant women is twice more than the level of its isolation from samples taken from vaginal and cervical discharge in pregnant women. Therefore, urine is an appropriate sample for the diagnosis of Chlamydia trachomatis since the sampling method is non-invasive and has more positive cases

Aims:

 Women’s empowerment refers to empowering women to make independent decisions about significant life issues. Women’s empowerment affects demographic processes and fertility behaviors. The aim of this review was to investigate the factors related to empowering Iranian women’s fertility behaviors.

Information and Methods :

This review examined all related studies conducted from 1997 to 2017 in Google Scholar, PubMed, Elsevier, Scopus, Proquest, Irandoc, SID, and Magiran using some keywords, i.e., fertility, empowerment, decision-making, and childbearing. 

Findings:

31 articles related to the objective of the current study were finally selected and examined. The studies demonstrated that factors associated with empowering Iranian women’s fertility behaviors could be classified into four main categories: contextual, economic, socio-cultural, and moral and emotional factors.

Conclusion :

Empowering women’s fertility behaviors is related to the contextual, economic, socio-cultural, and moral-emotional factors. By planning and making policies aimed at improving women’s position and educational and occupational facilities, improving social services and quality of life, and creating equal opportunities for getting access to facilities and credits, indicators of human development empowerment and women’s fertility behaviors can be promoted

Introduction:

 Gestational trophoblastic diseases (GTD) is the only group of female reproductive neoplasms derived from paternal genetic material (Androgenic origin). GTD is a continuum from benign to malignant; molar pregnancy is benign, but choriocarcinoma is malignant. Approximately 45% of patients have metastatic disease when Gestational trophoblastic neoplasia (GTN) is diagnosed. GTN is unique in women malignancies because it arises from trophoblast but not from genital organs. It is curable with chemotherapy, low-risk GTN completely response to single-agent chemotherapy and does not require histological confirmation. In persistent GTN, clinical staging and workup of metastasis should be performed. The aim of the present study was to review the new management of GTD.

Conclusion:

 In the case of brain, liver, or renal metastases, any woman of reproductive age who presents with an apparent metastatic malignancy of unknown primary site should be screened for the possibility of GTN with a serum HCG level. Excisional biopsy is not indicated to histologically confirm the diagnosis of malignant GTN if the patient is not pregnant and has a high HCG value. Given the vascular nature of these lesions, a biopsy can have significant morbidity. In every woman with abnormal bleeding or neurologic symptom without documented reason, the probability of malignant GTN should be in mind and determination of HCG titer is recommended. In selected cases with low-risk GTN, repeat curettage is done to reduce the need for chemotherapy courses. In recent years personalized medicine is encouraged for treatment of GTN.

Introduction :

Swyer syndrome is determined by primary amenorrhea, normal external genitalia, and the presence of a vagina, uterus, and 46XY karyotype. The aim of this case report was to introduce a patient with Swyer syndrome referred with pain and an abdominal mass.

Patient Information:

 This case study was done in Gynecology Clinic of Ghaem Hospital in Mashhad, Iran, in 2015. A single 18-year-old woman came to the clinic with complaints of primary amenorrhea, pain, and abdominal mass underwent laparotomy. Based on her histopathology report which indicated a left ovary dysgerminoma and a right ovary gonadoblastoma, a bilateral salpingo-oophorectomy, followed by chemotherapy, was conducted. The patient was under Bleomycin, Etoposide and Platinum (BEP) chemotherapy and has been living without evidence of recurrence.

Conclusion:

 A genetic disorder in patients younger than 20 years with an ovarian mass and diagnosis of dysgerminoma should be rejected.

Introduction:

 Heterotopic pregnancy or combination of intra and extra- uterine pregnancy is very rare, but its incidence increased sharply in recent years due to the development of medically assisted reproductive technology. This condition carries a significant maternal morbidity and mortality due to the risk of rupture of ectopic pregnancy. This study was a case report of heterotopic pregnancy.

Patient Information :

A 25 year old pregnant woman with abdominal pain and nausea and vomiting was admitted in 12 March 2018 in Firoozgar hospital that ultrasound examination suggested heterotopic pregnancy and laparotomy and left salpingectomy was performed, and intrauterine pregnancy continued.

Conclusion :

A high index of suspicion can help in timely diagnosis and appropriate intervention and decrease the risk of complications and maternal mortality.