International Journal of Women’s Health and Reproduction Sciences
Volume:9 Issue: 2, Apr 2021

Different drugs are prescribed for the induction of ovulation in patients with polycystic ovary syndrome (PCOS). The aim of this study was to compare the effect of letrozole alone with letrozole plus N-acetyl cysteine (NAC) on the pregnancy rate in patients with PCOS.

This clinical trial studyincluded317 patients with PCOS in the infertility clinic of Zahedan in 2018. Patients were randomly divided into letrozole and NAC plus letrozole groups. Then, several parameters were evaluated in both groups, including the pregnancy rate, number of follicles larger than 18 mm, endometrial thickness, and the endometrial pattern. Finally, data were analyzed using SPSS 25, and t-test and chi-square tests were used for statistical analysis.

The mean age of study participants was 28.5 ± 4.9 years old. The mean duration of infertility in the intervention group was 4.5 ± 3.8 years. The mean anti-Müllerian hormone and the mean endometrial thickness of patients in the intervention group were 4.4± 3.6 ng/mL and 7.6 ± 2.5 mm, respectively. Eventually, the pregnancy rate was 14.6% (n = 23) and 7.5% (n = 12) in the intervention and control groups, respectively (P = 0.046).

The results of this search revealed that the number of follicles with the size of 18 mm in the control group was higher compared to the intervention group, but the fertility rate in patients with PCOS receiving letrozole plus N-acetylcysteine was significantly higher.

Cervical cancer is preventable through cervical cancer screening. People may be unwilling to take screening tests when they are healthy, and performing regular screening tests largely depends on motivational factors. Accordingly, the present study aimed to investigate the effectiveness of motivationally tailored interventions on women’s cervical cancer screening.

In this systematic review, the electronic databases of the Cochrane Library, Web of Science, PubMed, Scopus, Embase, and Google Scholar were searched for all interventional studies (i.e., trials, pre- and post-test, or quasi-experimental ones) published before 2019. Then, the Cochrane tool was implemented to evaluate the quality of trial studies (7 articles).

This systematic review study included 7 articles with 1337 female participants. The result of our study showed that different motivational interventions (MIs) (i.e., face-to-face interviews, consultation sessions or calls, and educational programs) can effectively improve cervical cancer screening behavior in women.

Overall, motivational interventions (MIs) seem to be effective in cervical cancer screening.

Breast cancer that occurs from the beginning of pregnancy to one year after pregnancy is called pregnancy-associated breast cancer and identifying and knowing its risk factors can greatly affect the health of the mother and the baby/fetus. Therefore, the present study was conducted to investigate breast cancer during pregnancy.

To this end, published articles until 2019 were obtained from Persian and English databases using keywords such as “pregnancy (Mesh)” and “breast cancer (Mesh)” and included based on the inclusion and exclusion criteria.

Epidemiological findings, pregnancy factors affecting breast cancer, and treatments were collected and presented from several articles.

In general, self-induced abortion, preeclampsia, and gestational diabetes were considered as risk factors for breast cancer. In the case of breast cancer, radiotherapy is better in the third trimester. In addition, adjusted mastectomy is preferred to other surgical and chemotherapeutic methods except for the organogenesis period, and a period of three weeks before delivery is associated with minor fetal and maternal complications.

To study the effect of the unengaged fetal head in primigravida on labour outcomes and to determine its association with maternal and perinatal outcomes.

A hospital-based prospective study was conducted between August 2017 and September 2019 at hospitals affiliated with Kasturba Medical College, Mangalore. All primigravidas with an unengaged head at term with single live intrauterine gestation and vertex presentation with no cephalo pelvic disproportion were included in the study. The time of engagement, engagement to delivery interval, duration of labour, and oxytocin augmentation with the number of “fifths” of the fetal head above the pelvic brim were analyzed based on the aim of the study.

A total of 350 women were evaluated in this study. The free-floating fetal head, 4/5th palpable fetal head, and 3/5th palpable were observed in 251 (71.7%), 65 (18.6%), and 34 (9.7%) subjects, respectively. In addition, 270 (77.14%) women were in the gestational period of 38-40 weeks and 191 (76.1%) of them had the fetal head level above the brim at 38-40 weeks of gestation. Among the freefloating head, 205 (68.1%) and 62 (95.4%) cases in the 4/5th level of fetal head engaged in the active phase of labour and were found to be statistically significant (P=0.0001). Further, the duration of labour was more than 6 hours in 159 (67.1%) in the free-floating head and 39 (60%) in the 4/5th level of the fetal head (P=0.000). Finally, 109 (43.4%) of women with the free-floating head delivered by cesarean section (P=0.087).

In general, primigravida with an unengaged fetal head at term in labour requires intense monitoring, intervention, and labour augmentation in order to reduce the maternal morbidity and perinatal complications.

Using uterotonic drugs to prevent postpartum hemorrhage is recommended in the health centers. However, the related studies are contradictory, thus the evaluation of non-invasive methods with minimal side-effects such as icepack would be useful. Traditionally, icepack has been applied, along with drugs in most deliveries in postpartum hemorrhage (PPH) in Iran although it has not evidenced yet. Therefore, the present study aimed to evaluate the effect of the icepack on blood loss.

This study was a randomized controlled trial. The sample size included 58 women including 29 intervention and 29 control groups. The intervention group benefited from an icepack placed on the lower abdomen 2 hours after placental delivery while the control group received 20 units of oxytocin. Subsequently, the amount of lost blood after placental delivery was measured via weighting the sheets and pads. The mean difference between the two groups was detected with 80% power at the two tails of a 5% significance level.

Based on the results, there was no significant difference between the groups in parity, neonatal weight, and hemoglobin levels before and after delivery in the second and third stage of delivery and breastfeeding. Moreover, excessive PPH was 12.1% (17.2% vs. 6.9%). Thus, no significant difference (P>0.05) was observed between the groups in terms of blood loss (254 ± 68 mL vs. 245 ± 53 mL, respectively) although the only complication in the intervention group was an unpleasant cold feeling in the abdominal area.

The application of the icepack in low-risk women is a non-pharmacological and affordable method that can be a good alternative to oxytocin in order to decrease blood loss after delivery

Sexual health counseling and education are important parts of pre-marital counseling programs, which can play effective roles in the prevention of sexual dysfunction and an increase in marital satisfaction. In this regard, this study aimed to assess the effect of the pre-marital sexual counseling of couples on self-efficacy and sexual function among females who referred to pre-marital training courses in Zahedan, Iran.

This quasi-experimental study was conducted on 110 couples before marriage, who were randomly divided into intervention and control groups. The intervention group was subjected to two 60-minute sexual counseling sessions whereas the control group received only the routine training in this regard. The obtained data were analyzed by SPSS software (version 21) using independent and dependent t tests. A P value of less than 0.05 was considered statistically significant.

In this study, the mean score of sexual self-efficacy within the intervention group decreased from 20.61±6.05 before attending the counseling sessions to 17.34±4.89 three months after the intervention. However, the mean score of sexual self-efficacy within the control group represented a decrease from 17.87±5.49 to 17.45±5.86. Moreover, mean changes in the sexual self-efficacy scores of females in the intervention and control groups were -3.27±1.16 and -0.42±0.37, respectively. Furthermore, there was a significant difference between the intervention and control groups regarding the mean score of the sexual self-efficacy of females after the intervention (P=0.01). In addition, there was a significant difference between the intervention and control groups in terms of the mean score of sexual function among females (P=0.0001).

In summary, educational interventions and pre-marital counseling with regard to sexual health helped improve the marital relationships of couples

Cytokines regulate ovarian activity through controlling internal ovarian processes as paracrine or autocrine regulators. In the current study, the follicular fluid (FF) concentration of some cytokines including interleukin (IL-3), IL-5, and IL-6 were investigated and compared between 39 patients diagnosed with polycystic ovary syndrome (PCOS) and 34 healthy normal women with male factor infertility as the control group.

To this end, FF samples were collected by following gonadotropin-releasing hormone antagonist protocol. Then, the FF concentration of the studied cytokines was evaluated using the enzyme-linked immunosorbent assay method. Finally, the characteristics of the participants were collected and compared between PCOS and control groups.

Based on the results, the FF concentration of IL-3 and IL-5 revealed a remarkable reduction in the PCOS group in comparison to the control group (P=0.0004 and P=0.04, respectively). In addition, there were noticeable differences in the body mass index (P=0.009), endometrial thickness (P<0.0001), menstrual cycle (P<0.0001), history of ovarian surgery (P<0.0001), hyperandrogenism (P<0.0001), and hirsutism (P<0.0001) between the groups.

In general, the finding of the diminished concentration of IL-3 and IL-5 in PCOS patients may represent an altered immune response to the inflammatory condition in this syndrome.

Using hair dye has spread globally in recent years. Concerns have arisen about the safety of hair dyes during pregnancy. The primary goal of this study was to examine the association between hair coloring and pregnancy outcomes.

This cross-sectional study was conducted on 2040 pregnant women aged 14 to 48 years, in Talegani teaching hospital of Tabriz University of Medical Sciences from January 2017 to December 2019. Three trained midwives collected relevant information from the women on the admission to the labor room and recorded pregnancy outcomes. Chi-square test of independence with post hoc tests and logistic regression analysis were used for data analysis. Odds ratios with a 95% confidence interval and contributing effect sizes were reported. The significance level was set at P ≤ 0.05.

The majority of participants (62.67%) colored their hair in the third trimester. There was no statistically significant association between hair coloring and neonate 1-minute (P=0.23) and 5-minute Apgar scores (P=0.99). The logistic regression model did not confirm a rise in overall neonatal complications (NCs) associated with hair coloring at any time during the pregnancy (odds ratio [OR]: 0.027, P<0.001). Higher rates of low birth weight (LBW) were seen among those who dyed their hair in the preconception period and third trimester compared to the woman who colored their hair in the first and second trimesters (P<0.001).

We observed associations between hair coloring and LBW, however there were no increased odds for NC. The evidence for the safety of hair dye during pregnancy is still limited.

Pregnancy and childbirth are physiological events and they are pleasant in most cases although they are occasionally associated with complications that can be dangerous for the mother and the infant if left unattended. The child’s gender can have emotional-psychological, economic, social, and normative dimensions for different people. Therefore, the present study was done to investigate the difference in gender and the costs of childbirth and evaluate their association with postpartum depression.

The present cross-sectional study included 260 primiparous women as the sample who were selected by the convenient-nonprobability sampling method. Data collection tools included the Edinburgh Postnatal Depression Questionnaire and forms related to demographic information, infant gender, and the like, which were completed through interviews.

In this study, 260 women were evaluated after delivery, and the prevalence of postpartum depression was 56.9%. There was a statistically significant relationship between postpartum depression and unwanted pregnancy, delivery method, weeks of pregnancy, social and economic costs of having a child, and gender. However, no significant relationship was found between postpartum depression and maternal aging, and the individual costs of having a child.

Postpartum depression has a high prevalence in our society in which almost one mother out of two mothers is involved with depression problems, which can affect the health of the mother, her infant, and the whole family. Therefore, it seems that postpartum depression should be considered as an essential component of postpartum care.

The main goal of this study was to investigate the relationship between the maternal gestational diabetes and body mass index (BMI) of three-year-old children.

We conducted a descriptive analysis of 100 diabetic pregnant women and 200 healthy pregnant women and their children who were referred to the maternity wards of the teaching hospital of Babol. The measurement of the height and weight of 3-year-old children were done in the clinic.

The average age of mothers participating in this study was 23.73±3.03 years. The BMI and the birth weight of infants within the normal weight range in the diabetic group were significantly more than those of non-diabetic children (16.47 ± 1.42 kg/m2 , 16.09±1.3 kg/m2 , P= 0.04, 330.33±214.12 g, 3130.65±242.75 g, P=0.001, respectively). The BMI of the male children of the diabetic group was significantly more than that of the control group at the age of three years although this difference was not significant in girls (16.55±1.40 kg/m2 ,16.01±1.42 kg/m2 , P=0.03 and 16.36±1.47 kg/m2 , 16.19±1.31 kg/m2 , P=0.53 for boys and girls, respectively).

The findings of the current study showed that the children of mothers with gestational diabetes have a higher BMI compared to their peers although its relationship to gestational diabetes was not significant. However, these findings were significant for boys after gender segregation while not being significant for the girls. Finally, BMI at three years of age had no significant relation with gestational diabetes

To establish the circulating levels of copeptin and fibronectin in normal and preeclamptic Black South African pregnant females.

Serum copeptin and fibronectin levels were measured in preeclamptic and normotensive women via enzyme-linked immunosorbent assays. Data are presented as medians and interquartile ranges. Spearman’s chi-square test was used to evaluate bivariate associations between analytes and clinical variables.

Fibronectin levels were downregulated in preeclampsia (PE) compared to the control group (P<0.05). Copeptin levels displayed an upward trend in PE compared to the normotensive group. Blood pressure (systolic and diastolic) was significantly different between preeclamptic and normotensive women (P<0.005). In the preeclamptic group, gestational age was negatively correlated with systolic blood pressure (r=-0.8, P<0.05). In addition, diastolic blood pressure was negatively correlated with maternal weight (r=-0.58, P<0.05) and gestational age (r=-0.76, P<0.05) in the preeclamptic group. Eventually, a positive correlation was noted between diastolic blood pressure and systolic blood pressure (r=0.65, P<0.05) in PE.

This was the first South African study to measure copeptin and fibronectin in pregnant women. The findings demonstrated a dysregulation in copeptin and fibronectin serum levels between the normotensive pregnant and preeclamptic groups, suggesting a potential diagnostic indicator of PE development.

Endometriosis is the deposition of endometrial glands and stroma outside the uterus and can be of pelvic or extrapelvic type. Thoracic endometriosis syndrome (TES) is associated with endometriosis in the pleura or the lungs, as well as cyclical pneumothorax, chest pain, haemoptysis, and pulmonary nodules. TES can be misdiagnosed for the more prevalent pulmonary tuberculosis in countries such as India.

A married woman aged 26 years old was presented with complaints of hemoptysis and chest pain during menstruation. On further investigations, she was diagnosed with pulmonary endometriosis after ruling out tuberculosis and Wegener’s granulomatosis. The patient was treated with depot Medroxyprogesterone acetate and regestrone since she was unwilling for surgical management. The significant change in management is that most cases of pulmonary endometriosis have been managed surgically whereas our case has been successfully managed medically.

This case is an example for successful medical management of pulmonary endometriosis in patients who cannot or do not want to undergo a bilateral oophorectomy and a possible thoracotomy. Surgical management with bilateral oophorectomy is associated with premature menopausal symptoms, increased risk of cardiovascular diseases, and obesity. In cases of subfertility or in nulliparous women, the medical management of pulmonary endometriosis gives women a chance at fertility in the future.

The fetal middle cerebral artery-peak systolic velocity (MCA-PSV) is a noninvasive tool for detection of intrauterine fetal anemia. Premature restriction of foramen ovale (FO) may prevent proper blood supply to the fetal brain. We presented a 29-year-old Rhesus-negative mother who had been referred to our center due to positive indirect Coombs test. A single live intrauterine fetus at 30 weeks of gestation was observed with normal MCA-PSV- multiples of the median (MoM). The mother was under weekly follow up due to an isoimmunized pregnancy. In the third week of followup, the MCA-PSV- MoM was within the normal range though fetal echocardiography showed that the findings were in favor of premature restriction of FO; so premature delivery was decided at the same day. A boy was delivered with significant paleness, hemoglobin level of 3 g/dL, positive direct Coombs test, and reticulocyte count of 20%. These findings resulted in a significant intrauterine hemolysis process due to Rh alloimmunization not detected by Doppler examination of MCA- PSV during pregnancy. The aim of this study was to show that MCA-PSV- MoM may not be a diagnostic method for detection of possible anemia in the fetus with congenital heart disease.