مجله زنان مامائی و نازائی ایران
سال بیست و چهارم شماره 11 (دی 1400)

Postpartum depression has harmful effects on mother and infant. Regarding the sedative effects of infusion Lippia citriodora (L.C) or lemon verbena in traditional medicine, this study was performed with aim to evaluate the effects of aqueous and alcoholic leave extracts of L.C on postpartum depression.

This animal study was performed in 2018 on female mice in Mashhad Pharmacy School.   At first, postpartum depression was induced by progesterone injection (IP) (progesterone at a dose of 5 mg/kg/day for five days, three days without progesterone, then normal saline was injected at eight day). After depression induction (compare with control group, and doing the FST (forced swimming test) and TST (tail suspension test)), the aqueous and ethanolic leave extracts of Lippia citriodora (50,100 and 200 mg/Kg) were injected (IP) to depressed mice in different groups and then TST and FST were performed after one hour. Statistical analysis was performed by Unpaired T test and One-way ANOVA using GraphPad Prism software. A P value of <0.05 was considered statistically significant. 

The aqueous (200 mg/kg) and ethanolic (100 mg/kg and 200 mg/kg) extracts significantly reduced the immobility time in FST and TST tests (p<0.0001).

The aqueous and ethanolic leave extracts of L.C possess anti-depressant effects in postpartum depression. It seems that the ethanolic extract of LC is more potent than the aqueous extract due to the high level of verbascoside.

Deep vein thrombosis is a fatal complication during pregnancy. Lack of accurate knowledge of the epidemiology of this dangerous complication will lead to its concealment, followed by later diagnostic and ancillary measures; therefore, this study was performed with aim to epidemiological study of deep vein thrombosis in pregnant women admitted to the intensive care unit.

This descriptive-analytical study was performed in 2019 on 49 women admitted to the intensive care unit (before pregnancy and postpartum) in Taleghani and Al-Zahra hospitals (Tabriz Medical Sciences). Venous thrombosis information was recorded in the form related to the causes of deep vein thrombosis. Data were analyzed by SPSS statistical software (version 22) and Chi-square test. P<0.05 was considered statistically significant.

Smoking (P=0.036), obesity (P=0.011), diabetes (P=0.035), heart disease (P=0.033), hypertension (P=0.011), multiple (P=0.029), thrombocytopenia (P= 0.048), prenatal bleeding (P=0.041), blood transfusion during pregnancy (P=0.049), history of surgery in recent three months (P=0.048), amniotic infection (P=0.039) were the factors affecting deep vein thrombosis.

Smoking, obesity, diabetes, heart disease, hypertension, multiple births, thrombocytopenia, prenatal bleeding, blood transfusion during pregnancy, history of surgery in recent 3 months and amniotic infection are the risk factors for deep vein thrombosis in women admitted to the intensive care unit. Therefore, attention and care is essential in people with risk factors mentioned in pregnant women.

Due to the acceptance of laparoscopic hysterectomy by surgeons and patients and the fact that the prevalence of some complications of hysterectomy such as deep vein thrombosis, which is a dangerous and unpredictable complication, has not been accurately determined; this study was performed with aim to determine the factors affecting deep vein thrombosis following laparoscopic hysterectomy.

This descriptive cross-sectional study was performed in 2020 with participation of 55 women candidates for laparoscopic hysterectomy in Alzahra Hospital, Tabriz. The prevalence of deep vein thrombosis and its effective factors was evaluated with D-dimer test and the researcher-made checklist (extracted from articles). Data were analyzed by SPSS software (version 22) and Spearman coefficient test. P<0.05 was considered statistically significant.

The prevalence of deep vein thrombosis in the present study was 12.72%. Variables of age>60 years (P=0.001), high body mass index (P=0.009), previous history of deep vein thrombosis (P=0.008), history of long-term use of contraceptives (P=0.005) and prolonged immobility in the recent three months (P=0.011) were directly related to the incidence of deep vein thrombosis after abdominal hysterectomy.

The prevalence of deep vein thrombosis after laparoscopic hysterectomy in the present study was 12% that old age, high body mass index, use of contraceptives pills and complete immobility are its risk factors. It is recommended that preventive and therapeutic measures be considered before surgery for patients at risk for this complication.

Obstructive vaginal anomalies such as transverse septum and vaginal agenesis usually present with primary amenorrhea and pelvic pain. This study was performed with aim to evaluate the results of vaginal reconstructive surgery (vaginoplasty) in patients with vaginal agenesis (Rokitansky syndrome) and transverse vaginal septum.

This cohort study was performed on all patients with vaginal agenesis and transverse vaginal septum who had underwent vaginoplasty in the pelvic floor disorders department of Imam Khomeini Hospital ,Tehran in 2014-2019. Basic information, clinical symptoms at admission, type of Mullerian anomaly, type of surgery, complications during surgery, vaginal re-stenosis and pregnancy were collected from patients' files and by phone calls and follow up visits after surgery. Central and dispersion indices were used to describe the data. Frequency distribution was presented in the form of tables.

33 patients had transverse vaginal septum and 35 cases had vaginal and uterine agenesis (Rokitansky syndrome). In terms of early symptoms at admission, the most common symptoms were amenorrhea, pelvic pain, and inability to sexual intercourse or dyspareunia. In 11 cases (33.33%), vaginal re-stenosis occurred after correction of transverse vaginal septum, all of which occurred in the first 3 months after surgery due to incorrect use of vaginal dilator. Laparotomy was performed in 2 cases (6%) due to severe abdominal pain after initial surgery that was diagnosed as pelvic endometriosis. In the vaginal agenesis group, vaginal re-occlusion occurred in5 cases (14.28%) after the surgery.

The most common complication after surgery was vaginal re-obstruction, so training the patient and emphasizing on the regular use of vaginal dilator is very important to prevent this complication.

Preterm labor is one of the most important topics of neonatal morbidity and mortality. One of best of the methods for prevention of premature birth is cervical cerclage. This study was performed with aim to evaluate the frequency of preterm delivery in patients with cervical cerclage in Emam Ali Hospital of Zahedan.

 In this retrospective descriptive cross-sectional study conducted during 2016-2017, the   records of pregnant women with preterm labor who had undergone cerclage due to a history of second trimester abortion or short cervical canal length < 2.5 mm in Emam Ali   Hospital of Zahedan were examined. Data were analyzed by SPSS statistical software (version 20).

 The frequency of total of the patients during the study period was 3152 records that among them, the frequency of preterm labor without considering other variables such as medication, fetal malformation, amniotic fluid level and surgical history was 318 cases (10.08%). Also, from a total number of 67 mothers with cerclage, 43 cases (64.2%) had term delivery, but 24 (35.8%) resulted in preterm delivery.

In the present study, preterm delivery occurred in less than 50% of the population who had cervical cerclage, but still shows a high prevalence of preterm labor in general population.

Bleeding following intubation and extubation after general anesthesia is a relatively common complication that is associated with a high prevalence in some surgeries such as breast surgeries. The use of traditional medicines has been welcomed by anesthesiologists due to their minor side effects. This study was performed with aim to investigate the effects of rosemary on bleeding and pain of intubation after general anesthesia for women candidates for breast surgery.

The clinical trial study was performed in 2017-2018 on 70 patients who need general anesthesia in Imam Reza Hospital, Tabriz. The subjects were randomly divided into two groups of intervention (inserting sterile gas impregnated with rosemary in the patient's throat) and control (inserting sterile gas impregnated with stilled water in the patient's throat). Observation of bleeding and pain due to intubation was measured by VAS instrument in the recovery and 2, 6, 24 hours after the surgery. Data were analyzed by SPSS statistical software (version 25) and independent t-test and chi-square test. P<0.05 was considered sttisticallyy significant.

Eleven patients (31.42%) in the intervention group and 14 (40%) in the control group had post-extubation bleeding (P = 0.309). Also, the number of pain due to intubation (P <0.05) and pain intensity (P >0.05) at different times showed no statistically significant difference between the two groups.

Sterile packs impregnated with rosemary extract could not prevent bleeding and pain due to intubation in women candidates for breast surgery.

Considering that anesthesia method is involved in the incidence of the symptoms of deep vein thrombosis (DVT) after abdominal hysterectomy, and this can be effective on the development of DVT, and lack of accurate information about the occurrence or non-occurrence of it leads to the start of treatment; this study was performed with aim to compare the incidence of the symptoms of DVT in general anesthesia and spinal anesthesia after abdominal hysterectomy.

This descriptive-analytical study was performed in 2019-2020 with participation of 70 women after abdominal hysterectomy that underwent the surgery under one of the two methods of general anesthesia and spinal anesthesia in Al-Zahra Hospital, Tabriz. DVT was diagnosed by the checklist of clinical symptoms and Doppler ultrasound. Data were analyzed by SPSS statistical software (version 22) and t-test and Chi-square test. P<0.05 was considered statistically significant.

The incidence of DVT symptoms in patients receiving general anesthesia was 17.14% and in those receiving spinal anesthesia was 22.85%; the incidence of these symptoms in the group receiving spinal anesthesia was non-significantly higher than the group receiving general anesthesia (P = 0.103). However, the incidence of this complication after Doppler ultrasound was zero in both groups.

The incidence of DVT was not significantly different in women candidates for abdominal hysterectomy that underwent surgery under one of the two methods of general anesthesia and spinal anesthesia; however, the method of anesthesia has no role in the incidence of DVT.

Sexual dissatisfaction is a common problem in women with pelvic organ prolapse which affects the quality of life. This study was performed with aim to evaluate the effect of cosmetic reconstructive surgery (colporrhaphy) on improving sexual satisfaction in married women.

This randomized controlled clinical trial study was carried out on 30 women before and after undergoing cosmetic reconstructive surgery in terms of sexual satisfaction between 2015 and 2016 in Sarakhs. The Larson Sexual Satisfaction Questionnaire was used to collect data related to the patients' sexual satisfaction after surgery. Data were analyzed by SPSS statistical software (version 16) and independent t-tests. P<0.05 was considered statistically significant.

The results of independent t-test showed that cosmetic reconstructive surgery (colporrhaphy) was effective on improving sexual satisfaction in married women )p <0.001).

Although cosmetic reconstructive surgery improves sexual satisfaction, it is better to use this surgery only for therapeutic purposes and in cases of severe symptoms.

Most menopausal women experience changes due to decreased estrogen secretion. Vaginal atrophy is one of the most common changes during menopause. This study was performed with aim to determine the effect of vaginal cream containing herbal extract (Foeniculum vulgare, Salvia officinalis and Flaxseed) on mental symptoms of vaginal atrophy in postmenopausal women.

The triple-blind clinical trial study was performed in 2019 on 60 postmenopausal women with symptoms of vaginal atrophy referred to the selected health centers in Ahvaz, Iran. The subjects were randomly divided into two groups of 30 women to receive vaginal cream containing herbal extract (Foeniculum vulgare, Salvia officinalis and Flaxseed) and placebo for eight weeks. Mental symptoms of vaginal atrophy including dryness, burning and itching, vaginal pain and pain during intercourse were assessed using the most bothersome symptom (MBS) checklist before the intervention and two, four and eight weeks after the treatment. Data were analyzed by SPSS software (version 22) and Mann-Whitney, Friedman and independent t-test. P<0.05 was considered statistically significant.

After treatment with the vaginal cream containing herbal extracts (Foeniculum vulgare, Salvia officinalis and Flaxseed) in the intervention group, the mental symptoms of vaginal atrophy significantly reduced compared to the beginning of the study (P<0.001). The vaginal cream containing herbal extracts (Foeniculum vulgare, Salvia officinalis and Flaxseed) compared to placebo cream significantly reduced the mental symptoms of vaginal atrophy in postmenopausal women after two weeks (P=0.046), four weeks (P<0.000) and eight weeks (P<0.000).

The use of vaginal cream containing herbal extracts (Foeniculum vulgare, Salvia officinalis and Flaxseed) compared with placebo cream reduces the symptoms of vaginal atrophy in postmenopausal women. Therefore, this cream is recommended for women with vaginal atrophy.

Postpartum pain is one of the common postpartum problems that has adverse consequences for both mother and infant. The side effects of chemical drugs have led to the tendency to use herbal medicines to reduce postpartum pain. This study was performed with aim to investigate the effect of Saliva hydrangea capsule on postpartum pain.

This double-blind randomized clinical trial study was performed in 2018 on 100 mothers that 2 hours had passed from their normal vaginal delivery and had severity of moderate to severe postpartum pain based on visual pain scale (VAS). The women were randomly assigned in two groups: Saliva hydrangea+mefenamic acid and placebo+mefenamic acid. The capsules were used every 6 hours. The intensity and duration of pain were recorded before and one hour after the intervention by VAS. Data were analyzed by SPSS software (version 21) and independent- t and paired t-test, Mann-Whitney U test and repeated measures. P<0.05 was considered statistically significant.

After the end of the intervention, the mean of pain score in Saliva hydrangea group (0.32 ± 0.12) was significantly lower than placebo group (0.92 ± 3.60) (p <0.05). Pain relief time interval in the intervention group after the first dose (0.25 ± 1.36) and after the final dose (0.48 ± 1.30) significantly decreased compared to the placebo group after the first dose (0.81 ± 3.27) and after the final dose (0.88 ± 3.62) (p <0.05).

The combination of Saliva hydrangea and mefenamic acid is more effective on the severity of postpartum pain and the time required to relieve pain compared to mefenamic acid alone, and as a herbal drug can decrease the severity of postpartum pain.

For various reasons, such as the lack of focus on studies on the relationship between periodontitis and preeclampsia, as well as the small number of people who develop preeclampsia after periodontitis, scattered research has been conducted in different parts of the world. They are not collected regularly so that researchers can have the results together; therefore, this study was performed with aim to investigate the relationship between periodontitis and preeclampsia to assess the role of periodontitis as an independent factor in preeclampsia.

This systematic review study was performed in 2020 with searching for keywords of preeclampsia, periodontitis, periodontal, pregnancy complications, pregnancy outcomes, relationship and treatment (Based on Mesh) in databases of PubMed, Scopus, Google Scholar, SID, IranDoc, Web of Sciences, Science Direct, OVID and Springer without time limit among the published articles in Persian and English and their information was recorded in a checklist designed for this research. 

Out of 759 articles found, only 9 (6 cohort articles and 3 clinical trial articles) were included in the study. Five cohort articles confirmed that periodontitis could lead to preeclampsia, and three clinical trial articles found no association between treatment of periodontitis and reduction of preeclampsia.

Periodontitis can be effective in preventing diseases during pregnancy; the role of this variable in preeclampsia has not been determined precisely, but the results of studies suggest that periodontitis may lead to preeclampsia; the results of this study should be used with caution.

Uterine artery malformation is a rarely condition in late bleeding after a cesarean delivery or curettage in women at reproductive age. The patient may face severe and repeated vaginal bleeding that threatens her life. This report introduces a case of uterine artery embolization caused by an arteriovenous malformation (AVM) in a woman, eight weeks after spontaneous abortion.

The patient was a 35-year-old woman G1P1 referred to one of the hospitals of Ahvaz claiming severe vaginal bleeding. The patient had 8 weeks spontaneous abortion 40 days ago. AVM was diagnosed by Doppler ultrasonography. The patient underwent uterine artery embolization due to repeated bleeding and failure to control it, and also low parity.

It is crucial to diagnose vascular malformations at the initial stages in patients with abnormal uterine bleeding. Embolization is the first and best choice for women who wish to preserve their fertility.