International Journal of Women’s Health and Reproduction Sciences
Volume:10 Issue: 4, Oct 2022

Although antenatal anomaly screening tests (AAST) provide valuable information about fetal health, performed to prevent the birth of children with chromosomal abnormalities, uncontrolled stress while performing such tests may negatively affect the mother’s mental health. This study aimed to systematically review clinical trial studies in which reducing pregnant women’s anxiety and concern in the process of performing AAST was among their objectives.

In this systematic review, six electronic databases (Scopus, Cochrane Library, Science Direct, PubMed, Google Scholar, and CINAHL) were searched. Data extraction was performed through randomized controlled trials (RCTs) in English, which the core fell onto designing an intervention to reduce pregnant women’s anxiety and concern associated with performing AAST.

Out of the 1946 studies, six were included in this systematic review. In most studies, a positive impact on knowledge and satisfaction with the information received was observed. However, no effect was reported regarding decreasing or increasing the anxiety and concern of pregnant women in the process of performing AAST. Studies were heterogeneous in terms of intervention type and gestational age of participants.

Interventions aimed at providing pregnant women with specific information about prenatal screening for chromosomal abnormalities have no impact on reducing their anxiety and concern. Therefore, designing educational-psychological interventions to prevent and reduce anxiety and concern of pregnant women in this period is recommended.

Assessment the effectiveness of non-invasive prenatal screening (NIPS) for identifying pregnant women at high risk of giving birth to a child with Down syndrome.

The retrospective cohort study included 25798 pregnant women who underwent NIPS in Russia from January 2013 to December 2018. 21042 and 4756 participants underwent tests from the Natera laboratory, USA (non-invasive prenatal test 1, NIPT-1) and the Genomed laboratory, Russia (non-invasive prenatal test 2, NIPT-2), respectively.

A high risk of trisomy 21 (T21) was detected in 544 cases (2.59%). The mean age in women at high risk of T21 was 37.3 years. According to the NIPT results, in patients who revealed a low risk of T21, the mean age was 33.8 years (P<0.001). In 535 cases, invasive prenatal diagnosis was performed. In 7 (1.3%) cases, the presence of T21 in the fetus was not confirmed. In 528 (97.3%) cases, T21 was confirmed by fetal karyotyping. Among women who revealed a low risk of T21 (N = 25086), in 4 cases (0.015%), fetal trisomy 21 was missed. Thus, the indicators of the effectiveness of NIPS in Russia in relation to T21 are as follows: sensitivity - 99.25%, specificity - 99.96%, PPV - 98.7%, NPV - 99.98%. In the first trimester, in the presence of fetal T21, the level of the fetal fraction of free-DNA is significantly lower.

NIPS has good prospects for implementation in pregnancy management programs and increasing the effectiveness of prenatal detection of T21. The level of the fetal fraction is associated with the presence of fetal T21.

Coronavirus disease 2019 (COVID-19) can affect the menstrual cycle and menstrual flow. To examine changes in menstrual symptoms of women recovering from COVID-19 and to identify factors that influence these changes.

A questionnaire, prepared using Google Forms, was completed by 180 women (26.08±6.62 years) recovered from COVID-19. The menstrual symptoms, menstrual pain, fatigue severity and anxiety level of the participants were evaluated respectively with the Menstrual Symptom Questionnaire (MSQ), visual analogue scale (VAS), fatigue severity scale (FSS), and coronavirus anxiety scale (CAS).

Post-COVID-19 individuals’ MSQ totals, subgroup scores, FSS scores and menstrual pain levels showed significant increase compared to pre-COVID-19. Regression analysis identified that age at menarche, changes in FSS and VAS scores as contributors to 38.4% of the variance explained in the significant regression for change in MSQ score. Individuals with prolonged fatigue, muscle– joint pain and dyspnea symptoms showed increase in MSQ total scores (P=0.006, P=0.009, P=0.046 respectively) and MSQ negative effects/somatic complaints scores (P=0.004, P=0.002, P=0.017 respectively). Individuals with prolonged gastrointestinal symptoms showed increase in MSQ pain symptoms (P=0.029) and MSQ coping methods scores (P=0.002), while those with prolonged muscle and joint pain showed increase in MSQ coping methods (P=0.022) scores.

The results of this study indicated that menstrual symptoms, fatigue, and menstrual pain severity are deteriorated in women recovered from COVID-19. Age at menarche, changes in fatigue and menstrual pain after COVID-19 were determiners of the deteriorated menstrual symptoms. Menstrual symptoms were more severe in those who have prolonged fatigue, dyspnea, muscle– joint pain and gastrointestinal symptoms.

The burden of premenstrual syndrome (PMS) is increasing and affects the quality of life of young women. This study aimed to measure the prevalence of PMS and identify the associated factors amongst students and staff belonging to the King Saud University (KSU) in Riyadh city, Saudi Arabia, 2019.

This cross-sectional, questionnaire-based study was conducted during 2019 with 409 women (both students and staff), aged 18-30 years belonging to the KSU (female campus), in Riyadh city, Saudi Arabia. The questionnaire comprised sociodemographic information, premenstrual symptoms, smoking, physical activity, and social support. Standard protocols were followed to measure anthropometric indices, including height, weight, hip, and waist circumference. Multivariate logistic regression analysis was conducted to identify the significant factors associated with PMS.

Participants’ mean age and body mass index were 22±3.3 years and 24.0±5.3 kg/m2 , respectively. The mean scores for total symptoms were 6.71±2.81, ranging from 0 to 12, with more than 90% of women reporting at least one symptom. The physical symptoms were more frequently reported as compared to psychological symptoms. The multivariate regression found that high-level studies (OR= 2.26, 95% CI: 1.31-3.92) and participants reporting income level <10000 Saudi Arabian Riyal (OR= 2.66, 95% CI: 1.40-5.03) were significantly associated with PMS.

A significantly large number of women are suffering from PMS. Lifestyle interventions focusing on body weight and income-generating programs can help decrease premenstrual symptoms. We recommend that national-level studies should be conducted to highlight any urban-rural differences related to PMS.

The current research was established to make a comparison between the delayed-start GnRH antagonist and flare-up GnRH agonist protocols in poor response patients.

The present study is a randomized, prospective, controlled trial that was performed on 150 women who referred to two distinct in vitro fertilization (IVF) centers in Iran. Patients were randomly assigned to two experimental groups, as one group was treated with the delayed-start GnRH antagonist protocol (delayed-start group), while another group was treated with the flare-up protocol (flare-up group).

The serum concentrations of estradiol and progesterone, along with the thickness of endometrial tissue and the number of follicles ≥13 mm was significantly increased in the delayed-start group compared with the flare-up group. Also, the number of total oocytes, retrieved mature oocytes, total embryos, fertilized oocytes, as well as the quality of embryos were markedly higher in the delayed-start group when compared with the flare-up group. No statistically significant difference was found in the rates of fertilization, implantation, and pregnancy between the two experimental groups.

According to the above evidence, it seems that the effect of delayed-start protocol on ovarian responsiveness was more pronounced during controlled ovarian stimulation in comparison with the flare-up protocol and the delayed start protocol probably lead to better implantation and pregnancy rates in comparison with the flare up agonist protocol cycle in poor responders.

Premenstrual syndrome (PMS) is a combination of physical, spiritual, and emotional symptoms, which periodically happens before the cycle. The current research aims to investigate the effect of group counseling on depression, stress, and anxiety of PMS.

The current study is a randomized clinical control trial on 112 married women who experience PMS that makes them refer to health centers in Qazvin city. The samples were divided into two groups of 55 in control and 57 in the trial group, randomly. Three sessions of group counseling were held for the trial group, each session was 45 minutes long and including teaching about PMS and its symptoms, depression, stress, and anxiety caused by this syndrome, and also negative mood and stress management skills. Data were gathered by demographic information questionnaire, Depression, Anxiety and Stress Scales 21, and PMS scale.

Initially, when starting the study, the results of the studied variables were homogeneous in both intervention and control groups. Moreover, no significant difference was seen in the severity level of PMS symptoms (P=0.70) and depression (P=0.61), stress (P=0.10), and anxiety (P=0.60) score before intervention in both groups. After intervention, the mean scores of severity of the PMS (P<0.001), depression (P<0.001), stress (P<0.001), and anxiety (P<0.001) in the intervention group significantly decreased.

Group counseling caused a significant reduction in the severity of PMSs and depression, stress, and anxiety. Counseling protocol for reducing the severity of the PMS and treating depression recommended.

The adverse effect of chemotherapy on the proliferation of granulosa cells has been indicated in recent studies. Gonadotropinreleasing hormone (GnRH) antagonists exert protective effects on granulosa cells against the side effects of chemotherapy. In the present study, we aimed to evaluate the impact of cetrorelix on the proliferation of ovarian granulosa cells following administration of thiotepa in the ovaries of female mice.

In this experimental study, 30 adult Balb/c female mice (5-8 weeks old, weighing 24-28 g) were divided into three groups (n=10/ each group) (Control group, T. group, and C. group). T. group received 2.5 mg/kg of thiotepa for four consecutive days. The C. group received cetrorelix (0.25 mg/kg) before and at the same time as thiotepa administration and a week after the end of thiotepa administration. Ovaries were used for quantitative and immunohistochemical studies at the end of the investigation.

The mean numbers of follicles such as primordial, primary, secondary, and tertiary significantly decreased in the T. group than control group (P=0.02). Cetrorelix treatment exerted a protective effect against thiotepa-induced damage by increasing the mean numbers of follicles in the ovarian cortex (P=0.04).

As a GnRH antagonist, cetrorelix can be considered as one of the effective drugs to protect the granulosa cells against chemotherapy-induced damages in cancer disease.

Depression is highly prevalent during pregnancy and after childbirth, and many factors, including the type of delivery, can contribute to developing this condition. Considering the increased use of remifentanil in painless labor and the need for conducting more studies on the consequences of this method this study aimed to determine the mean score of postpartum depression in women giving birth by either remifentanil-induced painless delivery or elective cesarean section.

The present study was a longitudinal investigation conducted on140 women referred to private hospitals, Tabriz, Iran, between 2020 and 2021 in two groups: women with elective cesarean delivery and women with vaginal delivery with remifentanil analgesia (n=70/each). Depression during pregnancy was assessed at 35-37th weeks’ gestation, and postpartum depression was determined four weeks after childbirth using the Edinburgh Postnatal Depression Scale (EPDS). Independent t test and paired t test were used to compare depression scores.

Postpartum depression was significantly higher in women who had undergone a cesarean section than in those giving birth by remifentanil-induced painless vaginal delivery (P = 0.009).

The prevalence of postpartum depression was higher in women who underwent elective cesarean section than women who underwent painless vaginal delivery with remifentanil. Considering the steady rise in worldwide cesarean section rate and the health burden and consequences of postpartum depression on mothers and children, health legislators should take measures to reduce women’s tendency towards the cesarean section in the long run