مجله زنان مامائی و نازائی ایران
سال بیست و پنجم شماره 9 (آذر 1401)

Polycystic ovary syndrome (PCOS) is the most common cause of oligomenorrhea and anovulation in women referring with infertility. The present study was performed aimed to investigate the effect of combined administration of Onsoli syrup and Samgh capsule on clinical and laboratory symptoms in women with PCOS.

This pilot study is a pre-and post-clinical study without control group which was performed in 2019 on 20 women aged 17-45 years with PCOS complaining of oligomenorrhea in Persian Medicine Clinic of Shahid Beheshti University of Medical Sciences. Samgh capsule and Tonic Onsoli syrup were used for two months. Anthropometric indexes, endometrial thickness, ovarian size, hormonal evaluation, number of menstruation per month, menstrual duration, and volume of menstruation bleeding were evaluated and compared at the beginning and end of the study. Data were analyzed by SPSS software (version 23) and paired t-test and Wilcoxon test. P<0.05 was considered statistically significant.

There was no significant difference in body mass index, body fat mass, waist to hip ratio, endometrial thickness, left ovarian size, FSH, LH before and after treatment (p>0.05). The size of the right ovary and testosterone levels significantly deceased after treatment (p=0.02). The number of menstruation per month significantly increased from 0.35±0.18 to 0.92±18 (p=0.00). Also, the duration of menstruation significantly decreased from 7.53±2.43 days to 4.05±3.17 days (p=0.00). The volume of mensuration bleeding decreased from 33.40±15.28 ml to 31.07±10.05 ml, which was not significant (p=0.368).

Due to the effectiveness of combined administration of Persian medicine products (Onsoli syrup and Samgh capsule), it seems that the use of these products is effective in controlling of the symptoms of PCOS. It is necessary to conduct future studies with a larger sample size and longer evaluation time.

The goal of developing midwifery and maternal care is to create a safe delivery and increase maternal satisfaction from birth process. The present study was conducted aimed to evaluate mothers’ satisfaction with transcutaneous electrical nerve stimulation (TENS) in relieving post-episiotomy pain.

This randomized clinical trial was performed on 80 primiparous women referred to Sanandaj Besat Hospital in 2018. Patients were randomly divided into two groups: intervention (TENS-On) and placebo (TENS-Off) groups. TENS electrodes were located in the genitofemoral and pudendal nerves. The satisfaction from TENS was assessed by a researcher-made questionnaire. Data were analyzed using SPSS (version 20.0) and Pearson correlation, Independent t-test, Kruskal-Wallis, variance analysis, and Mann-Whitney tests. P<0.05 was considered statistically significant.

The intervention and placebo groups had a high level of satisfaction. However, the mean satisfaction in the intervention group (17.35±1.96) was significantly higher than the placebo group (13.45±2.02) (p<0.001). There was no significant relationship between demographic variable and satisfaction level (p˃0.05).

TENS can have a noticeable effect on the level of maternal satisfaction. Therefore, it is suggested to implement TENS to reduce post-episiotomy pain in all maternity units in order to increase the level of satisfaction of patients and improve the level of mental health of mothers.

Frequent nausea and vomiting in the first trimester of pregnancy is seen in more than half of pregnancies. Severe nausea and vomiting in pregnancy, called hyperemesis gravidarum, sometimes persists until the pregnancy termination. The present study was performed aimed to determine the relationship between Helicobacter pylori infection and hyperemesis gravidarum in pregnant women.

In this case-control study which was performed in 2017-2019, 83 pregnant women with Hyperemesis gravidarum as cases and 83 pregnant women with no symptom of sever vomiting as controls entered the study. The data were collected through a questionnaire containing demographic information of mothers as well as questions about the frequency of retching, vomiting and the feeling of sick to their stomach. Serum levels of anti-Helicobacter pylori immunoglobulin G were measured in participants. Data were analyzed by SPSS (version 20) and chi-square, T-test, and logistic regression. P<0.05 was considered statistically significant.

The frequency of Helicobacter pylori seroposivity in case group and control group were 33.7%, 18.1%, respectively, this difference was statistically significant (P=0.021). Logistic regression showed that among the variables of age, parity, gravidity, BMI, gestational age, and Helicobacter pylori infection, only Helicobacter pylori infection was found as a risk factor for hyperemesis gravidarum (p=0.017) (OR= 2.524, CI 95%= 1.180-5.400).

In this study, there was a significant difference between Helicobacter pylori and Hyperemesis gravidarum. Since there is no specific therapy for Hyperemesis gravidarum, it can be one of the goals of future studies.

Due to the high risk of Covid-19 disease, especially delta variant in pregnant women, as well as the novelty of this epidemic in the world and the lack of similar studies in Iran and the region, it seems necessary to perform a study on mortality rate and laboratory and clinical findings of the disease in pregnant women. Therefore, this study was performed aimed to determine the laboratory and clinical findings in hospitalized pregnant women with Covid -19 based on disease outcome during the outbreak of Delta variant (summer and autumn 2021) in Ardabil province.

In this cross-sectional and descriptive study, all pregnant women with Covid-19 admitted to the hospitals of Ardabil province in summer and autumn 2021 at the time of delta outbreak were included. Finally, 187 infected pregnant mothers were studied. Demographic information, clinical signs and laboratory findings were studied in all mothers. Data were analyzed by SPSS (version 24) and Fisher Exact test and Pearson Correlation. P<0.05 was considered statistically significant.

Of the 187 infected pregnant women, 8 mothers died. Comorbidity was observed in 41 pregnant women. The most common clinical finding was shortness of breath (Dyspnea) and cough, and the most common laboratory finding was lymphopenia. Comparing the cured and dead mothers according to laboratory findings using Fisher's exact test showed that the difference between ALT (p <0.05), lactate dehydrogenase (p <0.001), AST (p <0.001), BS (P <0.05), creatinine (p <0.05) and total bilirubin (p<0.05) were statistically significant between the two groups.

Infection to delta variant of Covid-19 disease resulted in 187 hospitalizations and 8 deaths of pregnant mothers in Ardabil province. Shortness of breath (Dyspnea) and cough were the most common clinical findings and lymphopenia was the most common laboratory finding.

Given the role of chronic inflammation in developing GDM (gestational diabetes mellitus), investigating hematological inflammatory indicators such as platelet-to-lymphocyte ratio (PLR), hemoglobin-to-platelet ratio (HPR), and other blood biomarkers can be helpful in GDM patients. The present study was conducted aimed to evaluate the hematological inflammatory indicators of women with GDM compared to the control group.

In this retrospective study, the profiles of 300 pregnant women with a definite diagnosis of GDM admitted to Mohebbe Yas Hospital (Tehran) from 2019 to 2021 were investigated. In this study, the absolute number of blood cells and other hematological parameters were evaluated in separate groups of diabetic and normal pregnant mothers. The sensitivity and specificity of each statistically significant variable were determined by ROC curve analysis. Data were analyzed by SPSS (version 22) and Mann-Whitney U, Independent t-test, Wilcoxon, and Chi-square tests. P˂0.05 was considered statistically significant.

In terms of absolute lymphocyte count (ALC), the results of comparison between GDM and normal groups showed that this index had a sensitivity of 84.07% and a specificity of 37.98% in the diagnosis of GDM patients, and it was statistically significant (p= 0.022). The absolute neutrophil count (ANC) index had a sensitivity of 66.78% and a specificity of 53.49%, which was statistically significant (p= 0.012). The PLR index had a sensitivity of 54.08% and a specificity of 66.67% (p<0.001). However, HPR and NLR indices were not statistically significant (p>0.05).

This study showed that in GDM patients, ALC and ANC indices decrease and PLR increases. To improve the screening process of high-risk pregnant women for GDM, the predictive value of each of these indices in the incidence of GDM can be investigated in future studies.

There is a strong association between ABO blood groups and increased susceptibility to certain diseases including cardiovascular events, viral and bacterial infections, colorectal cancer, intracranial aneurysms and thromboembolic diseases. The present study was performed aimed to investigate the relationship between maternal blood groups and adverse pregnancy complications.

In this cross-sectional (descriptive-analytical) and retrospective study, the file of 400 pregnant women referred to the maternity hospital of Ali Ebn Abi Taleb Hospital of Zahedan from 2017 to 2019 were included. The variables of this study were ABO blood groups, preeclampsia, eclampsia, placental abruption, gestational diabetes mellitus, preterm labor and intrauterine growth restriction. The data collection tool included an information form in which the required information was entered. Data were analyzed by SPSS (version 22) and chi-square test. P<0.05 was considered statistically significant.

Out of a total of 400 pregnant women with a mean age of 33.09±7.53 years, 153 (38.3%) had blood type O, 116 (29%) B, 97 (24.3%) A and 34 (8.5%) AB. The relationship between ABO blood groups and preeclampsia (p = 0.848), placental abruption (p = 0.833), preterm birth (p = 0.705) and intrauterine growth restriction (p = 0.214) was not statistically significant, but gestational diabetes (p=0.049) and eclampsia (p=0.039) had a significant relationship with blood groups.

There was no significant difference between preeclampsia, placental abruption, preterm labor and intrauterine growth restriction with ABO blood groups, but there was a significant difference between eclampsia and gestational diabetes with ABO blood groups.

Cervical cancer is one of the most common causes of cancer death in women. The present study was performed aimed to evaluate and compare Pap smear and colposcopy findings as cervical cancer screening methods in patients reffered to Amir Al-Momenin hospital of Semnan.

In this cross-sectional and retrospective study, liquid-based Pap smear and colposcopy results of 200 colposcopiy candidates referred to the clinic of Amir Al-Momenin Hospital were studied in 2016-2018. In this study, all patients who had undergone colposcopy for various reasons and also had done Pap smear were examined. The data of each patient were recorded in a researcher-designed checklist. The checklist consisted of demographic and main data sections. The abnormalities in Pap smears included pre-invasive and invasive positive cervical lesions. The abnormalities in colposcopy included pre-invasive and invasive positive cervical lesions. Data were analyzed by SPSS (version 23) and independent t-test, chi-square, or Fisher's test. P<0.05 was considered statistically significant.

From 200 patients, 40 cases (20%) showed positive Pap smear. Also, colposcopy results showed that 17 patients (8.5%) had positive findings. There were signficant differences in the frequency of positive and negative results of Pap smear and colposcopy in patients with symptoms of post coital bleeding (P=0.021), intermenstrual bleeding between periods (P=0.035), vaginal discharge (P=0.009), and pelvic pain (P = 0.011). 

The non-positive results of Pap smear in positive cases of colposcopy emphasizes the quality control of Pap smear procedures and indicates the need to use colposcopy in suspicious cases. Direct colposcopy is recommended in case of warning signs such as post coital bleeding and abnormal discharge.

Constipation is a common problem in pregnancy and using herbal medications is one of the methods to improve it. The present study was performed aimed to determine the effect of Allolax on constipation during pregnancy in those referring to midwifery clinic of Qom city.

This single-blind randomized clinical trial study was performed on 70 pregnant women referred to the midwifery clinic of Qom city in 2020. Mothers with constipation symptoms were divided into two groups of intervention and control with 35 mothers in each group. In addition to routine training, the intervention group took 2 tablespoons of Alolax syrup with a glass of warm water one hour after breakfast and dinner for 1 month, if needed. Both groups completed a checklist of constipation symptoms according to Rome III criteria before and after the intervention. Data were analyzed by SPSS software (version 22) and independent and dependent T-test, Chi-square, and Wilcoxon tests. P< 0.05 was considered statistically significant.

There was a significant difference between the intervention and control groups in the improvement of constipation symptoms after taking the drug (p<0.001). Among the symptoms associated with constipation, the feeling of incomplete excretion and fullness in the intestines (P = 0.13), feeling of bloating (p<0.001), and the number of defecation per week (P = 0.048) were significantly different between the two groups. But other symptoms such as nausea, feeling of pain and burning, sores, and bleeding were not significantly different (p>0.05). The improvement in the intervention group with the ten-point scale (VAS) method was significantly higher than the control group (p<0.001).

Allolax is effective in improving constipation in pregnant mothers and so far, no side effects have been observed.

Cervical cancer is the fourth common cancer in women and human papillomavirus is the most common risk factor of it. The present study was performed aimed to determine the relationship between Vitamin D and human papillomavirus in women referring to the hospitals of Shahid Beheshti University of Medical Sciences.

This comparative study was conducted on 140 women referring to the hospitals of Shahid Beheshti University of Medical Sciences of Tehran in 2020. The case group were women with HPV infection and the control group in the same centers were the women with no HPV infection based on liquid based pap smear. Data was collected by interview and completing the questionnaire of Pap smear and measuring serum level of vitamin D. Data were analyzed by SPSS software (version 26) and Mann-Whitney test, independent t, chi-square, Fisher's exact and logistic regression. P<0.05 was considered statistically significant.

Logistic regression results and control of confounding variables of education and hookah consumption showed that 64 women (91.43%) in control group and 70 women (100%) in case group had vitamin D level less than 20 ng/ml and 6 women (8.57%) in control group had vitamin D level of 21-29 ng/ml. There was significant relationship between vitamin D and HPV infection (OR: 0.3, CI: 95%, P<0.001, 0.69-4.03). The risk of HPV infection increased as 0.3 by each 1 ng/ml reduction of vitamin D level.

In the present study, serum level of vitamin D was lower in women with HPV, but due to the limitations of the present study, more extensive research is needed in this regard.  Sufficient vitamin D level can help maintain and promote women's health.

One of the medical interventions in childbirth is episiotomy which is used to widen the pelvic outlet. Plantago is one of the oldest medicinal plants that have wound healing properties due to its flavonoids and phenolic compounds. The present study was performed aimed to determine the effect of plantago cream on intensity of pain and episiotomy wound healing in nulliparous women.

This triple-blind clinical trial study was performed in 2019 on 107 nulliparous women who had referred to Valiasr Hospital in Birjand for natural childbirth. The participants were randomly divided into two groups of placebo and drug. After delivery, mothers used 2-3 cm of prescribed cream on the sutures for 10 days and twice a day. The wound healing rate was evaluated on the third, seventh and tenth days after delivery using the Reda tool. Data were analyzed using SPSS 21 software and Chi-square and Mann-Whitney tests. P< 0.05 was considered statistically significant.

The mean of Reda score in the drug group was 3.433 ± 0.635 on the third day, and 0.773 ± 0.422 on the seventh day, but in the placebo group, it was 5.611 ± 0.492, 2.185 0 0.478, respectively. The two groups had significant difference on the third and seventh days in terms of wound healing (p<0.001).  The median McGill score in the drug group was 26 on the third day and 7 on the seventh day, but in the placebo group, it was 44 and 19, respectively, and the two groups had a statistically significant difference in terms of pain intensity on the third and seventh day (P<0.001)

The use of plantago cream in comparison with placebo increases the speed of improvement of pain intensity and episiotomy wound healing in nulliparous women.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines are administered worldwide. However, lactating women have been excluded from clinical trials, and limited information is available on the safety of vaccines against SARS-CoV-2 in lactating women. Therefore, comprehensive information is needed for mothers to make informed decisions about the need for vaccination to control the spread of the virus. This review study was conducted aimed to know the necessity of vaccination of breastfeeding mothers against the SARS-COV2 virus and to know the immune responses created in plasma and breast milk after the injection of COVID-19 vaccines.

In this systematic review study, Google Scholar, PubMed, and Science Direct information sources were used in the period of 2021 to 2022 to extract research articles containing information and the safety of milk and serum of lactating mothers vaccinated against SARS-COV-2. The articles which were not related to the purpose of the article were removed from the study process.

Out of 1770 articles related to the initial search, data from 30 papers met the inclusion criteria. Among the available vaccines, only the effects of AstraZeneca, Pfizer, and Moderna vaccines wereidentified on antibody secretion in breast milk and serum. The results of the presentresearch confirmed the presence of anti-SARS-CoV-2 antibodies in vaccinated serum and breast milk. So, IgG was the predominant antibody reported in many studies after vaccination.Thus, unlike post-viral immunity, the specific response of the vaccine is to dominate IgG and not IgA.The role of IgM was also less than that of other antibodies.

Vaccination of lactating mothers enhances the protective effects of milk against COVID-19 infection. More efforts are needed to encourage breastfeeding mothers to be vaccinated and support breastfeeding during the outbreak.

The bilateral cell traffic between fetus and mother probably occurs in all pregnancies and is participated in the development of fetal immune system, tissue repair in autoimmune diseases, cancer and maternal immune surveillance. Progressive evidences indicate that after giving birth, embryonic cells persist and lead to microchimerism. Despite ample evidences of two-way cell traffic, a significant portion of embryonic microchimerism remains ambiguous. This review study was performed aimed to investigate the latest data about the microchimerism and its function in both mother and baby.

In this review, to find the related articles, databases of PubMed, Science Direct, Scopus, and Google Scholar were searched using the keywords of microchimerism, maternal-fetal cellular trafficking (MFCT) and semi-allogeneic fetus from 1991 to 2021. Q1 journals and articles with documented information were prioritized.

During a successful human pregnancy, the semi-allogeneic fetus is protected from the attack of the maternal immune system possibly by suppressing the placental immune response, which contributes to microchimerism. Embryonic cells mainly are stabilized in the maternal bone marrow and are able to differentiate into tissue-specific adult cells in damaged organs of mother

Microchimeric cells are significantly involved in some immune responses and diseases related to the immune system. Also, the ability of embryonic cells to cross the placental barrier and the blood-brain barrier, migrate to various tissues and differentiate into several types of cells, have developed the strategies for cell therapy by intravenous transplantation of stem or ancestral cells. Also, the nucleated embryonic cells circulated in the mother's blood can provide fetal DNA for noninvasive prenatal diagnosis.

Gestational diabetes (GDM) is one of the serious complications of pregnancy which can lead to adverse outcomes for mother and offspring in the short and long-term. This systematic review study was performed to investigate the relationship between GDM and neurodevelopmental disorders in the offspring.

In this review study, to find the related articles, databases of PubMed, Scopus, Web of Science, and Google Scholar were searched using the keywords of gestational diabetes, offspring, cognitive disorder and behavioral disorder up to March 2022. The Newcastle-Ottawa scale was used to assess the quality of the studies. The findings of this study were reported qualitatively.

This study reviewed 14 observational studies with 728140 participants. The findings of included studies on the incident of neurodevelopmental complications in the offspring of mothers with GDM, who were diagnosed using different diagnostic criteria, show the possibility of neurodevelopmental complications in the offspring of mothers with GDM. The most common diagnosing criterion of GDM was the Carpenter-Coustan criterion; after that, the World Health Organization diagnostic criterion was the most common.

The available evidence mainly indicated the association between GDM and neurodevelopmental disorders in the offspring, while due to limited studies, it was not possible to compare the outcomes of different diagnostic and therapeutic approaches.