مجله زنان مامائی و نازائی ایران
سال بیست و پنجم شماره 10 (دی 1401)

Maternal diseases during pregnancy have many effects on the fetus and infant, and on the other hand, respiratory and infectious problems are very common in premature neonates, so this study was performed with aim to compare these two common problems in mothers with normal and problematic pregnancies.

In this retrospective descriptive study, the premature neonates hospitalized in the NICU of Ghaem Hospital, Mashhad during 2014-2022 were examined, and the information related to the study, including maternal information (mother's age, type of delivery, maternal diseases  and pregnancy complications) and newborn information (respiratory problems, blood culture, complete blood cell count, C-reactive protein(CRP) and Erythrocyte Sedimentation Rate ( ESR)) were recorded. Then the neonates' characteristics in the two groups of healthy mothers and mothers with common pregnancy diseases were compared. Data were analyzed by SPSS (version 26) and Independent t-test and Chi-square test. P<0.05 was considered statistically significant.

From a total of 982 mothers and newborns, mean gestational age in the group of healthy and diseased mothers was 31.93 and 30.95 weeks, the incidence of respiratory distress syndrome was reported in 39 (32.5%) and 357 infants (56.9%), non-specific respiratory distress in 13 (7.8%) and 105 infants (12.9%), primary pulmonary hypertension in 0 and 22 infants (2.7%), sepsis in 37 (22.4%) and 219 infants (26.8%), and the incidence of meningitis in 2 (1.2% ) and 15 infants (1.8%), respectively (P<0.001)

Prematurity, its severity and related problems increase in infant of mothers with problems during pregnancy. Respiratory and infectious problem, respiratory support and necessary care also increase.

Cervical cancer is one of the most important malignancies in women which has a unique progression due to premalignant lesions. The present study was performed with aim to evaluate the expression of NQO1 protein in patients with premalignant cervical lesions and squamous cell carcinoma (SCC) of the cervix and its comparison with non-dysplastic tissues.

In this cross-sectional study, paraffin-embedded blocks of patients with cervical SCC and different degrees of dysplasia and non-dysplastic tissue during 2018 to 2020 were selected as the control group from the pathology ward of Mashhad Ghaem Hospital to assess NQO1 expression by immunohistochemistry with mouse monoclonal antibody against human NQO1. Demographic data, clinicopathologic features, and survival data were assessed. Data were analyzed by SPSS (version 22) and Chi-square test, Fisher's exact test, analysis of variance, Tukey post-hoc test and log rank test. P<0.05 was considered statistically significant.

In this study, 152 subjects including 31 patients with cervical SCC, 91 with different degrees of dysplasia and 30 non-dysplastic tissue were evaluated for NQO1 protein expression. Increased expression of NQO1 protein in SCC, CIN3, CIN2, CIN1 and healthy patients was 96.8%, 96.7%, 73.3%, 6.5% and 3.3%, respectively (p <0.0001). No significant correlation was found between NQO1 protein expression with tumor type (p=0.99), lymph node involvement (p=0.33), and tumor grade (p=0.40).

The expression of NQO1 protein in lesions with severe dysplasia was more than moderate dysplasia and in lesions with moderate dysplasia was more than mild dysplastic lesions, indicating the possible role of NQO1 protein expression changes in progression of cancer and increased severity of these lesions.

Anemia increases the risk of adverse pregnancy outcomes including preterm delivery and low birth weight. This study was performed with aim to determine the relationship between the severity of anemia with preterm delivery and low birth weight and the level of hemoglobin which causes these consequences.

This cross-sectional study was conducted in 2019-2020 on 737 pregnant women referred to Ayatollah Rouhani Hospital in Babol who underwent delivery. Demographic information, hemoglobin level of mothers, gestational age, type of delivery, weight, height, head circumference and Apgar of the newborn were recorded in the checklist. Data were analyzed by SPSS (version 25) and univariate ANOVA, t-test, Chi-square and correlation coefficient tests.

The prevalence of anemia in pregnant mothers was estimated at 24.15%. Gestational age, weight, height, head circumference, and Apgar of the newborn were significantly lower in the anemic group (p<0.001). By dividing the mothers into two groups of term and pre-term, there was no significant difference in their hemoglobin level (p=0.11); however, by dividing preterm mothers into early and late preterm groups, hemoglobin was reported to be lower in early preterm mothers (p=0.004). It was found that hemoglobin less than 11.7 g/dL in a pregnant mother increases the risk of preterm delivery (less than 34 weeks) and birth weight less than 2500 g.

It seems that despite reaching the hemoglobin to the minimum normal level, there is still a significant possibility of adverse outcomes in the newborn, so one should try to keep the hemoglobin level above the minimum normal level.

Proper and accurate screening of congenital anomalies and genetic diseases reduces the birth of babies with disorders and it is necessary to evaluate the diagnostic accuracy of the tests. Therefore, this study was performed with aim to evaluate the prevalence of aneuploidy in pregnancies with high-risk results of fetal screening methods.

This cross-sectional (descriptive-analytic) study was performed on 1454 patients referred to perinatology clinic in Sabzevar. After obtaining demographic information, the prevalence of aneuploidy in high-risk pregnancies was recorded. Data were analyzed by SPSS (version 26) and Chi-square and Fisher's exact tests. P<0.05 was considered statistically significant.

Based on amniocentesis and CVS test results, it was found that 1369 patients (94.2%) had normal, 41 (2.8%) had trisomy 21, 25 (1.7%) had Turner-Kleinfelter, 11 (0.8%) had trisomy 18, 2 (0.1%) had Trisomy 13 and finally 6 (0.4%) had other cases. There was a significant relationship between high-risk pregnancy tests and the presence of anaploidy (P <0.05). This means that screening tests have been able to optimally identify cases of aneuploidy. Only this relationship between high-risk test for trisomy 13 and genetic results was not significant (P=0.43).

Although normal cases are high in high risk individuals, but if a disorder be observed in screening, amniocentesis and CVS should be performed because especially in increased NT and nasal bone hypoplasia and in cases with high risk of trisomy 21 and 18, more accurate tests should be performed to prevent the birth of children with genetic defects by early diagnosis.

Given the high prevalence of severe preeclampsia and its complications and the conflicting reports on the role of antiphospholipid antibodies, especially anti-cardiolipin, this study was performed aimed to compare the anti-cardiolipin antibody titer in pregnant women with preeclampsia and control group.

In this case-control study, 220 pregnant women in the third trimester of pregnancy who referred to Ali ibn-e Abitaleb Hospital in Zahedan in 2012 were evaluated in two groups of pregnant women with preeclampsia and control group.  4 cc of blood samples were taken from all the women under study and sent to the laboratory for   tests under standard conditions. Anticardiolipin IgG and IgM levels were determined by ELISA method. Data were analyzed by SPSS (version 19) and Mann-Whitney test. P<0.05 was considered statistically significant.

In the present study, the mean IgM antibody titers in pregnant women with severe preeclampsia were 1.0±856.842 mg/L and in the control group 2.1±215.610 mg/L which was not significantly different between the two groups (P=0.531). Mean IgG antibody titers were also 2.1±468.163 mg/L in pregnant women with severe preeclampsia and 2.139±0.545 mg/L in the control group which was not significantly different between the two groups (P=0.345).

In this study, no correlation was found between the levels of anti-cardiolipin antibody titers in pregnant women with preeclampsia compared with normal pregnant women.

Human papillomavirus is the leading cause of cervical cancer and with timely diagnosis and prompt treatment of these infections, the progression of cervical cancer can be prevented. This study was performed with aim to investigate the prevalence of high-risk human papillomavirus serotypes in cervicovaginal smears of wives of men with genital warts and its relation with Pap smear.

In this cross-sectional study, which was conducted between 2018 and 2020 in a private practice or affiliated clinics of the Islamic Azad University of Mashhad, 74 wives of men with genital warts were included in the study after confirmation of inclusion criteria. High-risk serotypes of human papillomavirus were determined by the Cobas apparatus, which is based on molecular methods. Cellular changes and inflammation of cervicovaginal smear samples were also examined by liquid base method in their spouses with genital warts. Data were analyzed using SPSS (version 20) and Kolmogorov-Smirnov, Chi-square, Fisher and ANOVA tests. P<0.05 was considered statistically significant.

The prevalence of premalignancy lesions or low and high grade dysplasia in the wives of men with genital warts was 10.8% and 4.1%, respectively, while in 85.1% of the sample examined, no dysplasia was observed. Also, high-risk serotypes were observed in 29.7% of the wives of men with genital warts, that 8.1% were serotypes 16, 2.7% genotypes 18 and 18.9% other serotypes.

Due to the high prevalence of high-risk human papillomavirus in the wives of men with genital warts (29.7%), Pap smear test and determination of human papillomavirus serotype is recommended in these individuals.

Adopting a safe method to accelerate labor can reduce maternal and fetal mortality and morbidity. Prolonged labor, perineal rupture and episiotomy can be associated with short and long-term maternal and fetal complications. This study was performed aimed to examine the effect of vaginal and perineal massage with duck oil on the length of the second stage of labor, the frequency of episiotomy, and perineal laceration in nulliparous women.

This randomized controlled trial study was performed in 2020 on 129 nulliparous women with singleton pregnancy aged 18-35 years, gestational age 37-42 weeks, and cephalic presentation. The participants were divided into duck oil group (n=43), lubricant gel group (n=43), and control group (n=43). During the second stage of labor, a gentle massage was performed with the index and middle fingers impregnated with duck oil (for the oil group) or lubricant gel (for the gel group). The control group received massage without gel or oil. Data were analyzed by SPSS software (version 23) and Kruskal-Wallis, paired comparison and Chi-square tests. P<0.05 was considered statistically significant.

The mean length of the second stage of labor in the duck oil group (35.77 ±21.47) was significantly lower than the control group (49.65±17.54) and the gel group (44.19±21.35) (P=0.01). There was no significant difference among the groups in terms of perineal rupture and the frequency of episiotomy (p >0.05).

Perineal and vaginal massage using duck oil in the second stage of labor can shorten the length of the second stage of labor, but had no effect on episiotomy and perineal rupture.

Prolonged labor, especially the second stage, negatively affects labor outcomes. Previous studies reported different findings for the effect of lubricants such as oils and gel on vaginal delivery process and outcomes. The Iranian Traditional Medicine recommends massage with oils such as sesame oil to facilitate birth. This study was performed aimed to evaluate the effect of vaginal and perineal massage with sesame oil in comparison with lubricant gel on the duration of the second stage of labor, perineal damage and episiotomy in nulliparous women.

This randomized clinical trial was performed in 2020 on 180 nulliparous women in Ahvaz. The subjects were randomly divided into three groups of sesame oil, lubricant gel, and control group (60 women in each group). In the Sesame oil group, perineal and vaginal massage was performed in the second stage of labor with 5 cc of sesame oil during vaginal examination. The gel group received the same massage with lubricant gel. The control group received only routine care. The duration of the second stage of labor and the frequency of perineal laceration and episiotomy were compared in three groups. Data were analyzed by SPSS (version 22) and covariance and chi-square test. P<0.05 was considered statistically significant.

There were no significant differences among the three groups in terms of demographic characteristics, perineal laceration, and episiotomy (P≥0.05). The duration of the second stage of labor was significantly shorter in the sesame oil group (32.60 ± 1.78 min) than the lubricant gel group (37.50 ±1.78 min) and the control group (44.92 ±78.1 min) (p <0.05).

Vaginal and perineal massage with sesame oil can reduce the duration of the second stage of labor.

Achillea Millefolium is used as one of the herbal remedies for dysmenorrhea. Due to the existence of its various forms and the lack of studies comparing them, this study was performed with aim to compare the effect of Achillea Millefolium teabag and capsule on the severity of primary dysmenorrhea.

This randomized clinical trial study was conducted in 2020 on 60 female students living in the dormitories of Gonabad University of Medical Sciences. The research units were randomly allocated into two groups of 30 individuals receiving Achillea Millefolium teabag and extract capsules.  Data were collected from demographic and fertility characteristics form of the research units and visual pain scale. Pain intensity in both groups was measured and recorded in the pre-intervention cycle and at the end of the first, second and third days of the two intervention cycles. Data were analyzed using SPSS software (version 16) and Chi-square, Independent t and U-Man-Whitney tests. P< 0.05 was considered statistically significant.

The results of this study showed that the mean pain intensity in the first cycle in the two groups was not statistically significant (P=0.69), while in the second cycle, the mean pain intensity was significantly lower in the group receiving Achillea Millefolium extract capsules (P=0.006).

The use of Achillea Millefolium capsules had a greater effect on reducing pain intensity than Achillea Millefolium teabag.

Vasomotor symptoms during menopause occur on average in 75% of women. Hot flashes are the most common of these symptoms. Hormonal drugs  are the most effective method of treatment. Due to the known risks of hormone therapy, many researchers have investigated the effect of herbal medicines to improve vasomotor symptoms, especially hot flashes. This study was performed with aim to investigate the clinical trial studies conducted on the effectiveness of various herbal medicines on hot flashes.

In this study, to find the related articles, databases of Google scholar, Scopus, PubMed, Web of science, Science direct and national databases such as (MagIran), (SID), (IranDoc) and (IranMedex) were searched from the beginning of January 2005 to January 2020. Data were combined using STATA software (version 12.2) and using meta-analysis method, random effects model.

In the present study, 11 clinical trials were included in the meta-analysis according to the inclusion criteria.In the medicinal plants group, mean reduction in the number of hot flushes was 2.41 times (95% CI: -1.56 to -3.27%) less than the control group, which was statistically significant (p<0.05).In addition, in the medicinal plants group, the intensity of hot flashes was 20.28 degrees (95% CI: -71.70 to -22.87) compared to the control group, and this difference was statistically significant (p<0.05).

Medicinal plants containing phytoestrogens have good effects on reducing the frequency and intensity of hot flashes in menopausal women and can be a suitable treatment for hot flashes in menopausal women.

Headache is one of the common problems after spinal anesthesia following cesarean surgery. Various pharmacological methods have been proposed for the treatment of headache after spinal anesthesia. This study was conducted with aim to evaluate headache after spinal anesthesia following caesarean section in the form of a narrative review of clinical trial articles conducted in Iran.

In this narrative review study, to find related studies, the Persian language databases of "SID", "Magiran" and the Google Scholar and English language databases of Scopus, PubMed, and Web of Science were searched with the keywords of PDPH, spinal anesthesia and cesarean section wiyhout time limitation.

In this narrative review study, 29 articles were examined. The reviewed studies were done from 2007-2022. The investigated drugs include: Pregabalin, gabapentin, theophylline, ondansetron, aminophylline, dexamethasone, caffeine, mannitol, intravenous acetaminophen (paracetamol), normal saline, propofol and hydrocortisone. Among the investigated drugs, dexamethasone has been most effective in controlling PDPH, and then, ondansetron has been most effective in reducing and controlling PDPH.

The present study showed good evidence on the effectiveness of the drugs investigated in the studies. It seems that all the investigated drugs can be used as a treatment for headache (PDPH) after spinal anesthesia in cesarean section women; however, among the investigated drugs, since more studies have been performed on dexamethasone, it can be a more suitable choice for preventing headache after spinal anesthesia in cesarean section women.

There is a possibility of more accumulation of environmental pollutants due to lower levels of iron in the body of women. Different results have been reported on the association of lead with breast cancer, therefore, this systematic review study was performed with aim to determine the relationship between lead and breast cancer.

In this review study, to find the related articles, international databases (Web of Science, Embase, Scopus, Google Scholar and PubMed) and national (Irandoc, Magiran, SID and IranMedex) were searched with different keyword combinations related to "Lead" And "Breast Cancer" obtained from MESH in 2000 to 2022. Selection of articles was based on inclusion and exclusion criteria and articles' quality was assessed using the Newcastle Ottawa scale.

Out of 4057 articles reviewed, 13 articles had good quality. All studies were in English and were observational. According to most studies, serum lead levels were not associated with breast cancer, but lead levels in bone and breast tissue were also associated with exposure to lead as an environmental contaminant with breast cancer.

Different ways of exposure to lead have led to different results and it cannot be certainty said that exposure to lead causes breast cancer, while this relationship also depends on the method of measuring lead. In this regard, long-term studies with accurate measurement of environmental lead and body tissues, especially for women at higher risk are recommended.