Journal of Fertility, Gynecology and Andrology
Volume:3 Issue: 1, Dec 2023

Cervical elongation (CE) can occur in company with pelvic organ prolapse (POP). Preoperative cervical length assessment is imperative before decision-making for pelvic organ prolapse surgical repair. POP-Q is not effective at recognizing supra-vaginal elongation. In this case study, we are reporting a 70-year-old woman, a case of recurrent POP after sacrospinous hysteropexy, that POP-Q failed in diagnosing supra-vaginal elongation preoperatively. POP-Q is not effective at recognizing supra-vaginal elongation.

 Parabens (PBs) may have potential endocrine disruption effects and may affect fertility.

 This study aimed to find the relationship between the urinary concentration of PB derivatives, including methylparaben (MP), ethylparaben (EP), propylparaben (PP), and butylparaben (BP), with the hormonal profile and in vitro fertilization (IVF) outcomes of infertile women.

 This case-control study was conducted in an academic center in Tehran from April to December 2021. The demographic data and lifestyle components as well as the urinary MP, EP, PP, and BP among the infertile and fertile women were evaluated and compared. Also, in infertile patients, the correlation between the hormonal profile and IVF outcomes (the number and quality of oocytes and embryos) with urinary PBs was assessed and reported.

 A total of 206 women were included in the study. The distribution of urinary PB concentrations between groups was not significantly different. The frequency and comparison of used personal care products, cosmetics, detergents, and foodstuffs for some items except folic acid were significantly higher in the control group. Comparing the effects of PBs on hormones, a significant impact of MP on estradiol was observed for the second, third, and fourth quantiles. The follicle-stimulating hormone was significantly affected by the fourth quartile of EP. Additionally, the effect of EP on anti-mullerian hormones was negative and significant for the fourth quartile compared to the first quartile.

 Urinary PB levels may not be an indicator for infertility and hormonal distribution, at least for a short duration, and did not impact IVF outcomes.

In this report, a brief historical overview of preprints focuses on the impact of the COVID-19 pandemic on the distribution of preprints in obstetrics and gynecology, and the benefits and drawbacks of preprints are described. Preprints are manuscripts that are published before peer review. They are widely available even though they are recent in biomedical science. The COVID-19 pandemic enhanced the number of preprints prominently. It is known that 5% of all preprint articles issued during the pandemic were in obstetrics and gynecology. Some benefits include the increased pace of being available and the exposure rate. Also, it provides an opportunity to check for plagiarism and prevent malpractice earlier. Challenges to the distribution of preprints also exist, such as the potential lack of quality, premature data, and the possibility of misguiding normal people. Given the high importance of data release in obstetrics and gynecology, both the authors and the publishers should regulate strict yet rational guidelines before letting the information become widely accessible.

 The cesarean section rate has increased in the last decade, a significant risk factor for intra-abdominal adhesion. This study investigated the diagnostic accuracy of cesarean scar indicators for intra-abdominal adhesions in pregnant women.

 This cross-sectional study was conducted on pregnant women with a previous cesarean section who were candidates for elective repeated cesarean section. We gathered demographic information, including age, number of prior cesarean sections, past medical and surgical history, the time since the last operation, and the inspection of the cesarean incision. The evidence of pelvic adhesion was calculated in the operating room by the Manchester scar scale, and intra-abdominal adhesions were graded using a modified Nair's classification. The data were analyzed by proper tests.

 One hundred pregnant women were included in the study and divided into two groups with high and low incision indices. In the low incision index group, 82.1% had a history of one cesarean section, and 1.3% had three or more, and in the group with a high incision index, 54.5% had a history of one cesarean section, and 13.6% had three times or more (P < 0.05). Women with a high incision index had a higher adhesion rate than the other group (P < 0.001). The sensitivity and specificity of the scar index in the diagnosis of adhesions were 57.48% and 92.30%, respectively.

 It is challenging to accurately predict the severity of adhesions resulting from cesarean section, but it is urged to prevent an unnecessary cesarean section.

 By using probiotic products, such as Lactovag, which contain high amounts of a safe and beneficial bacterial strain, the vaginal microbiome can be near healthy in infertile women, and as a consequence, the reproductive outcomes are improved.

 The present study was done to assess the effect of Lactovag on pregnancy outcomes in IUI cycles.

 This single-blind clinical trial was conducted on 194 infertile women who underwent IUI in the infertility clinic of Yas Hospital between December 2021 and March 2022. In the intervention group, two weeks before IUI, Lactovage suppository was prescribed once per night, while in the control group, no extra interventions were done. All the patients underwent IUI in the same way. The primary outcomes of the study were biochemical and clinical pregnancy rates.

 The average age of women was 30.51 ± 4.6 years, ranging from 22 to 43 years. The average age of the women’s partner was 34.89 ± 4.41 years, ranging from 24 to 49 years. There were no significant differences regards the basic information of the two study groups. The most common infertility cause was polycystic ovary syndrome (40.7%). The biochemical and clinical pregnancy rate was 12.4% in the Lactovage group and 10.3% in the control group. Although the pregnancy rate improved with a Lactovage prescription, this difference was insignificant (P-value = 0.651).

 While the pregnancy rate in women with probiotic therapy was higher, it was insignificant. Future randomized studies are needed to definitively examine probiotic therapy and establish its benefit in women candidates for IUI.

 Self-care during pregnancy includes principles and care programs that lead to clinical outcomes and effectively reduce adverse pregnancy outcomes.

 This study was conducted to investigate the effectiveness of self-care training in improving the physical health status of pregnant women.

 This semi-experimental study was conducted on 116 pregnant mothers referred to the health centers of Sabzevar University of Medical Sciences in a simple random fashion with permutation blocks with two intervention (58 people) and control (58 people) groups. Demographic, skeletal, and muscular discomfort questionnaires were used to collect data, and data were collected before and after the intervention in both groups. After collecting the data, it was entered into SPSS 18 and analyzed with the help of descriptive and analytical statistics.

 In this study, the results showed that out of 116 pregnant mothers participating, 58 were in the intervention group and 58 were in the control group, and between the variables of age (P = 0.001) and occupation (P = 0.003), job status (P = 0.042), gestational age (P = 0.001), number of deliveries (P = 0.001), exercise (P = 0.002), also there was a significant relationship between exercise time (P = 0.003) and physical health, and there was no significant relationship with the rest of the variables, and the average physical health in the control group before the intervention was 29.74 ± 6.97 and after the intervention was 28.41 ± 7.44 and in the intervention group before the intervention, it was 30.82 ± 6.38, and after the intervention, it was 27.7 ± 6.33, and there was a significant relationship between physical health and intervention.

 The results showed that self-care training increases the physical health of pregnant women; on the other hand, it is a very important tool for designing and implementing educational interventions to improve women's health.

 An ovarian dermoid cyst is one of the most prevalent benign tumors in women of reproductive age. They can get complicated or be mistaken for malignant tumors. Most of the time, their pathology will not be discovered until after surgery.

 Finding the role of CA19-9 and CA125 tumor markers in diagnosing the dermoid cyst before surgery and distinguishing it from the malignant type.

 A case-control study was conducted on all cases of dermoid cysts and malignant tumors (both diagnosed by pathology) from 2019 to 2021. Required information such as age, level of tumor markers, size, and whether it is unilateral or bilateral were extracted, and the tumor marker levels were analyzed in benign and malignant groups.

 In this study, 95 cases of ovarian cysts and 85 control of malignant ovarian tumors were included. The mean level of CA19-9 and CA125 in the patients with dermoid cysts was 32.26 ± 5.45 units/mL and 31.37 ± 4.77 units/mL, respectively. In the malignant ovarian tumor group, the average level of CA19-9 and CA125 was equal to 9.56 ± 3.54 units/mL and 233.79 ± 54.57 units/mL, respectively. CA19-9 level was significantly higher in the dermoid cyst group (P-value < 0.001). CA125 level was significantly elevated among the malignant group (P-value < 0.001). It was observed that there was a significant relationship between the level of CA19-9 with the size of the cyst and the level of CA125 with the age of the patients. No significant relationship was found between the level of tumor markers and whether they were unilateral or bilateral.

 Regarding the correlation between the cyst size and CA19-9 in the comparison of the two groups, this tumor marker may be a suitable diagnostic marker in benign ovarian cysts along with ultrasound.

Nuchal translucency (NT) and crown-rump length (CRL) measurements are useful fetal screening tests. The extent to which maternal hematological and biochemical profiles may impact these markers has not been evaluated. This study is designed to address this issue.

Data from the first-trimester screening for aneuploidy and maternal laboratory results, including maternal fasting blood sugar (FBS), thyroid stimulating hormone (TSH), hemoglobin, hematocrit, vitamin D3, and ferritin, were collected at 11 - 13 weeks of gestational age. The association between NT/CRL and maternal laboratory tests was analyzed and reported.

258 women with a mean ± SD age of 32.6 ± 5.2 years participated in the study. NT and CRL values were not correlated with maternal laboratory variables. Otherwise, CRL was positively correlated with increasing maternal age, and NT was associated with increasing gestational age.

The results of this study indicate that NT and CRL values at 11 - 13 weeks of gestation are independent of maternal hemoglobin, FBS, vitamin D3, and ferritin status.

To investigate the association between intimate partner violence during pregnancy and maternal and neonatal outcomes.

This cross-sectional study was performed on 115 pregnant women referring to an academic center. Demographic data, maternal outcomes (vaginal bleeding during pregnancy, preterm delivery, intrauterine growth restriction, placental abruption, and premature rupture of membrane), and neonatal outcomes (birthweight and Apgar score) were evaluated. Domestic violence against pregnant women was ascertained by a validated domestic violence questionnaire. Finally, the association between domestic violence and maternal and/or neonatal outcomes was investigated.

The prevalence of domestic violence against pregnant women was 67.8%. Psychological violence obtained the highest prevalence (64.3%), followed by economic (34.8%), sexual (18.3%), and physical (12.2%) violence. Regression analysis showed that there was a significant association between domestic violence and preterm labor (P = 0.048, r = 0.385) and between economic violence and placental abruption (P = 0.040, r = 0.391). Also, there was a significant relationship between vaginal bleeding and sexual violence (P = 0.022). Educational level significantly and inversely correlated with economic (r = -0.21) and physical (r = -0.19) violence.

The results of this study indicated that intimate partner violence was commonplace during pregnancy and affected neonatal and maternal outcomes. It is suggested to implement educational programs for healthcare workers and screen all pregnant women for exposure to intimate partner violence to reduce maternal and neonatal complications.

Childbirth and delivery are among the most joyful and stressful parts of a woman's life and could considerably influence the mother and her child's health. Helping mothers reduce their stress and anxiety about this procedure, especially during cesarean sections, may lead to better outcomes.

In this study, virtual reality (VR) technology will be applied as a potential modality to reduce maternal anxiety and stress during cesarean sections and improve maternal and/or neonatal outcomes.

In this randomized clinical trial study, VR headsets, as a novel technology, will use to reduce maternal anxiety and stress during cesarean section by spinal anesthesia. Outcomes such as maternal stress, anxiety, pain, postpartum hemorrhage, and neonatal outcomes such as Apgar score and respiratory distress will be evaluated and compared with a control group.

In conclusion, our study wants to provide an initial insight into the advantages of using VR technology during cesarean section, and we will be able to understand if VR could improve the quality of surgeries.

In this report, a brief historical overview of preprints focuses on the impact of the COVID-19 pandemic on the distribution of preprints in obstetrics and gynecology, and the benefits and drawbacks of preprints are described. Preprints are manuscripts that are published before peer review. They are widely available even though they are recent in biomedical science. The COVID-19 pandemic enhanced the number of preprints prominently. It is known that 5% of all preprint articles issued during the pandemic were in obstetrics and gynecology. Some benefits include the increased pace of being available and the exposure rate. Also, it provides an opportunity to check for plagiarism and prevent malpractice earlier. Challenges to the distribution of preprints also exist, such as the potential lack of quality, premature data, and the possibility of misguiding normal people. Given the high importance of data release in obstetrics and gynecology, both the authors and the publishers should regulate strict yet rational guidelines before letting the information become widely accessible.

To investigate the preferred method and education subjects among gynecologists and obstetricians to find the gaps between the current and expected states of continuing medical education (CME).

An online self-administered questionnaire was sent to Iranian gynecologists and obstetricians. Three main parts of the questionnaire were demographic information, general skills such as stress management, legal knowledge, and documentation, and specialized skills such as medical and surgical management. The level of clinical capability, the need for further training, and the preferred training method, virtual, theoretical, or bedside in private or academic centers, were asked and reported.

Two hundred and eighty-six general gynecologists and obstetricians participated in this survey. The majority (87.3%) of them were not academic staff. Nearly 70% of the participants could perform common procedures in obstetrics, general gynecology, infertility, oncology, and urogynecology, although more than two-thirds felt they needed more training. The lowest level of preparedness was in urogynecology skills, while the highest level of educational needs was reported in infertility. Surprisingly, the preferred method of education for the most specialized skills was bedside training in academic centers.

Despite time constraints and COVID-19 restrictions, most clinicians are keen to receive more education, and in most cases, their preferred method is bedside training in academic centers. Therefore, proper strategic planning based on different fields of obstetrics and gynecology to design practical and bedside CME courses seems necessary. 

Context: In parallel with the rapidly advancing technology and progress in modern medicine, along with the influence of popular culture on individuals’ body perception, the concept of medicalization has come into the spotlight. The increasing use and impact of popular culture through media have undeniably contributed to the rise in medicalization rates in both women and men. Evidence Acquisition: This study relied on scientific research data to support the topic. The literature review was conducted to investigate the effects of medicalization on women and men under the influence of popular culture. Research articles and reliable sources were examined.

According to research findings, popular culture propagated through media significantly affects women’s body perception. The spread of popular culture, where media plays a crucial role, leads to the formation of different perceptions about women’s bodies and attributes to certain diseases related to women’s different life stages. This contributes to the widespread prevalence of medicalization among women.

Considering the role of popular culture in making medical decisions and enhancing societal awareness, healthcare professionals and media organizations should take an active part in positively shaping the impact of popular culture on medicalization and helping society make more informed decisions.

The present study aimed to compare inflammatory markers of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and maternal platelet count in patients with and without chorioamnionitis with premature preterm rupture of membrane (PPROM).

Women with PPROM and gestational age less than 34 weeks were enrolled in this cohort study. PPROM was confirmed with sterile speculum examination or the AmniSure test. A blood sample was drawn from mothers for complete blood count (CBC) and differential count (Diff) before administering antibiotics and corticosteroids. Another blood sample was drawn for CBC-Diff tests at the time of pregnancy termination. The status of mothers and fetuses was carefully monitored during hospitalization through the following indicators: vital signs, daily abdominal examination, uterus discharge, daily non-stress test, and weekly ultrasonography. All samples were collected in one year.

A total of 110 patients were examined. The reason for pregnancy termination was gestational age of 34 weeks in 30 patients (27.3%), chorioamnionitis in 19 cases (17.3%), pain and dilation in 32 cases (29.1%), and miscellaneous in 29 cases (26.4%). Among the study parameters, only NLR was significantly different between groups, and the order of values from highest to lowest was in the chorioamnionitis, pain and dilatation, miscellaneous, and gestational age of 34 weeks groups. We found that NLR at a cut-off point of 3.2 - 3.5 had an acceptable sensitivity and low specificity to detect the cases of chorioamnionitis. Raised NLR was associated with (95% CI) histological chorioamnionitis with a sensitivity of 86% and a specificity of 43%.

According to the findings of our study, NLR can be a suitable indicator for predicting chorioamnionitis in women who deliver preterm without clinical signs and symptoms of infection. It can be used for expectant management for PPROM after 34 weeks. 

Comparing the maternal and neonatal complications of COVID-19 with a healthy control group is important to identify the most accurate and up-to-date information about the effects of this disease on the health of mothers and neonates.

The study aimed to determine the maternal and neonatal complications and consequences related to COVID-19 infection.

This case-control study was conducted from February 2021 to February 2022 on women who were infected with COVID-19 during their pregnancy to evaluate the short and medium-term maternal and neonatal outcomes and compare them in the control group. Maternal outcomes, such as the rate of miscarriage, preterm delivery, stillbirth, and type of delivery, as well as gestational diabetes and preeclampsia, were evaluated. Indeed, neonatal complications, including hearing impairment, low birth rate, intrauterine growth restriction, and the rate of hospitalization in the neonatal intensive care unit, were evaluated and compared between groups.

In total, 600 women (300 cases in each group) participated in the study. The results showed that the frequency of cesarean delivery in patients with COVID-19 was 38%, while this rate was 20% in the control group. This difference was significant. It was also found that pregnant women suffering from COVID-19 had significantly more preterm labor. Babies born to mothers infected with COVID-19 had a significantly higher hospitalization rate in the intensive care unit than in the control group. Other maternal and neonatal complications were not significantly different between the two groups.

Women who are infected with COVID-19 during pregnancy face new maternal and newborn complications. Therefore, it is necessary to carry out further research on the long-term effects of COVID-19 on the health of the mother and baby in order to determine the appropriate strategies for the prevention and treatment of these complications. 

Corticosteroid administration may impair blood sugar control and cause other adverse effects in pregnant women with moderate to severe COVID-19. To our knowledge, there have been no studies on the effect of corticosteroid therapy on pregnant women with COVID-19 infection in terms of hyperglycemia or insulin needs.

The purpose of this study was to compare 2 different regimens of corticosteroid therapy, specifically dexamethasone, and methylprednisolone, in terms of their impact on newly diagnosed hyperglycemia in pregnant women infected with COVID-19, as well as the duration of this condition.

The current cohort study was conducted from August to November 2021 on hospitalized pregnant women with severe COVID-19. They received either the first protocol, which involved daily administration of 2 mg/kg of methylprednisolone intravenously, or the second protocol, which included daily intravenous administration of 6 mg of dexamethasone. The study aimed to compare the incidence and duration of hyperglycemia until delivery between these 2 groups.

A total of 59 participants were recruited after meeting the inclusion criteria. There were no significant differences in the demographic and clinical characteristics of patients between the 2 groups. Among the 59 pregnant women included in the study, 24 (40.7%) developed hyperglycemia that required insulin therapy. The incidence of hyperglycemia did not significantly differ between the 2 treatment regimens (P-value = 0.069). In the follow-up period, hyperglycemia resolved in both groups within up to 4 weeks after treatment, and they no longer required insulin.

Corticosteroid-treated pregnant patients are associated with transient hyperglycemia, the incidence of which is unrelated to the type of corticosteroid used. Therefore, corticosteroid administration should be initiated with caution and monitored appropriately in pregnant women with COVID-19 infection.