Journal of Obstetrics, Gynecology and Cancer Research
Volume:8 Issue: 5, Sep-Oct 2023

Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the end of 2030. Incidence of breast cancer had a clustering pattern in Iran, while central provinces had the highest ASIR (72 per 100,000 population), and South East provinces had the lowest ASIR (5-11 per 100,000 population). Numerous studies have shown that the peak incidence of breast cancer was occurred in the age group of 40-49 years in Iran. There has also been reported a rapid increase in the incidence in young women from different regions of the country. Known molecular and cellular processes involved in the development of breast cancer in Iranian BCs have been reported from various studies in recent decades, and the most well-known and prominent genes susceptible to breast cancer were BRCA1 and BRCA2.  They acted as tumor suppressor genes and inherited mutations leading to chromosomal instability. However, non-coding RNAs, epigenetic alterations, signaling pathways, immune responses, and antioxidant-related genes are the main molecular processes associated with the progression of breast cancer among Iranian patients. While we are facing a significant increase in the incidence of breast cancer, with a lower survival rate, breast cancer is currently considered as one of the major health problems in Iran, which emphasizes the importance of providing and designing prevention and early detection program of breast cancer.

 Pelvic organ prolapse (POP) is the herniation of the pelvic organs to or beyond the vaginal wall. Patients with POP may present with specific symptoms like vaginal bulge or pressure or associated symptoms including urinary, defecatory or sexual dysfunction, which could negatively affect the quality of life in these patients. This study aimed to assess the surgical outcomes of native-tissue apical suspension by sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS).پ

 This prospective cohort study was conducted to evaluate the outcomes of native-tissue apical suspension for pelvic organ prolapse within one year after the surgery from March 2017 to July 2019 at Imam Khomeini hospital, an academic hospital of Tehran University of Medical Sciences, Tehran, Iran. Inclusion criteria were patients with uterine prolapse at Stage 2 or 3 according to the Pelvic Organ Prolapse Quantification System (POP–Q) who planned for total vaginal hysterectomy and apical suspension using uterosacral ligament suspension (ULS) or sacrospinous ligament fixation (SSLF) with no history of pelvic organ prolapse surgery. The main outcome was surgical consequences within 1 year after surgery.

 There was no significant difference between the two groups in terms of relapse of anterior, posterior, or apical compartment prolapse. According to the clinical recurrence, although vaginal bulging and pressure were more common in sacrospinous ligament fixation (SSLF) group, the difference was not significant. The number of patients with severe buttock and pelvic pain was significantly higher in the sacrospinous ligament fixation (SSLF) group.

sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) are both optimal procedures with the same complications and similar surgical outcomes; however, uterosacral ligament suspension (ULS) had lower post-operative pelvic pain, and also the number of retreatment was lower in this group.

 Hypertension during pregnancy is associated with significant negative outcomes. In this study, we evaluated the effectiveness of dietary approaches to stop hypertension (DASH) on pregnancy outcomes of pregnant women with gestational and chronic hypertension.

 This randomized controlled clinical trial study was conducted on 60 pregnant women with a diagnosis of gestational hypertension and chronic hypertension. Women were randomly divided into the control (n=30) and the DASH diet (n=30) groups for 2 months and were followed until delivery. The outcomes of maternal pregnancy including the incidence of preeclampsia, placental abruption and preterm delivery (<37 weeks) were assessed during follow-up examinations. Birth weight and minute 1 and minute 5 Apgar score of the infant were also assessed.

 After 1 and 2 months of intervention, systolic and diastolic blood pressure in the DASH diet group was significantly lower than the control group (P<0.05). The incidence of preeclampsia (P=0.035), preterm delivery (P=0.020) and placental abruption (P=0.007) in the DASH diet group was significantly lower than the control group. The mean gestational age at the time of termination of pregnancy was not significantly different between the two groups (P = 0.467). There was no significant difference between minute 1 and minute 5 Apgar scores of the infants and the mean birth weight of the infants was not significantly different between the DASH and control groups (P = 0.756, P = 0.115 and P = 0.101, respectively).

The DASH diet could be used as an effective strategy to improve the clinical outcomes of pregnant women with gestational and chronic hypertension.

 Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.

 Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.

 Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.

Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.

 In all surgical interventions including cesarean section, pain is a challenging issue.  The aim of this study was to identify the underlying causes that affect post-cesarean pain intensity.

 A total of 128 consecutive patients who underwent cesarean section at Taleghani hospital were included in the study. A questionnaire was used to gather the patients’ demographic and clinical data. The length of the incision was measured with a ruler on the first day following the cesarean section. In addition, the pain intensity was assessed using a Likert scale at scales: 1, 2, 4, 8, 12, and 24, on the day after surgery and 48 hours and one week later. Descriptive statistics were calculated for all variables. Analyses were conducted using SPSS version 22 and a p-value < 0.05 was considered statistically significant.

 The study showed that overall, patient age, BMI, level of education, type of surgical incision, duration of surgery, type of cesarean section, type of anesthesia, and breastfeeding were not predictors of postoperative pain intensity. However, the study found that “indication of the cesarean section” and the “stage of labor” in which the cesarean was performed are correlated with postoperative pain intensity. (P-value<0.05).

In this study, we were able to identify 2 parameters that were independently associated to postoperative pain scores: “underlying indication of cesarean section” and the “stage of labor” in which cesarean section is performed. This information helps clinicians to identify high-risk patients in terms of postoperative pain and take early action.

 Oocyte donation is an assisted reproductive technique. The infertile couples' demand for using this technique has increased in recent years. This study aimed to evaluate psychiatric disorders, personality characteristics and intelligence quotient among women who are candidates for oocyte donation.

 This was a cross-sectional study. Thirty-nine parous women were entered into the study. A psychiatrist interviewed participants regarding the psychiatric axis I disorders. Also, participants were asked to answer the Millon Clinical Multi axial Inventory (MCMI III) and Raven’s Standard and Progressive Matrices (RSPM).

 The mean age of participants was 28.79 (SD = 4.1) years and it was 11.17 years (SD = 2.6) for education. The mean of donation frequency was 1.35 (SD =0.6). Twenty-one donors (53.8%) had only financial motivation and eleven (28.2%) had only altruist object. Twenty-eight (71.8%) women did not have any psychiatric axis I disorders while eight women (20.5%) had at least one disorder. Eleven participants (28.4%) suffered from at least one personality disorder. The mean intelligence quotient was 99.3 (SD =14.2).

 The results showed that oocyte donors might suffer from mental disorders and intelligence quotient problems irrespective of age, education, job status and motivation for donation. In conclusion, it seems that psychological assessment and help service is necessary for oocyte donors before any donation procedure.

 Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms in two aquatic and land-based trained groups before and after cessation of exercise due to COVID-19 outbreak.

 90 postmenopausal women participated in the study voluntarily. The daily and sport physical activities and menopausal symptoms were assessed through interviews three months after cessation of sport activities and qestions were designed and obtained from daily physical activity form and menopausal rating scale (MRS) questionnaire respectively.

 Before the cessation of exercise, the somatic, psychological, and sexual symptoms of menopause were lower in both active groups than the inactive group, while there was no significant difference in three categories of menopausal symptoms between aquatic and land-based exercise groups. After the cessation of exercise, menopausal symptoms in the two groups of previously active women increased significantly compared to the inactive group, so that there was no significant difference in menopausal symptoms between the exercise and inactive groups.

aquatic and land-based exercise reduces the symptoms of menopause similarly, while the beneficial effects of exercise on menopausal symptoms can disappear after the cessation of exercise for three months.

 Endometriosis is one of the most common diseases in the female population. The range of diagnostic delays in this disease is long and leads to adverse health-related consequences. The aim of this study was to evaluate diagnostic experiences in patients with endometriosis who are candidates for laparoscopic surgery.

 This cross-sectional study was performed on 433 patients with endometriosis who were candidates for laparoscopic surgery referred to Shohada-Tajrish Hospital in Tehran, Iran, between January 2016 and December 2021. A questionnaire including demographic and clinical information, MRI, and pathology reports were collected from participants. The MRI lesions were segmented and the results were compared with pathology and clinical examination. For statistical analysis SPSS software, version 22 was used.

 A total of 433 participated in this study with a mean age of 34.18±7.99. The average estimated duration of disease symptoms (months) was 40.58±42.33. The predictive value of clinical symptoms is weak compared to MRI. However, the probability that the disease is not present when the clinical signs are negative is acceptable in most of the endometriosis sites. MRI considerably shows the true negative rate, but its sensitivity is only relatively acceptable for the diagnosis of ascites (67.66%). Calculating the accuracy of MRI reports probably shows the overall classification of the patients via MRI test.

despite extensive research, there are no suitable and accurate non-invasive methods for diagnosing endometriosis. MRI and clinical examination alone are not useful for definitive diagnosis and it is better to examine biomarkers and artificial intelligence for non-invasive and accurate diagnosis of this disease.

 Aluminum (Al) is used in different industries to produce cosmetics, supplements, drugs, food packaging, toothpaste, kitchen utensils, and antiperspirants. Uterine fibroid (UF) is women's most prevalent benign tumor during the reproductive ages. Since Al can accumulate in the body's organs, it may play a role in the pathogenesis of UF. This study aimed to measure Al levels in serum and uterine samples (normal uterine tissue of control and UF patients, and leiomyoma of UF patients).

 In this descriptive study, we included ten women who underwent hysterectomy (five women due to UF and five women for a reason other than UF). Samples were obtained from serum, normal uterine tissue, and leiomyoma. Tissue and serum samples were digested with nitric acid (HNO3) and hydrogen peroxide (H2O2). Eventually, the Al levels in samples were analyzed by inductively coupled plasma atomic emission spectroscopy (ICP-AES).

 Al level was higher in the serum of the control group compared with UF patients (326.8 ± 360.8 µg/L vs. 211.2 ± 56.4 µg/L, P =0.310). Al level was higher in the control group compared with the normal tissue of UF patients (410.2 ± 244.7 µg/L vs. 300 ± 138.0 µg/L, P=0.465). Besides, leiomyoma had a higher Al level compared with the normal tissue of UF patients (1482.2 ± 2062.9 µg/L vs. 300 ± 138.0 µg/L, P=0.138).

The results showed that Al levels of tissue and serum samples in various groups differed, but these differences were not statistically significant.

 Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis lesions in laparoscopic surgery.

 In this cross-sectional study, 557 endometriosis patients who referred to the gynecology department of Shohadaye-Tajrish Hospital and underwent laparoscopic surgery during 2016-2021 were evaluated. Statistical analysis of data was done using SPSS software version 24.P-value less than 0.05 was considered statistically significant level.

 The results of this study show that the highest anatomical distribution of endometriosis lesions was ovarian endometriosis, and the lowest was vagina. Also, the highest rate of surface lesions is uterus and bladder, and the lowest is superficial lesions of the cul-de-sac cyst.

Our results demonstrate that the distribution of endometriosis lesions is asymmetric.

 The birth of a baby with a low birth-weight (LBW), which has numerous consequences, is one of the most significant problems associated with childbirth. By evaluating the factors influencing LBW in infants, therapeutic interventions can be improved to mitigate its effects. In this regard, the present study aims to identify the causes of LBW in infants and assess these causes' impact.

 In the current retrospective observational study, the required data regarding demographic variables and history of pregnancy and childbirth was extracted from 730 electronic records of deliveries performed from Alwiyah Hospital for Obstetrics and Gynecology in Baghdad in 2021 involving infants with LBW. The SPSS.23 software,the t-test, independent t-test, and multiple logistic regression were used to analyze the data. The results' significance level was deemed to be less than 0.05.

 The multiple logistic regression analysis model included variables with a significance level of less than 0.05. The results show that the variables of mother's age at delivery, the number of babies born in the current delivery, history of infertility, and iron deficiency anemia increase the chances of LBW by 0.48, 3.12, 0.38, and 0.56, respectively, and had a significant relationship with LBW infants (P<0.001).

 Paying particular attention to the treatment and improvement of the practical factors in LBW before birth in pregnant women is crucial.

 Granulosa cells, the endometrium, and the placenta all play a role in the secretion of G-CSF in the reproductive tract. G-CSF affects immunological regulation, which is crucial for enhancing pregnancy viability and maintenance. To evaluate the effects of granulocyte-colony stimulating factor subcutaneous injection on the miscarriage rate, ongoing pregnancy rate, and livebirth rate after single and multiple doses of G-CSF factor.

 At the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies at Al-Nahrain University, a prospective comparison study with a random sample selection was conducted from December 2021 to December 2022. It included 121 infertile women who had previously unsuccessful intracytoplasmic sperm injection (ICSI) procedures and who had finished ICSI protocols and reached the embryo transfer day. Patients were divided into three groups on the day of the embryo transfer: The non-G-CSF group (49 patients) received no additional treatment; the single-G-CSF group (31 patients) received a single subcutaneous injection of granulocyte-colony stimulating factor one hour after embryo transfer; and the multiple-G-CSF group (41 patients) received weekly injections of G-CSF until a fetal heartbeat could be detected, starting one hour after the embryo transfer.

 The multiple G-CSF group had better results in the miscarriage rate, ongoing pregnancy rate, and livebirth rate (23.5%, 34.1%, and 31.7%, respectively) when compared to the single G-CSF group (42.9%, 16.1, and 12.9%, respectively) and the non-G-CSF group (37.5%, 12.2%, and 10.2%, respectively).

Multiple subcutaneous G-CSF doses can improve the miscarriage rate, ongoing pregnancy rate, and live birth rate. A single dose of G-CSF for infertile women has no appreciable benefits.

 Obstructive sleep apnoea (OSA) is characterised by repeated episodes of upper airway obstruction resulting in hypoxemia, hypercapnia and sleep fragmentation. It is intriguing to consider the consequences of these events on pregnancy outcomes. This study was conducted to determine the prevalence of obstructive sleep apnoea among pregnant women and its association with pregnancy outcomes.

 It has been found that subjects belonging to the age group 21-25 years had increased sleep disturbances and reduced quality of sleep. Also, pregnant women in the first trimester were found to have poor quality sleep.

 Pregnancy outcomes associated with OSA were found as high chance of caesarean section, gestational diabetes mellitus, Gestational hypertension, low birth weight and APGAR<7.

Hence, early detection and its prevention can improve the pregnancy outcomes.

 One of the most prevalent musculoskeletal issues during pregnancy is pelvic pain, which most pregnant women may experience to varying degrees. The current research aims to identify and evaluate the risk factors contributing to pelvic pain in pregnant women.

 The present case-control research was conducted on 180 pregnant women at Baghdad's Alwiyah Hospital for Obstetrics and Gynecology in 2022. For data collection, two questionnaires and a checklist were utilized. The questionnaires included demographic information about women and questions about risk factors, and the checklist included the results of women's examinations to identify risk factors. Using SPSS.23 software, the data were analyzed, and the statistical significance level of the results was considered less than 0.05.

 The results showed that from the demographic variables, only the age variable showed a statistically significant difference between the two groups (P<0.05). Also, evaluating the risk factors indicated a significant difference between the two groups for the baby's weight, back pain before pregnancy, and back pain in the previous pregnancy (P<0.001). Other demographic variables and risk factors did not significant difference between the two groups (P>0.05).

 The results demonstrated that identifying the risk factors could aid in managing aggravating pelvic pain factors during pregnancy and preventing movement restrictions in postpartum women.

Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain was taken on the 4th day after the operation due to the improvement of the patient's general conditions and no discharge. It is recommended to consider pelvic abscess in patients suffering from fever, pain, pelvic pressure, and diarrhea after pelvic surgeries. Early diagnosis and treatment will reduce mortality and disability in patients.

As widespread prophylaxis with anti-D Antibodies has dramatically diminished anti-D-associated hemolytic disease of the newborn (HDN), other antibodies-associated HDN has become relatively more significant. Two genes encode Rh proteins: the RhD gene coding for the D and the Rh CcEe gene coding for Cc Ee Antigens. D is a rare Rh phenotype in which RBCs lack Cc/Ee antigens while D antigen is strongly expressed. Anti R17 antibodies are important monomorphic antibodies acting against all previously mentioned antigens. It can pass through the placenta as a G immunoglobulin, leading to fetal or neonatal hemolysis. Here, we reported an immunized pregnant female with D- - phenotype and a history of intrauterine fetal death who had high titer of anti-Rh17 antibodies in her subsequent pregnancy. We would discuss our management strategy which led to good perinatal outcomes. To the best of our knowledge, this is the second case of HDN reported in English written literature in Iran.

Vaginismus is a medical condition characterized by involuntary tightening of the muscles around the vagina. This situation disrupts sexual relations and impacts the chances of pregnancy. This study explores the occurrence of pregnancy in women with vaginismus after treatment in 2022 in East Java Indonesia. There were 60 patients with a diagnosis of vaginismus in 2022. Married less than 1 year as many as 6 people (10%), 1-5 years as many as 49 people (82%), and more than 5 years as many as 5 people (8%). Management is carried out independently and collaboratively. The management is independent dilatation with the help of dilators, Botox injection, hymenectomy, and collaboration with psychiatrists and andrologists. Of the 60 patients who underwent anamnesis and physical examination, five patients successfully obtained pregnancy treated with Botox injections, independent dilatation or independent dilatation, and andrology consultation. Proper management of vaginismus can increase the chances of pregnancy.