مجله زنان مامائی و نازائی ایران
سال بیست و هفتم شماره 1 (فروردین 1403)

Continuation of the disease after cervical conization is probable. Knowing the risk factors involved can facilitate the selection of treatment methods and appropriate follow-up; therefore, this study was conducted with aim to determine the factors related to the remaining positive margin after cervical conization.

In this retrospective cross-sectional analytical study, the clinical records of all women ≥ 18 years with intra-epithelial neoplasia (CIN) type 3 who underwent cervical conization in Imam Hossein (A) Hospital of Tehran (2017-2022) were selected by total population sampling and effective factors on the condition of the internal margin after cervical conization were investigated. The data was analyzed by SPSS software (version 23) and t and Mann-Whitney statistical tests. P<0.05 was considered statistically significant.

In this study, 100 people were investigated that a positive margin was found in 27 people (0.27%). Human papillovirus (HPV) infection (OR = 1.810, 95% CI = 0.071-2.74, P = 0.001), old age (OR = 0.630, 95% CI = 0.092-1.02, P = 0.002) and menopause (OR = 0.815, 95% CI = 0.096-1.32, P = 0.004), respectively with the highest chance had increased the possibility of a positive margin after cervical conization.

Old age, menopause and HPV infection are among the risk factors of positive margin after cervical cone removal.

Considering the prevalence of high-risk pregnancies in developing countries, the increase in maternal and fetal morbidity and mortality, as well as the adverse effects of these pregnancies on the mental health of couples، it is necessary to understand the experience of high-risk pregnancy in couples. Since one of the most realistic ways to achieve the challenges ahead is to use people's own experiences, this study was conducted with aim to explain the experience of couples with high-risk pregnancies.

 This qualitative study was conducted in 2018 on couples with high-risk pregnancies in the health centers and Sayad Hospital in Gorgan. The participants were selected in a purposeful way and with maximum diversity for structured in-depth interviews. Guba and Lincoln criteria were used for data accuracy. The data collection and analysis was done simultaneously based on the contract qualitative content analysis process based on Granheim's method and by MAXQDA software (version 10).

 Totally, 23 couples with high-risk pregnancies participated. The age range of women was 20-45 years and men were 22-52 years. The contents included the concern and fear of couples for maternal and fetal health, the way to deal with the problem, and need to comprehensive services and support of the relatives.

 Considering the worry about maternal and fetal health and the lack of comprehensive services, paying attention to increasing information and acquiring skills to cope with problems and a healthy lifestyle in couples, as well as providing comprehensive supportive services and support of the relatives is required in order to couples have a good experience of high-risk pregnancy by reducing high-risk pregnancy complications.

Considering the high prevalence of cesarean section and the methods of conducting it, this study was performed with aim to determine the relationship between rectus ablation in cesarean section and postoperative pain, thickness and distance of abdominal wall muscles.

This randomized controlled clinical trial study was conducted in 2022 80 pregnant women candidates for caesarean section referred to the Ayatollah Taleghani hospital in Tehran. The subjects were randomly divided into two groups of intervention (n=40, rectus muscle repair) and control (n=40). Pain, thickness and distance of abdominal wall muscles were evaluated. Patients' pain in the first 72 hours after entering recovery (12, 24 and 72 hours after surgery) as well as pain when leaving the bed and pain in the interval of one week after surgery was measured using the visual pain index (VAS). Data were analyzed using SPSS software (version 23) and Shipro-Wilk, t-test, Mann-Whitney and Chi-square tests. P<0.05 was considered statistically significant.

The intensity of pain in the control group compared to the intervention, when getting out of bed (P<0.001) and at 12 hours (P<0.001), 24 hours (P<0.001), 72 hours (P<0.001) and one week later (P<0.001) was lower. In the intervention group compared to the control, the need for painkillers was more (P=0.001) and diastasis recti in the epigastric area (P<0.001) and hypogaster (P<0.001) were lower.

The re-approximation of rectus abdominis muscle during cesarean section reduces the thickness of the abdominal wall muscles and diastasis recti, but on the other hand, it increases the amount of pain and the need for painkillers.

The present study was conducted with aim to investigate the expression of the CYFIP1 gene in the umbilical cord blood (UCB) of newborns and its possible relationship with different categories of pre-pregnancy maternal body mass index (BMI), lipid profile, birth weight and infant status for gestational age.

This cross-sectional study was conducted from 2020 to 2021 on UCB of 118 male newborns from Mousavi and Bahman hospitals in Zanjan. According to pre-pregnancy BMI, women were divided into three groups: normal, overweight and obese. Each UCB sample was divided into two parts. A part was used to analyze the lipid profile including low-density lipoprotein (LDL), triglyceride (TG), total cholesterol (TC) and high-density lipoprotein (HDL). mRNA extraction of peripheral blood mononuclear cells was performed to investigate the expression of CYFIP1 gene. Data were analyzed using SPSS statistical software (version 21) and Pearson's correlation test. P<0.05 was considered statistically significant.

The expression of the CYFIP1 gene was elevated in UCB from women classified as overweight or obese compared to those with normal weight (p=0.001). UCB of obese women exhibited higher cholesterol and LDL levels compared to normal-weight and overweight women (p=0.001). Positive correlations were observed between pre-pregnancy maternal BMI and cord blood CYFIP1 gene expression (r=0.333, p=0.0001), as well as cholesterol (r=0.520, p=0.0001), TG (r=0.290, p=0.001), LDL (r=0.397, p=0.0001), and birth weight of infants categorized based on gender and gestational age (r=0.262, p=0.001).

Increased expression of CYFIP1 gene is correlated positively with different categories of pre-pregnancy BMI and lipid profile, implying that regarding the role of CYFIP1 gene in brain development, the risk factors contributing to increasing BMI may have negative consequences on fetal health and development.

An increase in appetite and lack of enough movement accelerates the process of contracting chronic diseases, including diabetes, so the present study was conducted with aim to investigate the effect of 12 weeks of Pilates exercises on ghrelin serum levels and appetite in women with type 2 diabetes.

This experimental study was conducted on women with type 2 diabetes (from the Najafabad Diabetes Association) with an age range of 35 to 55 years in Najafabad city. People were randomly divided into experimental and control groups. The first group performed Pilates exercises for 12 weeks incrementally, 3 sessions a week and each session lasted 50 minutes, and for the control group who continued the routine life program, before and after the implementation of the exercise protocol, blood was taken and ghrelin was measured by Eliza method. Data was analyzed by SPSS software (version 22) and Mann-Whitney test. P<0.05 was considered statistically significant.

The result showed that performing 12 weeks of Pilates exercises was significant on the serum level of ghrelin (P≤0.001), feelings of hunger (P≤0.001), feelings of fullness (P≤0.001), feelings of satiety (P≤0.001) and feeling of desire for food (P≤0.001) in women with type 2 diabetes.

Pilates exercises can improve the serum level of ghrelin and appetite, therefore Pilates exercises may be an effective treatment method for women with type 2 diabetes.

With the increasing use of medicinal plants in the treatment of some diseases, studying their side effects is very important. One of these herbal medicines is fennel that various results have been reported regarding its side-effects on the amount of menstrual bleeding, therefore, the present research was conducted with aim to investigate the effect of fennel on the amount and duration of menstrual bleeding.

This quasi-experimental study was performed in 2016 on 50 students with primary dysmenorrhea living in the dormitories of Islamic Azad University, Ardabil. Participants were examined in three consecutive menstrual cycles. In the first cycle, participants did not take any medication; in the second and third cycles, in the first 3 days of menstruation they used fennel of 3-5 drops in water or tea three times a day. The standard Higham chart was used to determine the amount and duration of bleeding. Data was analyzed by SPSS software (version 17) and Paired-t test. P<0.05 was considered statistically significant.

The mean amount of bleeding before consuming fennel was 46.7±24.8 and in two consecutive cycles after consuming fennel were 48.4±26.2 and 49.5±24.3, respectively, which was not statistically significant. Moreover, no significant difference was observed in the duration of menstrual bleeding before the treatment (6.13±1.33) compared to two consecutive cycles after fennel consuming (6.82±1.45 and 6.26±1.02) (P>0.005).

In the present study, fennel consumption had no effect on the amount and duration of menstrual bleeding. To determine the definitive result and the safety use of fennel, conducting more studies is recommended.

Changes in the activity of the gene encoding internal rectifier potassium inwardly rectifying channel, subfamily J, member 11 (KCNJ11), due to some polymorphisms of this gene have far-reaching effects on the metabolic processes of people with gestational diabetes mellitus (GDM). This systematic review and meta-analysis were conducted with aim to further evaluate the association between the KCNJ11 (rs5219) polymorphism and GDM. 

In this systematic review and meta-analysis, a literature search was performed to identify the relevant articles in electronic databases such as PubMed, Web of Science, Scopus, Cochrane, EMBASE, and some Persian-language databases. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the association between KCNJ11 (rs5219) polymorphisms and susceptibility to GDM in four genetic models.

A total of 5578 participants from six articles were included in the meta-analysis. A significant relationship was identified between the KCNJ11 (rs5219) gene polymorphism and GDM in the study population through an additive genetic model (OR = 1.14; 95%CI: 1.00–1.30; P = 0.049) and a recessive genetic model (OR = 0.86; 95% CI: 0.75–0.98; P = 0.033). On the contrary, there was no significant association between the KCNJ11 (rs5219) gene polymorphism and GDM in an allelic genetic model (OR = 1.25; 95%CI: 0.93–1.69; P = 0.136) and the dominant genetic model (OR = 1.15; 95% CI: 0.94–1.41; P = 0.157).

The KCNJ11 gene polymorphism (rs5219) is associated with susceptibility to GDM in women. However, more studies on different ethnicities are required to confirm our results.

Ovarian granulosa cell tumors (GCT) include 2-3% of ovarian cancers. This study reported a rare case of granulosa at the age of 35 with early recurrence in sigmoid colon.

A 35-year-old female, Noli Gravid, with a history of primary infertility and a complaint of abdominal pain referred to Ghaem Hospital in Mashhad, Iran. With the diagnosis of ovarian mass, she underwent laparotomy. The intraoperative frozen examination was for an ovarian granulosa tumor. Right salpingo-opheretomy with surgical staging and endometrial curettage were done. The final pathology was adult-type granulosa tumor and other samples were normal. Three cycles of chemotherapy were performed. After 18 months of non-follow up, she returned with a complaint of abdominal pain. An 8 cm mass on the left side of the pelvis was reported. She was candidate for surgery. There was a mass attached to the mesenter of the sigmoid colon which was resected and sent for frozen. Frozen analysis reported the recurrence of the granulosa tumor. A total hysterectomy with a left salpingo-oophorectomy was performed. Then she underwent pelvic radiotherapy.

Recurrence is the main cause of patients' death. Due to late recurrence, patients should be trained to pay attention to the symptoms of recurrence in order to cooperate in long-term follow-up for early diagnosis of recurrence band treatment. Considering the rare cases of extra-pelvic and extra-genital recurrences, there is a need for new treatment strategies to be carried out in the form of clinical trials to improve the quality of life of patients and prevent frequent recurrences leading to their mortality.