Journal of Obstetrics, Gynecology and Cancer Research
Volume:10 Issue: 3, May-Jun 2025

Although hysteroscopic myomectomy as a safe and effective intervention is recommended for myoma resection, its effect on infertile patients who need the ICSI or IUI is not clearly defined. The present study was conducted aimed to evaluate the effect of hysteroscopic myomectomy on the outcome of pregnancy in in infertile patients who were candidates for IUI, ICSI, and FET cycles.

In this cohort study, 330 women underwent hysteroscopic myomectomy, of them 204 patients had history of infertility and 154 were candidates for ICSI cycles, 33 for FET cycles, and 17 for IUI cycles  at two tertiary teaching hospital and Royan institute between February 2008-February2012. Primary outcomes were chemical and clinical pregnancy rates.

Among 204 patients with a history of infertility, 116 (75.4%) had primary and 38 (24.6%) secondary infertility. In ICSI group, 129 patients had one myoma, 18 cases two myoma, 5 cases three myoma and 2 cases had five intracavitary myoma. In FET group, there were 27 cases with one and 6 cases with two intracavitary myoma. In IUI group, there were 15 cases with one and two cases with two intracavitary myoma. In the ICSI group, there were 17% clinical pregnancy, 1% missed abortion, 4% blighted ovum, and 2% chemical pregnancy. In FET group, the clinical pregnancy was detected in 28.6% of women including 7 clinical pregnancy, one blighted ovum and one chemical pregnancy. In IUI group, pregnancy failure rate was 100%.

Hysteroscopic myomectomy in addition to a safe and effective intervention for myoma resection, can improve pregnancy outcomes in infertile women.

PCOS is a common disease affecting females of childbearing age. It is the most common cause of infertility, in addition to other diseases like cardiovascular diseases (CVD). The present study was conducted with aim to predict CVD as a complication in PCOS by identifying the omentin-1 and the lipid profile.

The study consists of 58 patients with PCOS. The subjects were divided into two subgroups according to AIP: (1st group (G1) was PCOS patient with AIP<0.5) and 2nd group (G2) is PCOS patient with AIP ≥ 0.5), and 30 apparently control female. ELISA technique was used to evaluate the level of serum hormones, fasting insulin, and omintin-1. The spectrophotometric methods were used to measure levels of lipid profile, and FSG was performed in all groups.

There was a significant increase in mean levels of glucose, insulin, IR, LH, LH / FSH ratio Testosterone and lipid profile in PCOS groups compared to the control group, except omentin-1 and HDL-C showed significant decrease in the PCOS patients’ groups when compared to control group (P0.0001). G2 group showed significant decrease in omentin-1 levels than G1 group (49.24±1.44 ng/ml vs. 88.32±2.32 ng/ml). The association between omentin-1 levels and CVD remained significant after adjusting for major risk factors in a multivariate analysis. ROC curve based on omentin-1 levels to predict the existence of CVD in PCOS patients was 0.831.

The decreasing of omentin-1 may be added to an expanded danger of CVD in PCOS patient who had (AIP ≥ 0.5), although referred to the risk factors, e.g. HOMA-IR, dyslipidemia.

This study aims to analyze the survival outcomes and prognostic factors of patients with uterine sarcoma in the Department of Gynae-Oncology, between June 2015 and December 2022.

The study population consists of patients with histopathologically confirmed uterine sarcoma. The oncological data collected includes stage, pathological report, date and type of surgery, adjuvant therapy, recurrence, and mortality. Kaplan-Meier analysis used to estimate survival.

We identified 58 eligible uterine sarcoma patients: 13 leiomyosarcoma (22.4%), nine endometrial stromal sarcoma (15.5%), 32 carcinosarcoma (55.2%), two adenosarcoma (3.4%) and another two were undifferentiated sarcoma (3.4%). Mean age was 56.1 (SD=12.03) and 56% of patients were postmenopausal. Majority of patients presented in stage III and IV (53.4%) and only 22 patients (37.9%) in stage I. Adjuvant radiotherapy was given to 21 patients (36.2%); eight patients (13.8%) received chemotherapy, and nine patients (15.5%) received both radiotherapy and chemotherapy. The median follow-up period was 13.5 months (range: 73 months) and total of 35 patients (60.3%) had recurrence with median time to recurrence of 6.0 months (range: 35). Death occurred in 21 patients (36.2%) with median time to death 5.0 months (range: 36 months). Progression free survival (PFS) among all patients was 26.64 (range: 4.32) months with significant correlation with stage of disease. Overall survival (OS) in patients received surgery only, radiotherapy and combined radiotherapy and chemotherapy were 23.3, 54.8 and 62.4 months respectively (P. value 0.03).

Uterine sarcoma is a relatively rare tumor type with poor survival. Multimodality adjuvant treatments were shown to improve prognosis in those patients.

Endometriosis is a chronic gynecological condition affecting approximately 10% of women of reproductive age. Chronic pelvic pain is a common symptom of endometriosis which significantly impacts on a woman's quality of life, including sexual satisfaction. Botulinum toxin injection has been used as a treatment for chronic pelvic pain in endometriosis, but its effect on sexual satisfaction is not well understood. The present study was conducted with aim to investigate the effect of botulinum on chronic pelvic pain and sexual satisfaction in women with endometriosis.

This randomized controlled trial study was conducted on 32 women with endometriosis who were randomly assigned to receive either botulinum toxin injection or placebo. The primary outcome was a change in chronic pelvic pain assessed using the visual analog scale (VAS) at one month after treatment. Secondary outcome included changes in sexual satisfaction assessed using the Female Sexual Function Index (FSFI) at one month after treatment.

The botulinum toxin injection significantly reduced chronic pelvic pain compared to placebo at one month after treatment (P<0.001). There was also a significant improvement in sexual satisfaction in the botulinum toxin group compared to placebo at one month after treatment (P=0.001).

Botulinum toxin injection in women with endometriosis may be an effective treatment option for chronic pelvic pain and improving sexual satisfaction.

Cervical cancer is one of the most common cancers among women, and because of the origination from precancerous lesions, its mortality can be reduced by using appropriate screening methods and early detection.

This cross-sectional study was done in 2021-2022 at the Colposcopy Clinic of Shahid Beheshti Hospital, Isfahan. Patient with abnormal Pap smear or positive HPV test was referred to be examined with colposcopy. The information and history of the patients were collected by the intern of the clinic in pre-prepared files, and after the examination of patient by a gynecology oncology specialist, colposcopy and biopsy was performed if necessary. Then, the results were compared.

For one year, 648 patients underwent colposcopy, and their mean age was 34.14 ± 8.88 years. Among them, 486 people had normal colposcopy (75.9%) and 154 people had suspicious colposcopy (24.1%) and underwent biopsy. The most complains among women were pain (40.6%), postcoital bleeding (38.7%), and vaginal discharge (30%), respectively.

In the current study, according to the significant concordance of Acetowhite and Punctuation lesion with a precancerous and cancerous lesion, it can be concluded that the appearance of Acetowhite and Punctuation view in colposcopy is more likely to indicate a serious lesion. Also, the existence of two or three views in a patient together does not have more diagnostic value than one view for example Acetowhite or Punctuation alone.

Adolescent pregnancy defines as "The pregnancy of a female aged 10-19 years”. This is considered to be her age when she gave birth to her first child. The object of the study is to find out the association between the adolescent pregnancy and the normal age pregnancy with in relation to the neonate outcome.

Descriptive observational, Case-control Study was conducted between 18th January 2021 to 29th September 2021. Researchers studied all 654 pregnant patients at Kirkuk's Azady Teaching Hospital, from admission through labor and delivery, after they were randomly selected.

Adolescent mom had a higher incidence rate than adult mom regarding  Low birth weight (13.3% vs 8.7 %), Fetal distress (30.7% vs.25.2% ) ,and the rate of Respiratory distress (10.6% vs.10.1%), Asphyxia (3.7vs. 2.8%), Preterm(17.0% vs 6.0%), Congenital anomalies(4.1% vs1.4%), Stillbirth (5.5% vs 0.9%), Early neonate death(3.2% vs 1.8%), Admission to NICU (42.2% vs 27.5%).

This study clearly demonstrates that, in comparison to adult mothers, teenage moms were more susceptible to difficulties during labor and delivery. Adolescent pregnancy rates may be decreased by using specific techniques.

Immunocompromised patients and those receiving immunosuppressive treatments are more prone to severe forms of COVID-19 disease. Moreover, these patients may have asymptomatic SARS-CoV-2 infection, which could make the diagnosis challenging. It is thus crucial to accurately determine the prevalence of SARS-CoV-2 infection, and its association with clinical outcomes. This study aimed to evaluate SARS-CoV-2 IgM and IgG antibody serum levels in patients with gynecologic malignancies undergoing chemotherapy.

In this longitudinal study, all patients with gynecologic malignancies who were undergoing chemotherapy in the Gynecology and Obstetrics ward of Ghaem Hospital, Iran, were enrolled. Patients’ demographic data were extracted from the electronic archives. Levels of SARS-CoV-2 IgG and IgM antibodies were assessed in patients, once on the first day of hospitalization and once again two weeks later. Patients were also tested for COVID-19 PCR before hospitalization, or concurrently with antibody testing.

38 patients with a mean age of 49.08 ± 16.74 years were studied. 86.8% of patients had ovarian cancers, 44.7% were undergoing chemotherapy in a neoadjuvant setting, and 23.7% were being treated due to recurrence. TC was the most frequently employed chemotherapy regime, used in 68.4% of cases. Only one patient (2.6%) reported clinical symptoms of covid-19 infection (fever).Covid-19 PCR was positive in 2 (5.3%). First IgM levels were positive in all patients (94.7% low), while second IgM levels were negative in 89.5%. First IgG levels were positive in all patients (76.3% low), and second IgG levels were negative in 89.5%.

This research provided valuable data on the SARS-COV-2 seropositivity in patients with gynecologic malignancies. However, our study was limited by the small population size and lack of patients with clinical symptoms and positive PCR for COVID-19. Further studies are warranted to illuminate the relationship between SARS-COV-2 seropositivity and clinical outcomes.

Placenta accreta is a serious condition associated with abnormal placental attachment, leading to significant maternal and fetal complications. This study was performed with aim to explore the relationship between assisted reproductive technology (ART) related pregnancy and the incidence of placenta accreta, as well as to identify demographic characteristics and potential risk factors associated with this condition.

This retrospective cross-sectional study was conducted on 22,413 women who underwent vaginal or cesarean delivery at Imam Khomeini Hospital in Ahvaz, Iran, from 2019 to 2022. Data were collected using a researcher-made checklist, which included demographic information and details regarding current and previous pregnancies. The student t-test and chi-square tests were used for comparison of medical and demographic characteristics between patients with and without placenta accreta. P<0.05 was considered statistically significant.

The rate of placenta accreta was significantly higher in IVF pregnancies (P=0.047). In patients with placenta accreta, 35.11% had a history of abortion compared to only 3.25% in the patients without accreta (P<0.001). Additionally, 80.85% of those with placenta accreta had placenta previa, whereas only 0.57% of those without this condition (P<0.001). Additionally, patients with placenta accreta had a higher mean number of previous cesarean deliveries (2.43 ± 1.001 vs. 0.71 ± 0.037, P<0.001) and the mean number of gestations (4.08 ± 1.33 vs. 2.16 ± 0.086, P<0.001).

The findings of the present study demonstrated that IVF pregnancies have a higher incidence of placenta accreta. Furthermore, advanced maternal age, higher number of gestations, history of abortion, presence of placenta previa, and previous cesarean deliveries were associated with placenta accreta.

Neoadjuvant chemotherapy (NACT) is used to treat advanced or irreversible breast cancer tumors and increases the possibility of Breast-conserving surgery. There is evidence that pathological complete response (pCR) after NACT reduces the risk of recurrence and increases survival. This study aimed to investigate the factors affecting the pathological complete response in breast cancer patients treated with NACT.

We identified non-metastatic breast cancer patients receiving NACT during 2010–2020. Patients’ and disease characteristics, rates of pCR based on these characteristics were recorded in different subgroups. Analyzes were performed by descriptive and analytical statistics using SPSS.ver26 (IBM, USA).

204 patients had mean age of 45.3 years, 32.4% had grade 3, and 89.7% had ductal histology. Overall pCR rate was 33.3% and differed according to disease subtype (P<0.001), receptor status (P<0.001), grade (P=0.015), ki-67 (P=0.004), but not according to age, BMI, menopausal status, tumor size, surgery type after NACT.

In our study, pCR rates are conformed with other studies. Many patients have residual disease following NACT that suggests lower survival or higher risk of recurrence, therefore determining the factors affecting the pathological complete response can help physicians in treatment decisions.

Anemia is major public health problem throughout the world and the commonest cause behind it is iron deficiency. Oral iron intake is the treatment of choice, but parenteral administration of iron is necessary under certain circumstances like intolerance to oral iron or pregnancy near term. The objective of present study is to compare the efficacy and safety of parenteral Iron Sucrose to Ferric Carboxymaltose in improving the hematological indices in anemic pregnant women.

The study was a comparative, observational study conducted at Department of Obstetrics and Gynecology, Shri Guru Ram Rai Institute of Health and Medical Sciences, Dehradun from September 2018 to May 2020. Sample size was 120 pregnant women with iron deficiency anemia in each group. One group was treated with intravenous Iron Sucrose and other group was treated with intravenous Ferric Carboxymaltose after calculation of total iron dose. Hematological tests were repeated at day 14th and 28th of the treatment. Outcome was measured by improvement in hematological parameters and experienced side effects. Data was analyzed by using appropriate statistical tests.

According to our study, both groups were comparable in term of sociodemographic features and baseline hematological parameters.  Hemoglobin rise was more and rapid in group treated with ferric carboxymaltose (8.7 ± 0.47 g/dl to 11.6 ± 0.77 g/dl) than the iron sucrose (8.24 ± 0.57 g/dl to 10.60 ± 0.87g/dl) group. Rise in serum ferritin and MCV of RBC were also more in ferric carboxymaltose group than the iron sucrose group. Both groups have only minimal and mild side effects, but side effects were more in iron sucrose group than iron carboxymaltose group.

Hence we can conclude by our study that parenteral therapy with iron sucrose and carboxymaltose, both are able to successfully treat iron deficiency anemia in pregnancy but the improvement is faster, safer and more convenient with the use of ferric carboxymaltose than iron sucrose.

Degenerated Uterine Leiomyomas (ULs) is one of the most common complications of UL in pregnancy that may cause severe maternal symptoms. In this study, we present a rare case of UL permagna with cystic degeneration managed with Caesarean Section (CS) and myomectomy with uterus preservation.

A 37-year-old primigravid woman was referred to the clinic with the chief complaint of huge abdominal mass that coincides with pregnancy. Physical examination showed that the abdomen was overdistended and upon palpation a mass was felt at processus xiphoideus height. Ultrasound examination showed that the foetus had IUGR (Estimated Fetal Weight below the 10th percentile of the fetal growth curve with oligohidramnion) and a cystic mass with a clear border was found. The patient was diagnosed with cystic degeneration of UL premagna and IUGR. The first-line management was CS and myomectomy as an effort to maintain the uterus because is the patient was a case of pregnancy with 15 years primary infertility. The overall outcome was satisfactory. The neonate was born alive, Ballard score equivalent to 32 weeks, and weighing around 1480g. The degenerated UL was successfully extracted. The patient was discharged 4 days post-operatively. The baby was treated in the NICU for prematurity and discharged after the baby's weight reached 1800 gr.

Degenerated UL permagna in pregnancy is a very rare and serious condition. It needs to be studied further as there are no global consensus on how to manage such cases.