Journal of Family and Reproductive Health
Volume:11 Issue: 4, Dec 2017

Serum Anti-Müllerian hormone (AMH) has been implicated in the pathogenesis of cardiovascular disease. Its prognostic value in determining the risk of developing preeclampsia remains, to date, unclear. The purpose of the present systematic review is to accumulate current evidence in this field.
We searched Medline (1966–2017), Scopus (2004–2017), Clinicaltrials.gov (2008–2017), EMBASE (1980-2017), LILACS (1986-2017) and Cochrane Central Register of Controlled Trials CENTRAL (1999-2017) databases.
Four studies were included in with a total number of 401 women. Among them 146 had preeclampsia while 232 were recruited as normotensive controls. Current data are suggestive of the potential predictive value of serum AMH as its levels seem to be lower among women that develop preeclampsia. One study reported that women with and AMH value below the 10th percentile of the studied population had a 3.3 increased risk of developing preeclampsia (OR 3.3, 95% CI 1.2–8.7, p = 0.01).
Taking in mind these findings, future studies are needed in this field to establish optimal cut-off values and evaluate the specificity and sensitivity of this biomarker during the first trimester of pregnancy.

This study aimed to evaluate the effect of auriculotherapy on labor pain, the length of the active phase, and episiotomy rate among reproductive aged Iranian women.
In this study, 80 women were assigned to two groups: auriculotherapy (n = 40) and control group (n = 40). Auriculotherapy was performed in the earlobe in the Zero, Shen Men, Uterus, Pelvic, Abdomen, Spleen, External genitalia, and Master cerebral regions in the cervix dilation of 4, 6, and 8 cm between uterine contractions. The control group received routine hospital care. The labor pain, duration of the active phase, and rate of episiotomy were assessed in two groups. The independent t- test and chi-square were used for statistical purposes.
The mean of labor pain during the active phase was 7.56 ± 0.83 in the auriculotherapy group and 8.43 ± 0.69 in the control group (p Auriculotherapy is safe, cost effective and devoid of side effects to reduce the labour pain, length of the active phase and the rate of episiotomy in nulliparous women. This method can be considered as a complementary medicine in labour.

Preterm delivery is a common and eventful phenomenon with long standing complications, heavily burdening the health system. Many risk factors have been suggested to increase the likelihood of this event, one being hypothyroidism and high levels of anti-thyroid antibodies. The present study sought to explore the association between hypothyroidism and anti-thyroid antibodies with preterm delivery.
A case control study was conducted on 400 patients attending Educational-Medical centers of Urmia University of Medical Sciences (Urmia, Iran) between November 2013 and April 2016, in which 200 patients with term deliveries and 200 patients with preterm deliveries were compared for differences in hypothyroidism, existence of anti- thyroperoxidase (TPO) antibodies based on blood samples obtained from the patients which were tested using chemi-luminescence method.
In the group of patients with preterm delivery, 85 patients had hypothyroidism (42.5%), and from the term delivery group, 67 patients (33.5%) had hypothyroidism, the difference was not statistically significant (p = 0.14). But, when groups of early and late preterm deliveries were compared in terms of having anti-TPO antibodies, there was a significant difference between them, with early preterm delivery having 8 patients positive out of 44 patients and late preterm delivery having 7 positives out of 141 patients (p = 0.004).
Hypothyroidism had an insignificant effect on preterm delivery rates, but the existence of anti–TPO antibodies in the serum had a significant increasing effect on early preterm deliveries and could be regarded as a risk factor.

This cross sectional study aims to survey developing feeding disorders and nutritional deficiencies disorders in children with neurodevelopmental disorders such as cerebral palsy.
A total of 50 children (28 boys and 22 girls) with cerebral palsy and symptoms suggesting gastrointestinal problems such as choking, recurrent pneumonia and poor weight gain, who referred to the Pediatric department of Vali-asr Hospital, Imam Khomeini hospital complex between 1 October 2012 and 30 October 2013, were checked. Motor function classification system was used to classify patient's functional gross motor severity. All patients were examined and underwent deglutition videofluroscopy (modified barium swallow) and upper GI endoscopy with esophageal biopsies. Outcome of this study was the prevalence of oropharyngeal incoordination and GERD. Its relationship with some variables like motor and cognitive developmental delay were analyzed and p value Prevalence of GERD was 66% and oropharyngeal dysphagia was estimated 82%. According to results of video-fluroscopy and endoscopic biopsies, 52% of patients were affected by both GERD and oropharyngeal dysfunction. The gross motor function disability was the only variable that significantly related to the prevalence of feeding disorders (p = 0.015). Despite nutritional rehabilitation only 46% of children have weight gain.
Feeding disorders such as GERD and oropharyngeal dysfunction are more prevalent in children with cerebral palsy especially in children with severe gross motor disabilities. Since, clinical manifestations of these disorders can be similar accurate diagnostic methods should be selected for all children with cerebral palsy and gastrointestinal symptoms. Treatment should start early to reduce the complications and improve outcomes.

This study aimed to report on perceived stigma by PLWH and factors that affect it.
A cross-sectional study was carried out on 120 PLWH in Qom, Iran from November 2015 to April 2016. Persian version of Fife and Wright's scale was used to measure perceived stigma.
The mean score of stigma was 73.19 ± 12.23 (range: 48-97). The means of external stigma and internal stigma were 43.70 ± 8.61 (range: 19-60), and 29.49 ± 5.32 (range: 17-40), respectively. Living in a rural areas (β = 10.341, p = 0.006), unemployment status (β = 6.910, p = 0.006), and poor support from family members (β = 4.772, p = 0.028) significantly increased the level of perceived stigma. PLWH experience a considerable level of stigma in their daily life. Mass media involvement to increase public awareness and reduce HIV related stigma need be more highlighted.
Working with the patient's families, interventions in the rural areas and workplaces, and providing social supports is necessary to minimize the HIV related stigma.

Investigate the health literacy of pregnant women in the south of Iran.
The present descriptive-analytical study was conducted on 775 pregnant women in the south of Iran (including Boushehr, Ahvaz, Zahedan and Bandar Abbas cities) through the clustering sample selection method. The data were collected through the Test of Functional Health Literacy in Adults: TOFHLA, and were analyzed statistically via SPSS 16 through independent-sample t-test and ANOVA.
The average age of the subjects was 31.89 ± 7.54 years. The results indicated that 15.5% of the subjects had an inadequate level of health literacy; 41.7% had a border-line level of health literacy, and 42.8% had an adequate level of literacy. Significant correlations were found between each of these variables and the subjects’ level of health literacy: education, age, occupation and care provision during pregnancy (p 0.05). The highest mean score of health literacy belonged to Ahvaz while the lowest belonged to Boushehr.
According to the results, the health literacy level of pregnant women in the target geographical areas showed to be inadequate or on a border-line. Moreover, subjects’ education, age and occupation showed to be significantly correlated with health literacy. Therefore, promoting pregnant women’s health literacy through simplifying health-related information, use of audio-visual media, improving communicative skills among the health staff and mothers can be effective.

To evaluate the relationship between maternal serum levels of pregnancy-associated-plasma-protein-A (PAPP-A) and β-human-chorionic-gonadotropin (β-hCG) and pregnancy complications.
This is a case-control study conducted during 2015- 2016. Women at their first pregnancy were enrolled and serum PAPP-A and free-β-hCG were measured in 9-14 weeks of gestation. They were followed till the end of pregnancylooking for complications including preterm labor, pregnancy induced hypertension (PIH), abortion, and intra-uterine growth retardation (IUGR).
A total of 1070 pregnant women (mean age: 28.64 ± 4.95 years) were enrolled. Low serum levels of PAPP-A were more frequent in patients developing IUGR (17.4% versus 1.2%, p 0.05).
There is an association between low serum levels of PAPP-A and developing IUGR, preterm labor, and PIH.

To report a case of Successful Pregnancy Outcome in Recurrent Ovarian Cancer in a 26 year Old.
Case Report: A 26 years old primigravida presented in antenatal clinic at 23 weeks of pregnancy with recurrence of ovarian cancer of mucinous type. Following refusal of surgical management, two courses of single dose carboplatin was administered. However, before third cycle of chemotherapy could be administered ,there was deranged liver functions tests, following which elective Cesarean section with staging laparotomy was planned at 34 weeks for breech presentation with oligohydramnios. A live healthy baby girl 2.3kg was delivered. Total abdominal hysterectomy with right salpingo-oopherectomy, infracolic omentectomy, appendectomy was done. The final diagnosis was recurrent mucinous ovarian adenocarcinoma. Postoperatively, she was given six cycles of chemotherapy (carboplatin and paclitaxel).
Chemotherapy and surgery, both are safe beyond first trimester and multidisciplinary treatment must be planned after taking into account the wishes of couple.