فهرست مطالب
International Journal of Women’s Health and Reproduction Sciences
Volume:5 Issue: 2, Spring 2017
- تاریخ انتشار: 1395/12/18
- تعداد عناوین: 13
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Pages 82-89ObjectivesThe rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. With the growing application of imaging techniques, however, all normal and abnormal implantations can now be detected early. This review article tries to assess a workup of all localizations of human ectopic pregnancies.Materials And MethodsAll diagnostic and therapeutic modalities from the non-medical conservative method, to the medical non-surgical options through to the surgical laparoscopic approach for the treatment of ectopic pregnancies are assessed in this review.ResultsObservational treatment: Monitoring HCG levels until tubal abortion or resorption is a treatment option with the risk of failure and requires patience from the patient and the treating physician. Medical treatment: The predominant drug is methotrexate but other systemic drugs, such as actinomycin D, prostaglandins and RU 486, can also be applied. Surgical treatment: In the case of tubal pregnancies, salpingotomy, partial salpingectomy followed by laparoscopic anastomosis or fimbrial milking is performed to preserve tubal function. According to their localization non-tubal ectopic pregnancies (ovarian pregnancy, ectopic abdominal pregnancy, interstitial or cornual pregnancy/rudimentary horn, intraligamental and cervical pregnancies) all require their own specific treatment.ConclusionToday, ectopic pregnancies are diagnosed early enough to be treated effectively by laparoscopic surgery. In 5%15% of women the remaining positive HCG values in serum after treatment refer to remnant conception products and may be treated with a final methotrexate injection or expectantly.Keywords: Ectopic pregnancy, Laparoscopy, Methotrexate, Tubal function, Non, tubal ectopic pregnancy, Early diagnosis, Individualized treatment
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Pages 90-96ObjectivesAwareness about the causes for excessive vaginal discharge is very important to detect pathological entities from physiological forms in early stages to prevent associated complications. This study was aimed to describe knowledge and experience related to vaginal discharge among females aged 18 to 49 years living in estate communities in the Colombo District, Sri Lanka.Materials And MethodsThis was a community based cross-sectional study of 550 females using an interviewer-administered questionnaire. Both descriptive and chi square analysis were used for data analysis.ResultsNearly 78% of the participants were Tamil (n = 428) and the mean age was 33.8 (SD: ±8.15) years. For the knowledge on vaginal discharge, 98.5% had obtainedConclusionMajority of the study participants had poor knowledge on vaginal discharge displaying the inability to differentiate normal from abnormal. It is recommended to increase awareness to improve health seeking behaviour towards excessive vaginal discharge.Keywords: Health, Knowledge, Vaginal discharge
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Pages 97-102ObjectivesInfertility is the absence of pregnancy after 1 year of intercourse without contraceptive methods. This research aimed at exploring primary factors leading to surrogacy.Materials And MethodsThe present qualitative study was based on phenomenology approach. Participants were pregnant surrogate mothers referring to Isfahan Fertility and Infertility Center in 2014. Sampling was conducted using purposeful method through which 5 women were selected. Data collection was done utilizing deep and unstructured interviews which were then analyzed based on Colaizzi method. Reliability and validity of this study consisted of 4 elements including dependability, credibility, transfer-ability and confirm ability.ResultsThe mean age ± standard error (SE) of participants was 32.4±0.4 years. Overall, after analyzing the interviews, 74 primary codes associated with leading factors of surrogacy were extracted. The primary codes were categorized into 7 subthemes, namely, life background, failures and ineffective efforts to improve life, economical impasse, seeking independence, altruism, compulsion, sin atonement and making a trade with God. Finally, these 7 subthemes were integrated and the theme of primary factors leading to surrogacy was made.ConclusionCare and support systems should be invigorated in Iran so that derelict women could have insurance and are not compelled to donate ovum or undertake surrogacy several times. Exploitation of these women should be prevented and harm to human dignity must not happen.Keywords: Infertility, Surrogate mothers, Qualitative research
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Pages 103-106ObjectivesGlycodelin is a factor which regulates immunological activity and is required in implantation window. The present study was conducted to compare glycodelin concentrations in blood and uterine flushing samples from women with in vitro fertilization (IVF) failure and fertile controls.Materials And MethodsThis was a prospective clinical trial including 20 women with IVF failure and 19 fertile participants. Both groups initially filled a special questionnaire including their demographic profile and prior failed IVF attempts. Then samples of uterine flushing and blood samples were taken to measure glycodelin concentrations.ResultsThere were significant differences between mean glycodelin concentrations in the case and control groups, both in serum glycodelin (30.1 ± 5.30 vs. 44.5 ± 11.85 ng/mL, PConclusionWe found a significant decrease in glycodelin concentrations among patients with IVF failure. Since glycodelin has a role in immune system during endometrial receptivity, therefore, it may be required for prevention of IVF failures.Keywords: Embryo implantation, Endometrium, Fertilization in vitro, Glycodelin, Infertility
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Pages 107-111ObjectivesSex selection is an important concern for some couples. One of the relatively more simple and inexpensive methods, which does not need to use toxic chemicals to separate the Y and X sperms, is the Ericsson method. Therefore, the aim of this study is to evaluate the results of sex selection in infertile couples by using the albumin gradient method.Materials And MethodsThe present study is a quasi-experimental clinical trial study, conducted on 80 infertile couples. After the induction of ovulation and a vaginal sonography, sperm samples were prepared using the albumin gradient method, after which intrauterine insemination (IUI) was conducted. The rate of successful sex selection was then calculated.ResultsAmong 80 cases of performed IUI, 22 cases (27.5%) were successful, among which 3 cases (8.3%) suffered miscarriages and 19 cases (23.7%) were associated with a successful pregnancy. The success rate of sex selection was 59.1% in successful pregnancies. In general, the sex selection success rate was higher for the male gender; as a result, the success rates in 68 requests for male sex and 12 requests for female sex totaled 12 cases (17.6 %) and 1 case (3.8%), respectively.ConclusionAlbumin gradient is an appropriate sex determination method in IUI cycles due to a 23.7% chance of pregnancy in infertile women, while the success rate is 59.1% in sex determination.Keywords: Infertility, Insemination, Sex preselection, Spermatozoa
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Pages 112-118ObjectivesPlanned interventions can facilitate the maternal role for primiparous women by reducing postpartum stress. The present study aims to determine the effect of home-based supportive-educational counseling on primigravidas postpartum stress.Materials And MethodsIn this quasi-experimental study, 100 primigravidas, who had routinely referred to health centers from May to June 2016 for postpartum care on the third to fifth day after delivery, were selected and randomly assigned into two intervention (n = 50) and control (n = 50) groups. The Hung Postpartum Stress Scale (HPSS) was used for data collection. The intervention group underwent three supportive-educational sessions at home and the control group underwent usual postpartum care and trainings. Postpartum stress in both groups was evaluated at the end of sixth week after delivery. The gathered data were analyzed using statistical tests including independent t test, paired-sample t test, chi-square, and analysis of covariance (ANCOVA).ResultsThe mean score of postpartum stress as well as scores of three subscales of maternal role attainment, negative body changes and lack of social support after implementing home-based supportive-educational intervention in the intervention group were significantly lower than the control group (P = 0.0001).ConclusionGiven that home-based supportive-educational intervention has a significant and positive effect on postpartum stress reduction; therefore, visiting at home and providing supportive-educational counseling are recommended for postpartum programs.Keywords: Education, Postnatal care, Postpartum period
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Pages 119-122ObjectivesThe aim of this study was to evaluate the effect of 8 weeks of aerobic exercise on depression and sexual desire in middle-aged women diagnosed with depression.Materials And MethodsThe present study is a quasi-experimental study. Sixty females volunteered to participate in this study and were randomly divided into 4 groups; group A was prescribed with antidepressant drug (n = 15), group B employed aerobic exercises (n = 15), group C combination of drug and aerobic exercise (n = 15) and group D which was the control group (n = 15), respectively. Beck Depression Inventory was used in these 4 groups to assess their level of depression and sexual functioning. For statistical analysis of the data the t test, one-way analysis of variance (ANOVA) and Bonferroni post hoc test was used.ResultsComparison within groups showed a significant decrease in the pre-test on depression variables of the 3 groups; the drug group (P = 0.006), exercise (P = 0.011) and combination (P = 0.001) and also, regarding the variable libido, significant increase in the pre-test and post-test was observed. Regarding the sexual desire variable, results showed that only the aerobic exercise group had a significant increase in the pre-test and the post-test (P = 0.005). Comparison of the group variables showed a significant difference between the 4 study groups in both variables of depression and sexual desire.ConclusionConsidering the effectiveness of exercise on depression, it is expected that aerobic exercise would be considered as an effective non-pharmacologic treatment with less side effect in reducing depression and increasing sexual desire.Keywords: Aerobic exercise, Depression, Sexual dysfunction, Women
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Pages 123-128ObjectivesThe purpose of this study was to assess the educational need of infertile women admitted to Yazd Reproductive Sciences Institute.Materials And MethodsThis cross-sectional descriptive-analytical study was conducted in Yazd, Iran. The statistical population included 200 infertile women who were selected through convenience sampling method. The data collection instrument was a researcher-made questionnaire with statistical validity and reliability. Data were collected through interviews and self-reports and then analyzed using SPSS v.16 along with descriptive and analytical statistics.ResultsThe mean awareness scores of factors related to infertility, sexual satisfaction and nutritional needs were 4.36, 4.03, and 5.02, respectively. There was a significant relationship between awareness of infertility factors and variables such as level of education, spouses level of education and place of residence. Moreover, there was a non-significant relationship between awareness of infertility factors and variables such as age, spouses age, profession, spouses profession, number of referrals to the institute, and insurance type. There was also a significant relationship between awareness of nutritional needs and profession; whereas a non-significant relationship was seen between the specified awareness and variables such as age, spouses age, spouses profession, level of education, spouses level of education, number of referrals to the institute, place of residence and insurance type.ConclusionSince the studied participants exhibited limited awareness of related factors to infertility, it appears that developing a proper training program to raise awareness of infertility followed by its implementation and evaluation is necessary.Keywords: Needs assessment, Infertility, Yazd, Women
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Pages 129-136ObjectivesDue to enhanced life expectancy and an increasing elderly population, sexual and physical problems related to menopause are essential from the health point of view. This study was performed to evaluate the effect of Ginkgo biloba tablet and aromatherapy inhaler combination (lavender, fennel and geranium and rose) in decrement of sexual dysfunction in postmenopausal women.Materials And MethodsThis double blind randomized clinical trial was performed on 180 postmenopausal women with age range of 45-55 years referring to health care centers in Ardabil University of Medical Sciences, Iran. The participants were randomly divided into 3 groups of 60 subjects: Ginkgo biloba tablet and placebo aroma solution users, aroma solution with placebo Ginkgo biloba users, and placebo aroma with placebo Ginkgo biloba users who received 40 mg Ginkgo biloba either in tablet or placebo and 2-3 drops of aroma solution or placebo on the skin, 3 times a day for 6 weeks. The tool for collecting data was a questionnaire encompassed questions on the socio-demographical features and female sexual function index (FSFI). The primary outcome was the sexual function mean score after intervention in the research groups. The analysis was conducted according to intention-to-treat.ResultsThe mean (SD) scores of total sexual function at baseline in aromatherapy, Ginkgo biloba and placebo groups were 18.4 (5.4), 17.5 (6.8) and 15.8 (5.7) that enhanced to 22.9 (3.3), 21.6 (4.5) and 17.2 (4.2) in the mentioned groups respectively after intervention. Analysis of covariance (ANCOVA) test indicated significant discrepancy after intervention in total (PConclusionAromatherapy inhaler combination and Ginkgo biloba tablet improved sexual function in postmenopausal women.Keywords: Aromatherapy, Ginkgo biloba, Menopause
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Pages 137-142ObjectivesQuality of life is a sense of physical and psychological well-being and a concept affected by various factors such as place of residence. The present study was conducted with the aim to explore quality of life of postmenopausal women in urban and rural areas of Tabriz, Iran.Materials And MethodsThe present cross-sectional study was conducted on 544 postmenopausal women from rural and urban areas, selected by cluster sampling method. Data were collected through a 3-part questionnaire consisting of demographic details, quality of life (SF-36) and a research made questionnaire for assessment of physical and psychological menopausal symptom.ResultsFollowing adjustment of basic variables, rural women obtained significantly higher scores in physical function, general health and vitality. Although the subscales of bodily pain, social function and role limitation were better in urban women. Multivariate linear regression results revealed factors affecting quality of life, including the number of children, satisfaction with childrens conduct, income, occupation and score of postmenopausal symptoms in urban women; and satisfaction with childrens conduct, income, chronic diseases, age, postmenopausal duration, education, and score of postmenopausal symptoms in rural women.ConclusionThe present study results showed that various dimensions of quality of life were at an acceptable level, but the two groups were significantly different in most subscales. Considering the increasing middle-aged and older population, attention to the quality of life of women in these age groups is crucial. The present study determined the difference in dimensions of quality of life between urban and rural women and identified their possible health requirements.Keywords: Health, Menopause, Quality of life, Women
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Pages 143-146ObjectivesHuman papillomavirus (HPV) is a common sexual transmitted disease throughout the world. It has been considered as the main cause of cervical cancer and second common cause of cervical cancer in 15-49 years old women. The aim of this study was to determine the Knowledge of HPV and its incidence among women referring to Al-Zahra and Taleghani hospitals in Tabriz-Iran, 2014-2015.Materials And MethodsThis cross-sectional study was conducted on 221 women aged 15-49 years old that were suspicious to HPV based on gynecologic examination and colposcopy. Data was collected using questionnaires consisted of two parts: socio-demographic information and knowledge of these women concerning HPV.ResultsThe incidence rate of HPV among participants was 20.8%. The mean (standard deviation) of knowledge score was 12.04 (3.9) from total scores of 0-20. There was no significant differences between participants with HPV and without HPV infection in terms of knowledge about HPV.ConclusionAs women with HPV had low knowledge about this infection, therefore, health authorities should implement some interventions to enhance the knowledge of women about HPV infection in order to prevent its incidence and complications on womens health.Keywords: Human papilloma virus, Cervical cancer, Knowledge
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Pages 147-152ObjectivesMany anatomic and physiologic changes occur in womens bodies during pregnancy that make them vulnerable both physically and mentally. Depression is a common disorder that can be accompanied with obstetric, neonatal and postnatal complications. This study aimed to determine the relationship between depression and sleep quality among pregnant women in Tabriz-Iran, 2014.Materials And MethodsThis cross-sectional study was conducted on 565 pregnant women who referred to Tabriz health centers by 2-stage cluster sampling. The data were collected using socio-demographic questionnaire, Edinburgh Postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index (PSQI). General linear model was used in order to estimate the effect of independent variables (sleep quality and socio-demographic characteristics) on dependent variable (depression).ResultsThe mean (SD) of sleep quality score was 3.6 (1.4) from possible score range of 0-21 and the mean (SD) of depression score was 4.7 (3.7) from attainable score of 0-30. A significant correlation was found between depression score and total score of sleep quality and all its sub-domains except delay in sleeping. Also, according to adjusted general linear model, the variables of sleep quality, age, marital relationship, satisfaction of husband job, place of residence and place of receiving prenatal care were predictors of depression.ConclusionConsidering that the relationship between depression and sleep quality in pregnant women and also maternal and neonatal complications of depression, sleep hygiene education will be necessary in order to improve the quality and quantity of mothers sleep.Keywords: Depression, Pregnancy, Sleep, Women