مجله زنان مامائی و نازائی ایران
سال بیست و دوم شماره 9 (آذر 1398)

Regarding to the lack of reports about the prevalence of pregnancy varicose in Iran and the adverse effects of this type of varicose on pregnancy and childbirth, this study was performed with aim to evaluate the prevalence of pregnancy varicose and its related factors.

This analytical-cross-sectional study was performed on 275 pregnant women in gynecology hospitals of Tabriz in 2018. The CEAP checklist was used to determine the severity of varicose symptoms. Data were collected by the researcher after completion. Data were analyzed by SPSS software (version 20) and spearman correlation test. P<0.05 was considered statistically significant.

The prevalence of pregnancy varicose was 18.18% (n=50), and among women who had varicose, the majority (n=26, 9.4%) had mild varicose. Also, there was significant relationship between pregnancy varicose and age (P=0.005), BMI (P=0.02), gestational age (P=0.001), smoking (P=0.01) and history of deep vein thrombosis (P=0.03).

The prevalence of pregnancy varicose in the present study was about 18.2%. The factors such as age, body mass index, gestational age, smoking and history of deep vein thrombosis are among the main factors affecting the disease.

Ectopic pregnancy occurs during the first three months of pregnancy which leads to extensive mortality and disability. Early diagnosis and treatment of this type of pregnancy may be helpful in prevention and reducing its complications. This study was performed with aim to evaluate the endometrial thickness and sonographic endometrial patterns in ectopic pregnancy.

This case-control study was conducted on 179 patients (91 women with normal increase of serial βHCG and diagnosis of normal pregnancy and 88 with abnormal increase of serial βHCG and diagnosis of ectopic pregnancy) with positive pregnancy result and vaginal bleeding with or without abdominal pain at first trimester of pregnancy in Al-Zahra educational hospital, Rasht from March 20, 2016 to September 22, 2017. Patients underwent vaginal sonography by a gynecologist to rule out the ectopic pregnancy. Endometrial thickness and patterns were evaluated. Data were analyzed by SPSS software (version 17), and student t-test, and Chi-squared test. P < 0.05 was considered statistically significant.

In normal and ectopic pregnancy groups, endometrial pattern was homogeneous hyperechoic, heterogeneous hyperechoic and three-layered. Based on the results of student t-test, no significant difference was observed between endometrial ultrasound patterns in two groups (p>0.05). Mean endometrial thickness in normal pregnancy and ectopic pregnancy groups were 14.8±3.1 mm and 8.2±4.9 mm, respectively which was significantly higher in normal pregnancy group than ectopic pregnancy group (p<0.0001).

Use of endometrial thickness may be helpful as a diagnostic tool in ectopic pregnancy. Use of sonographic endometrial pattern has a low diagnostic value in distinguishing ectopic pregnancy from normal pregnancy.

Breast cancer is the most common malignancy and the second leading cause of malignancy in women, worldwide. Early diagnosis can lead to timely treatment and increase the life expectancy of patients. Various models have been designed to determine the risk of disease and identifying high-risk women. This study was performed with aim to evaluate the risk of breast cancer using different models in women of Kerman.

This cross-sectional study was performed on 454 women aged 35-75 years referred to comprehensive health centers in Kerman in 2018. The questions from the Gail and IBIS questionnaire were asked to assess the risk of developing 5-year and lifetime breast cancer risk. Data were analyzed by SPSS software (version 20) and Pearson correlation test. P<0.05 was considered statistically significant.

Mean of 5-year risk score for breast cancer was 0.81 ± 0.65% based on Gail model and 0.81 ± 0.58% based on IBIS model. Also, mean of lifetime risk based on Gail and IBIS models was 10.53 ± 5.52% and 11.28 ± 3.94%, respectively. There was a significant positive linear relationship between 5-year risk (r = 0.67) and lifetime risk (r = 0.51) on Gail and IBIS models (p<0.001).

In comprehensive health centers, risk assessment models can be used to identify high risk people for breast cancer. The Gail and IBIS models are relatively similar in risk prediction and their results are correlated.

Melatonin can play an important role in reducing oxidative stress products. This study was performed with aim to investigate the interactive effect of eight weeks of taking melatonin and combined training on some components of physical fitness and serum levels of malondialdhyde (MDA) in postmenopausal women with type 2 diabetes.

This randomized controlled clinical trial was performed on 18 non-active postmenopausal women with type 2 diabetes in Mashhad in 2018. Subjects were randomly divided into two groups of combined training + melatonin (n=10) and combined training + placebo (n=8). The subjects in first group received daily one tablet of melatonin (3 mg) for eight weeks and second group received the same amount of placebo. Combined training program was 8 weeks and 3 sessions per week. Body composition, physical fitness and biochemical variables were measured in two stages of the beginning and the end of the study. Data were analyzed by SPSS software (version 23), and independent t-test and dependent t-test. P < 0.05 was considered statistically significant.

The use of melatonin with combined training significantly reduced the percentage of fat and MDA levels and significantly increased the amount of peak oxygen consumption and muscle strength in the movements of the chest, axillary, throat and back thigh (p≤0.05). However, combining training alone significantly increased the amount of peak oxygen consumption and muscle strength in the movements of the chest, axillary, throat and back thigh (p≤0.05). Also, despite the differences between two groups, but no statistically significant difference was observed in none of the variables (p>0.05).

The interaction of melatonin and combined training improves the peak oxygen consumption, muscle strength, reduces body fat percentage and also free radical side products specially MDA and is effective in improving the risk factors for type 2 diabetes in postmenopausal women.

Having a child is a basic need in humans. Infertility can lead to unpleasant outcomes such as depression which is required to identification and appropriate interventions. Acupressure is one of the methods used in the treatment of depression. This study was performed with aim to determine the effect of auriculotherapy on depression in infertile women.

This randomized clinical trial was performed on 70 infertile women referred to Milad Infertility Centre at Mashhad in 2017. The subjects were randomly assigned to two groups of intervention and control. Before the intervention, depression in both groups was measured by Beck questionnaire. Then, in the intervention group, the ear glue was attached in one of the ears at the points of shenmen, anti- depressant and heart, and the patient was asked to press each of the points twice a day and 60 times for a period of one month. No intervention was performed in the control group. Depression was again measured immediately after the intervention and two months later in both groups. Data were analyzed by SPSS software (version 19) and independent t-test, Chi-square and ANOVA with repeated measurement. P<0.05 was considered statistically significant.

Depression score had no significant difference in two groups before the intervention (p> 0.05). However, depression scores immediately and two month after the intervention were less in the intervention group than the control group and there was a significant statistical difference between two groups (p <0.001).

Considering the presence of depression in infertile patients, auriculotherapy can be used as a non-pharmacological method to reduce depression.

Following the diabetic diet is of the most important challenges in controlling gestational diabetes. Maybe people receive a complementary therapy alongside with diet observance and found themselves more at risk, and have more adherence to the diet to control blood sugar during pregnancy. Therefore, this study was performed with aim to compare adherence to the diet of women with gestational diabetes between the groups of with and without okra powder.

This clinical trial was performed in 2018-2019 on 60 women with gestational diabetes mellitus who were under treatment with diet. The subjects were randomly assigned to intervention and control groups. Usual diet of gestational diabetes was trained in person for both groups. The intervention group in addition to this used 6 gr of okra powder daily at breakfast and lunch. Adherence to dietary questionnaire was completed at baseline and four weeks after the study by the research unit. Data were analyzed by SPSS software (version 21) and independent t-test, paired-t, Mann-Whitney test, Wilcoxon and covariance analysis. P<0.05 was considered statistically significant.

Changes in diet adherence score after the intervention than before it had no significant difference in the intervention group compared to the control group (P=0.087). In the intergroup comparison in both groups, change in diet adherence after the intervention than before it was significant (P<0.001).

In the present study, the use of supplemental medicine did not affect diet adherence. Diet adherence in the group which received complementary medicine in addition to diet had no difference compared with the group which only received the diet.

Vaginitis is a general term for vaginal disorders which is caused due to infection, inflammation or a change in the normal vaginal flora. Trichomonas vaginalis is the third most common cause of vaginitis. Antibacterial, antifungal and anti trichomoniasis effects of ferula have been shown by in vitro and in vivo studies. This study was performed with aim to compare the effects of ferula oral capsule and metronidazole oral pill on improving clinical symptoms of trichomonas vaginalis infection.

This clinical trial was performed on 70 non-pregnant women referred to gynecology clinics of Imam Reza and Ommolbanin hospitals due to vaginal infection symptoms in 2019. The subjects were placed in two groups: ferula and metronidazole. Trichomoniasis vaginalis infection was detected by wet smear test. Oral ferula capsule was prescribed to ferula group and oral metronidazole tablet to second group for 7 days. Data were collected by observation and interview forms. Data were analyzed by paired and independent t-tests, Chi-square, Mann-Whitney, Mcnemar and Wilcoxon tests. P<0.05 was considered statistically significant.

The findings of the study indicated that improvement of clinical symptoms was 100% in the ferula group and 40% in the metronidazole group ( p<0.001).14 cases (40 %) of metronidazole group had drug side effects including digestive disorders (54.3%) and nausea (45.7%). In ferula group, none of cases showed side effects (p<0.001). Moreover, 19 cases in metronidazole group (54.3%) and all in ferula group (100%) were agree to reuse the medicine or to suggest it to others (p<0.001).
 

The improvement percentage in clinical symptoms caused by oral ferula capsule is higher than oral metronidazole tablet. Therefore, by performing further studies, ferula capsule can be a replacement for metronidazole in order to improve the clinical symptoms of Trichomonas vaginalis infection for.

In cesarean section incision, like as any other surgery, there is possibility of delay in wound healing. According to studies, flaxseed oil is effective in wound healing. This study was performed with aim to determine the effects of flaxseed oil on cesarean wound healing.

This three-blind randomized clinical trial was performed on 120 women with cesarean section at educational hospitals of Imam Reza and Shahid Hasheminejad of Mashhad in 2018. Individuals were randomly assigned to three groups (flaxseed ointment, placebo, control). In two groups of flaxseed ointment and placebo, the ointment was applied on cesarean section wound for 8 consecutive days and twice a day, each time as one finger strap. Wound healing was measured 24 hours after surgery, 4th and 8th day after cesarean section by REEDA Scale. Data were analyzed using SPSS software (version 25), and Chi-Square and Kruskal-Wallis tests. P <0.05 was considered statistically significant.

According to the results of statistical tests, there was statistically significant difference between flaxseed group with control and placebo groups in terms of cesarean section wound healing on days 4 and 8 after the intervention (P <0.001). In addition, in the intergroup comparison, Friedman test showed that in all three groups, the variation of REEDA scale in different days was significantly different (P <0.001).

Regarding the reduction of REEDA cesarean wound score after the intervention, flaxseed oil is recommended as a suitable drug for cesarean section wound healing in mothers.

Epidemiological studies show that 10 to 15% of couples experience infertility worldwide. It is estimated that 40-50% of infertilities are related to female factors and 30% are male factors and others are attributed to both partners. Follicular fluid supplies an environment for ovulation and it reflects hormonal and biochemical activities of follicles in different stages. The effects of follicular fluid oxidative stress on ovum maturation and fertility are not well explained. Therefore, this study was performed with aim to evaluate and compare antioxidant properties of follicular fluid in healthy and infertile women and also, to examine the protein electrophoresis pattern of follicular fluid in these two groups. 

This case-control and cross-sectional study was performed on 17 infertile women with ovulation disorder and 17 healthy women with infertility related to male factor who were candidate for IVF and had referred to Fatemeh-Zahra infertility center, Babol in 2018. Follicular fluid specimens were collected from 34 infertile and healthy women. To measure antioxidant properties, FRAP (Ferric reducing antioxidant power) and DPPH (1,1-Diphenyl-2-picryl-hydrazyl) tests were performed. Lipid peroxidation was assayed using MDA (Malondialdehyde) test. SDS-PAGE (sodium dodecyl sulphate-polyacrylamide gel electrophoresis) was used to evaluate protein electrophoresis pattern. Bradford method was used to assess total protein. Data were analyzed by SPSS software (version 16) and t-test. P<0.05 was considered statistically significant.

Antioxidant properties and lipid peroxidation assay did not show any statistical significant differences between two groups (p=0.23 and p=0.45, respectively). Also, the results of electrophoresis test and total protein were not significantly different between two groups (p=0.73). Most amount of proteins in both groups was observed in heavy band between 48 -75 Kilo Dalton region.

Although there was difference in oxidative stress level between two groups, it was not statistically significant. It can be attributed to small sample size in each group. More close evaluation using 2-dimentional electrophoresis is needed to show difference in follicular fluid protein electrophoresis pattern.

Although labor pain is a part of labor progression, but uncontrolled pain can be dangerous for both mother and fetus. Reflexology has been reported in some studies as one of the non-pharmacological methods of labor pain relief, but the results of these studies have been contradictory. Therefore, this systematic review was performed with aim to investigate the effects of reflexology on the severity of labor pain.

In this review study, to access relevant articles, the English databases of Google Scholar, Scopus, Pubmed, and Science Direct were searched using the key words of "Pain", "Labor pain", "Reflexology" and "Foot Reflexology", as well as Persian databases including Magiran, SID, and Google Scholar with equal Persian keywords. Also, search was done as a combination of keywords using Bullins from inspection until May 2019. The quality assessment of the included studies was done using of the CONSORT 2017 checklist.

Of the 336 studies found from the databases, 7 studies with inclusion criteria were included. The results of the studies showed that foot reflexology during labor reduce the severity of labor pain.

Foot reflexology during labor can be effective in reducing the severity of labor pain. Therefore, it is suggested that this low-cost and easy method be used to reduce labor pain.

Sigmoid volvulus is rare in pregnancy, but can cause many complications during pregnancy. The complications of disease will increase during pregnancy due to late diagnosis and treatment. Clinical triad of abdominal pain, abdominal distension and absolute constipation can help to diagnose this condition during pregnancy. In this study, a case of sigmoid volvulus during cesarean section is reported.

The patient was a 31-year-old woman with gestational age of 36 weeks and 2 days who had referred to Ardabil Alavi hospital with complains of abdominal pain. She had no symptoms of acute abdomen and complete bowel obstruction at the time of referral. The day after visit, due to recording of uterine contractions and the onset of delivery symptoms underwent emergency cesarean section under general anesthesia. During the operation, because of abnormal bowel distension, a general surgical emergency consultation was requested. Sigmoid volvulus was detected and removed by general surgeon. After stabilization of the symptoms, the patient was transferred to the general surgeon's service and the elective surgery was done in the relevant service.

Due to dangerous maternal and neonatal complications of volvulus during pregnancy, it is recommended that one of the differential diagnoses of abdominal distention during pregnancy be sigmoid volvulus.