Journal of Obstetrics, Gynecology and Cancer Research
Volume:4 Issue: 2, Spring 2019

Fear of childbirth is an unpleasant and common condition that negatively affects pregnant women’s emotions and undermines the process of natural changes that occur during this period. This study was conducted to determine the relationship of fear of childbirth with the severity of fatigue and the level of mental well-being in pregnant women.

This descriptive cross-sectional study followed by a correlation design was carried out on 525 pregnant women who referred to Sabzevar healthcare in 2017. Based on a cluster sampling method data collection was performed using demographic characteristics form, the Wijma Delivery Expectancy Questionnaire (WDEQ-A), the 5-item World Health Organization Well-Being Index (WHO-5), and the Multidimensional Assessment of Fatigue (MAF) scale. The data were analyzed by SPSS 16, using descriptive statistics, independent t-test, and Pearson correlation coefficient. 

19% of the subjects scored above 85 and 6% of them scored higher than 100 on the WDE-Q. Also, 24.8% of these women scored less than 50 on the WHO-5. The studied women’s mean fatigue index was 20.3±12.7. Fear of childbirth had a positive correlation with fatigue (r=0.235) and a negative correlation with well-being (r=0.310) (P<0.05).

Women experience various degrees of fear of childbirth during pregnancy. Providing mental support for pregnant women and using psychological techniques aimed at reducing their fear of childbirth during pregnancy are highly recommended.

Due to increased rate of risk factors, the incidence of placenta accreta (PA) is increasing worldwide. This study aimed to investigate the important factors regarding the occurrence of PA, as well as outcomes and complications of Trans Abdominal Hysterectomy (TAH) in the patients with PA.

The study was performed as an observational cross-sectional study.  Between March 2011 and March 2017, 177 patients, known cases of PA that undergone TAH, were enrolled in our study. Extracted data include demographic characteristics, patient’s medical history, surgical approach and complications, such as blood loss and urologic problems.

The average of maternal age and gestational age were 33.6±4.70 (range= 22-43) years and 34.6±3.16 weeks, respectively. Neither maternal age (P=0.652) nor BMI (P=0.659) had significant association with abnormal placentation. Previous history of dilation & curettage (D&C) was found in 34 patients that was not related to the occurrence of the PA (P=0.508).Twenty-one (11.9%) of the patients needed urological intervention that did not associated with placental position, skin and uterine incision (P=0.258, 0.410 and 0.219). There is no relation between amount of blood loss with gestational age (P=0.7) and number of C/S (P=0.4), gestational age (P=0.7), anesthesia (P=0.2), and curettage history (P=0.3).

 Our mortality and morbidity rate is much lower than reported ones, indicating the high-level ability, skill and knowledge of the surgeons.

This study investigated the recurrence and survival rates of patients with borderline ovarian tumors in Yazd in the last 10 years.

This census survival study was performed on 24 patients with borderline ovarian tumors who referred to hospitals affiliated to Yazd University of Medical Sciences from 2006 to 2016. A data collection checklist was used as a measurement tool and was completed by the researcher by reviewing the subjects’ medical records. The questionnaire included age, infertility, the number of delivery, contraceptive use, body mass index, time of diagnosis, time to start the treatment, whether alive or not, stage of the disease, the type of pathology, the type of surgery, and postoperative treatment. Data was analyzed by SPSS 16 using descriptive statistics.

The mean age of these 24 patients was 33.58±10.61 and the mean recurrence time was 14±2 months. Sixteen (66.7%) patients had serous tumors and 8 (33.3%) patients had mucinous tumors. Among them, 18 (75%) patients underwent a hysterectomy, 2 (8.3%) patients underwent an oophorectomy and 4 (16.7%) patients underwent both total abdominal hysterectomy (TAH) and oophorectomy. Of the 24 studied patients, 4 patients (16.7%) received medicinal treatment (clomiphene citrate, HCG, HMG) after surgery. Three patients experienced recurrences, all in the contralateral ovary.

The recurrence time of epithelial borderline ovarian tumor was 14±2 months. There was no significant relationship between postoperative medicinal treatment and the recurrence rate.

 Cervical cancer is the second most prevalent cancer in women worldwide and is one of the leading causes of deaths in women with cancer in developing countries. The most well-known cause of this cancer is being infected with human papillomavirus (HPV). This study aimed at evaluating the concurrent methylation pattern of the human papillomavirus genome in studying the DAPK1 gene as a diagnostic biomarker in cervical cancer.

This study was approved by the Ethics Committee of the Islamic Azad University of Tabriz under the following ethical code, i.e., IR.IAU.TABRIZ.REC1398.001.This case-control study was conducted on 150 paraffin-embedded samples (75 marginal samples and 75 cervical cancer tissue samples) taken from women with cervical cancer. After extracting the total DNA, spectrophotometry and electrophoresis were performed on agarose gels to determine the quantity and quality of the extracted DNA. Changes in the DAPK1 gene methylation pattern were examined using High Resolution Melt Analysis Curve Method.

The changes in theDAPK1 gene expression in the cervical tumor tissues increased compared to the marginal tissues, indicating a statistically significant difference (P<0/0001).

The results of the current study showed that the DAPK1 gene can be introduced as a possible prognosis for cervical cancer diagnosis and treatment. However, more extensive studies with more samples are needed to be carried out.

Childbirth preparation classes are planned to make the delivery more pleasant and reduce the number of cesarean sections. This study aimed to examine the effect of attending childbirth preparation classes on prepartum and postpartum maternal mental well-being.

This single-blind clinical trial was conducted in Sabzevar healthcare centers. 120 nulliparous women were selected in 2017, applying a convenience sampling method, and randomly divided into two equal groups, intervention and control. The intervention group (at 20 weeks to 38 weeks of gestation) participated in 8, 90-minute sessions of the childbirth preparation classes; however, the control group only received the routine prenatal care. Before and after the intervention and 14 days after the delivery, the maternal mental well-being questionnaire was completed by the mothers and then analyzed by the repeated-measures ANOVA.

Results showed that the mean score of the intervention group’s maternal mental well-being index (73.7±1.8) was significantly higher than that of the control group (65.5±2.1) (P<0.001). Moreover, the trend of changes in the scores of this index was different in the two groups and did not change in the intervention group from pretest to posttest and follow-up, while it decreased in the control group (P<0.048).

Although maternal mental well-being reduces in the second half of pregnancy until after giving birth, attending childbirth preparation classes stabilizes prepartum and postpartum maternal mental well-being.

Despite the rarity of head and neck squamous cell carcinoma during pregnancy, the outbreak of its various malignant types is probable during pregnancy due to the increased maternal age and decreased age of cancer occurrence. Therefore, paying attention to any abnormal symptoms in any period, such as pregnancy, seems necessary. This study aimed to report a case of tongue cancer diagnosed during pregnancy.

Case Report: 

A 31-year-old woman who was at 18 weeks of her first pregnancy noticed an Aphthous stomatitis on her tongue. Since the routine Aphthous stomatitis treatment failed to treat the lesion and it developed and swelled in the neck and mouth region, the patient referred to her physician again. After carrying out a biopsy of the lesion, squamous cell carcinoma of the tongue was diagnosed. The patient underwent chemotherapy and radiotherapy after terminating the pregnancy by a cesarean section, and the malignant tumor shrank.

 It seems that a complete multidisciplinary study is needed to minimize fetal health risks and to optimize maternal treatment outcomes.

The history of infection is confirmed by serological tests and the incidence and severity of congenital Toxoplasma infection depend on the gestational age at the time of maternal infection. A precise serological diagnosis is important in the management of toxoplasmosis, and timely treatment prevents the complications of the infection. This study aimed to manage a case of acute toxoplasmosis during pregnancy and its results.

Case Report: 

In the present study, a pregnant woman was diagnosed with acute toxoplasmosis by considering the positive result of antibodies specific to Toxoplasma gondii and was treated based on the principal treatment that prevented congenital toxoplasmosis in her fetus.

Preventing acute Toxoplasma infection is very effective during pregnancy. Timely treatment can prevent the fetal and neonatal complications of toxoplasmosis.

Neonates with birth weights below the 10th percentile of gestational age- and sex-specific reference are known as neonates with intrauterine growth restriction (IUGR). Neonates with IUGR are more prone to diseases, infections, respiratory failure, and neonatal mortality. This study aimed to evaluate the association between perinatal Doppler findings and hematological indices in neonates with intrauterine growth restriction at gestational ages of 32 to 36 weeks.

In this analytical cross-sectional study conducted at Akbarabadi Hospital from 2016 to 2017, 90 neonates with IUGR who underwent umbilical artery Doppler ultrasound during pregnancy were haphazardly selected and the umbilical artery Doppler velocity was compared with neonatal hematological indices.

Results indicated that 48, 25, and 17 neonates had normal, absent, and reverse Doppler, respectively. A decreased umbilical artery Doppler velocity was associated with a reduction in platelet level (P=0.004) and an increase in NRBC level (P=0.002). Considering a P-value>0.05, white blood cell and hemoglobin levels had no associations with umbilical artery Doppler. However, IVH was correlated with the severity of abnormal umbilical artery Doppler (P=0.001). There was no significant relationship between hyperbilirubinemia and abnormal umbilical artery Doppler (P<0.05).

The severity of thrombocytopenia and the level of NRBC in IUGR neonates are directly related to abnormal umbilical artery Doppler and consequently, chronic hypoxia in these neonates. Furthermore, IVH is more likely to occur in neonates with chronic hypoxia. Early and perinatal diagnoses of these abnormalities can help us treat them faster and reduce long-term morbidities.