Journal of Obstetrics, Gynecology and Cancer Research
Volume:6 Issue: 2, Spring 2021

Today, opportunistic fungi, especially Candida albicans, are among the most common risk factors in patients with weakened immune systems. Fungal infections caused by Candida species and increasing number of azole-resistant strains are of great importance in immunocompromised patients. The toxicity of the drugs used, the development of resistance to these fungi, and the problems caused by drug interactions necessitate the use of more effective drugs with less toxicity. This study aimed to evaluate the antifungal activity of medicinal plant extracts on C. albicans. In this review study, Scopus, PubMed, MEDLINE, Google Scholar, SID, and Magiran databases were searched between 2000 and 2019 to identify related articles. The search keywords were “Candida albicans”, “Complementary”, “Herbal medicine” and their Persian equivalents. All in vivo and in vitro trials were included in the study. The reviewed studies showed the effectiveness of some compounds in inhibiting the growth of C. albicans. The results of the present research were in in-vitro conditions, but they need to be conducted in-vivo for human use.

Anemia in Pregnancy (AIP) causes many obstetric complications. Pregnant women’s awareness and knowledge play a pivotal role in management and prevention of AIP.

The questionnaire survey was conducted among 138 first trimester pregnant women visiting the obstetrics and gynaecology department for antenatal care on their first appointment. The diagnosed participants’ knowledge, awareness and management potential about AIP was assessed.

The mean age was 26.9 and 24.2 years in AIP and non-anemia in pregnancy NAIP groups, respectively. First trimester early week’s appointment was 38.3% and 37.6% of AIP and NIAP groups, respectively. AIP compared to parity (χ2 = 3.0739) and gestation age (χ2 = 0.8435) was not significant at P-value<0.05. According to WHO definition, AIP was reported in 49.2% of the study population involving 30.4% of urban and 18.8% of rural population. The knowledge and awareness of pregnant women towards anemia in pregnancy was not significant with eleven predictor’s odds ratio. However, both of the groups, 60.3% of the AIP and 46.2% of the NAIP cases were aware of the anemia-related complications during pregnancy.

First trimester anemia in pregnancy was a prominent health burden in spite of available resources and awareness programmes. There was a sensitization lacunae to rule out the misconception and the belief. A healthy state of mind and practice among women shall be instrumental in bringing about an improved perception of AIP and its prevention.

Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.

The study was designed as a historical cohort among pregnant women with and without asthma. A total number of 583 asthmatic patients were allocated to the case group and 753 women without asthmatic history were placed in the control group.  Pregnancy, labor and neonatal outcomes were compared between the two groups.

The baseline characteristics of the women in both groups did not show significant differences. Gestational hypertension was more in the asthmatic group [43 (7.37%) VS 26 (3.45%), P=0.001]. Also the rate of preterm delivery was higher in asthmatic women [72 (12.34%) VS 77 (10.22%) in the control group, P=0.04]. However, the rate of preeclampsia was less in the asthmatic group [29 (4.97%) VS 71 (9.42%), P=0.008].  Apgar score at minutes 1 and 5 was less in asthmatic group. Intra Uterine Fetal Demise (IUFD) [24 (4.1%) VS 13(1.7%), P value=0.009], and neonatal death [31 (5.31%) VS 10 (1.32%), P=0.001] were more in the asthmatic group. The maternal and neonatal complications did not show significant differences in various severities of asthma. Multivariate regression model showed more risks for neonatal death [adjusted odds ratio (AOR)=4.18; CI95% 2.03-8.60], IUFD (AOR=2.43; CI95% 1.22-4.82), gestational hypertension (AOR= 1.43; CI 95% 1.40-1.45), and lower risk for preeclampsia (AOR 0.37; CI95%0.17-0.79) in asthmatic women.

Regardless of the fact that asthmatic mothers had higher frequencies of gestational hypertension, IUFD and neonatal death, the effect of asthma on perinatal outcome is minimal, probably because of efficient medical control.

To evaluate the clinical course and CT findings of pregnant women

Fourthy (25 pregnant and 15 non-pregnant) patients were entered to the study. Chest CT features and clinical findings were evaluated between two groups. Data related to pregnancy and fetal status  evaluated in the pregnant group.

The average age of pregnant patients was 33.1±5.75 years and the non-pregnant group was 35.4±6.88 years. The gestational age ranged from 7 weeks to 39weeks+2days (mean =31weeks+5days). No significant difference was seen between the two groups about clinical findings except the duration of symptoms before CT which was more in pregnant patients (6.71 ± 5.5 days vs 3.53 ± 1.92 days). Two mortalities in pregnant and one in non-pregnant patients ,  2(8%) cases of premature rupture of membranes (PROM), 3 (12%) cases of intra-uterine fetal death (IUFD), 3 (12%) cases of fetal distress and 2 (8%) cases of  IUGR in pregnant group. Fifteen pregnant patients gave birth .No positive PCR result was detected in newborns. Unlike the control group, the common CT findings were ground-glass pattern.

In summary, although we found the clinical findings in pregnant and control group were similar but pattern of CT involvement was different in pregnant patients and rate of ICU admission and mortality rate were more than control group. This viral pneumonia was associated with some important complications such as IUFD in severely involved mothers. CT could be an efficient tool for the early detection and severity assessment in the pregnant patients with COVID-19 pneumonia.

Menstruation with cramping pain is one of the problems that appear during adolescence. The severity of dysmenorrhea affects the extent of activity limitation. Given the high prevalence of dysmenorrhea in adolescents and the personal-social effect of this condition on their daily lives, using reliable tools for assessing the severity of this condition in different populations of different countries can significantly contribute to the standard diagnosis, evaluation, and treatment of people suffering from dysmenorrhea.

This cross-sectional study was performed on a population of adolescent girls (Iran) in 2019. The research was approved and monitored by the relevant supervisory body, which issued the pertinent ethics licenses and letters of introduction. Sampling was performed using the cluster method from public schools. Inclusion criteria were Iranian nationality and not having any underlying diseases. The exclusion criterion was the unwillingness to continue participation. The data collection tools were a questionnaire of demographic and menstrual information as well as verbal rating scale (VRS; for both drug and pain) and working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) questionnaires.

The participants had a mean age of 15.6±2.3 years and a mean age of menarche of 12.5±1.3 years. The best sensitivity and specificity of the tools were respectively calculated as 63.7% and 56.9% for WaLIDD (at point 4.5), 57.3% and 70.8% for VRS (pain; at point 1.5), and 33.9% and 72.2% for VRS (drug; at point 0.5).

According to the results of this study, none of the tools had high specificity and sensitivity at the same time. However, WaLIDD had high sensitivity, and VRS (for both pain and drug) exhibited high specificity.

Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial (RCT) aimed to compare the effect of EPO and misoprostol on cervical ripening/dilatation.

In this double–blind RCT study, women of reproductive age without history of normal vaginal delivery (NVD) and menopause women (age range: 20–75 years) were enrolled. The subjects who were candidates of hysteroscopy, dilatation, and curettage were randomly assigned into two groups. In one group, 2 capsules of 500 mg EPO (N=81) and in the other group 2 capsules of 200 µg misoprostol (N=84) were placed in posterior fornix 2 hours before surgery. The time to reach complete dilatation (Hegar 3 to 10 mm), size of the first Hegar used to apply force, bleeding volume, and cervical laceration were compared between the groups using the IBM SPSS Statistics for Windows, Version 21.0 (Armonk, NY: IBM Corp).

The two study groups had similar demographic information, number of pregnancies, cesarean sections, and NVDs (P>.05), but had different frequency of surgical types (P=.018). EPO group had a larger mean size of the Hegar (7.32 vs. 6.58 mm; P=.004) and shorter time to reach complete dilatation (242.35 vs. 331.79 min; P=.002); however, bleeding volume and frequency of cervical laceration were not different between the groups (1.41 vs. 2.00 cc and 8.6% vs. 14.3%, respectively; P>.05).

The superiority of EPO capsules to misoprostol for cervical ripening before gynecologic procedures in women of reproductive age without history of normal NVD and menopause women suggests it as an appropriate alternative to misoprostol.

Being considered a common benign uterine disorder, Adenomyosis (AD) is defined as the presence of an endometrial gland and stroma within the myometrium. It causes symptoms such as dysmenorrhea, menorrhagia, chronic pelvic pain, and infertility. It has a step-by-step treatment, initiating with medical therapy, conservative surgery, and finally, the hysterectomy. As some of the women with adenomyosis are nulligravid and want to become pregnant later, most patients prefer fertility-preserving surgery.

Case Report: 

This study describes the management of diffuse posterior AD in a 36-year-old virgin female by triple flap technique and levonorgestrel intrauterine device (LNG-IUD) insertion during operation to prevent future recurrence and reduction of patient’s symptoms. The application of the triple flap technique and LNG-IUD in this patient was associated with excellent results.

The wide excision of the lesion leads to symptom improvement, especially hypermenorrhea and dysmenorrhea; besides, the reconstruction of the uterine wall with this technique increases the risk of the possibility of future pregnancy for our patient.

A variety of presentations may be manifested by retained sponge, including intestinal obstruction, intestinal fistula, malabsorption syndrome and chronic pain from adhesions; in some cases, it may have an asymptomatic clinical course.

Case report:

 In a 41-year-old female, gravida 4 para 4, with a history of laparotomy performed for an ovarian adenocarcinoma three years prior to her referral, a gossypiboma was incidentally detected on follow up imaging. The gossypiboma was safely excised by a midline laparotomy.

Asymptomatic gossypiboma should be considered in patients presenting with a mass, who have undergone laparotomy in the past.