Journal of Obstetrics, Gynecology and Cancer Research
Volume:6 Issue: 3, Summer 2021

Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patientchr('39')s quality of life. On the other hand, a complete surgical staging in endometrial cancer includes oophorectomy since 1988. There has been some research to assess whether an oophorectomy should be performed and in which cases, ovaries can be preserved.

 Aim of this study was to evaluate the coexistence of ovarian involvement in endometrioid endometrial carcinoma. In this study, we evaluated 180 patients with endometrioid endometrial cancer patients who were surgically staged at Imam Hossein Hospital between 2004 and 2017.

Mean age of subjects of the study was 56.78 ±10.59. Forty-six of patients (25.6 %) were less than 50 years old and 74.4 % (134) were older than 50. Twenty out of 180 (11.1 %) of them had ovarian involvement (one of them had simultaneous ovarian tumor) and 11 (55%) of these cases were less than 50 years old. In 55 % (11) patients, the involved ovaries were less than 5 cm with grossly normal appearance, lymph nodes metastases were detected in 3 out of 20 (15 %) of them although their ovarian size were 4, 4.5 and 6.5 cm. In 10 (50 %) of them, deep myometrial invasion was detected.

 In endometrial cancer staging, ovarian preservation could be a challenging decision and a real controversy which needs more researches.

Anti-mullerian hormone indicates ovarian reserve. The objective of this study was to compare the changes of AMH level following two methods of laparoscopic cystectomy in order to evaluate ovarian reserve in patients with endometrioma.

 To this end, 86 patients with endometrioma were selected on the basis of inclusion and exclusion criteria, divided into two groups, and subjected to laparoscopic cystectomy. The mean hormone levels were measured before and after surgery and the changes were compared between the two groups using the repeated measures tests. The data were also analyzed using the SPSS 22.

The mean number of childbirth was 2.06 in patients with a standard deviation of 1.64. Out of 86, 42 patients (48.8%) were treated with complete removal of cysts and the rest underwent partial removal. The length of cysts in patients undergoing complete removal was significantly larger than that in patients with partial removal (P=0.011), while the width of cysts was not significantly different between the two groups of patients (P=0.084). The AMH levels in patients undergoing complete removal significantly decreased from 2.22 before surgery to 1.96 after surgery (P<0.001). The AMH levels in patients undergoing partial removal was also decreased from 2.47 before surgery to 2.14 after surgery, representing a statistically significant difference (P<0.001).

Regarding the results of the study, the type of ovarian cyst removal has not any effect on after-surgery consequences.

The aims of present study were to compare the vitamin D concentration in pregnant women and the umbilical cord blood while investigating for a relationship between its level and anthropometric neonatal factors (i.e. birth weight, birth length, and head circumference).

 The study was performed as a descriptive cross-sectional study on pregnant women who were admitted to the labor ward for delivery. Serum level of 25-hydroxyvitamin D [25(OH) D], was measured and compared in women and the umbilical cord blood. The relationship between 25(OH) D levels and anthropometric neonatal factors including birth weight, birth length and head circumference was evaluated.

 A total of 106 pregnant women (53 Iranians and 53 Afghan refugees’ women) were evaluated. There was a significant correlation between maternal serum level of 25(OH) D and that of their neonates, both in Iranians and Afghans considering gestational age as a confounding factor (R=0.62, P=0.000). Maternal and neonatal 25(OH) D levels were significantly higher in Iranians than Afghans (27.2±11.5 ng/mL VS 21.9±12.7 ng/mL, P=0.026 and 26.5±11.2 VS 17.3±11.4, P=0.000) respectively. However, neonatal weight and head circumference (HC), were not different in Iranians and Afghans except for neonatal height which was higher in Afghans (P=0.015) irrespective of lower amount of neonatal 25(OH) D levels. The mean cord levels of vitamin D in boys and girls did not show a significant difference. There was no significant correlation between 25(OH) D serum level and pregnant women’s level of education, pre-labor rupture of membranes (PROM), past medical history (PMH), taking supplements and smoking.

Maternal and neonatal 25(OH) D levels did not influence neonatal anthropometry.

Cervical cancer is the second most common cancer and the fourth leading cause of death in women. Among the risk factors for cervical cancer, human papillomavirus (HPV) is the most important one.

 In this cross-sectional and retrospective study conducted from 2016 to 2020, 261 women with cervical intra-epithelial neoplasia (CIN) grade two and three referred to one of the gynecological oncology clinics of Shahid Beheshti University of Medical Sciences, who were eligible to enter the study and were evaluated by the research unit of the relevant university after receiving an ethics code. During the study, patients whose cervical cancer was confirmed by colposcopic diagnostic method, HPV screening was performed by COBAS method and lesions were sampled to determine the type of HPV.

Evaluation of the frequency distribution of colposcopic results compared to HPV, indicated that HPV-16 is the most common type of HPV in high grade CIN lesions. After HPV-16, other types of HPV are next in terms of frequency indicating the importance of other types of HPV. HPV-18 was also observed in people with CIN.

Performing a similar study with a larger number of samples at the national level is suggested. If the results of a larger study are consistent with this study, it would be for the best to highlight the role of other types of HPV in cervical cancer screening in women.

Vaginal laxity is a prevalent disorder that influences woman’s sexual satisfaction and quality of life. This study aimed to evaluate the impact of Higgs radiofrequency on pelvic organ prolapse and sexual function among women suffering from vaginal laxity.

 This was a pre- and post-intervention study. Twenty-two subjects who suffered from vaginal laxity referring to a pelvic floor clinic affiliated with Tehran University of Medical Sciences were studied. Higgs radiofrequency was administered at six sessions with a two-week interval. Women were evaluated by an urogynecologist for pelvic organ prolapse quantification (POP-Q) twice: before and three months after intervention. Also, women responded to the Female Sexual Function Index (FSFI-19) at baseline and three months follow-up assessment. Data were analyzed by descriptive statistics and paired samples t-test.

The mean age of participants was 40.30 (SD = 8.01) years. The mean number of gravidities was 2.45 (SD = 1.29). Seventeen women (77.3 %) suffered from severe or moderate vaginal laxity. After intervention, the point Ba (P=0.02), perineal body-point PB (P=0.058) and total vaginal length (0.014) significantly improved. Also, female sexual function and its six domains improved (P<0.001).

 The findings indicated that Higgs radiofrequency was a safe and noninvasive technique that improved some pelvic organ prolapse quantification and sexual function among women suffering from vaginal laxity.

Urinary incontinence (UI) is a common disease that affects millions of people throughout their lives. It is reported that UI has a considerable economic burden on patients and communities. The aim of this study was to find out the prevalence of urinary incontinence (UI) and its related factors among women living in Birjand city, Iran.

 A cross-sectional study from September 2020 to December 2020 was conducted on women 15 to 70 years living in nine areas of Birjand city. Data were gathered by researcher-made questionnaire and in-person interviews about demographic, obstetrics, and UI (stress, urge, and overflow UI) characteristics. Chi-square test was applied to analyze differences between women with and without UI about risk factors.

Of 3028 women (mean age 32.70±11.49 years), 828 (27.3%) reported to have UI. The rate of stress, urge, and mixed UI was 18.1%, 3.4%, and 5.9%, respectively. All types of UI were associated with age, education, BMI, chronic cough / dyspnea, constipation, diabetes mellitus, and smoking.

Women should be continuously educated by health care providers on the risk factors and activities which can reduce their risk for UI. Further studies on women across the country may help decision makers to measure the regional burden of disease and to plan population-level interventions.

COVID‐19 is a novel viral pandemic. It is believed that due to physiological changes within the pregnancy, pregnant women may be more susceptible to COVID-19. Currently, there exists no reliable evidence being available regarding the likelihood of infection for pregnant women compared to the general population. On the other hand, given the previous experiences with SARS and MERS, pregnant women are likely to be at high risk for COVID-19 and its complications. Comparing the results of studies on COVID-19 during pregnancy and that of the general population, it can be concluded that pregnant women develop COVID-19 at a younger age than the general population. The results showed that due to changes during pregnancy, pregnant women have a higher risk for COVID-19 than other people, perhaps due to the lower mean age of COVID-19 in pregnant women, this leads to less COVID-19 on the adverse pregnancy outcomes.

Currently, ultrasound is a well-known clinical modality for pregnancy management and has a prominent role in clinical decision-making. Accordingly, developing guidelines to outline the minimum performance standards of using ultrasound is necessary for different areas of obstetric ultrasound. The fetal brain is one of the most important assessments in anomaly scan. For a basic brain assessment, 3 axial planes are routinely defined. According to most guidelines, the fetal skull’s integrity, shape, and bone density should be assessed while measuring the head size. In this paper, we present 2 cases of skull bony defect with normal routine 3 axial planes. For better detection of CNS anomalies, it is necessary to add other views such as sagittal view to three routine planes. It leads to early detection of anomalies especially in first and early second trimester. Consequently, it helps in deciding for termination, planning interventions and further management.

The prevalence of nonimmunological hydrops fetalis has been reported between 1 in 1500 and 1 in 4000, with an approximate 80% mortality rate. This case-report study explains a case of hydrops fetalis, presented with generalized edema and pleural and pericardial effusion at 30 weeks of gestation with preterm birth at this age due to preterm uterine contractions. No etiology was found for hydrops and all signs resolved thoroughly after birth without treatment. After birth, the newborn was admitted to neonatal intensive care unit and discharged after 47 days in good condition. The infant was completely healthy within three months after delivery.

Thymomas are seldom encountered in the general population, and even more-so uncommonly encountered in pregnancy. Patients usually present with either local, compressive symptoms such as shortness of breath or are asymptomatic and diagnosed incidentally on imaging studies. A subset of them may even present in association with myasthenia gravis. Management of pregnant patients with thymomas are challenging and require multi-disciplinary care involving thoracic surgeons, maternal-fetal medicine specialists, neonatologists and anaesthesiologists to facilitate safe progression of the pregnancy.  We discuss the management of a patient that presented to us with a B2-type thymoma in pregnancy who successfully underwent a video-assisted thoracoscopic excision of the mass and went on to have a safe delivery. The optimal way forward in managing patients with thymomas in pregnancy would be through early recognition of the condition and instituting a mutlidisciplinary approach.