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Pilehvari S, Radnia N, Ahmadiani S, Talebi-Ghane E, Alimohammadi N, Mousaei Tokaldani Z. The value of ovarian hyperstimulation syndrome in predicting pregnancy outcome in women with polycystic ovarian syndrome and candidate for in vitro fertilization: A case-control study. Int J Reprod Biomed 2023; 21:921-928. [PMID: 38292512 PMCID: PMC10823122 DOI: 10.18502/ijrm.v21i11.14655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 08/07/2023] [Accepted: 10/18/2023] [Indexed: 02/01/2024] Open
Abstract
Background: Ovarian hyperstimulation syndrome (OHSS) as a known complication in women with polycystic ovarian syndrome (PCOS) may occur following inducible fertility treatments such as in vitro fertilization (IVF) and can affect the sequels of these treatments. Objective: This study aimed to assess the effects of OHSS on pregnancy outcomes through IVF in women with PCOS. Also, we assessed the value of baseline sexual hormones to predict the pregnancy's success. Materials and Methods: This case-control study was conducted on 180 consecutive women suffering from PCOS who were candidates for IVF at Fatemieh hospital in Hamadan, Iran, from May-July 2022. The women were assigned to the case group (with OHSS, n = 129) and the control group (without OHSS, n = 51). Measuring the sexual hormones was performed using the enzyme-linked immunosorbent technique. Results: In the multivariable logistic regression model, OHSS could not predict the likelihood of clinical or chemical pregnancy following IVF. None of the baseline sexual hormones could predict the successful chemical or clinical pregnancy in PCOS women following IVF. Conclusion: OHSS may not influence IVF-related outcomes in PCOS women. The values of sexual hormones may not also determine the pointed outcome.
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Affiliation(s)
- Shamim Pilehvari
- Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Radnia
- Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Somayeh Ahmadiani
- Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Elaheh Talebi-Ghane
- Modeling of Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Neda Alimohammadi
- Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zahra Mousaei Tokaldani
- Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran
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Radinmehr H, Radnia N, Tabatabaei A, Asadi MR, Rahbar S, Talimkhani A, Irani AD, Hajvalie GR. Transcutaneous tibial neurostimulation and Solifenacin in urgent incontinence of postmenopausal women. Eur J Transl Myol 2023; 33:11358. [PMID: 37345495 PMCID: PMC10388598 DOI: 10.4081/ejtm.2023.11358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/24/2023] [Indexed: 06/23/2023] Open
Abstract
Symptoms of overactive bladder syndrome (OAB), including urinary incontinence, affect a person's quality of life and cause many personal, social and economic problems. Patients were randomly divided into three groups and received transcutaneous tibial nerve stimulation (cTTNS) with fixed parameters or with variable parameters (vTTNS) and Solifenacin drug. The main outcomes including quality of life questionnaire and OAB score and other secondary outcomes were evaluated before and after treatment for 6 weeks. ANOVA test did not show any significant difference between the three groups in quality of life score (p=0.672), OAB symptom score (p=0.159) and incontinence severity (p=0.422). The t-test demonstrated that the post treatment average quality of life score, OAB score, and incontinence severity were significantly different when compared with before treatment in all three groups (p < 0.05). All three methods were effective in treating symptoms of OAB. However, based on the clinical symptoms, cTTNS is recommended as a preferred and acceptable and safe strategy for the treatment of OAB in women over 50 years old.
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Affiliation(s)
- Hojjat Radinmehr
- Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan.
| | - Nahid Radnia
- Hamadan University of Medical Sciences. Fatemie Hospital, Hamadan.
| | - Azade Tabatabaei
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran.
| | - Mohammad Reza Asadi
- Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan.
| | - Soulmaz Rahbar
- Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan.
| | - Ailin Talimkhani
- Department of Physiotherapy, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan.
| | - Amin Doosti Irani
- Department of Epidemiology, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan.
| | - Gholam Reza Hajvalie
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran.
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Sedaghat M, Talebi-Ghane E, Goodarzi A, Kamkari S, Anvari R, Beheshti rouy R, Radnia N. Evaluation of Vitamin D Serum Levels in Pregnant Women with COVID-19 Compared with the Control Group in Pregnant Women: A Case-Control Study. SN Compr Clin Med 2023; 5:140. [PMID: 37193317 PMCID: PMC10170026 DOI: 10.1007/s42399-023-01478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/18/2023]
Abstract
The findings of studies on serum 25-hydroxy-vitamin D [25(OH) D] levels in pregnant women with or without coronavirus disease 2019 (COVID-19) were found to be controversial and inadequate. The present study was thus carried out at to fill the gap felt in this regard. In this case-control study, 63 pregnant women with singleton pregnancy who were infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and 62 pregnant women who were matched for gestational age and not infected by COVID-19 were examined. Based on clinical symptoms, the patients with COVID-19 were divided into three groups: mild, moderate, and severe. ELISA method was adopted to measure [25(OH) D] level. The [25(OH) D] means of 23.4 ± 9.2 ng/ml and 31.2 ± 0.15 ng/ml were noted in the case and control groups, respectively (p < 0.001). The [25(OH) D] level of lower than 30 ng/ml was observed in 43.5% of the control group (n = 27) and 71.4% of the case group (n = 45; p = 0.002). Multivariate linear regression analysis to match age, gestational age, [25(OH) D] supplement use, and number of pregnancies showed that [25(OH) D] mean in the case group is 8.2 units lower, compared to the control group (p < 0.001). The [25(OH) D] level in pregnant women with COVID-19 is lower, compared to non-infected pregnant women. However, there is no significant relationship between [25(OH) D] level and disease severity. A sufficient level of [25(OH) D] may protect pregnant women against COVID-19.
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Affiliation(s)
- Maryam Sedaghat
- Resident of obstetrics and gynecology , clinical research development unit of fatemieh hospital , department of gynecology , school of medicine, Hamadan university of medical sciences, Hamadan, Iran
| | - Elaheh Talebi-Ghane
- Assistant professor of biostatistics , Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Science, Hamadan, Iran
| | - Aryan Goodarzi
- General Physician, Clinical Research Development Unit of Fatemieh Hospital, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, Hamadan, Iran
| | - Sima Kamkari
- Assistant Professor of Obstetrics and Gynecology, Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology , School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Roghayeh Anvari
- Assistant Professor of Obstetrics and Gynecology, Fellowship of Infertility Fellowship Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rezvaneh Beheshti rouy
- Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, School of Medicine, , Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Radnia
- Assistant Professor of Obstetrics and Gynecology, Fellowship of Female pelvic Floor disorders, Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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Radnia N, Hosseini ST, Vafaei SY, Pirdehghan A, Mehrabadi NL. The effect of conjugated estrogens vaginal cream and a combined vaginal cream of vitamins D and E in the treatment of genitourinary syndrome. J Family Med Prim Care 2023; 12:507-516. [PMID: 37122641 PMCID: PMC10131947 DOI: 10.4103/jfmpc.jfmpc_1364_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/24/2022] [Accepted: 11/14/2022] [Indexed: 05/02/2023] Open
Abstract
Background and Aim Genitourinary syndrome occurs due to a decrease in ovarian hormones; this can have a significant negative impact on women's interpersonal relationships and sexual function. The present study aimed at comparing the therapeutic effect of conjugated estrogens vaginal cream and a combined vaginal cream of vitamins D and E in the treatment of genitourinary syndrome in postmenopausal women. Methods This study was conducted as a double-blind randomized clinical trial (RCT). As many as 64 postmenopausal women suffering from genitourinary syndrome were randomly divided into study and control groups. The study group was treated with a combined vaginal cream of vitamins D and E, and the control group was treated with conjugated estrogens vaginal creams for 12 weeks. The patients were visited at the beginning of being admitted, the fourth week, the 12th week, and four weeks after the treatment and their information was recorded by checklists and a sexual function questionnaire. The data were finally analyzed by SPSS-25 at a significant level of 0.05. Result At four visits, libido, orgasm, and frequency of sexual intercourses, as well as vaginal symptoms such as burning, itching, dryness, and dyspareunia were improved in both groups (P <.05). However, there was no difference between the two groups in terms of the frequency of severity of these symptoms during the four visits (P >.05). Investigating the female sexual function index showed that using vitamin D and E vaginal creams, like the use of conjugated estrogens vaginal creams, improves sexual function in women (P <.01). Conclusion According to the results, it can be concluded that the combined vaginal cream of vitamins D and E is a suitable alternative to vaginal estrogens in relieving the symptoms of genitourinary syndrome in postmenopausal women, especially those who are unable to use hormone therapy or have little compatibility with this therapy.
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Affiliation(s)
- Nahid Radnia
- Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Tahereh Hosseini
- Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Address for correspondence: Dr. Seyedeh Tahereh Hosseini, Department of Obstetrics and Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran. E-mail:
| | - Seyed Yaser Vafaei
- Department of Pharmaceutics, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azar Pirdehghan
- Department of Community Medicine, School of Public Health and Research Center for Health Science, Hamadan University of Medical Sciences, Hamadan, Iran
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Mohsenpour F, Radnia N, Ahmadi M, Mohsenpour Z, Jamali M, Mohsenpour MA. Effects of Selenium Supplementation on Incidence and Severity of Preeclampsia: A Randomized, Double-Blind, Placebo-Controlled Pilot Trial. JNFS 2023. [DOI: 10.18502/jnfs.v8i1.11777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background: Preeclampsia is a serious hypertensive condition of pregnancy associated with high maternal and fetal morbidity and mortality. In this study, the effect of selenium supplementation on the incidence and severity of preeclampsia in pregnant women was evaluated. Methods: The present double-blind, placebo-controlled, parallel study was registered at Fatemieh Hospital of Hamadan, Iran. One hundred eighty women in the first trimesters of pregnancy were assigned to either selenium (SG, n = 90) or placebo (PG, n = 90) groups. SG and PG received 100 μg of selenium supplement or placebo per day, respectively. Results: In this study, no significant difference was observed between two groups in terms of age, body mass index, and serum selenium before the intervention (P > 0.05). The incidence of preeclampsia in the SG and PG was 9 and 5, respectively (P = 0.28). There was no statistically significant difference between sex and Apgar score of neonates in the two groups (P = 0.73). The mean birth weight, systolic and diastolic blood pressure in the SG was significantly higher than PG (P = 0.003, 0.01, and 0.007, respectively). The mean gestational age in the SG was insignificantly lower than the PG (P = 0.41). After the study, preeclampsia incidence was not significant between the groups (P = 0.28). Conclusion: The administration of 100 μg of selenium supplementation in pregnant women, had no effect on decreasing preeclampsia, but it may reduce the severity of preeclampsia.
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Radnia N, Khansari S, Jiriaei N, Hosseini SA, Salemi L, Hamoon M. The relationship between perineal size and episiotomy during delivery. J Med Life 2022; 15:1379-1383. [PMID: 36567847 PMCID: PMC9762365 DOI: 10.25122/jml-2021-0390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/08/2022] [Indexed: 12/27/2022] Open
Abstract
Women have anatomically different perineal sizes. Different perineal sizes in primiparous women may be related to episiotomy and its consequences. The aim of this study was to investigate the relationship between perineal size and episiotomy during delivery. 376 primiparous women referred to Fatemieh Hospital in Hamadan with single pregnancies, in the first stage of labor, and with a gestational age of 37 weeks and more, out of which 372 participated in this study. Before entering the first stage of labor, they underwent perineal measurements, such as perineal body (PB), genital hiatus (GH), and anogenital area (AGD), in a forced position. Then, they were followed up for episiotomy and vaginal wall rupture until the end of the second stage of labor. Our outcome in this study was an episiotomy during delivery. The mean gestational age was 39.10±1.21 weeks, and the neonatal weight was 3107.37±42.39 g. 86.3% of women had an episiotomy, and 5.4% experienced perineal tear (laceration). Mean perineal size was 3.99±0.77, genital hiatus was 3.040±0.74, GH+PB was 7.39±1.05, and AGD was 8.49±1.22 cm. There was a statistically significant relationship between perineal body size episiotomy (P=0.011), GH+PB (P=0.003), AGD (P=0.017), neonatal birth weight (P=0.021), as well as grade 1 and 2 rupture (P<0.001). The size of GH+PB at the cut-off point of 6.25 cm and AGD at the cut-off point of 9.25 cm significantly increased the chance of performing an episiotomy. In primiparous women with a gestational age of 37 to 42 weeks, vaginal delivery, shorter perineum, vaginal hiatus, and anogenital distance significantly increased the likelihood of an episiotomy. On the other hand, performing an episiotomy significantly reduced grade 1 and 2 perineal tear rates.
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Affiliation(s)
- Nahid Radnia
- Department of Obstetrics and Gynecology, School of Medicine, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahedeh Khansari
- Department of Obstetrics and Gynecology, School of Medicine, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran,Corresponding Author: Shahedeh Khansari, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran. E-mail:
| | - Nasrin Jiriaei
- Department of Social Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Arezoo Hosseini
- Department of Obstetrics and Gynecology, School of Medicine, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Laleh Salemi
- Department of Obstetrics and Gynecology, School of Medicine, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Minoo Hamoon
- Department of Obstetrics and Gynecology, School of Medicine, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
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Daneshvar F, Radnia N, Alimohammadi N, Garousian M, Talebi-Ghane E, Basiri B, Bashirian S, Eskandarlo T. Comparison of Maternal and Neonatal Outcomes among COVID-19 and Healthy Pregnant Women in the West of Iran: A Retrospective Cohort Study. CWHR 2022. [DOI: 10.2174/1573404819666221101124433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background:
In the COVID-19 epidemic, pregnant women, fetuses, and newborns are a
high-risk population that is more susceptible than the general population. These groups are more susceptible to serious respiratory illnesses and pneumonia because of their weakened immune systems.
This study compared maternal and neonatal outcomes in postpartum women with COVID-19 with
similar healthy women at the hospital
Study Design and Methods:
In this retrospective cohort study, the characteristics of 100 pregnant
women with COVID-19 (confirmed by a positive PCR test during pregnancy) were compared to 150
healthy pregnant women who were referred to Fatemieh Hospital in Hamadan from March, 2020 to
February, 2021. The maternal and neonatal outcomes were collected from the medical record of patients and analyzed using SPSS software (Ver. 26).
Results:
No significant differences were observed in the average ages (± standard deviation) of the
two groups of COVID-19 (30.25 ± 6.24 years) and healthy (29.48 ± 6.73 years) women. In this study,
pregnant women were infected with COVID-19 from weeks 7 to 41 of gestation, with a median infection time of 35 weeks. The odds ratio (95% confidence interval) of pre-eclampsia and preterm birth
was significantly higher in women with COVID-19 than in healthy women with the following values
2.79 (1.61, 7.34) and 22.26 (2.86, 173.33), respectively.
Conclusion:
Pregnant women suffering from COVID-19 had considerably greater rates of gestational
issues, neonatal difficulties, pre-eclampsia, and premature delivery, according to the findings of this
study. During epidemics, it is advised that pregnant women and their newborns receive more basic
care.
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Affiliation(s)
- Fariba Daneshvar
- Clinical Research Development Unit of
Fatemieh Hospital, Hamadan university of Medical Sciences, Hamadan, Iran
| | - Nahid Radnia
- Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences Hamadan, Iran
| | - Neda Alimohammadi
- Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of
Medical Sciences, Hamadan, Iran
| | - Maryam Garousian
- Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of
Medical Sciences, Hamadan, Iran
| | - Elaheh Talebi-Ghane
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of
Medical Sciences Hamadan, Iran
| | - Behnaz Basiri
- Clinical Research Development Unit of Fatemieh Hospital, Department of neonatology, School of Medical, Hamadan University of Medical Sciences Hamadan, Iran
| | - Saeed Bashirian
- Social Determinants of Health
Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Tahereh Eskandarlo
- Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of
Medical Sciences, Hamadan, Iran
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Sohbati S, Hajhashemi M, Eftekhar T, Deldar M, Radnia N, Ghanbari Z. Outcomes of Surgery with Vaginal Native Tissue for Posterior Vaginal Wall Prolapse Using a Special Technique. J Med Life 2021; 13:554-561. [PMID: 33456606 PMCID: PMC7803322 DOI: 10.25122/jml-2020-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There are several techniques for repairing prolapse in the posterior vaginal compartment, yet there is no general agreement on the best surgical procedure. This study was performed to investigate the outcomes of the common vaginal route technique for posterior vaginal wall prolapse repair in the first Iranian fellowship teaching center for female pelvic floor disorders. This prospective cohort study was performed on women with posterior vaginal wall prolapse with or without prolapse of other vaginal compartments who underwent surgery between 2014 and 2018 in a referral center for female pelvic floor disorders. A follow-up period of 12 months was considered. Patients subjected to the transvaginal technique by attachment of the rectovaginal fascia to the pericervical ring using vaginal native tissue were included. Among the 107 patients, the Pelvic Floor Distress Inventory-20 (PFDI-20) scores were 141.87 ± 34.48 and 100.87 ± 26.48 before and after surgery, respectively, showing the significant improvement of patient's symptoms after surgery in the 12-month follow-up. Comparing Pelvic Organ Prolapse Quantification (POP-Q) results before and after surgery, a significant improvement in patients' conditions was seen at the 12-month follow-up. Based on the results of the present study, the surgical procedure of the rectovaginal fascia attachment to the pericervical ring in posterior vaginal wall prolapse repair seems an effective surgical intervention without significant morbidity in the short-term follow-up.
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Affiliation(s)
- Samira Sohbati
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Hajhashemi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Eftekhar
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Deldar
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Radnia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Zinat Ghanbari
- Department of Obstetrics and Gynecology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Radnia N, Hajhashemi M, Eftekhar T, Deldar M, Mohajeri T, Sohbati S, Ghanbari Z. Patient Satisfaction and Symptoms Improvement in Women Using a Vginal Pessary for The Treatment of Pelvic Organ Prolapse. J Med Life 2019; 12:271-275. [PMID: 31666830 PMCID: PMC6814872 DOI: 10.25122/jml-2019-0042] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Pelvic organ prolapse is a common complaint among older women. Vaginal pessary insertion is an appropriate treatment as a non-surgical method with few complications. This paper is a prospective observational study of 68 patients with pelvic organ prolapse that was carried out at the Imam Khomeini Hospital's Pelvic Floor clinic. The degree of pelvic organ prolapse was graded according to the Pelvic Organ Prolapse Quantification (POP-Q) System. For all patients, the Pelvic Floor Distress Inventory-20 (PFDI-20) questionnaire was completed before vaginal pessary insertion, and after approximately 6 months of treatment. After 6-8 months, we found out that vaginal discharge was significantly increased and the feeling of fullness in the vagina was significantly decreased. However, sexual dissatisfaction, the feeling of incomplete evacuation, fecal and urinary incontinence, frequent urination, and pain or discomfort in the genital region were not significantly different after using a pessary. Approximately half a year later, 96.7% of the women with a successful pessary fitting trial were satisfied and reported a significant improvement in symptoms. Further studies with larger sample size, a different type of pessary, and a longer follow-up duration are recommended to evaluate all the symptoms associated with pelvic organ prolapse and its treatment.
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Affiliation(s)
- Nahid Radnia
- Department of Obstetrics & Gynecology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Hajhashemi
- Department of Obstetrics & Gynecology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tahereh Eftekhar
- Department of Obstetrics & Gynecology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Deldar
- Department of Obstetrics & Gynecology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Taraneh Mohajeri
- Department of Obstetrics & Gynecology, Mashhad Islamic Azad University of Medical Sciences, Mashhad, Iran
| | - Samira Sohbati
- Department of Obstetrics & Gynecology, Kerman University of Medical Sciences, Kerman, Iran
| | - Zinat Ghanbari
- Department of Obstetrics & Gynecology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Radnia N, Manouchehrian N, Shayan A, Shirmohamadi N, Eskandarloo T, Otogara M. Frequency and causes of emergency hysterectomy along with vaginal delivery and caesarean section in Hamadan, Iran. Electron Physician 2017; 9:4643-4647. [PMID: 28848642 PMCID: PMC5557147 DOI: 10.19082/4643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 04/20/2017] [Indexed: 11/20/2022] Open
Abstract
Background Emergency hysterectomy (peripartum) is a high-risk surgery that almost always is done in the treatment or prevention of severe and life-threatening bleeding that occurs after vaginal delivery or caesarean. Objective To compare the frequency and causes of emergency hysterectomy along with the vaginal delivery and caesarean section (CS). Methods The cross-sectional research was conducted on patients who underwent a peripartum hysterectomy from 2005 to 2015 at Fatemieh Hospital in Hamadan City, Iran. Data collection tools included a questionnaire about demographic features and factors associated with hysterectomy surgery. Data were analyzed using SPSS version 21 and by descriptive statistics, chi-square, paired t-test, and one-way analysis of variance (ANOVA). Results The mean age of women was 33.4±5.09 years. In recent years, 37 cases of hysterectomy were reported, with the peak occurring in 2015. The highest prevalence of hysterectomy was associated with 28 (77.8%) women with a third pregnancy and second parity, while 32 cases (86.5) were related to those with no history of vaginal delivery, 15 (45.5%) were related to repeated CS and second repeated CS; 28 cases (75.7%) to those with no history of placenta previa; 21 cases (56.8) to the majority with the anterior placenta;, 33 cases (97.1%) to those with no over-distance of uterine; and 36 cases (97.3%) to those without a history of uterine myoma. Among 37 cases who had hysterectomy, placenta accreta was observed in 27 cases (77.1%), with placenta increta in three (8.1%) and placental attachment, including percreta, were seen in seven cases (18.9 %). Conclusion The rate of hysterectomy in multiparous women (in their third or fourth pregnancy) was higher. The greatest cause of hysterectomy was related to attached placenta including accreta, uterus atony, a history of CS, multipara, and repeated CS. Therefore, due to the increase in the number of CSs in recent years, planning should be taken into account in order to encourage pregnant women for vaginal delivery.
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Affiliation(s)
- Nahid Radnia
- Assistant Professor, Clinical Research Development Unit of Fatemieh Hospital, Department of Genecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Manouchehrian
- MD., Associate Professor, Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Arezoo Shayan
- M.Sc., Instructor, Faculty of Midwifery, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasrin Shirmohamadi
- M.Sc., Department of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Marziyeh Otogara
- Ph.D. of Health Education and Health Promotion, Department of Public Health, Health Sciences Research Center, Faculty of Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Otogara M, Karimi-Shahanjarini A, Hazavehei SMM, Poorolajal J, Radnia N, Akrami F, Bagheri F. Exploring perceptions of instructors about childbirth preparation training courses: A qualitative study. Electron Physician 2017; 9:4215-4224. [PMID: 28607658 PMCID: PMC5459295 DOI: 10.19082/4215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/14/2017] [Indexed: 11/20/2022] Open
Abstract
Background Childbirth preparation training courses on maternal and neonatal health increase awareness, and capability of pregnant women in overcoming fear and anxiety and managing labor pains. Objective To identify the affecting factors and barriers of these courses from the perspective of their instructors. Methods This qualitative study of the content analysis type, has been conducted on 16 certified teachers of the training courses of the Hamadan city in 2015. Data were collected by semi-structured in-depth interviews and were then analyzed by using MAXQDA10 application. Results Participants’ experiences are indicated on three main themes including the objectives of the course, facilitators and barriers. The main objectives of the course were reported as to improve maternal and newborn health, promote natural childbirth and preparedness for parenting and breastfeeding. The main facilitators of the successful implementation include observing educational standards, strengthening the communication and relationship between mothers and staff, mobilization, and the role of instructor. The major barriers are reported as inadequate support from management system, insufficient intra-sector collaboration, poor attitude of obstetricians and physicians, inadequate access, theory-practice gap and not intended to labor naturally. Conclusion The results of our study show that multiple factors are involved in the participation of pregnant women in antenatal classes. Promoting natural childbirth requires intra-sector and inter-sectoral collaboration, as well as the community participation.
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Affiliation(s)
- Marzieh Otogara
- Ph.D. Student of Health Education and Promotion, Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Akram Karimi-Shahanjarini
- Ph.D. of Health Education, Associate Professor, Social Determinates of Health Research Center and Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Mohammad Mehdi Hazavehei
- Ph.D. of Health Education, Professor, Research Center for Health Sciences and Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Ph.D. of Epidemiology, Associate Professor, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Radnia
- M.D., Gynecologist, Assistant Professor, Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Forouzan Akrami
- Ph.D. by Research Student, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Bagheri
- Ph.D. Student of Health Education and Promotion, Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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