Introduction: Childbearing and rejuvenating society are serious challenges in today's world. Polycystic ovary syndrome (PCOS), which is associated with obesity, has become a common concern for fertility. Early diagnosis of PCOS can improve the treatment process and the quality of life of the family. The present study was conducted with aim to train machine learning models with hormonal marker data and metabolic syndrome to identify PCOS and then present exercise strategies for infertile women. Methods: Data from 1000 infertile women aged 20-45 years with and without PCOS were initially processed, and subsequently, 500 individuals were selected using various methods, including random forests (RF), recurrent feature elimination (RFE), and interaction (MI), to identify important features and incorporate them into different algorithms. Results: Training Decision Tree (DT) model with feature selection by the RF method had the highest accuracy in diagnosis compared to others. Also, according to the results of feature selection by RFE, MI, and RF methods, it was shown that, in addition to sex hormones, fasting glucose, cholesterol, high-density lipoprotein, vitamin D3, and thyroid-related hormones are prominent factors that play a role in predicting PCOS with high accuracy. Conclusion: Diagnosis of PCOS and investigation of its related biomarkers with artificial intelligence showed that metabolic indicators, along with sex hormones, are of particular importance in the diagnosis and treatment of this disease.
Introduction: It seems that vascular function plays a role in the development of diabetes; the present study was conducted with aim to investigate the effect of resistance training on ankle-brachial index, blood pressure and bone morphogenetic protein 4 in women with diabetic peripheral neuropathy. Methods: This randomized clinical trial study was conducted in 2024 on 28 type 2 diabetic women with peripheral neuropathy (Michigan Score higher than 7).The subjects were placed in two groups of resistance training (n=13) and control (n=15). The training group performed 12 weeks of 1RM training including 11 movements at intensity of 50-60% of maximum strength and 1-3 progressive sets (increasing by one set every 4 weeks) performed three days a week. Before the first session and 48 hours after the last training session, blood pressure, brachial plexus index (ABI), and anthropometric indices were measured and blood sampling was collected. Data analysis was performed using SPSS statistical software (version 27) and dependent t-test and analysis of covariance. P<0.05 was considered significant. Results: In ankle-brachial index (P=0.011), systolic blood pressure (P=0.02), blood sugar (P=0.001), insulin resistance (P=0.001) and 4-BMP (P=0.001) based on the covariance values, there was a significant decrease in the values of the training group compared to the control group; However, there was no significant difference for weight, body mass index, fat percentage and diastolic blood pressure (P>0.05). Conclusion: According to the results, BMP-4 decreased during resistance training and it seems that the decrease may be related to exercise-induced arterial changes, but needs more research in this field.
Introduction: Postpartum pain can have a negative impact on the mother's psyche and the relationship with the baby. Herbal medicines, with greater acceptability and fewer side effects are a suitable method for reducing pain. The present study was conducted with aim to determine the effect of soft gel capsules of Rosa damascena (Damask rose) on the severity of postpartum pain in multiparous women. Methods: This triple-blind randomized clinical trial was conducted in 2023–2024 on 88 multiparous women with moderate to severe postpartum pain in Shabihkhani Maternity of Kashan. The subjects were randomly assigned to two groups of: Rosa damascena capsules and placebo (n=44 in each group). The intervention group was given Rosa damascena capsules 2 hours after delivery and every 8 to 24 hours, and the control group was given placebo with the same characteristics. The participants' pain intensity was measured using a visual pain scale before and one hour after capsule consumption. Data analysis was performed using SPSS statistical software (version 26) and chi-square, independent t-test, paired t-test, repeated measures analysis of variance, and analysis of variance. P<0.05 was considered significant. Results: According to the results, the mean pain intensity after the intervention was not significantly different between the two groups (p>0.05). After the intervention and over time, the intensity of postpartum pain decreased in both groups receiving Rosa damascena capsules (p<0.001) and placebo (p<0.001). Conclusion: In the present study, the effect of Rosa damascena soft capsules was compared with a placebo. The results indicated no statistically significant difference between the two groups, and insufficient evidence was found to confirm the effectiveness of Rosa damascena under the study conditions. Therefore, further studies with different designs (such as higher doses, longer duration of administration, different formulations, or larger populations) are recommended to more accurately evaluate the effect of Rosa damascena on the reduction of postpartum pain.
Introduction: Blood pressure disorders and gestational diabetes are common problems during pregnancy that threaten the health of mother and fetus. The acidic load of the diet is known to be an effective factor in the occurrence of these complications. The present study was conducted with aim to investigate the effect of diet on blood pressure disorders and gestational diabetes. Methods: In this systematic review, databases of PubMed, Web of Science, Scopus, Embase, SID and Magiran were searched using the related keywords "Dietary Acid Load", "Acidity", "Alkaline diet", "Gestational Diabetes" and "Hypertensive disorders" in Persian and English language until July 2025. The selection of articles was based on the inclusion and exclusion criteria and the quality of the articleswas assessed with the Newcastle-Ottawa scale. Results: Finally, 5 relevant studies were selected and reviewed with a total volume of 7869 pregnant and non-pregnant women. The data were mainly extracted and calculated from the semi-quantitative food frequency questionnaire and acid load indices such as NEAP and PRAL. According to most studies, high dietary acid load is associated with a significant increase in blood pressure disorders and gestational diabetes. Increasing the consumption of fruits and vegetables and reducing animal protein can decrease these risks. Conclusion: Despite limited studies, regulating dietary acid load by modifying maternal nutritional patterns is effective in preventing and reducing hypertension and gestational diabetes. Prospective studies and clinical trials are necessary to more accurately confirm this association.
Introduction: Women's health is recognized as a fundamental axis in family and community health. This study was conducted with aim to investigate the common reasons for women's referral to the specialized women's clinics in Ahvaz. Methods: This cross-sectional retrospective study was conducted on 252 women referring to the specialized women's clinics in Ahvaz. Data were collected by census method from medical records between Oct 2023 and Mar 2024. Demographic information, medical history, and reasons for referral were reviewed in full compliance with ethical standards. Simple random sampling was performed from 1600 records and considering the inclusion and exclusion criteria. Data analysis was performed by SPSS software (version 26) and Chi-square test. P<0.05 was considered significant. Results: In this study, 21 (8.3%) had a history of infertility and 231 (91.6%) reported no history of infertility. Also, 64 (25.4%) reported a history of at least one miscarriage and 41 (16.2%) had irregular menstrual bleeding. Polycystic ovary syndrome (PCOS) was the most common with 27 cases (10.7%), and then vaginal infections with 17 cases (6.7%) and chronic pelvic pain with 15 cases (5.9%). Moreover, 5 (2.0%) of the women had primary infertility and 11 (4.3%) had secondary infertility. Oncological problems with 3 cases (1.2%) and genital warts with 1 case (0.4%) had the lowest prevalence among the patients. Pregnancy care with 140 cases (55.5%) was the most common reason for women to visit the hospital (P<0.05). Conclusion: Prenatal care was the main focus of referrals, while attention to preventive screenings and management of common problems such as obesity, miscarriage, and polycystic ovary syndrome in the study population needs to be strengthened.
Introduction: Bacterial vaginosis (BV) during pregnancy is associated with adverse outcomes. Some studies have suggested that vitamin D deficiency may contribute to the development of BV, while others have found no association. This systematic review was conducted with aim to determine the relationship between serum vitamin D levels and bacterial vaginosis in pregnant women.Methods: Electronic databases including PubMed, Web of Science, Scopus, and Embase were searched using the keywords of pregnancy, vitamin ", and bacterial vaginosis without time restrictions up to March 12, 2025. Google search engine was also reviewed. The quality of the included studies was assessed using the modified Newcastle–Ottawa Scale. Meta-analysis was performed using Stata software. Study heterogeneity was assessed using the I² index and Cochran’s Q test, and publication bias was evaluated using funnel plots and Egger’s and Begg’s tests.Results: Of the initial 224 studies, 15 studies with 4963 participants were included in the review. The association between vitamin D levels and bacterial vaginosis, based on the adjusted odds ratio (AOR=0.98) (95% CI: 0.91–1.05), indicated that due to no statistically significant relationship, vitamin D deficiency was not associated with increased or decreased risk of BV.Conclusion: Serum vitamin D levels showed no statistically significant association with bacterial vaginosis during pregnancy. It seems that this relationship is influenced by multiple intervening factors, and vitamin D alone cannot be considered an independent risk factor.
Introduction: Abnormal uterine bleeding that deviates from the normal pattern or volume has a high prevalence, and it is essential to know the appropriate treatment to reduce this complication. According to studies, one of methods in the treatment of uterine bleeding is acupuncture, which needs more scientific evidence. The present study was conducted with aim to investigate the effect of acupuncture in the treatment of patients with abnormal uterine bleeding. Methods: This clinical trial study was conducted in 2022-2024 on 38 patients referred to the gynecology clinic of Mashhad Medical Sciences Teaching Hospitals. The patients were randomly assigned to the intervention group (drug treatment and acupuncture) (n=19) and the control group (drug treatment without acupuncture) (n=19). In the control group, drug treatment with hormone therapy was performed for 3 months, and in the intervention group, in addition to drug treatment, acupuncture treatment was performed for 12 sessions over a period of 3 months. Then, the menstrual cycle pattern was compared in the patients of the two groups. Data analysis was performed using GPOWER statistical software (version 3.1) and the chi-square, Fisher's exact, and Mann-Whitney tests. P<0.05 was considered significant. Results: In the study of the therapeutic outcomes of acupuncture in the treatment of abnormal uterine bleeding, there was no difference between the two study groups in the frequency of menstrual cycles 3 months after treatment (p=0.863) and 6 months after treatment (p=0.729), duration of bleeding 3 months after treatment (p=0.339) and 6 months after treatment (p=0.418), and severity of bleeding 3 months after treatment (p=1) and 6 months after treatment (p=1). Conclusion: No strog evidence was found in favor of the effect of acupuncture on improving the conditions of patients with abnormal uterine bleeding.
Introduction: The Pro12Ala polymorphism of the PPARγ gene affects insulin sensitivity, but its distribution in Iranian patients with polycystic ovary syndrome (PCOS) based on diabetic status has been less investigated. This study was conducted with aim to determine the frequency of Pro12Ala genotypes in diabetic and non-diabetic PCOS patients in Mashhad. Methods: This cross-sectional study was conducted in 2020 on 200 women with PCOS based on Rotterdam criteria, including 100 diabetic and 100 non-diabetic patients. Demographic information including age and body mass index (BMI) was recorded for all participants. Genotyping was performed using PCR-RFLP method, and fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) were evaluated. Data analysis was performed using SPSS software (version 26) with Chi-square, Fisher's exact, independent t-test, and analysis of covariance (ANCOVA). P<0.05 was considered significant. Results: The mean age and BMI were significantly higher in the diabetic group compared to the non-diabetic group (p<0.05). The frequency of the Ala allele was significantly lower in the diabetic group (4.5%) than in the non-diabetic group (11%) (p<0.05). The odds ratio for the presence of the Ala allele in the non-diabetic group compared to the diabetic group was 2.62 (95% CI: 1.15-5.98). After adjusting for age and BMI using ANCOVA, the difference in HOMA-IR between the two groups remained significant (p=0.012). Also, carriers of the Ala allele showed lower HOMA-IR values compared to individuals with the Pro/Pro genotype, although this difference was not statistically significant (p>0.05). Conclusion: The Pro12Ala polymorphism has a lower prevalence in PCOS patients with diabetes. The findings of this study suggest that the Ala allele may be associated with a reduced risk of developing type 2 diabetes in women with PCOS (OR=2.62; 95% CI: 1.15-5.98).
Introduction: Along with the growth of modern technologies, the use of artificial intelligence (AI) in infertility diagnosis and treatment has expanded rapidly; however, the available evidence is scattered and heterogeneous, and most studies have not provided a comprehensive systematic review. Previous studies have shown that AI models have promising performance than traditional methods in predicting IVF success, assessing embryos, and analyzing sperm; however, results have been inconsistent, necessitating a systematic review. This study aims to systematically review the applications of AI in the field of infertility and to analyze the accuracy, benefits, and limitations of this technology. Methods: In this narrative review which was conducted in accordance with PRISMA 2020 guidelines, a search was performed in PubMed, Scopus, Web of Science, Google Scholar, and Cochrane databases between 2015 and 2025. Out of 4,320 retrieved records, 70 studies met the inclusion criteria after screening and quality appraisal using the QUADAS-2 tool. The data were synthesized narratively. Results: Artificial intelligence models have demonstrated considerable effectiveness in various areas of infertility. In predicting the success of in vitro fertilization (IVF), the accuracy of machine learning–based models has been reported to range between 75% and 92% in different studies. In addition, in the assessment of embryo quality using time‑lapse imaging, deep learning models in some cases have shown better performance than human evaluation. In sperm analysis, computer vision algorithms have also demonstrated greater accuracy than manual methods in detecting morphological abnormalities and DNA fragmentation. Furthermore, machine learning models have shown promising results in personalizing treatment protocols, particularly in determining gonadotropin dosage and predicting ovarian response. In the diagnosis of causes of female infertility, the accuracy of artificial intelligence models in identifying conditions such as polycystic ovary syndrome (PCOS) and certain hormonal disorders has been reported to range between 70% and 88%. Conclusion: AI can significantly enhance diagnostic accuracy, improve embryo selection, and enable personalized reproductive care. Nevertheless, challenges remain, including data bias, lack of standardized datasets, and limited external clinical validation. Future research should focus on improving algorithm transparency and developing more reliable models.
Introduction: Midwifery education is a part of the medical education system that deals with human life. This study was conducted with aim to evaluate the quality of approved midwifery curricula in the clinical education program of medical students with the job needs of physicians working in the health centers of South Khorasan Province. Methods: In this descriptive-analytical study, 86 general practitioners of South Khorasan Province were selected using convenience sampling and examined in 2023. The data collection tool was a researcher-made questionnaire with 33 questions that assessed the quality of approved midwifery training topics in the clinical training program of medical students with the job needs of practicing physicians. Data analysis was performed using SPSS statistical software (version 16) and one-sample t-test, independent t-test, and analysis of variance statistical tests. P<0.05 was considered significant. Results: Based on the results of the study, the mean score of the topics of prenatal care, labor physiology, labor course, postpartum care, preterm labor, and post-term pregnancy was less than the theoretical mean of 1.5; therefore, it can be said that these topics correspond slightly to the job needs of general practitioners and were statistically significant. Other midwifery topics were highly consistent with the job needs of general practitioners (p=0.0001). Conclusion: Given that in deprived and remote areas, access to specialist doctors and sufficient treatment facilities is not easily possible, general practitioners in the health service system must be able to diagnose emergency diseases of pregnant women, therefore, the homogeneity of midwifery topics in the general medicine course with the job needs of physicians is of great importance.
Introduction: Trying to control postoperative pain in patients undergoing hysterectomy surgery in order to improve faster and reduce the length of hospitalization has always been the focus of gynecological surgeons. The present study was conducted as a systematic review with aim to evaluate postoperative pain control following hysterectomy. Methods: In this systematic review study, all the articles that were the result of clinical trials conducted in Iran in Persian or English, without time limit until 30 September 2022 (September 21, 2023), were reviewed by searching in Scopus, PubMed, Magiran, SID, Medlib, Cochrane, Science Direct and Google Scholar search engine. To search for articles in Persian sources, the keywords hysterectomy, abdominal hysterectomy, pain, spinal anesthesia, general anesthesia was used and in English sources, their English equivalent, with all their possible combinations were used. Jadad checklist was used to evaluate the quality of the articles. The information obtained include name of the author (first author), year of publication, place of study, investigated drugs, clinical trial code, sample size, age of patients, pain criteria, times of measuring pain intensity and the final outcome of the study were evaluated and reviewed. Results: Among the reviewed articles, 32 studies were selected. A total of 2688 patients (15–58 years old) were included in the studies. Preoperative administered medications were prescribed 30 minutes to 2 hours before anesthesia and rest were administrated during or after surgery. The most investigated drugs in the studies were related to gabapentin and ketamine with 7 studies and the least related to drugs; clonidine, dexamethasone, magnesium oxide, diclofenac, tramadol, morphine, dexmedetomidine, tizanidine and naproxen with 1 study. Conclusion: Gabapentin drug can reduce pain after hysterectomy surgery. It seems that this drug can be used as a suitable alternative to opioids in hysterectomy surgery.
Introduction: Preeclampsia is caused by inadequate perfusion of the placental body due to inadequate regeneration of the spiral arteries of the uterine body. Early diagnosis and treatment with aspirin can prevent the occurrence of preeclampsia (PE) and fetal and maternal complications. The present study was conducted with aim to compare the effectiveness of high and low dose aspirin in the prevention of preeclampsia in pregnant mothers with impaired Doppler.Methods: This double-blind, randomized, placebo-controlled, parallel-group trial was conducted in the Sabzevar Perinatology Clinic during 2001-2002. A total of 300 women with singleton pregnancies and abnormal uterine artery Doppler on ultrasound performed in the first trimester, before 22 weeks, were enrolled in the study. The intervention consisted of daily high-dose aspirin (160 mg) or low-dose aspirin (80 mg) until 36 weeks of gestation. Pregnancy outcomes were compared in the two groups using the Mann-Whitney and Chi-square tests.Results: The incidence of mild preeclampsia was reported in 8 patients (5.4%) and severe preeclampsia in 4 (2.7%) in the high-dose group, compared to 3 patients (2.0%) with mild preeclampsia (p=0.13) and 1 (0.7%) with severe preeclampsia (p=0.18) in the low-dose group. In the high-dose group, 12 patients (8.1%) had intrauterine growth restriction (IUGR), 39 (26.4%) had preterm labor, and 22 (14.9%) had high blood pressure. In the low-dose aspirin group, these rates were 6 patients (4.0%) (p=0.10), 27 (18.0%) (p=0.055), and 16 (10.7%) (p=0.055), respectively. Mean of infant weight was 3102.46±509.47 in the high-dose group versus 3064.68±437.6 in the low-dose group (p=0.3).Conclusion: Low-dose aspirin (80 mg) compared to high-dose aspirin (160 mg) before 22 weeks of gestation in women with abnormal uterine artery Doppler findings has the same effect in preventing preeclampsia, preterm delivery, intrauterine growth restriction, hypertension, and infant weight.
Introduction: Many factors predispose pregnant mothers to premature rupture of membranes and premature birth. Premature rupture of membranes has complicated approximately 10% of pregnancies. Examination of umbilical cord blood gases is performed to evaluate the fetal response to labor stress. Severe acidemia can increase neonatal mortality and damage the newborn's neurodevelopment. Given the importance of the problem, the present study was conducted with aim to determine and compare the acidity of umbilical artery blood at different gestational ages with ruptured amniotic sac. Methods: This descriptive-analytical cross-sectional study was conducted on all mothers with rupture of membranes who referred to Imam Sajjad Yasouj Hospital in 2022. The women were placed in three groups: “before 37 weeks”, “after 37 weeks before starting pain and rupture” and “term”. Data related to gestational age, infant gender, maternal age, multiples, Apgar score at 1 minute and 10 minutes, maternal underlying disease, type of delivery and umbilical cord arterial blood pH were extracted from their records. Data analysis was performed using SPSS statistical software (version 28) and one-way ANOVA, Kruskal-Wallis and post hoc tests with Bonferroni correction. P<0.05 was considered significant. Results: Based on the analyses, there was a significant difference between pH of the umbilical artery in rupture of the amniotic sac at term and before term (P=0.003). There was a significant difference in distribution of umbilical artery acidity at different times of rupture of the amniotic sac (P=0.013). The distribution of umbilical artery pH acidity in vaginal delivery had a statistically significant difference (P=0.001). However, no statistically significant difference was observed in cesarean deliveries (P=0.493). The distribution of umbilical artery acidity in female newborns, unlike male newborns, had a statistically significant difference (P=0.013). Conclusion: The blood gases of the newborns in vaginal delivery were different in the three groups and there was a relationship between the Apgar score and umbilical artery blood gases in the first hour of birth. Given the importance of umbilical cord pH, it is recommended to measure umbilical artery pH to determine the prognosis of stressed neonates in vaginal and cesarean delivery.
Introduction: Given the prevalence and high physical and psychological complications of urinary incontinence, as well as the need to identify more effective treatments, this study was conducted with aim to determine the efficacy of Solifenacin succinate in treatment of mixed urinary incontinence. Methods: In this randomized controlled clinical trial, 200 women with mixed urinary incontinence who visited Taleghani Hospital in Tehran between 2022 and 2024 were selected based on inclusion criteria and through convenience sampling. They were randomly assigned using block randomization into two groups: the intervention group (n=100, 5 mg oral solifenacin succinate once daily for three months) and the placebo group (n=100). The severity of urinary incontinence was assessed using the standardized QUID questionnaire once before the study and then at 1.5 and 3 months after the study, with comparisons made between the two groups. Data analysis was performed using SPSS statistical software (version 23) and the paired t-test, Mann-Whitney, Chi-square, and Fisher's exact tests. P<0.05 was considered significant. Results: The QUID scores decreased significantly more in the intervention group compared to the control group at 1.5 months post-study (-8.47 ± 2.94 vs. -0.88 ± 1.42, p<0.001) and at 3 months post-study (-11.87 ± 3.04 vs. -5.70 ± 4.24, p<0.001). In the intervention group compared to the control group, the QUID questionnaire scores were significantly lower at 1.5 months (6.65 ± 1.08 vs. 14.80 ± 2.52, p<0.001) and at 3 months post-study (3.25 ± 1.11 vs. 9.98 ± 4.34, p<0.001). Conclusion: It appears that Solifenacin succinate is an effective medication for treatment of mixed urinary incontinence.
Introduction: Oligoasthenoteratozoospermia (OAT) is one of the most common causes of male infertility, leading to significant alterations in sperm parameters. Increased production of reactive oxygen species (ROS) can cause cellular damage and reduce fertility. Myo-inositol (MYO) has been suggested to improve certain sperm parameters and mitigate the negative effects of ROS. This study was conducted with aim to evaluate the efficacy of myo-inositol-containing supplements on sperm parameters in men with OAT. Methods: A systematic search was conducted in Magiran, PubMed, Scopus, Web of Science, Cochrane, SID, and Google Scholar databases using Persian and English keywords (Male Infertility, Myo-Inositol, Sperm Quality, Sperm Motility, Randomized Controlled Trial, Meta-Analysis) and keywords with Boolean operators AND/OR. Data analysis was performed using Egger software. Heterogeneity among studies was assessed using Cochran’s Q test and the I² index. Results: Out of 23.250 identified articles, 10 studies entered the study, and among them, 4 studies were eligible for meta-analysis. The analysis using fixed-effect model showed that myo-inositol supplementation was associated with significant improvements in sperm parameters: sperm motility (effect size: 2.66; 95% CI: 0.58–4.73), progressive motility (3.20; 1.44–4.96), sperm concentration (3.93; 2.64–5.41), and sperm morphology (6.19; 5.63–6.75). Conclusion: The findings indicate that myo-inositol supplementation can significantly improve sperm parameters and male fertility in men with OAT, supporting its potential use as an effective adjunct in the management of male infertility associated with OAT.
Introduction: Infertility is one of the major global health challenges with extensive physical, psychological, and social dimensions. In Iran, cultural and social pressures on infertile women further increase the complexity of this issue. In vitro fertilization (IVF) is one of the most successful methods for infertility treatment; however, its acceptance is influenced by various factors. The present study was conducted with aim to examine the factors affecting infertile women’s willingness to undergo IVF using the Health Belief Model.Methods: This descriptive–analytical survey study was conducted in 2024–2025 among 206 infertile women attending infertility treatment centers in Qom. Data on infertile women’s inclination to use IVF were collected using a researcher‑made questionnaire based on the Health Belief Model. Data were analyzed using multiple linear regressions.Results: The results showed that self‑efficacy and perceived benefits had a positive and significant effect on the willingness to undergo IVF, while perceived barriers had a negative and significant effect. Perceived susceptibility and perceived severity showed no significant effect. Strengthening self‑efficacy, increasing awareness of the benefits of IVF, and reducing economic and social barriers through educational and supportive interventions may improve acceptance of this treatment method.Conclusion: The findings indicated that strengthening self‑efficacy, increasing awareness of treatment benefits, and reducing perceived barriers can be the most effective strategies for improving acceptance of IVF.
Introduction: Postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, with uterine atony being its most common etiology. Rare pathological placental abnormalities, such as chorangiosis, may contribute to the occurrence and severity of PPH, although reports on this association are scarce. In this study, a case of severe postpartum hemorrhage with treatment-resistant atony due to placental chorangiosis is reported. Case Presentation: We report a case of a 27-year-old primigravid woman (G1) at 38 weeks and 4 days of gestation who underwent an emergency cesarean section due to oligohydramnios and breech presentation. Following the delivery of a healthy newborn, the patient developed severe uterine atony refractory to standard therapeutic measures and ultimately required a subtotal hysterectomy due to massive hemorrhage. Histopathological examination of the placenta revealed chorangiosis. After stabilization of hemodynamic status and intensive care management, the patient was discharged in good general condition. Conclusions: This case suggests a possible association between placental chorangiosis and severe refractory PPH. Awareness of this rare placental condition may help clinicians anticipate life-threatening complications and optimize management strategies.
Introduction: Recurrent pregnancy loss is defined as at least two pregnancy losses up to 20 weeks of pregnancy. Various genetic, immunologic, and anatomic etiologies lead to recurrent pregnancy loss; however, about 50% of them remain idiopathic. Among the possible causes, the role of different inherited thrombophilia polymorphisms as one of the effective factors in recurrent pregnancy loss still remains unclear. The present review study was conducted with aim to investigate the association of common single nucleotide polymorphisms in hereditary thrombophilia with recurrent pregnancy losses in female population of Iran. Methods: In this review study, using keywords including “Thrombophilia”, “Recurrent pregnancy loss”, “Recurrent miscarriage”, “Single Nucleotide Polymorphism”, “MTHFR polymorphism”, “Prothrombin G20210A”, “PAI-1 polymorphism”, “Factor XIII V34L”, and “Iran”, all articles in English or Persian investigating the association between common single nucleotide polymorphisms within inherited thrombophilia and recurrent pregnancy loss in female population of Iran from 2008 to 2025 were evaluated. Results: In the initial search, 788 results were found. Following the screening based on the titles, abstracts, and full texts according to the inclusion and exclusion criteria, finally, 23 articles remained for the data extraction. The results showed that while there was no consistent evidence for FVL G1691A and FII G20210A polymorphisms in the Iranian population, MTHFR and PAI-1 4G/4G gene polymorphisms showed more consistent association in the studies. Conclusion: A review of the available evidence in Iran showed that the MTHFR and PAI-1 4G/4G polymorphisms are likely to be associated with an increased risk of recurrent pregnancy loss, while the evidence for FVL G1691A and FII G20210A was inconsistent, and for FXIII V34L, a significant association was mostly not reported. These findings emphasize the need for more standardized studies based on larger populations.
Introduction: Chlamydia trachomatis is a common infection in young and sexually active women. Although most cases of infection are asymptomatic, but, potentially dangerous, regarding women's reproductive health. The present study was conducted with aim to compare the frequency of active chlamydia infection by polymerase chain reaction (PCR) in women with ectopic and intrauterine pregnancies. Methods: In this case-control study, 200 pregnant womenو including 100 patients with ectopic pregnancy as the case group and 100 women with normal intra-uterine pregnancy as the control group, were evaluated and compared regarding chlamydia infection, history of exposure to cigarette smoke, age of marriage, history of urinary tract infection, genital infection and abortion. PCR was used to diagnose chlamydia trachomatis. Data were analyzed by statistical SPSS software (version 25) and independent t-test, chi-square and Fisher's exact test. P < 0.05 was considered significant. Results: In the case and control groups, mean age were 32.6 ± 2.9 and 31.27± 3.7 years, frequency of chlamydia was 1% and 10% (P=0.005), history of active and inactive exposure to cigarette smoke was 39.7% and 19.8% (P=0.015), genital infections were 39.1% and 16.8% (p=0.011), recent urinary tract infections as 11.4% and 9.7% (p=0.719) and sexually transmitted infections were 60.4% and 16.6% (p=0.001), respectively. Conclusion: The frequency of exposure to cigarette smoke and the history of previous sexually transmitted infections were higher in women with ectopic pregnancy than those with normal pregnancy, but chlamydia trachomatis was lower in ectopic pregnancy than normal pregnancy. Given the contradictory findings, it seems that more research is needed for evaluating the possible effect of active Chlamydia trachomatis infection on development of ectopic pregnancy.
Introduction: Postpartum pain is one of the common problems during the postpartum period. Due to the harmful effects of chemical drugs, the use of herbal medicines has become popular. Therefore, this study was conducted with aim to investigate the effect of Juniperus sabina L plant capsule on the severity of postpartum pain in multiparous women.Methods: This triple-blind, randomized, controlled, clinical trial was conducted on 66 mothers who gave birth in 2024-2025 at the hospitals affiliated with Shahid Beheshti University of Medical Sciences. During the first 24 hours after delivery, the intervention group was given up to 4 doses of Juniperus sabina L capsules every 8 hours and the control group was given placebo capsules. The intensity of postpartum pain was recorded using the VAS tool half an hour, one hour, and two hours after each intervention. Data analysis was performed using SPSS statistical software (version 21) and statistical tests such as Chi-square, Fisher's exact, independent t-test, and regression analysis.Results: There was a significant difference between the mean pain score in the two groups over time (P<0.001), so that the mean pain intensity score before the first dose in the intervention group decreased from 7.6±1.7 to 0.44±0.86 2 hours after the fourth dose. The results of repeated measures analysis of variance showed that there was a significant difference between the mean pain score within the group over time in the intervention group (Eta2=0.530, P<0.001), so that the use of Juniperus sabina L capsules was effective in reducing postpartum pain by about 0.53%.Conclusion: Considering the reduction in pain intensity and the absence of complications, the use of Juniperus sabina L capsules can be recommended.
