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Volume 57, Issue 1 (4-1999)
It this prospective cross sectional study out-patient endometrial biopsy by PIPELLE was compared with diagnostic curretage (D&C) in patients suffering of Abnormal Uterine bleeding (AUB). Diagnostic accuracy, sufficient tissue sampling, intensity of pain and effective factors in biopsy results were the evaluated parameters in this study. In 70 patients with complaint of AUB (20 of them were post-menoupsal age admitted in hospital for D&C) endometrial biopsy was conducted by PIPELLE before operation and the results were compared. 96% of total patients (67) and 91% of patients with post menopause age had tolerance of undergoing out-patient PIPELLE biopsy of endometrium. 79% of these individuals complained of mild pain and 21% of moderate pain. Endometrium biopsy by PIPELLE in 77% of patients had similar accurate diagnostic results as compared to D&C. PIPELLE in 34% of patients (24) could not be conducted with the same accuracy of D&C patients, although in 14 (20%) of them, notissue samples could be collected by D&C. In none of these methods endometrial hyperplasia or endometrial cancer were detected. This study showed that in 77% of the total patients, the extra cost and general anesthetical risk of D&C could have been eliminated, by utilization of out-patient biopsy with PIPELLE
Volume 65, Issue 2 (3-2008)
Background: Preterm labor is defined as delivery before 37 weeks of gestation. Recurrence of preterm labor in future pregnancies is 6-8%. History of preterm labor is a strong risk factor for future preterm labor. Preterm labor is the leading cause of neonatal mortality in developed countries, but permanent morbidity in these premature neonates has many side effects for the newborn as well as their family members and society. For this reason we conducted a survey to identify risk factors for recurrent preterm delivery among primiparous women with previous preterm delivery.
Methods: This prospective case–control study included patients from three university hospitals, namely Imam Khomeini, Shariati and Mirza Koochakkhan Hospitals, all in Tehran, Iran. Subjects, including 539 primiparous women who delivered preterm (22–36 weeks), were divided into two groups: 47 had a second preterm delivery (study group) and 492 had first preterm delivery (control group). Exclusion criteria were induced preterm delivery due to medical indications in mother and primigravid. Data collection and analysis was performed using SPSS 10 and t-test and χ2 test were used to analyze the significance of the results.
Results: From a total of 6,537 deliveries, we found 539 cases of preterm delivery, among which 47 cases were identified as recurrent preterm delivery. The control group was composed of 492 deliveries. The recurrence of preterm delivery was 8.7%. Uterine anomaly, cardiovascular, renal and thyroid disease in mother and blood group A had a significant correlation with recurrent preterm delivery.
Conclusion: Expectant mothers with uterine anomalies, cardiovascular, renal or thyroid diseases or group A blood type should receive extra care, observation and instructions in order to limit the risk of preterm delivery and its subsequent effects.
Volume 65, Issue 7 (10-2007)
Background: Uterine sarcomas are malignant mesenchymal neoplasms that represent three to five percent of all uterine tumors, and are classified into three major groups: 1) mixed mullerian sarcoma 2) endometrial stromal sarcoma 3) leiomyosarcoma. The purpose of this study is to determine the association of different prognostic factors with patient survival and tumor relapse.
Methods: Twenty-seven patients with a previous diagnosis of uterine sarcoma were entered into this survival study. Inclusion criteria were presence of primary uterine tumor, confirmation of previous diagnosis in pathologic reassessment and availability for follow-up. We evaluated the association of overall and disease-free survival with eight factors, including FIGO stage, lymph node status, mitotic count per 10 high-power fields, vascular status, age, histology of sarcoma, myometrial depth of invasion and size of tumor.
Results: The median age of our patients was 47 years, ranging from 18 to 73 years, and median time of follow-up was 28 months, ranging from 1 to 114 months. Five-year survival was 61% and the mean time of overall survival was 78 months, with a 95% confidence interval, ranging from 56 to 100 months. LSS histology type, in contrast to other subtypes, and a mitotic count of 0-9, in contrast to 20 and more, were two factors that significantly related to relapse of tumor (p<0.05). The three factors related to survival were FIGO stage (p=0.0039), mitotic count (p=0.0005) and LSS histology type in contrast to other subtypes (p< 0.05). Relapse occurred mostly in the pelvic region or lung.
Conclusion: From our findings and a review of other reports, the FIGO stage is associated with survival, although other factors discussed in the literature are controversial. Some factors had been reported to have significant association only within a restricted histological subgroup. However, due to the limitation of our number of cases in each subgroup, we could not make such an analysis. Future studies with adequate numbers of samples are recommended.
Volume 65, Issue 10 (1-2008)
Background: Tumor diathesis (TD) refers to the granular proteinaceous precipitates on the slide surface of cytologic (Pap) smears. Found in the background of smears from some, but not all, invasive carcinoma cases, TD is present in the majority of smears from large cell nonkeratinizing carcinoma. It is more pronounced than keratinizing SCC also is almost always present in small cell carcinoma. Smears from patients with adenocarcinoma are frequently associated with dense inflammatory and fresh blood exudates and less often there is a recognizable tumor diathesis.
Methods: To determine the prevalence of TD in cervicovaginal smears from patients with uterine cervix carcinoma, cytologic smears and histologic slides of 46 patients with histologically-confirmed uterine cervix carcinoma were reviewed for the presence or absence of TD, red blood cells and neutrophils on cytologic smears, as well as depth of invasion, histologic types and grade of differentiation of tumor on histologic slides.
Results: TD was identified in 28 smears (60.9%), 18 patients with squamous cell carcinoma (62.1%), seven patients with adenocarcinoma (58.3%), two patients with adenosquamous carcinoma (66.7%) and one patient with endometrial carcinoma that involved the uterine cervix. TD was seen in smears from four (33.3%) patients with uterine cervix carcinoma with invasion <5 mm and 17 (65.4%) carcinomas with invasion >5mm. However, some of the patients with invasive carcinoma lacked TD on the cytologic smears. Red blood cells were identified on 16 (34.8%) smears.
Conclusions: Although TD is the hallmark of invasive carcinoma of the cervix on cytological smears, there have been few studies performed on it. We found that tumors with greater depth of invasion and reduced differentiation are associated with TD cytologic smears. TD was absent in some cases, particularly in micro-invasive carcinoma. This study reinforced what has been recognized from other studies.
Volume 66, Issue 6 (9-2008)
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Background: The
prevalence of Rh alloimmunization has decreased following the use of anti-D
immunoglobulin. With serial amniocentesis, Doppler sonography of the middle
cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal
mortality has declined. However, Rh alloimmunization in twin pregnancies poses
a diagnostic and therapeutic challenge.
Case report: We are reporting,
for the first time in Iran, the successful treatment of severe Rh
alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the
live births of both neonates. Before treatment, the fetal hemoglobin levels
were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were
treated with several IUTs.
Results: After treatment, the neonates were
delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational
age of 34 weeks.
Conclusion: 10%
of population in Iran is Rh-negative, although Prophylaxis for Rh
alloimmunization is universal, as other part of the world it cannot irrigated.
For the best management of these cases, we need a well-equipped referral
center.
Volume 67, Issue 11 (2-2010)
Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Preterm delivery is a relevant public health problem since it is an important factor determinant of morbidity and the main reason for neonatal mortality. Many publications have pointed at clinical methods, biological, biochemical and ultrasonographic markers, which applied in combination or on their own, aim at predicting spontaneous preterm delivery. Transvaginal sonography is an effective method for the study of uterine cervix during pregnancy since it permits to assess the cervical morphology and biometry in detail with a high degree of reliability. The aim of this study was to evaluate the association between spontaneous preterm delivery (SPTD) before 35 and 37 weeks of gestational age, in high risk population and the measurement of the cervix length and cervical funneling.
Methods: A prospective cohort of 200 women carrying high
risk pregnancies were evaluated by transvaginal sonography between 14th and 28th weeks of gestation.
Results: Cervical length less than 18mm before 35th and 37th weeks of gestational age and the presence
of cervical funneling presented a satistically significant association with
spontaneous preterm delivery before 35 weeks. The cervical length with less 18 mm demonstrated a strong association with SPTD before 37 weeks (p<0.005 OR=92.15) and before 35 weeks' gestation (p<0.001 OR=32.33). The logistic regression analysis suggested the
cervical length with less than 18mm as the only variable that revealed satistically significance association
with SPTD.
Conclusion: The results seem to indicate
that the assessment of cervical length is an important ultrasound marker for
predicting spontaneous preterm delivery.
Volume 69, Issue 4 (7-2011)
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Background: Intrauterine insemination (IUI) is a less expensive
and less invasive treatment in comparison with other assisted reproductive
techniques, and it has been widely used for a variety of indications as well as
in the treatment of couples with infertility. The outcome of IUI
may be affected by numerous factors but in this study, we evaluated the effects
of cervical mucus removal undertaken before IUI
on clinical pregnancy rates.
Methods : In this randomized clinical trial study, all infertile women who were
candidates for IUI and attended Shahid
Akbar Abadi Hospital during 2009 and 2010
were recruited. The participants were randomly assigned into two groups. Cervical
mucus was removed prior to IUI in patients in group
A but in group B,
a classic IUI was done without removing
the cervical mucus. Pregnancy rates were assessed in the two groups by serum
levels of β-HCG
and detection of fetus in the uterus.
Results : 291 women including 143
in the classic IUI group and 148
in cervical mucus removal group completed the study. The pregnancy rates were 14.2%
(21 pregnancies upon 148
cycles) in the cervical mucus removal group and 7% (10
pregnancies upon 143 cycles) in the
control group (P=0.04, OR: 2.199 CI 95%: 0.997-4.85).
Conclusion: The
findings showed that cervical mucus removal could result in a two-fold increase
in pregnancy rate in comparison with classic IUI.
Thus, we suggest this practical and noninvasive method to improve pregnancy
rate in these patients.
Volume 69, Issue 4 (7-2011)
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Background: Recurrent miscarriage is defined as the loss of three or more pregnancies.
Recurrent Pregnancy Loss (RPL) is traditionally
investigated after three or more consecutive losses. Although some believe that
the investigation must be launched after two miscarriages, there is not enough
compelling evidence to draw conclusion.
Methods : In this cross-sectional study, we studied 58 women
with two or more consecutive abortions (37 women
with two and 21 women with three or
more miscarriages) from 2005 to 2009.
The following risk factors were analyzed and compared between the two groups:
endocrine dysfunctions, genetic abnormalities, uterine anomalies, infections,
thrombophilia, polycystic ovary syndrome, autoimmune disorders, sperm
characteristics, and advanced maternal age.
Results : We did not find any known factor for pregnancy losses in 18
(31.03%) patients but in the rest, the most common
cause of Recurrent pregnancy loss was endocrine disorders (41.4%).
The other causes were uterine abnormalities (12.1%),
infections (12.1%), maternal age more
than 35 years (12.1%),
thrombophilia (8.6%), abnormal semen
analysis (8.6%), genetic defects (6.9%)
and autoimmune disorders (1.7%). There were no
significant differences between the two groups in regards with the causes of
abortion except uterine abnormality (P=0.039)
which was more frequent in women with three or more three miscarriages (23.8%)
relative to women with two abortions (5.4%).
Conclusion: There were no significant differences between women with two or women with three
or more three abortions in regards with the causes of abortion except uterine
anomalies. Therefore, it seems quite reasonable and perhaps beneficial to start
the investigation in patients with two abortions.
Volume 70, Issue 12 (3-2013)
Background: In molar pregnancy, when hydatidiform changes are local and some embryonic components are observed, the term of partial mole is used. The risk of persistent trophoblastic tumor after partial mole is much lower than complete mole. In this persistent cases almost all are non metastatic. The aim of this study is to report a case of uterine rupture following incomplete molar pregnancy.
Case presentation: The patient was a 26 year old woman with obstetric history of an abortion and one molar pregnancy and no child. She was referred to emergency unit in Ghaem University Hospital, Mashhad, Iran in May 2011. She had an evacuation curettage following molar pregnancy three months before and without any follow up visit. The patient was referred to emergency unit with hemorrhagic shock. She immediately underwent laparotomy. The uterine fundal rupture was repaired and evacuation curettage performed. In post operative evaluation, she had a nine millimeter metastatic nodule in base of right Lung. As a patient in low risk stage III, she received weekly intramuscular methotrexate (40mg/m2) for six courses. In follow up visit -hCG titer was negative (<10miu/ml) at 5th week.
Conclusion: In cases of in complete molar pregnancy risk of metastasis is very low. Serial beta-hCG titer is the most accurate method for detection of persistent gestational trophoblastic disease (GTN). In neglected cases like this case preservation of ruptured uterus in GTN is possible.
Volume 72, Issue 8 (11-2014)
Background: Uterine leiomyoma is one of the most common benign smooth muscle tumors occurring in 20-40% of women worldwide in their reproductive years. Recent studies revealed that estrogen plays an important role in the pathogenesis of this disease. Since glutathione S-transferase (GST) gene family are involved in the biosynthesis of estrogen, the prior probability that variants at this locus are associated with uterine leiomyoma is likely to be above the null. Therefore, this study was carried out to examine whether GSTP1 polymorphism (Ile105Val) is associated with increased risk of uterine leiomyoma in Iranian population. Methods: In this case-control study, 50 women diagnosed with uterine leiomyoma and 50 healthy controls were recruited from subjects referred to the Pasteur Institute of Iran from November 2012 to September 2013. The genomic DNA was extracted from peripheral blood leucocytes using the standard phenol-chloroform method and subsequently the GSTP1 polymorphism was genotyped using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Logistic regression analysis was applied to estimate odds ratios and 95% confidence intervals after age adjustment using the SPSS statistical software package, version 18.0. Results: The results showed significant differences between case and control groups in terms of genotype frequency (P<0.0001). In addition, the results indicated that the presence of the valine allele significantly increased risk of uterine leiomyoma about three times more in individuals carrying the mutant allele compared to control group (Odds Ratio: 3.34 95%CI: 1.82-6.15 P<0.0001). Conclusion: To our knowledge, this is the first study performed in Iranian population assessing the association between GSTP1 Ile105Val polymorphism and risk of uterine leiomyoma. However, further extensive studies with a large number of samples from different populations and ethnicities are required to validate the results obtained in this study.
Volume 73, Issue 2 (5-2015)
Background: Rupture of uterus is a catastrophic complication associated with significant maternal and fetal morbidity and mortality. The prevalence of an unscarred uterine rupture is very rare. Although the most important complication of dilatation and curettage is perforation of uterus, dilatation and curettage is not introduced as an important cause of uterine rupture. Case presentation: Here we present a case of uterine rupture in a pregnant woman that was admitted in Tehran General Women Hospital, in December 2014, with reducing fetal movement in her 41th weeks of pregnancy. She did not have any risk factors for rupture of uterus including cephalo-pelvic disproportion and polyhydramnios, also there was no history of uterine surgery such as myomectomy and uterine abnormality repair. A term dead male neonate was delivered by cesarean section due to arrest of descending in stage 2 of labor. The baby weighed 3400 gr and had anomaly in ears, larynx, uvula and soft palate. Its chromosomal study depicted both trisomy and monosomy for chromosome 13 and 21. Mother had a history of illegal curettage and trauma to the uterus in her first pregnancy two years ago. She did not say to us this history and abortion during admission. After cesarean section we saw that in the left side of the posterior wall of uterus was ruptured and baby was died. At surgical exploration, moderate hemoperitoneum was evident. Fetus was already dead at the time of extraction. Total estimated blood loss was 100 ml, the patient was transfused with two units of packed cell. The woman was discharged on the fifth postoperative day in good condition. Conclusion: Effective contraception and safe curettage can reduce maternal mortality and morbidity. Also special attention to a history of curettage to predict uterine rupture is critical.
Volume 74, Issue 4 (7-2016)
Background: Human papilloma virus (HPV) is one of the most important factors in cervical cancer. Viral sequences are integrated into the host cell genome. In mild cases the virus causes skin damages, in severe cases it leads to cancer. Like many other cancers, telomerase gene expression was increased in cervical cancer. This enzyme is a reverse transcriptase that contains two common subunits: i) catalytic protein called human telomerase reverse transcriptase (hTERT) and, ii) RNA sequence called hTR. hTERT expression is hardly found in any somatic tissues. Detection of high telomerase activity in human cells, lead to tumor genesis. So hTERT can be used as a diagnostic tool in cancer detection.
Methods: This experimental study was carried out from May 2013 to April 2014 in Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences in Tehran, Iran. Caski and Hela cancer cell lines were used which contain HPV16 and HPV18 respectively. Cell lines were cultured and total RNA was extracted. Following normalization agent glyceraldehyde-3-phosphate dehydrogenase (GADPH), hTERT expression level was determining by real-time PCR method. For each sample, the expression level of hTERT and GAPDH were quantified as copy numbers (per reaction) using the standard curve. Finally, hTERT levels in Hela and Caski cell lines were compared quantitatively by t-test using GraphPad statistic software version 5 (San Diego, CA, USA).
Results: According to the charts real-time PCR, hTERT gene expression in Hela and Caski cancer cell lines is significantly different (t=0.0319).
Conclusion: All results confirm that hTERT expression levels in Hela and Caski cell lines are significantly different and the level of hTERT expression in the Caski cell line was slightly higher than that of Hela cell line. The significant difference between hTERT mRNA expression levels reported here could be used as a tumor marker for HPV16 and HPV18 in cervical cancer.
Volume 74, Issue 12 (3-2017)
Background: Late postpartum hemorrhage (PPH) is defined as uterine bleeding between 24 hours until 12 weeks after delivery. Uterine artery pseudoaneurysm is a rare cause of life-threatening late postpartum hemorrhage (PPH). Emergency uterine artery embolization (UAE) is an appropriate method for control of hemorrhage. The aim of this report was to present a case of uterine artery embolization in late postpartum hemorrhage due to uterine artery pseudoaneurysm.
Case Presentation: A 25-year-old woman with the history of three previous cesarean sections was admitted 35 days after the last cesarean. She had severe vaginal bleeding for 35 days after cesarean section. Because of severe vaginal bleeding 35 days after cesarean section, the patient was at nearly shock state (BP=90.60 mmHg, positive tilt test, tachycardia PR=120/m). In speculum examination, she had severe vaginal bleeding, but there was no lesion in vagina or cervix, also, bimanual examination of the uterus and adnexal area were normal. She reanimated by two liters of normal saline and uterotonic agents (oxytocin and methergine) were administered.
Laboratory data showed severe anemia (Hb=6.5 gr/dl), but coagulation tests were normal. Ultrasonography didn’t show any abnormality. Because of continuation of vaginal bleeding after stabilization of the patient, UAE was planned. During pelvic angiography, a pseudoaneurysm was diagnosed and then it was treated by successful UAE.
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Conclusion: Uterine artery embolization is a conservative management for control of late postpartum hemorrhage. It can be a useful and alternative method for uterine and hypogastric artery ligation and hysterectomy, therefore it has an important role in treatment and fertility preservation for young women. |
Volume 76, Issue 2 (5-2018)
Case presentation: Our patient was a 24-year pregnant woman with gestational age of 28 weeks. She had nausea and vomiting and right upper quadrant tenderness, she was admitted in surgery ward on January 2017 in an academic hospital in Mashhad and candidate for laparoscopic cholecystectomy with diagnosis of cholecystitis. Her fundal height was 28 centimeters. Laparoscopy was done with Hasson technique and three punctures. During abdominal trocar insertion uterine perforation occurred. Amniotic fluid leaked in the abdomen. Perforation repaired immediately and then cholecystectomy was done. Fetal heart rate was normal. After surgery according to stable vital signs and absence of bleeding and contraction, the patient was transferred to the midwifery department. The patient received one course of betamethasone for fetal lung maturation. Antibiotic therapy initiated. During the hospitalization, the patient was monitored daily for vital signs (fever and tachycardia), uterine contraction, vaginal bleeding and vaginal bleeding. Daily fetal heart monitoring was performed. After close prenatal care cesarean section was done in 38 weeks of pregnancy and a healthy baby was born with appropriate Apgar score.
Conclusion: Laparoscopy in pregnant women is usually safe. Pregnancy-specific complications such as uterine injury are not common, but with a series of precautions before and during surgery. These complications can be reduced. Uterine perforation during laparoscopy if properly managed is usually not associated with significant risk.
Volume 76, Issue 12 (3-2019)
Case presentation: A 30-year-old G2L1 woman with history of a previous cesarean section and possible diagnosis of missed abortion referred to the Gynecology Clinic of Ghaem Hospital, Mashhad University of Medical Sciences, Iran, in 21 May 2017. Cervical pregnancy was diagnosed during curettage. Severe hemorrhage occurred after curettage and the hemodynamic status of the patient was unstable immediately after curettage. Severe threatening vaginal bleeding was controlled with intrauterine Foley catheter containing 60 cc normal saline and then vaginal packing. The patient was discharged with good general condition.
Conclusion: In cervical pregnancy and unstable hemodynamic status and desire to preserve fertility, intrauterine Foley catheter and vaginal packing after curettage is helpful.
Volume 77, Issue 11 (2-2020)
Methods: A retrospective cohort study was conducted, including 65 patients, from March 2012 to March 2018, in Valiasr Hospital, Tehran, Iran. Data including the age, history of cervical insufficiency, history of abortion, history of cervix surgery and curettage, gestational age, presence of vaginal and cervical anomaly as well as complications such as bleeding and severe cervical pain and prognosis of cerclage were extracted.
Results: In our study, 65 women who undergone cerclage were evaluated, the mean age of the participants was 28.4 years. Abortion was present in 27.7% of cases, 16.9% once, 7.7% twice and 3.1% three times. In 21.5% of cases, there was a history of curettage and 66.2% had a history of preterm labor. For 4.6% of the subjects, the length of cervix was under 10 mm. Gestational age at the end of cerclage was under 26 weeks in 5.8% of patients. The termination of pregnancy was higher in patients with lower gravida, and the termination of pregnancy was significantly higher in those who were not curetted (P= 0.001). There were no complications, and the prognosis is considered good, in case the termination is above 32 weeks. The birth weight mean was 3041.5 grams. According to our study, the failure of the cerclage is associated with previous history of dilation and curettage (D&C) and higher gravidity.
Conclusion: Putting all the results together, 80% of the cerclage, performed in our institution were successful, without any complications.
Volume 78, Issue 3 (6-2020)
Case Presentation: A 66 years old grand multiparous woman (6 normal vaginal delivery) who was menopause since 15 years ago, was referred to the emergency unit of an academic hospital of Mashhad University of Medical Sciences at October 2016 due to postmenopausal uterine bleeding, cramp-like abdominal pain and mass protrusion from the vagina. The vital sign was stable at the first visit but a big non-necrotizing red vaginal mass was protruded from vaginal opening that connected to other soft intravaginal mass. Abdominal ultrasonography revealed the dilated vaginal cuff and some air-fluid levels in the uterine cavity. The patient referred to the operative room and vaginal myomectomy was done with diagnosis of pedunculated submocusal leiomyoma. Then, total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed after the correction of uterine inversion by abdominoperineal approach.
Conclusion: Acute uterine inversion is a potentially dangerous condition (due to vaginal bleeding, severe abdominal or pelvic pain, and the possibility of uterine necrosis and even systemic infection). This condition should be considered as an important differential diagnosis as a vaginal mass in the post-menopausal period.
Volume 78, Issue 11 (2-2021)
Methods: This was a cross-sectional study and a sampling method was available in this study, from January 2014 to August 2016, 994 cycles in 803 infertile couples referred to Royan Research Institute in Tehran were analyzed. Inclusion criteria were: male factor infertility, combined causes, ovarian disease, and infertility of unknown cause. To evaluate pregnancy, 12-16 days after IUI, it was considered positive if pregnancy test followed by transvaginal ultrasound at week 4 after IUI were positive.
Data were analyzed using SPSS software, version 20. T-test and chi-square were used to compare the case and control groups. Linear-by-linear test was also used to calculate the relationship between female age and clinical and multiple success rates. P<0.05 was considered significant for the results of these tests.
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Results: The success rate of pregnancy in all cycles (16.5%) and live birth rate per cycle (14.5%) were calculated. The mean age in the pregnant group was significantly lower than that of the non-pregnant group (P = 0.01). Our findings were: Infertility with unknown cause (290 people, 29.2%), male factor (395 people, 39.7%), ovulation disorders (201 people, 20.2%) [which include: decreased ovarian reserve (1 person) 0.5%), polycystic ovary syndrome (188 patients, 93.5%) and hypothalamic amenorrhea (12 patients, 6%)] and a combination of different factors (108 patients, 10.9%). There was also a significant relationship between the cause of infertility and clinical pregnancies (P<0.001). A Significant decrease in pregnancy success rate was observed with increasing infertility duration (OR=0.8, CI=0.8-0.9, P<0.001).
Conclusion: Women’s age, etiology of infertility, duration of infertility, irregular menstruation, semen volume, and gonadotropin dose were important factors in COH+IUI cycles. |
Volume 78, Issue 11 (2-2021)
Case Report: The patient was a 24-year-old woman who had referred to the outpatient clinic of Ghaem Hospital in September 2016 due to prolonged post coital bleeding after intercourse. At the time of the pelvic examination, posterior lip of cervix was very vascular and there was black color that had extend to the vagina. The patient underwent colposcopy. Following colposcopy, due to severe cervical bleeding, the vagina packed. The patient's bleeding was controlled with the pack after 24 hours. Cervical pathology revealed a cavernous hemangioma.
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Conclusion: Cervical cavernous hemangioma is extremely rare. This should be considered in the differential diagnosis of patients with abnormal vaginal bleeding, especially those of childbearing age, and no clinical or radiologic findings such as leiomyoma, adenomyosis, or dysfunctional uterine bleeding. Pelvic examination is the first step in the management of the patient with vaginal bleeding. Increased awareness of this unusual cervical lesion can lead to early diagnosis and conservative treatment approaches. In most cases, hysterectomy is performed, but the patient with mild symptoms can be treated with conservative management. Increased awareness of this unusual cervical lesion can lead to early diagnosis and conservative treatment approaches.
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