[Comparison of the effect of single and multiple-dose methotrexate therapy on tubal patency in women with ectopic pregnancy]

Background and Aim: Ectopic pregnancy is one of the leading causes of death among the women of reproductive age. Injection of single or multiple doses of methotrexate can be used as a therapeutic approach. The aim of this study was to compare the effect of single and multiple-doses of methotrexate therapy on the tubal patency in women with ectopic pregnancy

Material and Methods: This was an interventional study and included 80 patients with ectopic pregnancy who had been treated with a single dose or multiple doses of methotrexate. After 3 months of hospitalization and treatment, hysterosalpingography was conducted to assess tubal patency. Data were analyzed using SPSS version 21

Results: The frequencies of ipsilateral tubal obstruction were 12 [30%] and 3 [7.5%] in the patients who had received multiple-doses of methotrexate and single-dose methotrexate respectively. Also, 33 [82.5%] patients in the single-dose methotrexate group and 18 [45%] patients in the multiple-dose methotrexate group did not have bilateral obstruction. There was a significant difference in the frequencies of tubal obstruction between the two groups treated with single and multiple doses of methotrexate [P<0.05]

Conclusion: The incidence of tubal obstruction in women with ectopic pregnancy was significantly lower in single-dose methotrexate group compared to multiple dose methotrexate groups

Impact of the endometrioma on ovarian response and pregnancy rate in in vitro fertilization cycles

Our objective was to evaluate the effect of ovarian endometrioma on ovarian stimulation outcomes in in vitro fertilization cycles [IVF]. In this prospective cohort study, we followed 103 patients who underwent intra-cytoplasmic sperm injection [ICSI] procedures over a 24-months period. The study group consisted of 47 infertile women with either unilateral or bilateral ovarian endometrial cysts of less than 3 cm. The control group consisting of 57 patients with mild male factor infertility was candidate for ICSI treatment during the same time period as the study groups. Both groups were compared for number of oocytes retrieved, grades of oocytes, as well as embryo quantity and quality. Our results showed similar follicle numbers, good embryo grades [A or B] and pregnancy rates in the compared groups. However, patients with endometrioma had higher gonadotropin consumption than the control group. The mean number of retrieved oocytes in patients with endometrioma was significantly lower than control group [6.6 +/- 3.74 vs. 10.4 +/- 5.25] [p<0.001]. In addition, patients with endometrioma had significantly lower numbers of metaphase II [MII] oocytes [5 +/- 3.21] than controls [8.2 +/- 5.4] [p<0.001]. In patients with unilateral endometrioma, there were no significant differences in main outcome measures between normal and involved ovaries in the patients with endometrioma. Patients with ovarian endometrioma had poor outcome. They showed poor ovarian response with lower total numbers of retrieved oocytes and lower MII oocytes during the stimulation phase; however, it does not affect the total number of embryos transferred per patient, quality of embryos, and pregnancy rate per patient

Traumatic injuries in pregnant women: a case of motor vehicle accident for "ground round" discussion

The main objective for introducing this case study is to create a platform from which the importance of road traffic related injuries and traumas can be emphasized and discussed within and across various fields of investigation. The long term goal is to entice public campaign around unmet needs for higher road safety measures to reduce primary, secondary, and tertiary risks of injuries and traumas. a 28-year-old pregnant woman with a 16-week gestational age fetus was involved in a road car crash resulting in multiple traumas. Evaluation and treatment was initiated in the local Urgent Care Unit and continued in the emergency department and operation room. Patient underwent the following procedures: laparotomy, diverting colostomy, terminating pregnancy, right calcaneal traction and long leg splint, as well as multiple irrigation-debridements. Finally, the wound was left open and the patient was admitted to Intensive Care Unit. We hope that the introduction of this case for a "Ground Round" discussion will stir up a comprehensive discussion regarding the injury and trauma related preventive measures as well as treatment approaches in cases involving pregnant women in car accidents, and will bring about a holistic overview of this issue by the experts in various fields

Bloodless correction. a case report

This report describes a 74 year old woman with urinary symptoms progressing to complete anuria with dense labial adhesions. This condition is mostly reported in pediatric age group but few reports addressed this condition in postmenopause

Study of types of external genital traumas in women admitted to Motazedi hospital, Kermanshah in 1376-1382

The external genital traumas may lead to emotional and physical complications which can be prevented in case of knowing the types and common creating causes. This study was carried out to determine the frequency of external genital trauma in patients who were admitted to Motazedi hospital at Kermanshah University of Medical Sciences in 1376-1382. This descriptive study was carried out by available data. The data was collected by information form that contained some variables such as patient s age, job, menarche situation, season, cause of trauma and related complications. The records of all of the patients who were admitted to Motazedy hospital in 1376-1382 were studied. The collected data was analyzed by descriptive statistics. The study on 82 patients showed that 30.5% were students, 68.3% housewives, 64.4% lived in cities, the maximum frequency of genital trauma in summer and spring were30.5% and 24.4% respectively. The most common trauma was due to first coitus [47.6%] and the damage was most often located at the vulvovaginal [67.1%] as well as urethra [31.1%]. This study showed the most common cause of genital trauma is due to first coitus, thus it is recommended to plan a well educational program to increase knowledge and prepare young person before getting married