Comparison of Misoprostol and Evening Primrose Oil on Cervical Preparation Before Gynecological Surgery.

This study aimed to evaluate the efficacy and safety of evening primrose oil (EPO) for cervical ripening before gynecologic procedures and compare it to misoprostol. In this study, 40 hysteroscopy and dilation and curettage candidates were enrolled. Patients were randomly assigned to receive either 2000 mg of vaginal EPO (n = 20) or 200 µg of vaginal misoprostol (n = 20) 2 hours before the expected procedure. The measured outcomes were the size of the Hegar dilator that passed through the cervix effortlessly, uterine cervicovaginal complications, and drug-related side effects. The two groups were not significantly different in age, number of gravity, parity, type of delivery, and menopausal status (P > .05). The mean ± SD size of the first dilator was 5.25 ± 1.55 in the misoprostol group and 7.30 ± 1.08 in the EPO group (P < .001). The pain complaint in the EPO group was significantly lower (P = .027), but the two groups were not significantly different in terms of other complications. No cases of uterine or cervical rupture were seen in either group. The present study showed that 2000 mg of vaginal EPO was significantly more effective for cervical ripening than 200 µg of vaginal misoprostol before gynecological surgery. Therefore, it is recommended to use EPO as an alternative to misoprostol.

Prevalence of parvovirus B19 specific antibody in pregnant women with spontaneous abortion.

Human parvovirus B19 is a very common viral infection especially in school-aged children. The infection during pregnancy can affect the fetus due to lack of mother's immunity. Although, there is still no evidence of fetal teratogenic effects with parvovirus B19, but non-immune fetal hydrops and abortion may be caused by vertical transmission of the virus during pregnancy. This study was aimed to assess the prevalence of parvovirus B19-specific antibody (IgM) in pregnant women who had a spontaneous abortion. This cross-sectional study was carried out in all pregnant women who referred due to a spontaneous abortion. All demographic information such as age, occupation, and gestational age, last history of abortion, gravity, and presence of children below the age of six was recorded and a blood sample was provided for all the women. Then, the blood samples were tested to assay parvovirus B19-specific antibody (IgM) by EuroImmune ELISA kit. Among 94 pregnant women with the mean age of 28.4 years who had a spontaneous abortion, parvovirus B19 specific antibody (IgM) was detected in 17 participants (18.1%). Meanwhile, 14 women (14.9%) were suspected for presence of the antibody in their blood sample. There was no significant difference between the presence of antibody and age of pregnant women, occupation, gestational age, number of previous abortion, presence of children below the age of six and number of pregnancy. These findings revealed that a high percentage of pregnant women are probably non-immune against parvovirus B19, and also there might be a number of spontaneous abortions in which parvovirus infection caused fetal death.  However, more studies are needed to prove the absolute role of parvovirus B19 in these abortions.

Screening of von Willebrand disease in Iranian women with menorrhagia.

BACKGROUND: Menorrhagia is a common health problem in women, particularly those with bleeding disorders. Little is known about the course of menorrhagia or other bleeding symptoms in women with the most common congenital bleeding disorder, von Willebrand disease (vWD). OBJECTIVES: The aim of this study was to estimate the prevalence of vWD in women with diagnosed menorrhagia. MATERIALS AND METHODS: In this cross-sectional study, a total of 460 consecutive patients, presenting menorrhagia, were analyzed. The initial screening and confirmation tests for the diagnosis of vWD included determination of prothrombin time (PT), partial thromboplastin time (PTT), bleeding time (BT), fibrinogen, factor VIII, vWF antigen, and vWF activity. A questionnaire was filled for every patient. The data were then analyzed using the SPSS software. RESULTS: Mean age of our patients was 32.5 ± 10.6 years. The level of von Willebrand factor in 22.5% and von Willebrand activity in 19.6% of patients was abnormal. The prevalence of vWD among patients with menorrhagia was 24%. CONCLUSIONS: The high prevalence of vWD among our patients was the same as other previous reports, suggesting low awareness about this disease and under diagnosis of mild cases.

Effect of omega-3 fatty acids on intensity of primary dysmenorrhea.

OBJECTIVE: To examine whether dietary supplementation with omega-3 fatty acids relieved symptoms of primary dysmenorrhea. METHODS: Women aged 18-22 years with primary dysmenorrhea were enrolled in a double-blind crossover study. Women assigned to group 1 (n=47) received 1 omega-3 capsule daily for 3 months, followed by placebo for 3 months. Women in group 2 (n=48) received placebo for 3 months, followed by omega-3 for 3 months. A washout period was performed in both groups. Participants used 400mg of ibuprofen as a rescue dose if severe menstrual pains were experienced. RESULTS: A marked reduction in pain intensity was observed after 3 months of treatment with omega-3 fatty acids (P<0.05). Women who received omega-3 fatty acids required fewer rescue doses than women who received placebo (P<0.05). The mean numbers of ibuprofen tablets used after 3 months with omega-3 fatty acids were 4.3±2.1 (group 1) and 3.2±2.5 (group 2); the mean numbers of tablets used after 3 months of placebo were 5.3±2.2 (group 1) and 6.0±2.6 (group 2) (P=0.001 for both). CONCLUSION: Supplementation with omega-3 fatty acids reduced the symptom intensity of primary dysmenorrhea. Supplementation efficacy was sufficient to decrease the ibuprofen rescue dose.