Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 3 2024 10 05 146 153 EN Azadeh Tarafdari Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran Mahdieh Nazarpour Department of Obstetrics and Gynecology, Imam Khomeini Hospital Complex, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran Nikan Zargarzadeh Maternal Fetal Care Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States of America Sedigheh Hantoushzadeh Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mohammadamin Parsaei Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran 2024 05 10 2024 08 24 Objective: To compare residual myometrial thickness (RMT) and cesarean scar defect (CSD) development after cesarean section using double-layer locked and unlocked closure techniques. Materials and methods: We conducted a randomized double-blinded trial comparing double-layer locked and unlocked uterine closure techniques following cesarean section in primiparous women. The locked technique involved continuous suturing of the full myometrial thickness in the first layer, followed by back-and-forth needle maneuvering on both sides of the incision for the second layer. The unlocked method included running suturing of two-thirds of the myometrial thickness in the first layer, followed by suturing the upper half of the myometrial thickness in the second layer. Transvaginal ultrasonography was performed one year post-cesarean section, with RMT as the primary outcome and scar depth and width as secondary outcomes. Independent t-test and Chi-square test were utilized for statistical analysis. Results: All 30 patients from the locked and 26 from the unlocked group in the follow-up were diagnosed with CSD (scar depth>2mm). The mean RMT for the unlocked and locked groups were 4.44±1.07mm and 4.12±0.48mm, respectively, showing no significant difference (p =0.14). There was also no significant difference in mean scar width between the locked and unlocked groups (3.68±1.44mm vs. 3.95±1.00mm, p =0.42). However, the mean scar depth was higher in the unlocked group (3.77±1.11 mm vs. 3.16±1.1mm, p =0.04). Conclusion: We have found no significant differences in the RMT and CSD prevalence between two-layered locked and unlocked uterine closure techniques, while the scar depth was greater in the unlocked group. Nonetheless, future randomized trials implementing larger sample sizes are required to precisely compare the outcomes of the double-layer locked and unlocked uterine suturing techniques.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2740 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2740/688

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 3 2024 10 05 154 159 EN Afsaneh Tehranian Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Marzieh Vahid Dastjerdi Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Sare Hatamian Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Akram Ghahghaei-Nezamabadi Department of Obstetrics and Gynecology, Arash Women's Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2024 03 02 2024 08 24 Objective: Considering the prevalence of Human Papillomavirus (HPV) infection and the lack of HPV vaccination program in Iran among young women and the importance of quality of life and sexual performance in women, we decided to conduct a study to examine the relationship between HPV infection and sexual dysfunction and quality of life in Iranian women. Materials and methods: In this cohort study, 250 married women who infected with HPV were recruited via convinence sampling from colposcopy clinic of Arash women hospital (Tehran, Iran) from April 2020 to May 2022.They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire (the total FSFI score is calculated by the sum of the nineteen items). Sexual quality of life-female (SQOL-F) items (Likert-type scale with a cut-off of 65 points) were organized into four sub-scales: psychosexual feelings, sexual and relationship satisfaction, self-worthlessness, and sexual repression. All patients filled out the female sexual function index (FSFI) and sexual quality of life (SQOL) questionnaires. Variables were analysed via correlation coefficient and linear regression tests. Results: Mean age and mean marriage duration were 38.5±4.5 and 12.2±7.2, respectively. There was a weak correlation between FSFI and SQOL (r=0.15, p=0.001).Time of marriage and genital warts were the predictors on the FSFI and SQOL. Conclusion: The findings suggest that HPV infection can impair sexual function and quality of life. This research contributes valuable insights, especially considering the prevalence of HPV. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2650 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2650/689

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 3 2024 10 05 160 163 Samira Abodollahi Department of Obstetrics and Gynaecology, Alborz University of Medical Sciences, Alborz, Iran Shamimeh Poorbahri Ghesmat Cardiovascular Research Center, Alborz University of Medical Sciences, Alborz, Iran Mahsa Khoshnam Rad Midwifery and Reproductive Health Department, Alborz University of Medical Sciences, Alborz, Iran Kamran Behrouzi Department of Neonatology, Alborz University of medical Sciences, Alborz, Iran 2024 04 24 2024 09 01 Objective: Oxytocin is commonly used during labor and delivery for induction of labor and prevention of postpartum hemorrhage. While previous studies have explored the effects of labor oxytocin use on maternal and neonatal outcomes, there is a paucity of research on its impact on newborn liver enzyme function. This study aimed to assess the effects of labor oxytocin use on liver enzyme function in newborns. Materials and methods: A case-control study was conducted. The case group consisted of 70 newborns whose mothers received oxytocin during labor, while the control group consisted of 70 newborns whose mothers did not receive oxytocin. Complete blood count (CBC), lactate dehydrogenase (LDH), creatine phosphokinase (CPK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total and indirect bilirubin levels were measured in all newborns on the second day of life. Results: The levels of AST and total and indirect bilirubin were found to be higher in the case group than in the control group (51 vs. 42, 7.8 vs. 4.6, and 7.4 vs. 4, respectively; p < 0.005). The levels of CPK and LDH were also higher in the case group (p < 0.005). However, the difference in ALT levels was not significant between the study groups. Conclusion: The observed increase in liver enzymes in this study can indicate the effect of maternal oxytocin on the newborn's liver function. While the changes in liver enzyme levels due to oxytocin use were not found to be high enough to cause liver damage, the increase in CPK and LDH levels could potentially elevate bilirubin levels due to hemolysis. Further research is needed to confirm these findings and explore the underlying mechanisms. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2712 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2712/690

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 3 2024 10 05 164 169 EN Hanieh Najafiarab Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Farah Farzaneh Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Niki Talebian School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Zahra Ghasemi Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Maryam Talayeh Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2024 05 02 2024 08 24 Objective: Uterine fibroids (UFs) are the most common benign tumors in women, and their prevalence varies between 5.4 and 77.0% in reproductive-aged women. Patients with UFs may experience severe symptoms that they can affect different aspects of their lives, including quality of life. This study aimed to investigate the health-related quality of life among Iranian women with UFs. Materials and methods: This cross-sectional study was conducted at Imam Hossein Hospital, Tehran, Iran, between November 2023 and February 2024, Data collection was based on the census method. Uterine Fibroid Symptom and Health-related Quality of Life (UFS-QOL) questionnaire was used to assess symptom severity and health-related quality of life (HRQOL) of women with UFs. Data were analyzed using the SPSS software version 23.0. Results: Overall, 220 patients with a mean age of 43.10±5.01 years were included in the study. Patients had total UFS-QOL score of 64.11±20.35 with the following subscales’ scores: symptom severity: (19.00±6.39), concern: (60.79±26.47), activities: (71.76±23.02), energy/mood: (54.39±25.14), control: (66.52±22.82), self-consciousness: (77.63±26.39), and sexual function: (59.40±31.18). Furthermore, patients with multiparity history (P= 0.001), obesity (P<0.001), increased menstrual duration (P<0.001), irregular menstruation (P<0.001), and hyper menorrhea (P<0.001) had lower HRQOL scores. Conclusion: All subscales’ scores of HRQOL were over 50 in patients with UF. HRQOL in these patients can be affected by certain factors, such as features of the menstrual cycle, multiparity, and obesity.   https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2724 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2724/691

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 3 2024 10 05 170 179 EN Natalia Karpowicz Department of Gynecological Endocrinology, Clinical Hospital of Duchess Anna Mazowiecka, Medical University of Warsaw, Warsaw, Poland Katarzyna Mączka Department of Gynecological Endocrinology, Clinical Hospital of Duchess Anna Mazowiecka, Medical University of Warsaw, Warsaw, Poland AND Doctoral School, Medical University of Warsaw, Warsaw, Poland Adrian Skoczylas Department of Gynecological Endocrinology, Clinical Hospital of Duchess Anna Mazowiecka, Medical University of Warsaw, Warsaw, Poland Natalia Pacocha Department of Gynecological Endocrinology, Clinical Hospital of Duchess Anna Mazowiecka, Medical University of Warsaw, Warsaw, Poland Michał Kunicki Department of Gynecological Endocrinology, Clinical Hospital of Duchess Anna Mazowiecka, Medical University of Warsaw, Warsaw, Poland Monika Grymowicz Department of Gynecological Endocrinology, Clinical Hospital of Duchess Anna Mazowiecka, Medical University of Warsaw, Warsaw, Poland Roman Smolarczyk Department of Gynecological Endocrinology, Clinical Hospital of Duchess Anna Mazowiecka, Medical University of Warsaw, Warsaw, Poland 2024 05 07 2024 09 01 Objective: Over the decade, variety and effectiveness of contraception methods have greatly improved, resulting in increased popularity of oral contraceptive pills (OCPs). However, hormonal contraception carries the risk of multiple side effects. The lack of sufficient knowledge often leads to the development of health concerns, which can affect patient’s adherence. The aim of our research was to describe a side effect profile of OCPs and assess the most frequent concerns and discontinuation reasons in Polish women. The survey included questions regarding OCPs utilization patterns, side effects, health concerns and attitudes of the responders. Materials and methods: This cross-sectional study was based on a survey, which was distributed online and open from 29 April to 15 May 2022. The survey included questions regarding OCPs utilization patterns, side effects, health concerns and attitudes of the responders. Results: Out of 1699 respondents, the current OCPs intake was reported by two thirds of women and 22% had a history of using them in the past. Seventy-nine percent of all OCPs users experienced adverse effects while 9% reported having concerns about safety and potential adverse effects. Decreased libido and weight gain were the most significant reasons for ceasing hormonal contraception. Moreover, the most common concerns and the most unfavorable side effects varied in different age groups. The occurrence of anxiety depended on age and education. Conclusion: Healthcare professionals prescribing OCPs should provide their patients with comprehensive counseling. Understanding and addressing concerns of young women can improve their compliance and reduce the number of unintended pregnancies. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2737 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2737/692

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 18 3 2024 10 05 180 187 Shakiba Pourasad Shahrak Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Serge Brand Center for Affective, Stress and Sleep Disorders (ZASS), University of Basel, Psychiatric Clinics (UPK), Basel, Switzerland AND Division of Sport Science and Psychosocial Health, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland AND Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran AND Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran AND School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Ziba Taghizadeh Nursing and Midwifery Care Research Center, Department of Midwifery and Reproductive Health, Tehran University of Medical Sciences, Tehran, Iran Abbas Ebadi Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran 2024 05 14 2024 09 01 Objective: The purpose of the present study was to design the Farsi Scale of Sexual-Reproductive Needs and Concerns of never-married women over 35 and to assess its psychometric properties. Materials and methods: This mixed method research had two phasesl quality of life and increase the chance of negative consequences such as spouse violence, infidelity, and intercourse reduction. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2108 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2108/623

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 4 2022 12 13 272 281 Mamak Shariat Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran Nasrin Abedinia Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran Hasti Charousaei Maternal, Fetal and Neonatal Health Research Center, Institute of Family Health, Tehran University of Medical Sciences, Tehran, Iran Fatemeh Fatahi Department of Clinical and Health Psychology, Shahid Beheshti University, Tehran, Iran 2021 06 13 2022 11 20 Objective: This study aimed to investigate and identify the psychosocial factors that are associated with paternal postpartum depression. Materials and methods: A longitudinal correlation study with 150 fathers was performed with three time frames (late pregnancy, postpartum, and four weeks postpartum). The Edinburgh Postnatal Depression Scale assessed those with depression (38.7%; n=58) and those without depressive symptoms (61.3%; n=92). Psychological variables related to paternal depression were also assessed through questionnaires. Results: Psychological variables such as marital adjustment and stress had a significant relationship with paternal depression. In addition, depressed fathers experienced less marital compatibility and more tension than non-depressed fathers. Conclusion: These findings emphasize the importance of considering the psychosocial variables that affect paternal psychological health. Mental health professionals may be able to reduce mental disorders, stress, psychological distress, and marital maladjustment in fathers with appropriate psychological interventions. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1808 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1808/624

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 4 2022 12 13 282 289 Elahe Rezayof Department of Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran AND Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Setareh Akhavan Department of Gynecology Oncology, Vali-E-Asr Hospital, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran Leila Afshar Department of Medical Ethics, Shahid Beheshti University of Medical Sciences, Tehran, Iran Marjan Ghaemi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Leyla Sahebi Maternal-Fetal, and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran Somayeh Akbari Farmad Department of Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2022 09 06 2022 11 20 Objective: Breaking bad news to the patient is challenging, especially for the physicians and the residents, due to the lack of structured and practical training. This study aimed to design and evaluate a novel virtual instructional design for improving obstetrics and gynecology (Ob/Gyn) residents breaking bad news skills. Materials and methods: Virtual instructional design was performed based on the ADDIE model (Analysis, Design, Development, Implementation and Evaluation) from September 2020 to July 2021 at the Department of Ob/Gyn, a referral hospital affiliated with Tehran University of Medical Sciences, Tehran. Iran. The five steps of ADDIE virtual instructional design were applied sequentially. Results: Totally 33 of the Ob/Gyn residents included in the study that 77% needed specific training. The awareness of the performance of the residents in seven areas including interview context, strategy, planning, professionalism, empathy, knowledge, and receiving information needed to be trained for breaking bad news. The content of the virtual training package was designed based on the prior assessment needs in four multimedia lectures of professors, one short educational video, a 65-page file that combines text and images in 4 parts. The pre-test and post-test mean scores (SD) were 9.45 (2.0) and 10.67 (1.7), respectively (p-value≤0.001) in the cognitive and attitudinal domain. In the final step, the final corrections were made in the virtual training package. Interestingly, the satisfaction of residents' attitudes was 96.5%. Conclusion: Most Ob/Gyn residents do not have the necessary perception and skills to deliver bad news to the patients. Designing an appropriate virtual training package for improving communication skills is associated with satisfaction. Thus, the efficacy of the training program should be implemented for all Ob/Gyn residents. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2167 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2167/625

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 4 2022 12 13 290 295 Azadeh Shabani Department of Obstetrics and Gynecology, Shahid Taleghani Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Amene Abiri Department of Obstetrics and Gynecology, Arash Women’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Seyedeh Noushin Ghalandarpoor-Attar Department of Obstetrics and Gynecology, Baqyiatallah Hospital, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran Alireza Hadizadeh School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Seyedeh Mojgan Ghalandarpoor-Attar Maternal, Fetal & Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran AND Department of Obstetrics and Gynecology, Baharloo Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2022 04 06 2022 07 17 Objective: This descriptive-analytic cross-sectional study aimed to figure out whether maternal serum vitamin D concentration correlates with cervical length measurement in mid-gestation or not. Materials and methods: During Jun-Jan 2021, 213 pregnant women at 18-22 weeks of gestation were investigated. First, demographic features were obtained then, maternal serum vitamin D concentration was measured by enzyme-linked immunoassay and cervical length was measured via transvaginal sonography according to fetal maternal foundation guideline and appropriate statistical test was used to analyze the correlation between maternal vitamin D level and cervical length in mid-pregnancy. Results: It was shown that 29.6% and 25.4% of participants had vitamin D deficiency and insufficiency, respectively. Spearman’s test found no significant correlation between maternal vitamin D level and cervical length in mid-pregnancy. Moreover, cervical length and maternal vitamin D level had no association with maternal BMI. Conclusion: Although maternal vitamin D level and its sufficiency status was not associated with cervical length in mid- pregnancy, as a trend toward decreased maternal serum vitamin D level by advancing gestational age was observed. It may be concluded that it is prolonged vitamin D deficiency during gestation that may lead to cervical length shortening and subsequent preterm delivery later in gestation. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/2065 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/2065/626

Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 16 4 2022 12 13 296 299 EN Shahram Samadi Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Zahid Hussain Khan Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Seyed Mohamad Mireskandari Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Kasra Karvandian Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Afshin Jafarzadeh Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Asghar Hajipour Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2022 06 21 2022 11 06 Objective: During the COVID-19 pandemic, burnout of healthcare workers, including anesthetists, has become a critical issue. This study aimed to provide a practical framework for decreasing and