Broad ligament pregnancy in the presence of an intrauterine contraceptive device: A case report

Introduction: Abdominal pregnancy though scarce is associated with considerable morbidity and mortality. Few cases till now have been diagnosed or managed by laparoscopy. Case presentation: In this study, a case of an abdominal pregnancy in a woman with intrauterine contraceptive device (IUD) in situ and a history of cesarean section is described. Clinical discussion: Our case was a brief description of a broad ligament pregnancy as a subcategory of abdominal pregnancy .It was located medial to the pelvic sidewall, lateral to the uterus, inferior to the fallopian tube and superior to the pelvic floor. Conclusion: The pregnancy was in the location of the left broad ligament which was diagnosed on laparoscopic evaluation. © 2021 The Author(s

Conservative management of ovarian fibroma in a case of Gorlin-Goltz syndrome comorbid with endometriosis

Ovarian fibromas are the most common benign solid ovarian tumors, which are often difficult to diagnose preoperatively. Ovarian fibromas, especially in bilateral cases, may be cases of Gorlin-Goltz syndrome (GGS), a rare autosomal dominant disorder with predisposition to basal cell carcinomas (BCCs) and other various benign and malignant tumors. This case report describes a 25 year-old female with GGS, bilateral ovarian fibroma, endometriosis and septated uterus, which was referred to the Gynecology Clinic of Rasoul-e-Akram Hospital in October 2016. This patient had facial asymmetry due to recurrent odontogenic keratocysts. In young cases of ovarian fibromas as reported here, conservative surgical management can preserve ovarian function and fertility. These patients must be followed up by a multidisciplinary team and submitted to periodic tests. © 2018, Royan Institute (ACECR). All rights reserved

Hemoperitoneum due to bleeding from a vein overlying a subserous uterine myoma: A case report

Background: Fibroids are the most common pelvic tumors in women; serious complications are rare but can be life-threatening. Case presentation: We present a case report of a 38-year-old Persian woman with acute abdominal pain and a history of uterine fibroids. The patient refused to undergo a laparoscopic myomectomy. Her ultrasound examination revealed free fluid in the abdominal cavity, and her vital signs were indicative of vasogenic shock. A diagnostic laparoscopy was performed to identify and control the source of bleeding: 400 ml of blood and blood clots were removed. Active bleeding was seen from a vein overlying a subserosal myoma. A laparotomic myomectomy was performed, and the patient was discharged 3 days after surgery with no complications. Conclusion: Surgeons should consider the possibility of this complication in women with acute abdominal pain and a history of uterine leiomyoma. © 2020 The Author(s)

Conservative management of ovarian fibroma in a case of Gorlin-Goltz syndrome comorbid with endometriosis

Ovarian fibromas are the most common benign solid ovarian tumors, which are often difficult to diagnose preoperatively. Ovarian fibromas, especially in bilateral cases, may be cases of Gorlin-Goltz syndrome (GGS), a rare autosomal dominant disorder with predisposition to basal cell carcinomas (BCCs) and other various benign and malignant tumors. This case report describes a 25 year-old female with GGS, bilateral ovarian fibroma, endometriosis and septated uterus, which was referred to the Gynecology Clinic of Rasoul-e-Akram Hospital in October 2016. This patient had facial asymmetry due to recurrent odontogenic keratocysts. In young cases of ovarian fibromas as reported here, conservative surgical management can preserve ovarian function and fertility. These patients must be followed up by a multidisciplinary team and submitted to periodic tests. © 2018, Royan Institute (ACECR). All rights reserved

The impact of COVID-19 pandemic on stress and anxiety of non-infected pregnant mothers

Background: The newly emerging COVID-19 has caused severe anxiety around the world and it is infecting more people each day since there is no preventive measure or definite therapy for the diseases. The present study aimed to evaluate its effect on anxiety and stress of pregnant mothers during perinatal care. Methods: Three�hundred pregnant mothers without COVID�19 infection who were referred to the hospitals affiliated to Iran University of Medical Sciences for delivery during April 2020, based on negative clinical symptoms and the results of polymerase chain reaction (rt-PCR) for COVID�19, were recruited by census method and asked to complete the Persian version of the perceived stress scale (PSS); participants views about their anxiety level and the role of COVID�19 as the source of their stress and worries were recorded. Women who refused to continue the study were excluded. The frequency of variables and mean scores were calculated using SPSS v. 21. Results: Mean age of mothers was 30.20±16.19 years; 31.3 were primigravida and mean gestational age was 38.00±4.14 weeks. Moreover, 16.3 asked for earlier pregnancy termination and 39 requested Cesarean section (C/S). Assessing the mothers� anxiety revealed a high/very high level of anxiety in 51.3. The majority felt worried and frustrated because of COVID�19 (86.4). Social media had a great impact on the level of stress among these mothers (60.3). Conclusion: COVID-19 pandemic is an important source for the increased anxiety and stress among healthy pregnant mothers. © 2021 Avicenna Research Institute. All rights reserved

The effect of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis

Background: To our knowledge, data on the effects of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis are limited. This study was conducted to determine the effects of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosis. Methods: The current randomized, double-blind, placebo-controlled trial was conducted among 60 patients (aged 18�40 years old) with endometriosis. Participants were randomly allocated into two groups (30 participants each group) to receive either 50,000 IU vitamin D or placebo each 2 weeks for 12 weeks. Results: Vitamin D supplementation significantly decreased pelvic pain (β � 1.12; 95 CI, �2.1, �0.09; p=.03) and total-/HDL-cholesterol ratio (β � 0.29; 95 CI, �0.57, �0.008; p=.04) compared with the placebo. Moreover, vitamin D intake led to a significant reduction in high-sensitivity C-reactive protein (hs-CRP) (β � 0.64 mg/L; 95 CI, �0.97, �0.30; p<.001) and a significant increase in total antioxidant capacity (TAC) (β 47.54 mmol/L; 95 CI, 19.98, 75.11; p=.001) compared with the placebo. Conclusions: Overall, our study demonstrated that vitamin D intake in patients with endometriosis resulted in a significant improvement of pelvic pain, total-/HDL-cholesterol ratio, hs-CRP and TAC levels, but did not affect other clinical symptoms and metabolic profiles. © 2021 Informa UK Limited, trading as Taylor & Francis Group

Vitamin D deficiency as a risk factor for endometriosis in Iranian women

Purpose: Vitamin D (Vit D), as an immunomodulator, has been hypothesized to play a critical role in the pathogenesis of endometriosis. Thus, in this study, we evaluated whether there is an association between 25-hydroxyvitamin D 25(OH)D and susceptibility to endometriosis in Iranian women. Methods: Women at reproductive age, including 56 healthy women and 54 patients with endometriosis, were enrolled in the study. Serum levels of 25(OH)D, calcium, parathyroid hormone (PTH), and peritoneal fluid (PF) levels of 25(OH)D were assessed. Results: The serum and PF levels of 25(OH)D in the patients with endometriosis were significantly lower than the control group (P = 0.001 and P = 0.03, respectively). Subjects with serum levels of 25(OH)D lower than 20 ng/mL had a 2.7 times higher risk of endometriosis than people with 25(OH)D serum levels higher than 20 ng/mL (non-deficient) (OR = 2.7, 95 % confidence interval: 1.24�5.80, P = 0.01). The serum levels of calcium and PTH were significantly lower and higher in patients with endometriosis compared with controls, respectively (P < 0.001, P = 0.02, respectively). Also, the serum levels of 25(OH)D were lower in stages I-II endometriosis than stage III-IV; however, no significant difference was observed. Conclusion: Our findings showed that people with Vit D deficiency are at higher risk of endometriosis. © 2020 Elsevier B.V