Current Women's Health Reviews - Volume 17, Issue 1, 2021

Background: Gestational diabetes mellitus is a common medical disorder of pregnancy associated with adverse outcomes for the mother and infant. This disease may result in maternal and fetal morbidity and mortality. Although therapies are available for the management of diabetes, which includes anti-diabetic drugs and insulin injections, yet continuous use of synthetic drugs provides lower healing with many side effects. Objective: The continuous search for effective anti-diabetic drugs from a natural source is the main reason behind exploring marine resources for therapeutic and nutritional compounds. Methods: As major articles of interest in the field of marine flora for gestational diabetes have been found, so this review has been proposed based on relevant information. A description of the studies is included in the review. Results: Marine bio-resources produce several novel scaffolds, which show their good efficacy and bioavailability in the treatment of gestational diabetes. Thus, marine resources have attracted much interest of the scientific community. Conclusion: This mini-review article presents some potential scaffolds from different marine sources such as algae, sponges together with their specific activity. Concerning the maternal risk factor, additional study is required.

Polycystic ovary syndrome (PCOS) is a condition that affects about 15% of women of reproductive age and is correlated with infertility, insulin resistance, and obesity. The etiology of PCOS is multifactorial and genetic, endocrine, and metabolic causes are involved. New evidence suggests a link between microorganisms residing in the digestive tracts of humans and the development of PCOS. Moreover, an imbalance in the gut microbial community could be a possible factor for the onset of insulin resistance and obesity. Hyperandrogenism, a key feature of PCOS, could also play a critical role in shaping the microbiome community. Probiotics could modify the gut microbiota and serve as a potential treatment for PCOS. Here we disclose the association between PCOS and intestinal microbiota and the possible role of probiotics as a new treatment approach.

The prevalence of obesity around the globe is increasing at such an alarming rate that WHO designated obesity as a major unattended public health problem worldwide. Obesity is associated with a greater risk of excessive fat related metabolic and endocrinal diseases related to a different set of illnesses and disabilities, including type 2 diabetes, cardiovascular diseases, kidney diseases, sleep apnea, arthritis, lung diseases and sexual disorders. Obesity is found to be associated with male and female sexual dysfunctions and several studies have indicated a positive correlation between obesity and sexual dysfunction among both males and females. The relationship between male obesity and sexual dysfunction has been widely discussed, whereas very little emphasis is laid on relationship between obesity and female sexual dysfunctions. Sexual dysfunctions are common and affects 20-50% of obese women. Particularly, female sexual dysfunction is a multi-factorial problem, including organic and psychological aspects involved. These disorders not only affect physical health of women, but to a greater extent, mental health is also affected. Considering this point of view, present review emphasizes the impact of obesity on female sexual dysfunctions.

Pregnancy-related complications can have long-term effects on mothers and fetus/child. Microbiome within the human gut is an important factor in maintaining optimum health during pregnancy and possibly reduces the incidence of these complications. Probiotics are active living microorganisms that can provide the host with health benefits such as; immune and hormonal regulatory and metabolic benefits when administered in adequate and optimum dose. Probiotic supplementations also regulate an abnormal and unbalanced microflora population that can control the pathogenesis of several diseases like obesity and diabetes. Probiotics also play a protective role in complications like preeclampsia, gestational diabetes mellitus and maternal weight gain and enhance successful outcomes of reproduction. This mini-review summarizes the maternal and fetal effects of probiotics during pregnancy.

Background: Childbirth is often conducted in a traditional biomedical paradigm. Nature’s simple plan for birth has been replaced by a maternity care system that increases unnecessary risks for mother and child. Strategies of comfort management can guide nurse professionals to face serious challenges and help a woman get benefits from normal birth. Objective: The purpose of this article is to determine strategies of comfort management in pregnant women during childbirth. Methods: Published articles from the electric databases, including CINAHL, PsyINFO, Pubmed, Cochrane, ThaiJO and other sources, were included from January 1, 2009, to March 1, 2019. The PICo mnemonics were used to guide the research question. The PICo tool was applied for search strategies. Two authors evaluated title, abstract and quality. The JBI Critical Appraisal Checklist for Qualitative Research has been used as a methodology for appraising the quality of all studies. Data were extracted by using a standard data extract tool from the JBI-Qualitative Appraisal tool by two independent researchers. Ten published articles have been selected to study by the PRISMA process. Results: Six themes of the strategy of comfort management emerged: 1) encourage a strong sense of self-control 2) support and continuous attendance 3) education and information 4) multidisciplinary approach 5) environment preparation and 6) attending a woman’s need. Conclusion: This study adds new knowledge about the strategies of comfort management that may guide the midwife with expanded options for women during childbirth, give the midwife understanding of their role and can provide comfort in effective childbirth.

Background: Sexual dysfunction mainly results from psychological and personal causes. These causes, including self-esteem, have been considered to be the dominant reason for sexual dysfunction. Self-esteem is, in fact, among the basic factors in desirable personality development. Objective: Investigation of the relationship between self-esteem and sexual dysfunction in women at reproductive ages referred to healthcare centers in Shiraz, Iran. Materials and Methods: This epidemiological, analytical, cross-sectional study was conducted on 268 women at reproductive ages referred to healthcare centers in Shiraz in 2014-2015. The study data were collected using a demographic information form, Female Sexual Function Index, and Rosenberg Self-esteem Scale. Results: The results revealed a significant relationship between self-esteem and sexual function (p=0.001), sexual desire (p=0.03), sexual arousal (p=0.01), and lubrication (p=0.026). However, no significant correlation was observed among self-esteem and orgasm (p=0.54), sexual satisfaction (p=0.3), and pain during intercourse (p=0.1). Investigation of the relationship between demographic indicators and self-esteem showed that the spouse's education level had a significant statistical relationship (p = 0.008) with self-esteem, while there was no significant relationship between self-esteem and women's education level, husband's job, income, Body Mass Index (BMI), and age of women. Conclusion: The results indicated that self-esteem was associated with sexual dysfunction. Accordingly, individuals with lower self-esteem showed higher sexual dysfunction.

Background: Postponing parenthood is associated with decreased number of offspring and increased pregnancy risks. Objectives: The present study aimed to investigate the effect of cognitive group counseling on childless couples' decision motivation for childbearing and preconception checkup. Methods: This experimental study was performed on 62 fertile women referred to health care centers in Qom. Signing the written consent form, the participants who were selected by the convenience sampling method entered the study. Childbearing Questionnaire (CBQ) was used to collect data. 6 cognitive group counseling sessions were conducted for the intervention group while the control group did not receive any training except one session on the disadvantages of postponed childbearing by the midwife under the supervision of the researcher. After the intervention, childbearing motivation was evaluated in both groups. The samples were also evaluated in one and two months after the intervention to see whether they have referred for pre-pregnancy checkups. The data were analyzed by SPSS20 using chi-square, and independent t-test. P-value was considered to be less than 0.05. Results: The results showed that after the intervention, the mean of Positive Childbearing Motivation (PCM) in the intervention group was significantly higher than that of the control group and the mean of Negative Childbearing Motivation (NCM) was significantly lower than that of the control group (p <0.001). The frequency of booking pre-pregnancy checkups two months after intervention was 69.57% and 10% in the intervention and control groups, respectively. Conclusion: Counseling could be more effective to motivate women to start booking for prepregnancy checkups.

Objective: Our study aimed to provide an improvised model that classifies the fetal distress using a two-dimensional Convolution neural network (CNN). It also helps in improving the visualization of FHR and UC signals. Background: Hypoxia or Fetal Distress is the main cause of death in the newborns. Cardiotocography is used to detect hypoxia in which fetal heart rate and uterine contraction signals are observed. Setting: Department of Computer Engineering and Technology, Guru Nanak Dev University, India. Subjects: The CTG-UHB database was used for classification purpose and 552 records were analyzed for classification purposes. Methods: Convolutional Neural Network was used for the classification purpose and HoloViz was used for the visualization of data in which HvPlot and HoloViews libraries are used in python. The CTG-UHB database was used for the analysis purpose. A total of 552 records were used for classification purposes. The classification was performed on the Keras software. Results: The accuracy achieved by our model was above 70%. Three classes were obtained named Normal Hypoxia (pH>7.15), Mild Hypoxia (7.05

Background: Prevalence and the risk of common antiphospholipid antibodies (aPLs), such as lupus anticoagulant (LA), anticardiolipin (aCL), and anti-β2-glycoprotein I (β2-GPI) antibodies, in preeclampsia is a matter of debate. Recently, interests have expanded in evaluating the risks of presenting non-classic aPLs in preeclampsia patients. Objective: The objective of this case-control study was to evaluate some hematological parameters besides assessing the presence of anti-annexin A5 and anti phosphatidylinositol (aPI) antibodies in preeclampsia patients compared to non-preeclampsia subjects. Methods: From two hospitals in Malaysia, a total of 84 subjects were recruited in this case-control study, including 42 preeclampsia and 42 age-matched non-preeclampsia subjects. Some hematological parameters [i.e., hemoglobin, total white blood cell, platelet, prothrombin time, and activated partial thromboplastin time (APTT)] were assessed besides screening for anti-annexin A5 and aPI antibodies. Results: Among the hematological parameters, APTT was significantly high in mild preeclampsia when compared to severe preeclampsia subjects (p=0.007). IgG anti-annexin A5 antibody was detected in a single preeclampsia subject only (2.4%) and none in non-preeclampsia subjects. Conclusion: Because of the low prevalence, non-classic aPLs should not be considered as a risk factor in developing preeclampsia and it is not justifiable to consider them as a routine assay in pregnant women.

Background: Every working woman has the right to continue to live as a healthy individual. The working environment has important effects on the general health status and reproductive health of women. If menopause period of women is not taken into consideration and if appropriate arrangements are not made at workplaces, their work performance and productivity decrease. It is important to have detailed knowledge about factors creating risk for health in order to develop effective policies and programs directed towards preventing them. Objective: This study was performed to determine the perceived effects of menopause on work life and attitudes of an institution towards menopausal women. Methods: The study population included 419 women aged 45-55 years and working at a university. Out of 419 women, 291 could be contacted. Data were collected with a questionnaire composed of questions about descriptive characteristics, effects of menopause on work life, and support from and attitudes of the institution about menopause. Data collected to reveal menopausal women’s experiences at work were analyzed with statistical methods frequency, percentages, and mean. Results: The mean age at which menopause started was 47 years and 89.7% of the women experienced menopausal complaints. Conclusion: Physical conditions at work and stressors were found to increase menopausal complaints and had a negative effect on work performance.

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends of β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected of early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and -HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among the 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found that the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their HCG. Those who had an IUP, 11% had a suboptimal increase in HCG. Conclusion: PUL rate in our unit was 6%. The majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial HCG values, clinical assessments and upon the consent of the patient.

Background: To date, no study has been performed on the relationship between depression and perimenopausal symptoms using the Path model in Iran. Objective: This study aims to assess the relationship between depression and menopause symptoms using the PATH model. Methods: A cross-sectional study was conducted for 4 months, in 2019, and 332 menopausal women were enrolled in 14 public health centeRs. Data collection instruments included questionnaires of demographic characteristics, anxiety instrument, Menopause Rating Scale, and the Beck Depression short Inventory (BDI-S). The hypothesized mediatoRs were assessed using Structural Equation Modeling (SEM). The model included depression symptoms (dependent variable), anxiety (mediatoRs), number of alive children (moderator), and menopausal symptoms (independent variable). Analyses were conducted by SPSS 16 and AMOS 20. Results: There was a significant positive correlation between menopause symptoms with total anxiety (Rs=0.52), state anxiety (Rs=0.47), trait anxiety (Rs=0.46), and depression (Rs=0.54). Depression had a significant positive correlation with total anxiety (Rs=0.64), trait anxiety (Rs=0.58), and state anxiety (Rs=0.59). Also, the total mediating effect of total anxiety and depression and the total moderating effect of the number of alive children were significant on menopause symptoms. Conclusion: According to the results of the present study, there is an association between depression and menopausal symptoms. Therefore, health provideRs should pay more attention to the psychological health of women during the perimenopausal period. The predictor factoRs should be considered in both intervention and clinical assessment of menopause women.