Razi Journal of Medical Sciences

fa بررسی فراوانی مول هیداتیفرم و توزیع آن برحسب خصوصیات دموگرافیک در زنان باردار مراجعه کننده به مرکز آموزشی –درمانی علی ابن ابیطالب در شهر زاهدان از سال ۱۳۹۲-۱۳۹۷ Study of Hydatiform Mole Frequency and Its Distribution According to Demographic Characteristics in Pregnant Women Who Attended in Ali Ebne Abitaleb Hospital in Zahedan During 2013-2018 زنان و زایمان Gynecology پژوهشي Research <h2 dir="RTL" style="text-align:justify">زمینه و هدف: مول هیداتیفرم از موارد اورژانس پرمخاطره‌ی بارداری، عبارت است از تورم و هایپرپلازی که در پرزهای کوریون جفت به وجود می‌آید. این بیماری نادر و خوش‌خیم است که ناشی از نقص ژنتیکی در <a href="https://fa.wikipedia.org/wiki/%D8%AA%D8%AE%D9%85" title="تخم">تخم</a> بارور شده ‌می‌باشد. مطالعاتی که در ایران انجام شده است شیوع بیماری را متفاوت گزارش کرده‌اند. این مطالعه با هدف بررسی فراوانی مول هیداتیفرم و توزیع آن برحسب خصوصیات دموگرافیک در زنان باردار انجام شد. روش‌ کار: در این مطالعه مقطعی تمام زنان باردار مراجعه کننده به بیمارستان علی ابن ابیطالب زاهدان در سال‌های ۱۳۹۷-۱۳۹۲ مورد بررسی قرار گرفتند. زنان باردار مبتلا به مول هیداتیفرم و دارای تایید پاتولوژی و پرونده با اطلاعات کامل در این مطالعه شرکت کردند. اطلاعات مورد بررسی شامل فراوانی بیماری، تعداد بارداری‌ها، سن حاملگی، سابقه‌ی سقط، سابقه‌ی حاملگی مولار، سن بیمار، گروه خونی، روش‌های جلوگیری از بارداری مورد استفاده، روش‌های کمک باروری در صورت وجود، و گروه خونی بود. اطلاعات بصورت داده های انبوه aggregate  گزارش شد. برای توصیف فراوانی از تعداد (درصد) استفاده شد. یافته‌ها: از مجموع ۳۳۷۳۰ زن باردار مراجعه کننده، (۰۰۵/۰ ٪) ۱۵۰ نفر دارای مول هیداتیفرم بودند که نشان دهنده شیوع ۴۵ نفری از هر ۱۰۰۰ نفر می‌باشد. از ۱۵۰ زن دارای مول هیداتیفرم، زنان دارای ۱ بارداری با (۷/۲۶ ٪) ۴۰ نفرفراوانی بیشترین تعداد را داشتند و زنان با سن حاملگی بین ۱۰ تا ۲۰ هفته با  فراوانی۸۰٪ و تعداد ۱۲۰ نفر، زنان دارای سابقه سقط با  فراوانی ۶۲٪ و تعداد ۹۳ نفر، زنان بدون سابقه حاملگی مولار با  فراوانی ۷/۸۲٪ و تعداد ۱۲۴ نفر، زنان با سن ۲۰ تا ۳۰ سال با فراوانی ۷/۳۸٪ و تعداد ۵۸ نفر، زنان بدون روش پیشگیری با فراوانی ۳/۶۵٪ و تعداد ۹۸ نفر و زنان دارای گروه خونی B با  فراوانی ۷/۴۰٪ و تعداد ۶۱ نفر بیشترین تعداد را داشتند. نتیجه گیری: حاملگی مولار از موارد اورژانس بارداری می‌باشد که در جامعه‌ی ما شیوع و عود نسبتا بالایی دارد و در تمام زنان باردار که با خونریزی مراجعه می‌کنند بعنوان یکی از تشخیص‌های مطرح باید مورد توجه قرار گیرد. همچنین بین سابقه‌ی مول هیداتیفرم و سن حاملگی و سن بیماری رابطه معنی داری مشاهده شد.  </h2> <div style="text-align: justify;">Background & Aims: Hydatidiform, which is one of the most dangerous emergency cases of pregnancy, is swelling and hyperplasia in the chorionic villi of the placenta, and histologically, it refers to abnormal changes in the placental villi, including trophoblastic proliferation and villous stromal edema. Moles usually occupy the uterine cavity but occasionally form in the fallopian tubes and even the ovaries. This is a rare and benign disease caused by a genetic defect in the fertilized egg. The occurrence rate of hydatidiform mole varies greatly in different parts of the world. Hydatidiform mole is diagnosed in approximately 1 in 1500-2000 pregnancies in the United States. It seems that there is a great variation in the incidence of moles, so that the incidence in the Far East and Southeast Asia is 5-15 times higher than in the industrialized countries of the West. Studies conducted in Iran have reported the prevalence of the disease differently. It seems that these differences are related to the study method, nutritional, socio-economic factors, environmental and genetic factors, as well as the size of the studied sample. Therefore, this study was conducted to investigate the frequency of hydatidiform mole and its distribution in terms of demographic characteristics in pregnant women referred to Ali Ebne Abitaleb Educational-Medical Center in Zahedan from 2013-2018. Methods: The present study is a cross-sectional (descriptive-analytical) study and includes all pregnant women referred to Ali Ebne Abitaleb Hospital in 2013-2018. A code of ethics (IR.ZAUMS.REC.1399.133) was received from the Research Ethics Committee of Zahedan University of Medical Sciences. In this study, all pregnant women referred to Ali Ebne Abitaleb Zahedan Hospital in 2013-2018 were examined. All pregnant women with hydatidiform mole and with pathology confirmation and records with complete information participated in this study. People with incomplete file information or missing data and not correctly classified in the file were excluded from the study. Finally, 150 pregnant women' files were reviewed and an information form was completed for each patient. The researcher referred to the archives of Ali Ebne Abitaleb Zahedan Hospital and after providing the permits, he/she obtained the necessary files from that center and entered the required information into the required form. The investigated information included the frequency of the disease, number of pregnancies, gestational age, history of abortion, history of molar pregnancy, patient's age, blood group, contraceptive methods used, assisted reproductive methods if any, and blood group. The information was reported as aggregate data. Number (percentage) was used to describe frequency. Finally, the data was entered in an analytical software (spss/excel 16). Results: The findings of the present study showed that, among a total of 33,730 referring pregnant women, 150 (0.005%) had a hydatidiform mole, which indicates a prevalence of 4.5 cases per 1,000 people. Out of 150 women with hydatidiform mole, women with 1 pregnancy had the highest frequency of 40 (26.7%), and women with gestational age between 10 and 20 weeks with (80%) 120, women with a history of abortion with (62%) 93, Women without a history of molar pregnancy with 124 (82.7%), women aged 20 to 30 years with 38 (38.7%), women without contraception with (65.3%) 98 and women with blood type B With (40.7%) 61 people had the highest number. Conclusion: Molar pregnancy is one of the emergencies of pregnancy that has a relatively high prevalence and recurrence in our society and should be considered as one of the most important diagnoses in all women of reproductive age who present with bleeding. In addition, a significant relationship was observed between the history of hydatidiform mole and gestational age and disease age. In other words, various factors such as environmental factors, genetics, individual characteristics and the onset of the disease are influential. According to the results of the present study, it is suggested: A study on the relationship between hydatidiform moles in pregnant women with demographic characteristics should be conducted. Diagnosis is recommended based on clinical findings, sonography and pathology. With routine sonography in the first trimester of pregnancy, it is possible to diagnose this disease as soon as possible. Also, a center should be provided to support patients with hydatidiform mole, and prospective researches with a larger volume should be conducted in this center. May it be a big step towards early diagnosis and treatment of this disease, reducing costs and helping the country's economy and improvements. Our results showed that a history of molar pregnancy affects the frequency of the disease. Furthermore, a significant relationship was observed between a history of hydatidiform mole and gestational age, and the age of the disease (patient's age). In other words, various factors such as environmental factors, genetics, and individual characteristics influence the prevalence of the disease.</div> حاملگی مولار, مول هیداتیفرم, زنان باردار, تشخیص Molar pregnancy, Hydatidiform mole, Pregnant women, Diagnosis 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-4992-3&slc_lang=fa&sid=1 Roghayeh Sheervalilou رقیه شیرولیلو 3900319475328460087810 3900319475328460087810 No Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran مرکز تحقیقات فارماکولوژی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران Fatemeh Paydar فاطمه پایدار 3900319475328460087811 3900319475328460087811 No Health Promotion Research Center, Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran مرکز تحقیقات ارتقا سلامت، بخش زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران Erfan Ayubi عرفان ایوبی 3900319475328460087812 3900319475328460087812 No Social Determinants of Health Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran مرکز تحقیقات عوامل اجتماعی موثر بر سلامت، پژوهشکده علوم و فناوری بهداشت، دانشگاه علوم پزشکی همدان، همدان، ایران Maryam Razavi مریم رضوی Dr.Razavi351@gmail.com 3900319475328460087813 3900319475328460087813 Yes Health Promotion Research Center, Department of Obstetrics and Gynecology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran مرکز تحقیقات ارتقا سلامت، بخش زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران