International Journal of Women's Health and Reproduction Sciences最新文献

{"title":"Evacuating Uterine Contents before Operative Hysteroscopy in Patients With Active Uterine Bleeding: A Randomized Clinical Trial","authors":"M. Sayyah-Melli, Maryam Kazemi-Shishavan, Nooshin Behravan, Parvin Mostafa Gharabaghi, V. Rahmani","doi":"10.15296/ijwhr.2022.11","DOIUrl":"https://doi.org/10.15296/ijwhr.2022.11","url":null,"abstract":"Objectives: Concurrent bleeding or existing clots usually obscure the vision field and decrease the hysteroscopy success rate. Therefore, any efforts made to have a clear view during the hysteroscopy will improve the diagnostic or treatment outcomes. We examined the effect of preoperative clot evacuation on hysteroscopy related outcomes. Materials and Methods: In this parallel-group randomized clinical trial conducted in Al-Zahra hospital, Tabriz, Iran, 114 women with uterine bleeding were randomly assigned to receive either clot evacuation before standard operative hysteroscopy or after that from December 2018 to September 2019. The study outcomes were the clarity of vision, amount of bleeding, the volume of required distension media, duration of the procedure, and postoperative complications. Results: There were statistically significant differences in the frequency of the clear vision (P<0.001), the severity of bleeding, mean procedure time (P<0.001), mean used distension media and the mean postoperative hematocrit levels in favour of women with pre-hysteroscopy intrauterine evacuation. There was no difference in in-hospital stay and anaesthetic complications among the two groups. The procedure was successfully performed on all participants of both groups with no post-operative complications. Conclusions: Removal of clots and other uterine contents before the insertion of the hysteroscope rendered better and faster access to the uterine wall to observe existing abnormalities. This additional surgical step could significantly impact surgical and clinical outcomes.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90612835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does COVID-19 Infection Affect Female Reproductive System?","authors":"Nevin Sağsöz","doi":"10.15296/ijwhr.2022.01","DOIUrl":"https://doi.org/10.15296/ijwhr.2022.01","url":null,"abstract":"China, and spreading rapidly all over the world, SARS-CoV-2 (COVID-19) has led to an increase in morbidity and mortality all over the world. The most common findings are fever, sore throat, and myalgia. Although clinical findings can be mild sometimes, symptoms can be serious enough to cause death, such as severe acute respiratory syndrome (SARS) (1). One of the mechanisms held responsible for the multiorgan complications of COVID-19 is its entry into the cell via angiotensin converting enzyme-2 (ACE2) (2). The S protein of the virus binds to ACE2 receptor of the host cell, and this complex is exposed to proteolytic processing by the host type II transmembrane serine protease (TMPRSS-2) enzyme and the virus enters the cell (3). Therefore, tissues with high ACE2 receptors may be more sensitive to this virus. The presence of these receptors in ovarian granulosa cells has been demonstrated in previous animal studies (4). Moreover, the importance of ACE2 in human ovary has been shown (5, 6). On the other hand, the uterus, especially endometrium, has pivotal role in fertility and, components of the reninangiotensin system (RAS) are found in epithelial and stromal cells of endometrium (7). Furthermore, viral entry is dependent on primary cleavage of the S protein, which cleavage can be activated by one or more host proteases, including FURIN, trypsin, cathepsin, TMPRSS-2, or TMPRSS-4 (transmembrane serine protease 4) (3). In human endometrium, the expression of proteases such as TMPRSS4, CTSA (Cathepsin A), CTSB (Cathepsin B), CTSL (cathepsin L), BSG (basigin), FURIN, and MX1 has been shown to vary in different phases of the cycle in both natural and controlled ovarian stimulation cycles. It has also been found that this expression increases with age. For this reason, it has been stated that the endometrium and implantation may be affected by the virus more specifically with age (8, 9). Therefore, Covid-19 may affect endometrium and implantation (10). In various studies, transient menstrual changes, usually in the form of prolonged cycles and reduced Does COVID-19 Infection Affect Female Reproductive System?","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"80 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82679017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does a Decrease in CA-125 in Advanced Ovarian Cancer Following Neoadjuvant Chemotherapy Predict the Clinical Outcome of Patients? A Cross-sectional Study","authors":"S. Akhavan, Y. Jefrideh, A. Mousavi, Mitra Modares-Gilani, Shahrzad Sheikh-Hasani","doi":"10.15296/ijwhr.2022.28","DOIUrl":"https://doi.org/10.15296/ijwhr.2022.28","url":null,"abstract":"Objectives: Although ovarian cancer is the sixth most common cancer among women, in most cases, it is not diagnosed until it covers the entire peritoneum. In the present study, it was examined the clinical outcomes of the women with epithelial ovarian cancer (EOC) in stage IIIC-IV treated with neoadjuvant chemotherapy (NACT) and its association with decreased ovarian cancer antigen (CA-125). Materials and Methods: In this cross-sectional study, 78 women with EOC (Stage IIIC-IV) who underwent NACT at Imam Khomeini hospital, Tehran, Iran were evaluated. Demographic characteristics, aged at diagnosis, severity and stage of disease, serum CA-125 level, histological type, tumor pathology before and after chemotherapy, overall survival, and recurrence of disease was examined. Results: In total, 78 women with mean age of 52.83 ± 10.18 (between of 29 to 77) years were evaluated. The majority of the patients had positive initial ascitic fluid cytology for malignancy (68.9%). After surgery, papillary serous was the most common histologic finding (73, 81.1%). CA-125 level post NACT (median of 25 U/mL) was significantly reduced compare to before NACT (median of 980 U/mL; P<0.0001), and the rate of CA-125 reduction was significantly lower in older participants’ ages (r=0.274, P=0.017). Survival time showed a significant and strong negative correlation with the CA-125 levels before (r=-0.363, P=0.003) and after NACT (r=- 0.383, P=0.002). Moreover, there was a significant negative correlation between survival time and chemotherapy courses (r=-0.363, P=0.003) and age (r=-0.474, P=0.000). Conclusions: The results of this study showed that the clinical outcomes of patients with advanced ovarian cancer can be predicted by a decrease in serum CA-125 levels after NACT.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"20 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77685165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L-Citrulline Level in Pregnant Adolescent With Severe Preeclampsia Compared to Without Preeclampsia: A Cross-sectional Study","authors":"Dini Hidayat, Triani Fitriasari, T. Djuwantono, Y. Hidayat, S. Irianti, M. Ritonga, S. Sunardi","doi":"10.15296/ijwhr.2022.03","DOIUrl":"https://doi.org/10.15296/ijwhr.2022.03","url":null,"abstract":"Objectives: Numerous studies have been performed on the effect of L-arginine supplementation on improving maternal outcomes, but studies on the impact of L-citrulline in pregnancy are limited. This study aimed to evaluate the L-citrulline level in pregnant adolescents with severe preeclampsia compared to those without preeclampsia. Materials and Methods: This is a cross-sectional study among 60 adolescent pregnant women giving birth in the Emergency Room and Delivery Room in Hasan Sadikin Hospital, Bandung, Indonesia from May to October 2020. The L-citrulline levels were examined in women with severe preeclampsia (n = 30) and those without preeclampsia (n = 30). Results: The L-citrulline level in adolescent pregnancies with severe preeclampsia was lower than those without preeclampsia (79.7±40.4, 122.3±61.9 pg/mL, respectively and P=0.003). But no correlations were observed between L-citrulline levels with systolic blood pressure, diastolic blood pressure, and mean arterial pressure (MAP). Conclusions: There was a difference in serum L-citrulline level of adolescent pregnancies with severe preeclampsia and without pre-eclampsia.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"5 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84922128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and Obstetric Outcomes of Post-date Pregnancies in Abakaliki, Ebonyi State, Southeast Nigeria: A Cross-sectional Study","authors":"A. Onyebuchi, L. Okafor, J. Mamah, V. Obi, C. Esike, O. Umeora, Chichetaram Otu","doi":"10.15296/ijwhr.2023.06","DOIUrl":"https://doi.org/10.15296/ijwhr.2023.06","url":null,"abstract":"Objectives: This study aimed to evaluate the fetomaternal outcomes of post-date pregnancies. Materials and Methods: We carried out a cross-sectional study of post-date pregnancies managed at Federal Teaching hospital, Abakaliki, Nigeria, from January 2013 to December 2015. Pregnancies delivered at 40 weeks and 10 days or more were included. Data was collected using a structured proforma, including sociodemographic characteristics, gestational age at delivery, and maternal and fetal complications. Data analysed using Epi Info version 7. Results: The majority of the women (80.7%) had labor induction at the gestational age of 41 weeks and three days. Vaginal delivery and cesarean sections were the mode of delivery in 73.9% and 25.0% of women, respectively. Cesarean sections were mainly for labor dystocia (54.5%). The mean age of the women was 28.0 ± 4.4 yr. 38.6% of women were nulliparous. The main neonatal complication was sepsis (10.2%). Perinatal deaths were reported in 1.1% of neonates. Primary postpartum hemorrhage was reported in 6.8% of women. Conclusions: Due to the higher prenatal complications and the need for obstetric and gynecological interventions in postpartum pregnancies, early ultrasound and induction of labor are recommended to reduce adverse outcomes.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90185642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do We Need Alternative Screening Approaches for Cervical Cancer During Covid-19 Pandemic?","authors":"M. Kurdoğlu, A. Khaki","doi":"10.15296/ijwhr.2021.43","DOIUrl":"https://doi.org/10.15296/ijwhr.2021.43","url":null,"abstract":"health since it may allow the detection of not only precancerous lesions but also the cancers in their earliest stages, before the symptoms appear. However, the screening is not available for all types of cancer and has been highly recommended for cervical, breast, lung and colorectal cancers in certain ages and risk groups. Coronavirus disease 2019 (COVID-19) pandemic had a negative impact on cancer screening by making the access to preventive care facilities difficult. It has been stated that during COVID-19 pandemic between March and July 2020, particularly the women and individuals aged 30 to 49 years have postponed cancer screenings in Germany (1). Sharp decreases especially in the use of cervical cancer screening programs (2) may have led some cervical intraepithelial lesions to stay undetected in a potentially treatable stage of the cancerous progression. A two-month screening lock-down in Slovenia between March 12 and May 8, 2020 resulted in an 92% epidemic deficit of screening, as well as 70% and 68% decrease in follow-up and human papilloma virus (HPV) triage tests, respectively (3). During the stay-at-home order in California, approximately 80% decrease in cervical cancer screening rates compared with baseline was observed in the Kaiser Permanente Southern California (KPSC) network including 1.5 million women (4). National data in Italy showed that beside the lock-down, the significant reduction in the number of screening tests was also related to the fear of COVID-19, which resulted in the suspension of booked screenings and the reduction in adherence to screenings (5). The effects of disruption of cervical screening in COVID-19 pandemic can be mitigated by several approaches like HPV-based screening conducted from self-collected specimens. Such a reliable screening method may also allow to extend the screening intervals with longer reassurance against cervical cancer if it yields a negative result. The testing supported by telehealth Do We Need Alternative Screening Approaches for Cervical Cancer During Covid-19 Pandemic?","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74855508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There a Relationship Between the Severity of Preeclampsia and Fetal Renal Doppler Indices?","authors":"Elnaz Afsari, F. Abbasalizadeh, Z. Fardiazar, Saeedeh Shahali, Y. Ahmadi","doi":"10.15296/ijwhr.2021.48","DOIUrl":"https://doi.org/10.15296/ijwhr.2021.48","url":null,"abstract":"Objectives: Preeclampsia is a high prevalence complication in pregnancy and is responsible for 36% of maternal mortality worldwide. The offspring of mothers with preeclampsia face many problems after birth and in their lifetime. The fetal renal is one of the most vulnerable organs following maternal preeclampsia. In this regard, the present study investigated the relationship between the severity of preeclampsia and fetal renal artery resistance and pulsatility. Materials and Methods: In general, 91 pregnant women were included and divided into control and preeclampsia groups. The control group included 43 women with normal pregnancy and the preeclampsia group consisted of 48 pregnant women who suffered from preeclampsia and were classified into patients in severe and non-severe preeclampsia groups each containing 24 cases. Renal artery Doppler ultrasound was performed, and then the systole/diastole ratio (S/D), pulsatility index (PI), and resistance index (RI) were measured as well. Results: The S/D ratio, RI, and PI significantly decreased in the preeclampsia group (P<0.001) compared to the control group. The S/D ratio in severe preeclampsia was significantly lower in comparison with non-severe preeclampsia (P<0.001). Finally, the amniotic fluid index was related to the PI (P<0.05), and severe preeclampsia significantly increased the pregnancy termination before 34 weeks (P<0.001). Conclusions: Preeclampsia deceased the resistance of renal arteries by altering the fetal renal blood flow. These changes can intensify in patients with severe preeclampsia compared to non-severe preeclampsia.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"29 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90446725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Assertiveness-Focused Cognitive-Behavioral Group Therapy on Women’s Orgasm: A Randomized Clinical Trial","authors":"Mina. Chizary, Nafiseh Seyyedzadeh Aghdam, M. Ranjbaran","doi":"10.15296/ijwhr.2023.14","DOIUrl":"https://doi.org/10.15296/ijwhr.2023.14","url":null,"abstract":"Objectives: Sexual dysfunction is a major health problem and orgasmic dysfunction is one of the common sexual complaints reported by women. The aim of this study was to determine the effect of sexual assertiveness-focused cognitive-behavioral group therapy (CBGT) on women’s orgasm. Methods: This randomized controlled clinical trial included 24 women with secondary anorgasmia referring to health centers in Tehran, Iran. After randomly assigning the participants to one of two groups of intervention (n=12) and control (n=12), an eight-session CBGT with the emphasis on sexual assertiveness training was administered to the intervention group. The primary outcomes were sexual assertiveness and the orgasm score of the participant. Sexual desire, sexual arousal, lubrication, sexual satisfaction, and pain were considered as secondary outcomes. Finally, the female sexual function index (FSFI) and the Hurlbert index of sexual assertiveness questionnaires were used for data gathering. Results: After CBGT implementation, there was a significant difference between the intervention (5.33±0.62) and control (2.47±0.76) groups in the mean score of orgasm (P<0.001). In addition, the mean score of sexual assertiveness (P<0.001) and all other domains of FSFI (P<0.001) significantly increased after CBGT. Conclusions: Sexual assertiveness-focused CBGT was effective in the treatment of secondary anorgasmia and increased their sexual function. To prevent marital conflicts, establishing counseling clinics in health centers can be established by authorities in order to correct ineffective sexual beliefs and self-assertiveness in the country.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"10 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88222490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do the COVID-19 Vaccines Cause Menstrual Irregularities?","authors":"Z. Kurdoğlu","doi":"10.15296/ijwhr.2021.29","DOIUrl":"https://doi.org/10.15296/ijwhr.2021.29","url":null,"abstract":"This new corona virus causes various health problems like pneumonia, acute respiratory distress syndrome (ARDS), kidney injury, myocardial dysfunction, and gastrointestinal diseases (1). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects the immune system and causes an increase in interleukin (IL)-6, IL-8, tumor necrosis factor-α (TNF-α) and other cytokines. In addition to COVID-19 itself, impaired immune system may cause alteration on hypothalamic– pituitary–gonadal axis (2). Some studies showed a change in menstrual cycle, worsening of premenstrual symptoms and menorrhagia in women with COVID-19 compared to before the pandemic (3, 4). On the other hand, World Health Organization (WHO) suggests safe and effective vaccines to end COVID-19, besides wearing masks, cleaning hands, ensuring good ventilation indoors, physically distancing and avoiding crowds (5). After vaccination, some women complained of menstrual irregularities such as heavy menstrual bleeding (menorrhagia), frequent bleeding (metrorrhagia/ polymenorrhea), or postmenopausal bleeding. One of the underlying causes may be a vaccine-induced thrombocytopenia (6). The female human menstrual cycles could be affected by many situations such as stress, weight gain, hormones etc. During pandemic, studies show that women have significantly higher stress, anxiety, and depression compared to men (7, 8). Hypothalamic– pituitary–gonadal axis is sensitive to inadequate sleep, physical and psychological stress. Pulsatile mechanism of hormones is essential for regular menstrual cycle. Therefore, disruption of regularity in hormone release may cause to menstrual disorders (9). In addition, the vaccines activate the immune system and activated immune system might attack immune cells and inflammatory molecules in the uterus. This event may be associated with changes in menstrual cycles. To clarify these hypotheses, controlled studies are needed. Until now; pain, redness, swelling, tiredness, headache, muscle pain, chills, fever, Do the COVID-19 Vaccines Cause Menstrual Irregularities?","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"140 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79666064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on the Global Prevalence of Severe Fear of Childbirth in Low-Risk Pregnant Women: A Systematic Review and Meta-Analysis","authors":"Shahrzad Sanjari, R. Chaman, S. Salehin, Shahrbanoo Goli, A. Keramat","doi":"10.15296/ijwhr.2022.02","DOIUrl":"https://doi.org/10.15296/ijwhr.2022.02","url":null,"abstract":"Objectives: Severe fear of childbirth (FOC) has adverse consequences for mother and child. This study aimed to update the global prevalence of severe FOC in low-risk pregnant women. Materials and Methods: Observational studies published in English were obtained through PubMed, Scopus, Science Direct, Wiley Online, and Google Scholar databases up to April 2020. After reviewing the title and introduction, the quality of the articles that had full text and met the inclusion criteria of the study was checked with the JBI checklist. Then, the final extracted data were entered into the STATA software. The overall prevalence of severe FOC and fear in subgroups were obtained using meta-analysis. Tests of publication bias and sensitivity analysis were also performed. Results: Overall, 27 observational studies were included (26014 participants). The global prevalence of severe FOC was 16% (95% CI: 14%–19%). The subgroup analysis showed that after 2015, the prevalence of fear was higher than before (%18 versus %14). The results also showed a higher prevalence of fear in women with a diploma and lower compared to women with a university education (%19 versus %13), in single/divorced women compared to married/cohabitation women (%21 versus %15), in nulliparous women compared to multiparous women (%17 versus %14) and in women experiencing the second trimester of pregnancy compared to women in the third trimester of pregnancy (%23 versus %14). Conclusions: The global prevalence of severe FOC was 16%. Diagnostic, preventive, therapeutic and follow-up strategies are needed to reduce fear in all countries.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"5 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72870962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}