JOURNAL OF MIDWIFERY & REPRODUCTIVE HEALTH
Year:2018 | Volume:6 | Issue:4|Papers Count:11

Background & aim: Estrogen and androgen deficiency in menopause leads to poor vulvovaginal blood flow, vaginal dryness, and dyspareunia which can reduce the quality of life among the women. In this regard, this study investigated the impact of date palm pollen capsules on vaginal lubrication and dyspareunia in postmenopausal women. Methods: The present triple-blinded, placebo-controlled clinical trial was conducted on 60 menopausal women aged 40-65 years, who referred to the health centers affiliated to the Mashhad University of Medical Sciences, Mashhad, Iran, in 2015. The subjects were randomly assigned to two groups of intervention and placebo (n=30), receiving date palm pollen and placebo capsules (350 mg, daily), respectively, for 35 days. The data were collected at two stages (at the baseline and after treatment) using the Female Sexual Function Index, a part of which evaluated vaginal lubrication and dyspareunia. Data analysis was performed in SPSS (version 16) using the independent t-test, Mann-Whitney U test, and ANCOVA. Results: There was a significant difference between the two groups after the intervention in terms of vaginal lubrication (P<0. 001) and dyspareunia (P=0. 048). The results of the ANCOVA revealed a significant difference between the intervention and placebo groups regarding the two investigated domains of sexual function by controlling the effect of the confounding factors. Conclusion: As the findings indicated, the administration of date palm pollen could improve vaginal lubrication and reduce dyspareunia in the postmenopausal women.

Background & aim: Ovarian hyperstimulation syndrome (OHSS) is a rare but most potentially life-threatening disorder in women under in vitro fertilization (IVF). This study aimed to determine the effect of low-dose human chorionic gonadotropin (hCG) on the prevention of OHSS and IVF outcome. Methods: This single-blind non-randomized clinical trial was performed from October 2008 to November 2012 in Motahari Hospital, Urmia, Iran. Overall, 202 infertile women undergoing IVF treatment were divided into two groups based on OHSS risk factors. Then, 87 women with serum estradiol level of 5000-8000 pg/ml received 5000 units of intramuscular hCG, and 115 women with serum estradiol level of > 8000 pg/ml, who were at high risk for OHSS, received 1600 units of hCG. Data were analyzed using independent t-test and Chi-square test in SPSS, version 16. Results: There were no significant differences in age, infertility duration, infertility factor, quality of embryo, pregnancy rate and number of abortions and OHSS rate between the groups (P>0. 05). The group that received 1600 units of hCG was in a better condition regarding the mean number of ova (11. 45± 5. 41 versus 9. 24± 4. 24; P=0. 01), mean number of good quality ova (11. 10± 5. 47 versus 8. 68± 4. 03; P=0. 001), and mean number of embryos (7. 38± 4. 24 versus 5. 53± 2. 85; P=0. 001). There was no significant difference in the rate of OHSS incidence and cancellation of embryo transfer between the two groups (1600 and 5000 units). Conclusion: Overall, the current study indicated that prescribing 1600 units of hCG in women who are at risk of hypersensitivity reaction may induce similar or perhaps better results regarding the quantity and quality of ova and embryos, however, OHSS risk is not completely eliminated by using a lower dose of hCG. It is therefore suggested to perform randomized clinical trials with greater sample size to verify these results.

Background & aim: Giving birth is a painful process, which exposes women to a lot of stress. It is the responsibility of the healthcare practitioners to make this process less burdensome. In this regard, the present study aimed to investigate the attitudes of postpartum mothers towards labor pain relief. Methods: This descriptive cross-sectional study was conducted on 153 females with spontaneous vaginal delivery within September to October of 2012. The study population was selected through convenience sampling technique. Data collection was performed using a semi-structured questionnaire. The data were analysed in SPSS (version 20), using descriptive statistics and Chi-square. P-value less than 0. 05 was considered statistically significant. Results: According to the results, 60. 8% of the respondents had knowledge about pain relief in labor. However, 58. 8% of the participants did not request for pain relief during labor because they believed that their pain could not be relieved. Women's attitude to labor pain relief showed a significant association with their age (P=0. 001), education level (P=0. 001), and parity (P=0. 001). Conclusion: Based on the findings of the study, the midwives are recommended to provide the pregnant women with health education on labor pain relief and dispel any misconceptions in this regard.

Background & aim: Despite the identification of hysteroscopy as the most accurate method for the diagnosis of uterine cavity disorders, the patients are initially subjected to hysterosalpingography (HSG). In this regard, the present study aimed to compare the diagnostic value of HSG and hysteroscopy in the detection of uterine cavity abnormalities in infertile women. Methods: This cross-sectional study was conducted on 91 infertile women who needed to undergo hysteroscopy in the Gynecology Ward of Imam Reza Hospital in Mashhad, Iran, due to the detection of a uterine abnormality in their HSG or failure of intrauterine insemination and in vitro fertilization during 2013 to 2014. The results of HSG and hysteroscopy to detect uterine cavity changes were compared. Data analysis was performed in SPSS software (version 16) using McNemar’ s test. P-value less than 0. 05 was considered statistically significant. Results: Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of HSG were 38. 78%, 78. 57%, 67. 86%, 52. 38%, and 57. 14%, respectively, in comparison to those of hysteroscopy. The results of the McNemar’ s test revealed a significant difference between the results of HSG and hysteroscopy in the diagnosis of uterine cavity abnormalities (P=0. 001). Conclusion: As the findings indicated, HSG had lower sensitivity, specificity, as well as positive and negative predictive values. Consequently, this method can be concluded as insufficient for the diagnosis of endometrial cavity disorders and incapable of diagnosing many factors affecting the outcome of infertility treatments. Therefore, all infertile women who are candidate for laparoscopy or those who need expensive infertility treatments are suggested to undergo hysteroscopy before the onset of treatment.

Background & aim: Preeclampsia is a serious pregnancy hypertensive disorder which is associated with high maternal and perinatal morbidity and mortality. One of the ways to reduce the risk of preeclampsia during pregnancy and childbirth is training midwives regarding its management. We aimed to compare the effects of mobile-based and lecture-based training methods on midwives' knowledge regarding management of pre-eclampsia/ eclampsia in 2017. Methods: This experimental study was conducted on 70 midwives working in Lar, Iran, in 2017. The patients who met the inclusion criteria and provided informed consent were included in the study. The subjects were randomly assigned to two educational groups of lecture-based and mobile-based education. To measure knowledge a questionnaire was completed before the intervention, one week and one month after the intervention by the participants. To analyze the data, independent t-test for inter-group comparison and paired t-test for intra-group comparison were run in SPSS. Results: No significant differences was seen between the two groups before the intervention, while one week and one month after the intervention, the knowlege scores were significantly different (P=0. 001). The results of paired t-test in both groups showed significant changes at the end of the study. Results were significant in both groups, but according to the mean score of knowledge before and after the intervention, the mobile-based had a greater score than lecturebased training group. Conclusion: Both mobile-based and lecture-based training methods increased the awareness of midwives regarding the management of preeclampsia and eclampsia, but the highest increase in knowledge was seen in mobile-based training group. . Thus, the implementation of midwifery training programs using mobile applications can increase midwives’ awareness concerning the management of midwifery emergency services.

Background & aim: Globally, human-immunodeficiency virus (HIV) is threating the lives of human being. Despite the several programs supporting male partner involvement in the prevention of mother-to-child HIV transmission (PMCHT), only few male partners have accepted and involved in this process. Regarding this, the present study aimed to assess male partner involvement in the PMCHT and its associated factors in Bishoftu, Central Ethiopia Methods: This cross-sectional study was conducted on 405 male partners whose mates gave birth in Bishoftu during June, 2016. The study population was selected using simple random sampling technique. Data collection was performed by means of a self-administered interview questionnaire. The data were analyzed in SPSS software (version 20) using Chi-square test and t-test. P-value less than 0. 05 was considered statistically significant. Results: A total of 405 male partners participated in this study with a response rate of 96. 2%. The mean age of the participants was 34. 03± 5. 8 years. Spousal participation index in the PMCHT service in Bishoftu town was obtained as 211 (52. 1%). The significant predictors of male partner participation in the PMCHT programs included low knowledge about PMCHT services (adjusted odds ratio [AOR]=2. 27, 95% CI: 1. 12-4. 57), negative attitude towards these programs (AOR=2. 09, 95% CI: 1. 23-3. 67), unawareness about the provision of PMCHT services in the public health facilities (AOR=2. 41, 95% CI: 1. 27-4. 95), and perceiving attending antenatal care and PMCHT program as only women’ s responsibility (AOR=3. 96, 95% CI: 2. 00-7. 81). Conclusion: As the findings indicated, male partner participation in the PMCHT service was not at a satisfactory level. Consequently, it is highly recommended to equip the male partners with knowledge, as well as positive attitude and perception towards these services.

Background & aim: Due to frequent waking at night for breastfeeding, nursing mothers are likely to suffer from sleep deprivation, which may lead to sexual dysfunction. To the best of our knowledge, few studies have been conducted on sexual distress in nursing mothers. Thus, we sought to examine the relationship between the frequency of breastfeeding and female sexual distress during postpartum period. Methods: This descriptive correlational study was conducted on 80 women aged 18-35 years, visiting healthcare centers in Mashhad, Iran, during 2016. To select the participants, multi-stage sampling method was used. The data collection tools included demographic and fertility-related questionnaire, the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the Female Sexual Distress Scale-Revised (FSDS-R). To analyze the data, Kruskal-Wallis H test, Spearman’ s rank-order correlation, and linear regression model were run in SPSS, version 16. Results: The mean score of postpartum sexual distress in mothers was 20. 43± 8. 00. According to the results of the Spearman’ s rank-order correlation, the frequency of nighttime breastfeeding was directly correlated with maternal sexual distress (P=0. 010, r=0. 26). However, there was no correlation between the frequency of daytime breastfeeding sessions and sexual distress (P=0. 976, r=0. 003). Conclusion: Considering the correlation between the frequency of breastfeeding at night and postpartum sexual distress in mothers, it seems necessary to adopt effective counselling approaches to overcome female sexual distress during this period.

Background & aim: Avoiding unintended pregnancy is an important issue among college students. Emergency contraception is considered as a practical method to prevent pregnancy after unprotected sex. This study was conducted to measure the knowledge of college students regarding emergency contraception in Zanjan, Iran. Methods: This cross-sectional study was conducted among 911 college students, who were studying humanity, engineering, and experimental sciences in Zanjan, Iran, during 2011 to 2012. The subjects were selected using stratified random sampling method, and the data were collected by a questionnaire developed by the researcher. The level of knowledge was considered as low, moderate, and high. Data analysis was performed using Chi-square test in SPSS software, version 16. Results: According to the results, 78 (8. 6%), 279 (30. 9%), and 545 (60. 4%) of the students had high, moderate, and low levels of knowledge about emergency contraception, respectively. Additionally, 524 individuals (58. 28%) had heard about emergency contraception so far. Furthermore, 256 (28. 6%) students knew about combined oral contraceptive pills, and 64 (7. 2%) of them knew about intrauterine device with copper as an emergency contraception. There was a significant relationship between marital status and the level of knowledge (P=0. 01). Conclusion: The results showed that the students had inadequate knowledge about the methods of emergency contraception. Conducting educational programs and making students aware through the media may be helpful for increasing their level of knowledge.

Background & aim: In most cases, infertility can have a profound impact on sexual relationship. In such a condition, individuals often have unpleasant feelings towards their bodies, lose their self-confidence, feel depressed and frustrated, and experience decreased sexual desire. Therefore, we sought to investigate the relationship between sexual satisfaction and genital self-image among infertile women. Methods: This cross-sectional study was conducted on 102 infertile women visiting Milad Infertility Center in Mashhad, Iran, during 2016. To select the participants, the convenience sampling method was used. The inclusion criteria were being Iranian and Muslim, having basic literacy, being aged 18-40 years, living with the spouse, not becoming pregnant after about one-year of regular and unprotected sexual intercourse, having a primary diagnosis of infertility as confirmed by a gynecologist, and being formally married. Moreover, the data collection instruments included a demographic form, the Female Genital Self-image Scale, and Golombok-Rust Inventory of Sexual Satisfaction. To analyze the data, Mann-Whitney U test, Chi-square test, Pearson product-moment correlation, and linear regression analysis were run in SPSS, version 16. Results: The mean scores of genital self-image and sexual satisfaction in infertile women were 47. 40± 9. 71 and 61. 03± 9. 81, respectively, indicating a significant correlation between genital self-image and sexual satisfaction in infertile women (r=-0. 500, P<0. 001). According to the results of linear regression analysis, female non-sexuality and anorgasmia were predictive of genital self-image. Conclusion: Considering the relationship between genital self-image and sexual satisfaction, it can be concluded that promoting sexual satisfaction and genital self-image in infertility centers is of utmost importance.

Background & aim: This systematic overview of reviews on complementary and alternative medicine (CAM) was performed to summarize the clinical efficacy of this approach in the treatment of erectile dysfunction (ED) and assess methodological quality of the included reviews. Methods: A comprehensive search was performed to find the systematic reviews and meta-analyses on CAM interventions (e. g., acupuncture, saffron, yohimbine, and ginseng) for ED treatment, published until October 2017. To this end, we searched the international databases, including PubMed, Scopus, and Cochrane, as well as Iranian databases, such as SID, IranMedex, and Magiran. The assessment of the methodological quality of the included systematic reviews was accomplished using the AMSTAR scale. Results: The searching process led to the inclusion of five systematic reviews examining CAM therapies, including acupuncture, saffron, Yohimbine, and ginseng. The methodological quality of the retrieved reviews was at a favorable level. Positive results were found for the administration of yohimbine, saffron, and ginseng as treatment agents for ED. However, there was insufficient evidence regarding the effect of acupuncture on this health problem. Major methodological defects included the use of a grey literature search, likelihood of publication bias, and conflicts of interests. Conclusion: As the findings indicated, CAM appeared to be an effective treatment for ED. However, it is essential to conduct further studies on the safety and value of CAM for the management of this condition.

Background: Diagnosis of ovarian mass during pregnancy may be postponed because they may mimic physiological signs of pregnancy. Ovarian masses can lead to complications such as overgrowth, torsion or cyst rupture. Therefore, to inform health providers concerning symptoms, safe diagnostic methods and proper management seem appropriate. Case report: A 19-year-old primigravida was presented to our clinic in the 16th week of gestation with an ultrasound document revealing a giant solid-cystic mass extending from pelvis to diaphragm, which was probably an ovarian cyst. During the ultrasound assessment of pregnancy, the mass was discovered incidentally. The only complaint of patient was insignificant abdominal bloating attributed to dyspepsia. Vital signs and laboratory tests, including tumor markers, were within normal limits. During laparotomy, an ovarian multilocular cyst extending beneath the diaphragm and measuring about 50 cm and 10 kg using was removed using a different technique. The volume of the cyst was decreased before the removal by inserting an angio catheter and withdrawing some fluid. Through this procedure, we prevented spillage of cystic fluid into the abdomen and pressed pregnant uterus during mass extraction. Ovarian serous cystadenoma was confirmed by pathology evaluation. Pregnancy passed normally until the delivery of a 3100-gm baby in the 38th week of gestation. Conclusion: Proper diagnosis of masses during pregnancy can save maternal and fetal health through preventing adverse outcomes, such as abortion or preterm labor. Therefore, pregnant women’ s complaints and precise physical examination should be taken into account in prenatal care centers. Also, surgical intervention with the least uterine manipulation is recommended in these cases.