Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2011 | Volume:14 | Issue:5|Papers Count:9

Introduction: Little is known about the mechanism and biochemical pathway of preterm delivery. Since some drugs used to treat preterm labor are also useful for the treatment of primary dysmenorrhea so this study attempted to evaluate the association between primary dysmenorrhea and preterm delivery. If the association is statistically significant, primary dysmenorrhea should be regarded as a risk factor for preterm delivery.Methods: A case-control study of 160 women with idiopathic preterm delivery as case group and 160 women with term delivery as controls was done in the women who referred to obstetric clinic of Imam Reza hospital in 1387. Both groups were healthy, singleton and without obstetric problems. Demographic information, history of primary dysmenorrhea and history of previous preterm labor were recorded in questionnaire and statistical data were analyzed by t-test, chi square test, Mann-Whitney test and logistic regression test by using SPSS software version 15.Results: Rate history of primary dysmenorrhea in women with preterm labor was greater and had significant difference with control group. Gravid women with a history of primary dysmenorrhea had 3.5-fold increased risk of preterm delivery in comparison with those without a history of primary dysmenorrhea (p=0.005). So in subgroup analysis, gravid women with a history of severe primary dysmenorrhea had 5.5-fold increased risk of spontaneous preterm delivery (p=0.000) while gravid women with moderate primary dysmenorrhea had 2.6-fold increased risk of spontaneous preterm delivery (p=0.001).Conclusion: Primary dysmenorrhea is associated with an increased risk of spontaneous preterm delivery. A common pathophysiologic pathway may exist between these two disorders.

Introduction: Preterm labor affects the new born exuberance in multiple aspects such as increasing the risk of very low birth weight infants, intrapartum hypoxia and birth trauma, the sequelae of intrauterine growth retardation, respiratory distress syndrome, necrotizing enterocolitis, intracranial hemorrhage and septicemia. So prevention of preterm labor can be effective in decreasing of these complications. Our study focused on the cervicovaginal levels of Beta-HCG in order to determine its predictive value in preterm labor.Methods: In this case-control study, we determined the Beta-HCG concentration in the cervicovaginal secretions of 87 pregnant women of whom 55 had preterm labor in their medical history (cases) and 32 of them didn’t have such medical history (controls) since 2006 to 2008 in 22 Bahman hospital affiliated to Islamic Azad university in Mashhad. After explaining the procedure and the potential benefits of the study, we obtained cervicovaginal samples at 28, 30, 32, 34, 36 weeks of gestation and labor time for measuring the Beta-HCG by ELIZA test. The data were analysed by statistical program of SPSS version 15, first the data were checked by Glumogroff and Smearnoff tests for being normal, then t-test and nonparametrical tests like mean whitney were used for normal and abnormal cases, respectively. Significance level of the tests was considered less than 0.05.Results: Among the 55 pregnant women (cases), 12 (21.9%) had preterm labor however none of the other 32 pregnants with no past history of preterm labor (controls) had preterm delivery (0.0%). The mean maternal age in this study was 24.55±5.57. In all, the median concentration of Beta-HCG in cervicovaginal secretions of the women at high risk of preterm labor (81.067mIU/ml) showed no statistically significant difference with that control normal risk group pregnant women (78.872mIU/ml and p>0.05). But there was statistically significant difference between the 12 high risk women who had preterm labor (92.098 mIU/ml) and the remaining 43 high risk women who had normal labor (75.492mIU/ml) in 28, 30, 32 and 34 weeks of gestation (p>0.05).Conclusion: Cervicovaginal Beta-HCG concentration is a good predictor of preterm delivery in patients with high risk of preterm labor.

Introduction: Premenstrual syndrome (PMS) is the term used to describe the physical, mental, or behavioral changes that mostly adult and middle-aged women experience during the luteal phase of menstrual cycle every month. The aim of this study was to study the correlation of aerobic power and the prevalence of premenstrual syndrome in female athletes and non athletes.Methods: In this study, forty women who had regular menstrual cycle were enrolled. The mean age of participants was 23 years old and the mean weight was 56 kg. All of the participants were engaged in Bruce test and filling of premenstrual syndrome questionnaire within luteal phase in days 18 to 28 of their menstrual cycle. The descriptive analysis was used for evaluation of descriptive variables and Pierson coefficient was used to study the correlation of variables in our study. The 0.05 was taken as the statistically significant value.Results: The results showed that symptoms of premenstrual syndrome were less prevalent in athletes group than other group. Also, the result of Pierson correlation test showed that there was significant inverse correlation between premenstrual syndrome with aerobic power (p<0.05, r=-0.67).Conclusion: Since, exercise is a safer alternative in comparison to medical treatment of premenstrual syndrome so women should do aerobic exercises to decrease symptoms premenstrual syndrome.

Introduction: Unwanted pregnancies are among factors causing maternal mortality that can affect women's quality of life. This study was done to show the incidence of unwanted pregnancy and its relationship with health-related quality of life in pregnant women.Methods: This descriptive cross-sectional study enrolled all pregnant women who referred to health centers of Tazehabad urban_rural health center during for routine prenatal care two month of January and February of 2007. According to the research aim, two questionnaires were completed for every pregnant woman: a questionnaire of pregnancy type and SF36 questionnaire to measure health-related quality of life. Data were analyzed with software of SPSS11.5 by using descriptive statistics and statistical analysis of T-test.Results: In our study 40.2% women had unwanted pregnancy. In 15.7% pregnancy was unwanted by the couple, 7.8% unwanted pregnancy by husband and 16.7% unwanted pregnancy by the wife. T-test showed the relationship between the average scores of health-related quality of life and type of pregnancy was significant (p=0.0001). Average scores of quality of life in mental and physical subscales of unwanted pregnancies were less than mothers with desired pregnancy (p=0.0001).Conclusion: The decreased incidences of unwanted pregnancies would promote health-related quality of life in pregnant women.

Introduction: Episiotomy is the most common operation performed in obstetrics. Since midline episiotomy has been shown to significantly increase the risk of anal sphincter injuries followed by fecal and gas incontinence, mediolateral episiotomy has become common. Despite the use of mediolateral episiotomy a large proportion of women still develop anal sphincter injuries. The aim of this study was to compare the extent of mediolateral episiotomies by doctors and midwives in Ahvaz maternity hospitals.Methods: This descriptive-analytic study was carried out on nuliparous women who referred to Imam Khomeini, Razi and Sina maternity hospitals of Ahvaz city in 2010. The perineal length, episiotomy length, distance from the midline, shortest distance from the midpoint of the anal canal and episiotomy angle were measured using a tape in the lithotomy position immediately after episiotomy repair. Data were analyzed using descriptive statistic t-test and chi square tests in SPSS software version 15.Results: Of 120 assessed episiotomies, 76 (%63.3) were performed by midwives and 44 (%36.7) were performed by doctors and %16.6 of episiotomies had been performed with true angles. In the other hand, %13.2 of midwives and %22.7 of doctors had performed truly mediolateral episiotomies and there was no statistical difference between the 2 groups (p value=0.12)Conclusion: These results show that the majority of episiotomies are not truly mediolateral, so more intensive training of doctors and midwives is clearly required.

Introduction: The transition from pregnancy to postpartum period is associated with changes in sexual function which is considered a psychosocial crisis. Different social, cultural and religious status might be responsible for the various results related to the prevalence and risk factors of sexual dysfunction during postpartum period. Recognizing these problems and making a timely intervention is effective in improving the quality of life. The aim of this study was to assess sexual dysfunction and its related factors among breast feeding women during the first year after child birth.Methods: This cross-sectional study was done on 528 women in health centers of Ghaemshahr (1387-1388) with cluster random sampling. The inclusion criterion was breastfeeding women who had spent 2 to 12 months of postpartum period, who were not divorced, educated and consented to participate in the study. Those, who had been away from their husband for any reason, lost their baby or suffered from severe physical and psychological diseases, were excluded from the study. The Demographic and midwifery data were assessed with related questionnaires. Sexual function was evaluated with female sexual function index. Data analysis was carried out using descriptive statistics, Chi-square and t-test.Results: Findings show that nearly half of the women (41.4%) had some degree of sexual dysfunction during the first year after the delivery, which was often mild (30.4%). Severe dysfunction was more common in the first 3 months of postpartum period (71.4%). Dysfunction prevalence decreased to 9 months and then increased slightly (p=0.01). Age, duration of marriage, more parity and children, infant with health problems and fatigue were significantly associated with sexual dysfunction. Conclusion: The prevalence of sexual dysfunction in postpartum period is more than the general population of women. Dysfunction is more common during the first 3 months and between 9 to 12 months of postpartum period. Since most women do not go to health centers for their problems, health providers must be aware of silent epidemiology of dysfunction and its risk factors to be able to provide preventive, therapeutic and counseling measures for females.

Introduction: Myometrial contractions are unique in the extent of pain in comparison to muscular contractions that a woman experiences during her life and women desire to get rid of such a pain. The purpose of this study was the compare two methods of superficial strocking & vibration massages on intensity and variation of low back pain during labor in primiparous women.Methods: In this clinical interventional study 120 women were enrolled who were referred to the lanor department of Hafez and Zeinabieh hospitals in Shiraz. Participants were randomly divided into three group of 40 .The first group got strocking massage, the second got vibration massage and third group was the control group. The massages were conducted in strocking and vibration groups in three stage of dilatation (3-4, 5-7, 8-10cm respectively) in T10-L1 area for 15 minute in each stage.Results: There was no significant difference between three groups in age & education level. Intensity of low back pain before and after of massage in two experimental groups were significantly different in 3 stages (p=0.001). Intensity of pain in 3 stages after conducting massage was significantly lower than control group (p=0.001) Variation of pain also was significantly different in 3 stages of dilatation.Conclusion: Both strocking & vibration massages in T10-L1 segment were effective in reducing the low back pain of primiparous women. Intensity of low back pain was descending in case groups mostly in third stage. But in control group the pain was increasing in intensity mostly in third stage.

Introduction: High levels of stress during pregnancy are clearly associated with several negative health consequences for offspring and mother. Hence, there appears to be a demand for studies taking into consideration factors which might play an effective role in protecting the pregnant woman and her unborn child against harmful consequences of heightened stress levels. This study was done in order to investigate the relationship between personality traits, coping styles with stress and stress level in pregnant women. Methods: This correlation study was done on 80 pregnant women who referred to Isfahan Shahid Beheshti Hospital in the year 2009. They completed NEO Personality Inventory, Endler and Parker Coping Inventory, Cooper Stress Questionnaire and demographic characteristics by self-report. Data were analyzed by utilizing correlation and regression analysis with SPSS software 16th version.Results: Findings demonstrated that stress in pregnant women was related to neuroticism (r=0.607), extraversion (r=-0.460), agreeableness (r=-0.492), conscientiousness (r=-0.429), problem-focused coping (r=-0.403) and emotion-focused coping (r=0.467) (p<0.01). Neuroticism, emotion-focused coping, problem-focused coping and agreeableness predicted 55 percent of stress levels in pregnant women (R2=0.547, p=0.00). In addition, personality traits statistically were related to coping styles. (p<0.01 p<0.05 respectively).Conclusion: According to this study, personality traits and coping styles had relationship with stress level in pregnant women. Moreover, the majority of stress level is predictable by personality traits and coping styles in pregnant women. Therefore stress management training, education and psychotherapy for mothers may be essential.