Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2017 | Volume:20 | Issue:5|Papers Count:18

Introduction: Cervical cancer is one of the main causes of women's mortality in many of developing world countries and had a significant increase in recent years. Using appropriate screening methods, this disease can be diagnosed at early stages and the deaths caused by it will be reduced. This study was performed with aim to compare the results of colposcopy and histology in patients with abnormal Pap smear or suspicious clinical findings.Methods: This cross-sectional analytic study was performed on 75 patients who had referred to Besat Hospital in Sanandaj from January 2013 to January 2016 with abnormal Pap smear and suspicious clinical findings in order to perform colposcopy and Pap smear. Colposcopic results and histological findings were extracted from the patients' files. Data were analyzed using SPSS software (version 22) and Chi-square test. The confidence intervals for diagnostic value indices were 0.05.Results: Histopathology and colposcopy studies were conducted on 36 patients with abnormal Pap smear and 39 patients with suspicious symptoms and clinical findings. Sensitivity and specificity of colposcopy were 69.23% and 73.46%, respectively. The positive and negative predictive values of colposcopy were 58.07% and 81.82%, respectively. There was significant relationship between the results of colposcopy and histology.Conclusion: In cases of abnormal Pap smear and suspicious clinical findings, colposcopy can be used to validate the findings.

Introduction: The most important part of marital relations is sexual relations which not only affects the health of individual and family, but also affects the public health. Delivery causes changes in sexual relationships and leads to significant problems in the marital life. This study was performed with aim to compared sexual problems after normal vaginal delivery and cesarean.Methods: This descriptive and cross-sectional study was performed on 800 women during the first 6 months after delivery in Ramsar health centers in 2014. Data collection tools included a two-part questionnaire consisted of demographic information and questions related to sexual problems. The sexual problems during the first six months after delivery was evaluated. Data was analyzed by SPSS software (version 15) and independent t-test, Chi-square and Fisher exact test. P<0.05 was considered significant.Results: Lack of libido (P=0.002), discomfort at the site of episiotomy (P=0.004), inadequate Lubrication (P=0.006), pain during intercourse (P=0.003) and fatigue (P=0.007) was higher in vaginal delivery group compared to cesarean group (P=0.007) that the significant relationship was observed.Conclusion: The rate of sexual problems is higher in vaginal delivery group than cesarean group.

Introduction: Premenstrual syndrome (PMS) is one of the most common psychosomatic disorders in women at reproductive age that affects their quality of life. Temperament modification can occur with changing in diet. Diet patterns also affect PMS. This study was performed with aim to evaluate the relationship between PMS and types of temperament in high school students.Methods: This descriptive-analytic study was performed on 200 high school students in Sabzevar during 2 months in 2016. Data collection tools included temperament standard questionnaire, temporary identification PMS questionnaire, Beck depression questionnaire, and PMS daily record form. The students who had severe depression according to the Beck Depression Inventory were excluded from the study, and the symptoms of this syndrome were collected in two consecutive menstrual cycles according to the premenstrual syndrome questionnaire. Data was analyzed by SPSS software (version 23) and Chi-square and Logistic regression test. P<0.05 was considered significant.Results: 165 participants (82.5%) had PMS. Most of them (49%) had moderate temperament. The prevalence of mix temperaments of hot and wet, hot and dry, and hot was 38% in PMS participants. Logistic regression test showed no relationship between variety of single and mix temperaments and having or not having PMS (P>0.05).Conclusion: However, PMS incidence was observed in combined hot and wet, hot and dry temperaments; there is no relationship between PMS and temperaments. So, it is recommended to do further studies in all layer of society with greater sample size.

Introduction: Most people experience some degree of anxiety before surgery that when it increased can cause serious complications. This study was performed with aim to evaluate the effect of educational multimedia on preoperative anxiety in patients undergoing cesarean section in Bushehr University of Medical Sciences.Methods: This single-blind clinical trial was performed on 162 patients aged 16 to 50 years referred to the educational hospitals of Bushehr for elective cesarean section in 2014. The subjects were assigned to experimental and control groups. One night before the surgery, the experimental group was given a VCD (containing educational videos related to surgery and various types of anesthetics) and was shown by the researcher. The control group received no intervention. Amsterdam questionnaire was used to assess preoperative anxiety. Data was analyzed by SPSS software (version 19) and t-test and ANOVA. P<0.05 was considered significant.Results: The mean score of total anxiety in the control group was 21.92±4.99 and in the experimental group was 17.44±5.88, and the difference was statistically significant (p<0.05). No significant relationship was observed between anxiety score in both groups and demographic factors of the samples.Conclusion: The use of educational multi-media is effective to reduce the patient's anxiety before surgery; therefore it is recommended to be used in patients before surgery.

Introduction: Breast engorgement is a common problem after delivery, which is considered as the third influential maternal factor on stopping the breastfeeding; it is possibly due to creating mastitis and breast abscess and reducing or stopping breastfeeding following breast engorgement. This study was performed with aim to determine the effect of breast oketani massage on the severity of breast engorgement.Methods: This clinical trial was performed on 94 lactating women who were suffering from breast engorgement within the first to fifth days after delivery referred tothe obstetrics clinic and gynecology department of Imam Reza Hospital in 2016. The subjects were divided into two groups of oketani massage and routine care. Severity of engorgement was determined by engorgement severity standard index. Both groups received two treatments on two consecutive days. The collected data regarding the severity of engorgement before and after the intervention were analyzed by SPSS software (Version 20) and Mann-Whitney, paired-t, independent t, Chi-square, and Analysis of Variance (ANOVA) with repeated measurements. P<0.05 was considered significant.Results: The mean of engorgement severity after intervention in right and left breast was decreased in oketani massage group and control group.However, there was a significant difference between two groups in terms of mean severity of engorgement in both breasts, so that the reduction in the severity of breast engorgement was significantly higher in the oketani group than the control group (P<0.001).Conclusion: Breast oketani-massage compared to routine care quickly and more efficiently reduces the severity of breast engorgement after delivery.

Introduction: Education of professional ethics is an important part of medical students program and professionalism is considered as one of the core competencies in medicine. Identifying the factors affecting learning professionalism in the obstetrics and gynecology ward with its own ethical challenges can help to the efficacy of training programs.This study was performed with aim to determine the views and experiences of clinical faculty members and medical learners of obstetrics and gynecology ward about the factors affecting the professional ethics development in practice.Methods: In this qualitative study in 2013, 10 faculty members and 30 residents and medical interns of obstetrics and gynecology wards in Shahid Sayyad Shirazi educational center were participated. To collect data, semi-structured individual interviews were used and stopped when theoretical saturation occurred. The interviews were transcribed line by line in accordance with a "conventional content analysis" and were coded and categorized.Results: The data analysis revealed four main themes including "humanistic profession, personality and character, role model, and educational and social factors" that explained the factors affecting the professional ethics development in the obstetrics and gynecology ward from the perspective of the faculty members, medical students and residents.Conclusion: The professors' role model and clinical training programs in the obstetrics and gynecology ward were the most important factors affecting the professional ethics development. Therefore, it seems that with appropriate educational interventions on these two important components, we could promote professional ethics education in clinical practice.

Introduction: Breast-feeding is one of the priorities of public health and the best starting in the life of every child. Considering the importance of parents' knowledge and attitude about the benefits of breastfeeding, this study was performed with aim to examine the effect of parents' education on their knowledge, attitude and performance in breastfeeding up to four months.Methods: This randomized clinical trial was conducted on 76 couples who had 3-5 days neonate and referred to Rastravesh Health Center in Karaj to receive health care services in 2015. The subjects were randomly placed in the control or intervention groups. Demographic and obstetrics, knowledge, attitude and performance questionnaire was completed by the parents. The educational intervention consisted of two 40-minute sessions with a week interval at first visit and one week later. Data were analyzed using SPSS software (version 21) and independent t-test, Chi-square, Mann-Whitney and covariance with repeated measures.P<0.05 was considered significant.Results: There was significant difference between intervention and control groups in terms of knowledge, attitude and performance of mothers and fathers at three times, including before the intervention, a week later and four months after the intervention (P<0.001). Statistical comparison showed that the mean score of knowledge, attitudes and performance of mothers and fathers had increased in the intervention group.Conclusion: Education has a significant effect on improving knowledge, attitudes and performance among parents on how to breastfeed the child; so using educational programs regarding correct breastfeeding practice can have an important effect on the growth and health of the neonate.

Introduction: childbirth self-efficacy points to the beliefs of a person about ability to use certain coping behaviors during labor. Studies showed that when people have false beliefs, use less of their abilities. This study was performed with aim to investigate the relationship between irrational beliefs and childbirth self-efficacy.Methods: This descriptive-correlational study was conducted on 702 pregnant women in 35-39 weeks of gestation, low risk, and third pregnancy referring to the health centers of Mashhad in 2015. Data collection tools included: Demographic and Midwifery questionnaire, Jones' Irrational Beliefs and Childbirth Self-efficacy Inventory. The form of subjects' selection and Demographic and Midwifery questionnaire was completed by the researcher through interview and data recorded in the file, and Irrational Beliefs and Childbirth Self-efficacy Inventory were completed by research's units in the presence of the researcher. Data were analyzed using SPSS software (version 16) and spearman correlation, linear regression and general linear models. P<0.05 was considered significant.Results: According to the results, mean score of irrational beliefs was 357.7±34.8 and 439.2±99.2 for childbirth self-efficacy. Childbirth self-efficacy had a significant direct linear relationship with irrational beliefs of emotional irresponsibility and dependency and had a significant reverse linear relationship with high self-expectations (P<0.001).Conclusions: Irrational beliefs such as emotional irresponsibility, dependency and self-expectation can predict coping with labor pain in pregnant women.

Introduction: fear of natural childbirth is a common problem during pregnancy and severe fear of childbirth may have a role in choosing mode of delivery by mother. This study was performed with aim to determine the relationship between fear of childbirth choosing mode of delivery in primiparous women referred to the health centers of Mashhad.Methods: This cross-sectional study was conducted on 220 primiparous women with gestational age of 28-30 weeks, who referred to Mashhad health centers in 2015-2016. Data collection tools included demographic questionnaire and Vigima fear of childbirth questionnaire. Data were analyzed using SPSS software (version 16) and Chi-square test, Fisher exact test, independent t-test, and logistic regression analysis. P Results: There was a significant correlation between intensity of fear of childbirth and choosing mode of delivery (P<0.001), so that there was severe fear of childbirth in 14 cases (14.4%) of women who had selected natural childbirth and 98 (79.7%) of women who had selected caesarean section. Also, mean score of fear of childbirth in women who had selected natural childbirth and cesarean was 50.18±18.68 and 70.23±12.48, respectively that had statistically significant difference (P<0.001), and the most common cause of fear of childbirth was fear of labor pain (45.9%).Conclusion: Given that caesarean rate was higher in women who had severe fear of childbirth than women with moderate fear of childbirth, some interventions are necessary to reduce fear of childbirth in primiparous women.

Introduction: Nowadays, there is a controversy regarding the efficacy of different educational methods on controlling of blood glucose in diabetic patients. This study was performed with aim to assess the effect of education thorough short massage system on blood glucose control of prediabetic pregnant women.Methods: This clinical randomized trial was performed on 100 prediabetic pregnant women who referred to the selected health centers of Ahvaz in 2016. Women were randomly assigned into intervention and control groups equally. The control group received face to face education and intervention group received short massage in addition to face to face education. In both groups, fasting blood glucose (FBG) was evaluated before (between 12-14 gestational weeks) and after the education (between 24-26 gestational weeks) and oral glucose tolerance test (OGTT) was assessed after the education. Data were analyzed using SPSS software (version 20) and Chi-square and independent t and paired t-tests. P<0.5 was considered significant.Results: There was not statistically significant difference between two groups regarding to FBG and 1-hour and 2-hour OGTT after the intervention (P>0.05), but after intervention, the blood glucose level in intervention group was lower than that in control group. Based on paired t-test, there was not statistically significant difference between two groups regarding to FBG before and after the intervention (P<0.001).Conclusion: Both methods of education through short message system and face to face education have similar effect and can decrease the blood glucose in prediabetic pregnant women; however, the effect was more observed in the group of education through short message system.

Introduction: Postpartum pain is one of the major and common problems of mothers after childbirth and in order to relieve the pain and to avoid the side effects of chemical drugs, doctors are turning to medicinal herbs. In recent years, with the clear need for evidence-based clinical practice, appropriate and valid information is needed. Therefore, this study was performed with aim to evaluate the clinical trials studies on the medicinal plants used in the treatment of postpartum pain in Iran.Methods: In this a systematic review, the data on the effects of medicinal plants on the postpartum pains were collected, without a time limitation, by Persian and English languages keywords, from the databases of PubMed, SID, Iran Medex, IRCT, Google Scholar, Magiran, Science Direct, MedLib, Scopus, Cochranelibra, Web of science and the library site of Shahid Beheshti Medical University and using the keywords of Postnatal care, Postpartum care, Postpartum program, Pain, Herbal medicine, Medicinal plants and Clinical trial. According to the Jadad standard, the articles which obtained the score of ≥3 were entered to the study.The data analysis was conducted qualitatively.Results: In this study, nine clinical trials including 10 types of medicinal plants (Lavender, Carum carvil, Cuminum cyminum, Ginger, Pimpinella anisum, Apium graveolens, Saffron, Anethum gravelens, Foeniculum and Chamomile) were evaluated. All plants had the desired effects in relieving postpartum pains. Most of these herbs had no side effects or the least side effects. Since the methodology of the studies were non-heterogeneous in terms of quality, meta-analysis was not possible to be done.Conclusion: Although all plants (Lavender, Carum carvil, Cuminum cyminum, Ginger, Pimpinella anisum, Apium graveolens, Saffron, Anethum gravelens, Foeniculum and Chamomile) reduced postpartum pain and are effective, but the number of such studies for each herb is low; thus, there is no sufficient clinical evidence for the practical application of each of the herbs, and more studies are needed in this field.

Introduction: One of the types of EP is Cesarean Scar Pregnancy (CSP) that its diagnosis is difficult and can cause serious complications such as uterine rupture, profuse hemorrhage and even maternal death. This study was performed with aim to report some rare cases of CSP and the successful treatment.Case presentation: The first case was a woman with history of 2 previous C/S with gestational age of 8 weeks. In TVS which was performed by radiologist, she had a gestational sac with a fetal pole having heart rate in cesarean scar. The patient underwent laparotomy and wedge resection of CSP. The second and third patients were detected with spotting and menstrual retard, and transvaginal sonography detected gestational sac with 6.5 & 7 weeks in the cesarean scar and were treated with elective intragestational sac methotrexate injections by ultrasound guidance and then curettage.Conclusion: CSP is a rare condition with serious complications. For early diagnosis, one must consider high clinical suspicion for detecting it in patients with previous C/S, and appropriate interventional treatment leads to decreased maternal morbidity and mortality.