Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2017 | Volume:20 | Issue:1 |Papers Count:11

Introduction: Stillbirth is a devastating pregnancy outcome and is often defined as fetal death after 20 weeks of gestation. Annually, 2.6 million stillbirths occur worldwide, 98% in developing countries. It is crucial that we understand the causes and contributing factors. This study was performed with aim to evaluate the factors associated with stillbirth in pregnant women admitted in Imam Reza Teaching Hospital in Kermanshah, Iran (2011-2014).Methods: This descriptive study was performed on 423 cases of stillbirth in Imam Reza Teaching Hospital in Kermanshah during 2011-2014. Demographic data and target variables such as fetal, maternal, placental, amniotic fluid, uterine, trauma, and causes were recorded in data collection forms. Data were analyzed by SPSS software (version 16).Results: Among 15376 births, 423 cases of stillbirth (2.75%) were registered. The causes of stillbirth were as follows: 117 cases (27.66%) fetal problems with the most frequency in gestational age of less than 27 weeks, 21 (4.96%) umbilical cord problems with the most frequency at 27-34 weeks of gestation, 68 (16.07%) placental problems with the most frequency at 27-34 weeks of gestation, 147 (34.75%) amniotic fluid problems with the most frequency in less than 27 weeks of gestation, 42 (9.93%) uterus problems with the most frequency in more than 34 weeks of gestation, 149 (35.22%) maternal problems with the most frequency in less than 27 weeks of gestation, 42 (9.93%) due to trauma and often in less than 27 weeks of gestation, and 73 (17.26%) were classified as unknown.Conclusion: The maternal, fetal and amniotic fluid problems were the most cause of stillbirth and it is required to be paid more attention in prenatal care.

Introduction: Infertility is considered as a major healthcare problem in many communities. The main part of infertility is related to environmental conditions and is preventable. Therefore, this study was performed with aim to determine the status of smoking habit, caffeine intake and body mass index (BMI) in infertile and healthy women aged 25-40 years.Methods: This cross-sectional study was performed on 144 infertile and 144 healthy women in Tehran during 2013-2014. Demographic data, food consumption and anthropometric measurements were collected through questionnaires. Data were analyzed by SPSS software (version 16) and Chi-Square, T-Test and Logistic regression.Results: The mean of caffeine intake in infertile women (140.68±105.32) was more than healthy women (122.5±96.8), but the difference was not significant (P=0.98). There was no significant relation between smoking and caffeine intake with infertility. The mean body mass index in infertile and healthy women were 26.74±4.11 and 24.98±2.88 kg/m2, respectively. Significant difference was observed between BMI in the subjects, so that the frequency of obesity was higher among infertile women (P<0.002).Conclusion: Regarding the prevalence of infertility in Iran and the relationship between obesity and infertility, it is necessary to teach about nutrition and prognosis in terms of negative consequences of overweight and obesity.

Introduction: Cancer is third leading cause of death in Iran and breast cancer is the most common cause of death in Iranian women. Early diagnosis can lead to effective treatment and improves the patient's quality of life. This study was performed with aim to determine the effect of demographic factors on women's Breast Self-Examination awareness in order to focus education on specific group's population in society women health management.Methods: This is descriptive-analytic and correlational study was performed on 200 women referring to Karaj health care centers in 2015. Data was collected by using a self-made questionnaire about demographic factors (age, economic status and literacy) and interviews to determine the proper awareness about BSE. Data was analyzed by SPSS software (version 16).Results: Among 200 women with mean age of 35.5±9.7, 97 cases (48.5%) were aware of breast self-examination and performed it in correct way and103 (51.5%) didn' t aware or performed it incorrectly.29 cases (29.8%) of aware women and 68 (52.4%) of unaware women were illiterate and semi-literate. There was significant relationship between educational level and breast self-exam awareness (P<0.05).While no significant relationship was found between BSE awareness with family income and age (P>0.05).Conclusion: There is a lack of breast self-examination awareness in the Iranian women. For women health management, education to families with lower educational levels may highly effective to early diagnosis and reduce mortality from this disease.

Introduction: Blood inflammatory markers are important as a predictor of cardiovascular disease and exacerbation of risk factors. Physical exercise is well recognized as an important strategy for reducing the risk of inflammation and chronic disease, but the effect of endurance-resistance exercises on these parameters is remained largely unknown. This study was performed with aim to investigate the effect of combine endurance-resistance training on inflammatory markers in sedentary postmenopausal women.Methods: This applicable semi-experimental study was performed on 22 postmenopausal women in Gilan province in 2015. They were randomly assigned to two experimental and control groups). Experimental group performed the eight weeks exercise training, three sessions per week and each session was 90 minutes. Aerobic exercises began at 50% of target heart rate and resistance training with a 50% of one repetition maximum intensity and both exercise intensity increased to 80% in the final session. Before and after 8 weeks of training, inflammatory variables including IL-6, TNF-a and hs-CRP and cardiorespiratory endurance were measured. Data was analyzed by SPSS software (version 22) and paired and independent t-tests.Results: The result showed that although 8 weeks of endurance-resistance training did not affect on serum TNF-α, however, it decreased hs-CRP along with IL-6 levels and increased cardiorespiratory endurance after the intervention (P=0.001).Conclusion: Combined training with a reduction in hs-CRP along with IL-6 levels and an improvement of cardiorespiratory endurance can be effective in preventing cardiovascular diseases.

Introduction: Infertility threatens the mental health of infertile couples. Society should have sufficient knowledge of the implanted embryo resulted of in vitro fertilization in the surrogacy as a therapy method. This study was performed with aim to determine the knowledge and attitude of patients in Mostafa Khomeini hospital on the use of surrogacy as a treatment method.Methods: This cross-sectional and analytic study was performed on 216 patients referred to Mostafa Khomeini Hospital in 2016. Data collection tool was a researcher-made questionnaire consisting of two parts: the first part was demographic questions and the second part included the questions about knowledge and attitude. Data were analyzed by SPSS software (version 16) and statistical tests of correlation test, independent t-test, Mann-Whitney, Kruskal wallis and ANOVA. P<0.05 was considered significant.Results: 185 subjects (85.6%) stated that they have information about surrogacy. While according to the results, only 31 subjects (14.8%) had good and very good knowledge of surrogacy.99 subjects (43.5%) had no religious perception about this method. 90 (41.7%) had negative attitude to the priority of surrogacy from family and friends.144 (66.7%) agreed about insurance protection. Independent t-test showed that the mean attitude of men and women was not different. ANOVA showed a significant difference between the attitudes of subjects in different educational groups (P=0.04).Conclusion: Most people had negative attitude toward emotional, legal, and religious issues of surrogacy, but they had positive attitude to solve problems and financial costs and insurance support.

Introduction: Women satisfying experience of childbirth is very effective on woman’s mental strength. Midwives support helps to pregnant mothers to understand a positive experience of delivery. Therefore, this study was performed with aim to determine the rate of respecting the bill of mother's rights in labor and delivery by midwife responsible for delivery by 360° evaluation in maternities.Methods: This cross-sectional correlational study was performed on 100 midwives in 2014. Evaluation of respecting the bill of mother's rights in labor and delivery was conducted through 360° evaluation. Each midwife was evaluated by herself, her colleague, the maternity officer, and parturient. Data were analyzed by SPSS software (version 19) and repeated measures ANOVA test, Post hoc test and chi-square test.Results: The most achieved score was related to the attitude of midwife who was responsible for delivery (131.4±16.2) and the lowest scores was related to the attitude of parturient (103.6±20.9). According to the results of repeated measures ANOVA test, there was a significant difference between mean score of respecting the bill of mother’s rights in labor and delivery from the perspective of midwife, colleague, the maternity officer, and parturient (P<0.05).Conclusion: Mother's rights is observed at an optimum level by the midwife who is responsible for delivery, but the perspective of who is responsible for delivery and maternity officer and parturient is different associated with this utility. This rights is observed in minimum level from the perspective of the maternity officer and parturient.

Introduction: Episiotomy is the most common surgery in gynecology which can cause infection or delay in wound healing like as any other wound. Scrophularia striata extract has been traditionally used for wound healing. Therefore, this study was performed with aim to investigate the effect of Scrophularia striata plant on episiotomy wound healing in primiparous women.Methods: This three-blind randomized clinical trial was conducted on 80 primiparous women referred to Ganjavian hospital of Dezful in 2014-2015. The subjects were divided to two groups of case and placebo (40 subjects in each two groups). After delivery and episiotomy, the mothers used a knuckle of prescribed cream in their sutures area once a night for 10 nights. Tools consisted of demographic and midwifery information questionnaire, REEDA scale form. Assessment of wound healing was performed using REEDA scale at 5th, 10th and 21th day days after delivery. Data was analyzed with SPSS software (version 21) and descriptive statistics (mean and standard deviation) and analytical (Mann-Whitney and t-test). P<0.05 was considered significant.Results: On days 5, 10 and 21 postpartum, a significant difference was found between the mean score of erythema, edema and total scores in the two groups. Also, in case group, the mean of REEDA scores were 4.43±1.7 at 5th day, 2.28±1.9 at 10th day and 0.66±1.5 at 21th day of postpartum, but in placebo group, it was 5.51±2.3 at 5th day, 3.05±1.9 at 10th day and 1.35±1.6 at 21th day of postpartum that two groups had significant difference in terms of wound healing (P<0.05).Conclusion: Scrophularia striata plant is effective on better and faster healing of episiotomy wound, so it can be used to accelerate episiotomy wound healing.

Introduction: Gestational diabetes mellitus is the most common medical complication during pregnancy that negatively affects the health of mother and fetus and neonate. Gestational diabetes mellitus occurs in 3-5% of pregnancies. Early detection of gestational diabetes can prevent of these complications. This study was performed with aim to determine the association between pregnancy-associated plasma protein A (PAPP-A) and gestational diabetes to detect a risk factor for predicting gestational diabetes.Methods: This prospective analytical study was performed on 250 pregnant women referring to six healthcare centers of Qazvin from February to October 2016. PAPP-A was measured at 11-14 gestational weeks, then 75 gr glucose tolerance test was performed on the samples at 24-27 gestational weeks. The association between gestational diabetes and PAPP-A was studied. Data were analyzed by SPSS software (version 21) and Chi-square, t-test, Mann-Whitney, relative risk, and logistic regression. P<0.05 was considered significant.Results: Twenty-four subjects (30.8%) of patients with decreased PAPPA and 15 (8.7%) of patients with normal PAPP-A were diagnosed with gestational diabetes. Chi-square test showed significant difference between two groups based in terms of gestational diabetes (P<0.001). The risk of gestational diabetes in the patients with decreased PAPP-A was 3.90 times more than control group (CI=1.87-8.14, P<0.001).Conclusion: Low level of PAPP-A at gestation weeks of 11-14 can be a possible risk factor for the incidence of gestational diabetes. Therefore, it can be used as an early detection test for preventing the fetal and maternal adverse effects.