Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2018 | Volume:21 | Issue:6 |Papers Count:14

Introduction: Dysmenorrhea, as one of the most common gynecologic problems in women, is characterized by pain in the lower abdomen, which disrupts normal life. The aim of this study was to investigate the effects of Pilates training on the severity and duration of dysmenorrheal pain and duration of bleeding in young girls.Methods: Thirty young girls with the mean age of 22.21 ± 1.71 years, body mass index (BMI) of 23.89 ± 1.41 kg/m2 and fatigue score of 29.22 ±3.71 were selected and randomly divided into two groups of Pilates training (n =15) and control group (n=15). At 24 hours before and 48 hours after the last exercise session, weight, BMI, fat percentage, severity and duration of dysmenorrheal pain and duration of bleeding were evaluated using McGill Pain Questionnaire and pain numerical rating scale. The experimental group performed the Pilates training protocol for eight weeks (three sessions per week). To analyze the data, independent t-test and Levene’s test were run in SPSS, version 16. The significance level was set at P-value less than 0.05.Results: Weight, body fat percentage and BMI were not significantly different before and after eight weeks of Pilates training (P=0.06). In addition, there was no significant difference in the control group in this regard during this period (P=0.20). After eight weeks of Pilates training, a significant decrease in pain intensity scale was noted. After eight weeks of Pilates training, there was a significant difference in the intensity of pain (P=0.001) and duration of dysmenorrhea (P=0.019) between the training and control groups, but the duration of bleeding did not show a significant difference (P=0.893).Conclusion: The results of this study indicated that eight weeks of Pilates training could be useful in reducing pain intensity and duration of dysmenorrheal pain, while not affecting the duration of bleeding.

Introduction The LI4 and SP6 acupressure points are the most common points to relieve post cesarean pain, but there is no consensus on the preferred point of pressure. Therefore, this study was performed with aim to compare the effect of acupressure at LI4 and SP6 points on the intensity of post cesarean pain.Methods: This double-blind clinical trial study was performed on 90 women referred to the maternity hospitals of Rafsanjan in 2017. They were randomly allocated into three groups: LI4 point, SP6 point and control group. Intervention was performed bilaterally, in 10 seconds of pressure and 2 seconds of rest for 20 minutes sequentially. In the control group, the points were touched with the same pattern without pressure. The intensity of post cesarean pain before, immediately and one hour after intervention was determined by visual analogue Scale in three groups. Data was analyzed by SPSS software (version 16) and ANOVA and repeated measurement variance analysis. P<0.05 was considered significant.Results: In this study, the mean score of pain at three times of measurement (the time effect) was significant different (p=0.33), but comparison of the mean of three pain score in each group was not significantly different with other groups (p=0.428). The result showed a decrease in pain score trend in the Li4 group during three time measurements and a decrease in pain score of in the Li4 group compared to the control group in 1 hour after the intervention (p=0.001).Conclusion: The acupressure function at the LI4 point in relieving post cesarean pain is better than the SP6 compression point.

Introduction: In the modern era, global endeavors are made to reduce the rate of cesarean section and encourage natural childbirth, and maternal satisfaction and its dimensions should also be addressed by the governments of developing country. The present study aimed to investigate the impact of massage therapy combined with breathing techniques on the satisfaction of primiparous women with childbirth.Methods: This clinical trial was conducted on 64 primiparous, pregnant women admitted to the obstetrics ward of Lolagar Hospital in Tehran, Iran in 2010. The subjects were divided into two groups of experimental and control via simple random allocation. The experimental group (n=32) received effleurage abdominal massage combined with Lamaze breathing techniques within the first 30 minutes in the active and transition phases of labor. The control group (n=32) received no intervention. Satisfaction with childbirth was measured using Mackey’s childbirth satisfaction rating scale. Data analysis was performed in SPSS version 17 using Mann-Whitney U test and independent t-test at the significance of P<0.05.Results: Mean total score of childbirth satisfaction was significantly higher in the experimental group (64.08±5.68) compared to the control group (42.87±7.09) (P<0.001). With the exception of satisfaction with spouse support (P=0.606), significant differences were observed in all the dimensions of childbirth satisfaction between the study groups, including general satisfaction (P=0.01), self-satisfaction (P<0.001), satisfaction with the midwife (P=0.001), and satisfaction with the condition of the neonates (P<0.001).Conclusion: According to the results, abdominal massage therapy with breathing techniques increased the satisfaction of primiparous women with childbirth. Therefore, it is recommended that this non-therapeutic approach be incorporated into labor for desirable delivery.

Introduction: One of the risk factors for postpartum hemorrhage is the elongation of labor. Today, various pharmaceutical and non-pharmaceutical methods are used to reduce pain and duration of delivery. One of these effective methods is the use of auriculotherapy (ear stimulation) in labor that not only reduces maternal pain, but also shortens the delivery duration. The effective methods in reducing labor duration may also affect the complications of increased delivery duration. Regarding this, the aim of the present study was to investigate the effects of this method on maternal postpartum hemorrhage and vital signs, as well as neonatal Apgar score.Methods: This randomized clinical trial was conducted on 84 pregnant women within the age range of 18-35 years referring to Shahid Beheshti Hospital in Isfahan, Iran, for delivery. The subjects were randomly assigned into two groups of intervention (auriculotherapy) and control (routine care). The data were collected using a questionnaire consisting of two parts, the first section of which covered demographic characteristics (i.e., age, place of residence, occupation, education level) and gestational age, and the second part was related to maternal postpartum hemorrhage and vital signs. Data analysis was performed in SPSS software (version 16), using independent t-test and Chi-square test. P-value less than 0.05 was considered statistically significant.Results: The mean neonatal fifth-minute Apgar score was higher in the auriculotherapy group than that in the control group (P=0.001). However, there was no significant difference between the auriculotherapy and control groups in terms of the rate of postpartum hemorrhage (P=0.51). Maternal respiratory rate (P=0.007) and postpartum temperature (P=0.021) showed significant changes in both groups. The results indicated that maternal vital signs in the intervention group were closer to normal conditions after delivery.Conclusion: In this study, auriculotherapy was used to stimulate the points of Shen Men, point zero, thalamic, endocrine, autonomic, cerebral, and sensorial points, specialized spots including three uterine points, anterior pituitary point, posterior pituitary (oxytocin), two prostaglandin points, and external genital points (perineum and vagina). This intervention resulted in the improvement of neonatal Apgar score and left no unpleasant complications for mothers.

Introduction: Diabetes mellitus is one of the most common metabolic disorders and important public health problems. This disease accounts for 9% of all mortalities in the world and can lead to neuropathy, nephropathy, retinopathy, and cardiac disease in the long term. Regarding this, the present study aimed to assess the effect of combined aerobic and resistance training on beta-endorphin level and its influence on μ receptor in skeletal muscles for reducing glucose and insulin resistance levels in sedentary women with type II diabetes mellitus.Methods: This randomized clinical trial was performed on 18 sedentary women with type II diabetes mellitus aged 40-50 years in 2015. The subjects were randomly divided into intervention and control groups. The exercise program was conducted for 8 weeks, three sessions a week. Each session included a 20-minute aerobic training, in addition to a strength training program. Blood samples were collected to investigate the serum levels of b-endorphin, glucose, and insulin 48 h before and after the intervention. Data analysis was performed in SPSS software (version 16) using Student’s, paired sample, and independent t-tests for the normal data and Wilcoxon and Mann-Whitney U tests for abnormal data to estimate the intra-group and inter-group differences, respectively. P-value less than 0.05 was considered statistically significant.Results: The results indicated that our combined training significantly increased maximal oxygen uptake, strength, and serum level of b-endorphin, and decreased the glucose and insulin-resistance levels (P£0.05).Conclusion: This study showed that the combined training declined glycemic index and augmented b-endorphin level. Consequently, this intervention could make a desirable effect on the reduction of risk factors in women with type II diabetes mellitus.

Introduction: Oxidative stress is known as a cause of male infertility. Antioxidants are considered as effective agents against oxidative stress. Regarding this, the present study was conducted to determine the relationship between dietary antioxidants intake and semen analysis parameters.Methods: This descriptive-correlational study was performed on 190 men referring to the Fertility and Infertility Center of Shahid Beheshti in Isfahan, Iran, during 2016-2017. The dietary intakes of antioxidants were obtained by Food Frequency Questionnaire (FFQ) and Nutritionist IV software.After analyzing the semen parameters, data analysis was performed using Mann-Whitney U test and Spearman correlation in SPSS software (version 16). P-value less than 0.05 was considered statistically significant.Results: The mean antioxidant intakes in men regarding vitamins A, E, and C were obtained as 2081.81±1459.47 mg, 5.52±3.55 mg, and 251.63±160.58 mg, respectively. The results showed that the mean amount of received antioxidants (i.e., vitamins A, E, and C) had no significant relationship with sperm analysis parameters, including sperm volume, number, mobility, and morphology, as well as white blood cell count in semen (P>0.05).Conclusion: As the findings indicated, the dietary intake of antioxidants, including vitamins A, E, and C, was not significantly correlated with sperm analysis parameters (i.e., sperm volume, count, motility, and morphology, as well as the number of white blood cells in semen).

Introduction: The elevation of stress hormones at the end of pregnancy will cause many problems, including a change in blood pressure. The extreme enhancement of gestational hypertension is associated with dangers, such as intrauterine growth restriction, preterm birth, placental abruption, and stillbirth. The aim of this study was to evaluate the effect of six weeks of pranayama training during the third trimester of pregnancy on serum cortisol and blood pressure levels in pregnant women.Methods: This randomized clinical trial was conducted on 18 women in the third trimester of pregnancy referring to a specialized gynecology clinic in Babol, Iran. The subjects were randomly divided into two groups of pranayama (n=8) and control (n=10). The pranayama group performed the relaxation and respiratory exercises for 6 weeks (two 60-minute sessions a week). Fasting blood pressure measurement and blood sampling (using median cubital vein) were performed in resting conditions 48 h before and after the implementation of the intervention. The data were analyzed in SPSS software (version 23) using Shapiro-Wilk test, as well as independent and paired sample t-tests. P-value less than 0.05 was considered significant.Results: The results showed that pranayama training significantly decreased serum cortisol levels (P=0.035). Furthermore, diastolic blood pressure in the pranayama group showed a significant decrease, compared to that in the control group (P=0.001). However, there was no significant difference between pranayama training and control groups in terms of systolic blood pressure (P=0.079).Conclusion: Given the importance of the third trimesters of pregnancy, pranayama exercises can be used to control blood pressure and other stress complications in case of high stress in pregnant women.

introduction: Postpartum depression is one of the most common disorders associated with various factors. Considering the level of hormones in different temperaments, this study was conducted to determine the relationship between cold and hot temperaments and postpartum depression.Methods: This descriptive and analytic study was conducted on 169 primi- and multiparous women in Sabzevar, Iran, in 2017. The temperament questionnaire was completed before delivery and the Edinburgh Depression Inventory was completed at the nearest health center in the third or fourth postpartum weeks. To analyze the data, logistic regression test was performed in SPSS, version 20. P-value less than 0.05 was considered significant.Results: Chi-square test showed a significant correlation between cold and warm temperaments and postpartum depression (P=0.001). Out of 48 cold-tempered participants 46 (95.8%) had postpartum depression. Depression rate was the lowest in moderate temperament (17.9%). Logistic regression test showed a significant relationship between postpartum depression and cold and warm temperaments (P<0.05).Conclusion: During the post-partum period, those who have a cold temperament are more likely to suffer from depression than those who are warm tempered. It is suggested that obstetricians and midwives should follow mothers' postpartum depression according to the type of temperament.

Introduction: The investigation and prediction of changes in the trend of cesarean and vaginal delivery can play a significant role in awareness and policy-making on health promotion and prevalence and incidence of health problems. Therefore, the aim of this study was to determine the proper time series pattern and trend for the prediction of deliveries in West Azerbaijan province, Iran.Methods: This longitudinal study was conducted during 2004-2013 through monthly recording of the number of vaginal deliveries and cesarean section in West Azarbaijan province. In order to model and forecast the delivery trend in the next 3 years, Box-Jenkins time series approach and its diagnosis and evaluation methods were employed. To fit the appropriate models for trend analysis in both types of deliveries, R and SPSS (version 23) statistical software were used.Results: According to the delivery data in the province, 37.4% and 62.6% of the deliveries were cesarean sections and vaginal deliveries, respectively, during 12 years. The results of the time series forecasting model predicting the trend of deliveries in the next 3 years showed that the number of caesarean section would decrease by 0.9%, compared to that in 2013, while the vaginal delivery rate would increase by 6.7%.Conclusion: Based on the results of the time series forecasting model, the rate of cesarean section is on a relatively decreasing trend, compared to that of the vaginal delivery and was estimated as about 37.1%. This is indicative of the actions of the Ministry of Health and Medical Education toward the promotion of vaginal delivery. However, this rate is still far from the WHO standard.

Introduction: Ovulation disorders are the most common causes of female infertility. Considering the importance of this issue in Persian medicines texts and the holistic view of this medical doctrine in the treatment of ovulation disorders, the present study was conducted to investigate infertility due to ovulation disorders in Persian and traditional medicine.Methods: In this review study, for the collection of data through a library method, all the causes of ovulation disorders were extracted based on classical medicine references, such as Speroff, Danforth, Novak, and Williams. Then, a search was performed in several electronic databases, including Scopus, Pubmed, and Magiran, using the Persian keywords, such as "Oghr", "Infertility", and "Ovulation disorders+infertility", and the English keywords, like "Infertility", "Persian medicine", and "Ovulatory disorder". Only clinical and review studies conducted in Persian or English language and published during 2000-2017 were included in the study. Finally, the overall causes of ovulation disorder were assessed and compared.Results: In the traditional medicine, the health status of ovarian-brain axis is considered important in ovulation. Similarly, the Persian medicine has given serious attention to this axis. According to the Persian medicine texts, in addition to the ovaries, the health of the brain, heart, liver, and digestive system also affects ovulation. The Iranian medicine scholars divide ovulation disorders into two categories, namely ovum disorders and disorders in the brain and other organs. According to this theory, the restoration of other organs' health is also essential for the treatment of infertility.Conclusion: The general causes of ovulation disorders were relatively similar in the Persian and traditional medicine. These two medical doctrines had an insignificant difference in the underlying causes of ovulation disorders. In this regard, the Persian medicine gave a special attention to the role of other organs in ovulation disorders, in addition to that of the ovaries. Therefore, attention to the holistic views of the Persian medicine, lifestyle modification, and improvement of the function of all organs, along with traditional medicine, can be effective in the success of infertility treatment.

Introduction: Erectile dysfunction (ED) is a common sexual dysfunction, which affects the quality of life in couples. The use of acupressure for treating ED has been reported in various studies. This systematic review was performed to evaluate the current evidence for the efficacy and safety of acupuncture in treating ED.Methods: In this systematic review, electronic databases of SID, IranMedex, Magiran, IranDoc, Scopus, PubMed, Cochrane, and Google Scholar were searched up to November, 2017 to identify all the studies reporting the effect of acupuncture for treating ED. The search was performed using the keywords of “acupuncture”, “electro-acupuncture”, “intradermal needling”, “erectile dysfunction”, “impotence”, and “male sexual dysfunction”. The quality of the included studies was assessed using the Jadad scale. The results were reported qualitatively.Results: Among 1274 articles retrieved in the initial search, five clinical trials (228 participants) were selected for this systematic review. The studies were conducted in Austria, China, the Netherlands, and Turkey. Most studies showed the beneficial effects of acupuncture for treating ED. Some studies investigated the possible side effects of acupressure and reported no serious adverse effects in this regard.Conclusion: Acupuncture for treating ED can be an effective method, but due to the poor methodological quality in the majority of trials, more high-quality studies with larger sample sizes are needed to confirm these findings.

Introduction: Trauma in pregnancy is a major cause of hospital admission and maternal and fetal mortality. Some of the main complications of trauma in pregnant women are intrauterine death, shock, placental abruption, intraperitoneal hemorrhage, and direct fetal injury. The present study aimed to report some of the cases of trauma in pregnancy and review the previous studies in this regard.Case Presentation: In this case series, we presented the case of four pregnant women with trauma, who referred to various teaching hospitals in Mashhad, Iran. The subjects had blunt abdominal trauma, burn injuries, multiple trauma, and traumatic brain injury.Conclusion: Stabilizing the mother is the primary goal in the management of traumatized, pregnant patients. In many cases, fetal outcome is directly correlated with the rapid, thorough maternal resuscitation. In viable fetuses, fetal monitoring is crucial. On the other hand, due to the high rate of complications during pregnancy, educational interventions should be considered for pregnant women and their families. Furthermore, pregnant women must be aware of risky conditions, such as motorcycle riding and not using seatbelts.