[ comparison of the pregnancy outcome in nulliparas with and without microalbuminuria at the end of the second trimester]

Poor pregnancy outcome and complications like pre-eclampsia, preterm delivery, premature rupture of membranes [PROM] and Intra Uterine Growth Restriction [IUGR] have special importance and finding new methods for their prediction have been always under serious concern. The purpose of the present study is to evaluate the poor pregnancy outcome in nulliparas who had microalbuminuria at the end of second trimester of their pregnancy. The study was conducted as a prospective cohort study on 490 nulliparous women who were at the end of the second trimester of pregnancy. Urine test for albuminuria and creatinine measurement was performed in all women and an albumin creatinine ratio [ACR] was calculated according to milligram per gram. The women were then divided into 3 groups of severe, moderate and mild microalbuminuria according to the ratio. Then the women were followed up to the end of their pregnancy and compared for preterm labor, pre-eclampsia, IUGR and PROM. Statistical analysis was performed using SPSS V.15. Student t - and Chi square tests were used for analysis. P value of less than 0.05 was considered as significant. There was no significant difference in regards to BMI, age and age of pregnancy at the time of sampling. Preterm labor [21 [55.26%] cases VS 65 [14.38%], p=0.001], pre-eclampsia [19 [50%] cases VS 39 [8.62%] cases, p=0.001], IUGR [15 [39.47%] cases VS 30 [6.63%] cases, p=0.001] and PROM [11 [28.94%] cases VS 47 [10.39%] cases, p=0.001] were more in the case group than control group. Gestational diabetes did not show significant difference between the 2 groups. Preterm labor, pre-eclampsia, IUGR and PROM were more in the women who had microalbuminuria at the end of the second trimester of their pregnancy

[Effects of pelvic floor muscle exercises on quality of life outcomes in women with stress urinary incontinence]

Stress urinary incontinence is a common problem among middle-aged women and can affect their quality of life. This study evaluated the effects of pelvic floor muscle exercise on quality of life outcomes in women with stress urinary incontinence. This clinical trial study was conducted at Shahid Akbarabadi Hospital of Tehran in 2009. After baseline evaluation, fifty women were assigned to this clinical trial. Participants were trained to do pelvic floor muscle exercises for 3 months and their quality of life were measured before and 3 months after intervention. The collected data were analyzed by the SPSS software using descriptive statistical tests and paired T experimental test. Forty-six women completed the trial. After 12 weeks, the descriptive statistical tests and paired T experimental test showed significant difference in the quality of life scores of women with stress urinary incontinence before and after intervention [P<0.0001]. 12 weeks exercise of pelvic floor muscle significantly improved the quality of life outcomes of women with stress urinary incontinence

effect of hands-off and hands-on methods on perineal status

Background and Purpose: Perineal damage is one of the traumas most frequently suffered by women during delivery. There are several techniques aimed at reducing the perineal damage. The present study is aimed at determining and comparing the frequency and degree of perineal rupture in hands-off and hands-on techniques of protecting perinea during labor

Method and Materials: This blind clinical trial [with the CI of 95% and test power of 80%] involved 187 women who, after signing their informed consent, were divided into the hands-off [n= 98] and hands-on [n=89] groups through random allocation. In the experimental [hands-off] method, the midwife guides the parturient and observes the process of labor without touching the perineum or the head. In the control [hands-on] group, the midwife protects the infant's head using Ringen maneuver. The data were analyzed in SPSS using chi-square and Fisher's exact test

Results: The result showed that the undamaged perinea in the hands-off group was 44.9%, versus 10% in the hands-on group, where the difference was statistically significant [P < 0.0001]. Perineal laceration was 51% in the hands-off group and 47.2% in the hands-on group but the difference between the two groups was not significant [p = 0.55]. Most ruptures were of the firstdegree type [50% in the hands-off and 64.3% in the hands-on group]. In the hands-off group, 3.1% underwent episiotomy as compared with 75.3% in the hands-on group

Conclusion: The results suggest that a policy of hands-off technique in protecting perinea can be safe and efficient technique and can be an alternative method in perineal protection during labor

Comparative study of using folly catheter balloon and syntocinon for cervical ripening

Cervical ripening is one of the methods used for cervical preinduction with the aim of facilitating labor and ending pregnancy. There are various recommendations on using labor inducing methods, but no preferred method has been known. The aim of this study was to compare the results of using folly catheter balloon and oxytocin for cervical induction. It was a randomized clinical trial. Two hundred and seventy pregnant women attending Shahid Akbarabadi center were recruited and randomly assigned to one of the 3 groups. The women in the first and second group were catheterized and their catheters were fixed using 30 cc and 80cc of normal saline respectively. The third group just received 5 units of syntocinon in 1000 ml IV solution. There were statistically significant difference between 3 groups in bishop score after cervical preparation [P=0.000]. Moreover, there were statistically significant difference between folly catheter groups and syntocinon group regarding type of labour [P=0.000], the time intervals between induction and the active phase of labour [P=0.000], and induction and labour [P=0.000]. The duration of the third stage and time interval between the third stage and labour were much shorter in catheter groups than syntocinon group. Using folly catheter balloon for ending pregnancy is effective and has no risk. Moreover, it has lees complications and more desirable delivery outcomes than oxytocin. Cervical ripening is also effective in the mode of delivery and reduces the need for surgical interventions and also the costs of hospitalization

[Effect of subdermal irrigation with Normal Saline on the wound infection in abdominal surgery of obstetrics and gynecology]

Background and Objective: wound infection in post-operation is one of the side effect that bothering the patients' quality of life. This study was done to determine the effect of subdermal irrigation with normal saline on the wound infection in abdominal surgery of obstetrics and gynecology

Materials and Methods: a randomized clinical trial of subdermal irrigation with normal saline versus no irrigation was performed on 200 patients who were candidate for abdominal surgery of obstetrics and gynecology. Contaminated wound was excluded. In the case group [100 patients] after facial repair and complete hemostasis, subdermic tissue was irrigated with 1000-milliliter normal saline and skin was closed. In the control group [100 patients] after facial repair and complete hemostasis skin was closed without subdermal irrigation. All of the patients were followed until complete repair of skin

Results: 2 groups were similar in age, BMI, duration of surgery and the type of operation. Wound infection was observed in 1% of case group and in 7% of control groups, which was statistically significant [P<0.05]

Conclusion: subdermal irrigation with normal saline is effective, simple, safe and not expensive which can reduce the wound infection and can be offered particularly in high risk patients for wound infection