ABSTRACT
Background: intra-ventricular hemorrhage [IVH] is acute cerebral complications of premature infants, which may lead to the long-term problems
Objective: according to the role of vitamin D in the stability of the blood vessels, the present study was carried out in order to compare the vitamin D level in the premature infants with or without IVH
Materials and Methods: this cross-sectional study was carried out on 180 premature infants in the Ghaem Hospital, Mashhad, Iran 97 infants without IVH [53.9%] and 83 with IVH [46.1%] through convenience sampling technique in 20152017. Serum vitamin D level of funiculus in the two groups was compared. A researcher made questionnaire was used which includes infants' personal and laboratory information; and their mother's information
Results: seventy nine percent of infants suffered from vitamin D deficiency in which 33.9% had a severe deficiency [less than 10 ng/ml], 30% moderate deficiency [10.1-20 ng/ml], 15% slight deficiency [20.1-30 ng/ml] and 21.1% had normal vitamin D [>30.1 ng/ml]. Vitamin D mean +/- SD of infants in the control group, 23.71 +/- 12.98 ng/ml and case group 15.92 +/- 10.27 ng/ml [p<0.001]. In total 92.8% of infants with IVH had levels of vitamin D below30 ng/ml, while this rate was 67% in infants without IVH
Conclusion: vitamin D deficiency in the premature infants is very common. Also, the serum vitamin D level in infants with IVH was less than infants without IVH. Therefore, the recommendation of vitamin D may be effective in the prevention of neonatal IVH
ABSTRACT
Background: A tool which can help to decide on the determinants in selecting the delivery type is an effective step towards the goals of the World Health. This study aimed to develop and evaluate the psychometric properties of a scale based on Iranian culture to make decision on the type of delivery
Methods: This is a methodological study using a questionnaire proposed by Schneider. The following steps were used to design the project. In the first step, perceptions and experiences of 45 pregnant women, postpartum women, midwives, gynecologists and non-pregnant women were determined based on interviews and observations using focused ethnography. In the second stage, the terms in the questionnaire based on qualitative study was assessed. Then, in the third stage, psychometric testing of the decision making on the type of delivery scale [DMTDS] based on the cultural concepts of decision making towards the type of delivery and its influencing factors based on focused ethnography using face validity, content validity, construct validity, internal consistency and reliability was done on400 pregnant and postpartum women
Results: The initially developed scale consisted of 60 items on a 5-point Likert scale, which reduced to 43 items following measurement of the face and content validity. The results of the exploratory factor analysis elicited 36 items and a seven-factor structure including motivational beliefs on vaginal delivery, social beliefs towards childbirth, motivational beliefs on cesarean delivery, personal beliefs, sources of information, catastrophic thinking and child birth experiences. Cronbach's alpha coefficient [0.80] confirmed the high internal consistency of the scale
Conclusion: The developed questionnaire appears to be a valid and reliable tool for health care providers to measure the women's decision making towards type of delivery. Therefore, this tool can be used in the Iranian community. The scale may help the midwives and obstetricians to be aware of the women's decision regarding their choice of delivery and as a result to plan appropriately in order to reduce unnecessary cesarean sections
ABSTRACT
Cesarean section [C-section] in the North of Iran accounts for 70% of childbirths, which is higher than the national average of 55%. Understanding women's perceptions towards modes of delivery in different cultures can pave the way for promoting programs and policies in support of vaginal delivery. We aimed to investigate women's perceptions towards modes of delivery in the North of Iran. Using a focused ethnographic approach and purposive sampling, 12 pregnant women, 10 women with childbirth experience, nine non-pregnant women, seven midwives, and seven gynecologists were selected from hospitals, healthcare centers, and clinics of Tonekabon and Chaloos, Mazandaran, Iran, during 2012-2014. Data were collected through in-depth interviews and participant observation. Data analysis was performed using thematic analysis using MAXqda software. Two major themes emerged from the data including: "vaginal delivery, a facilitator of women's physical and mental health promotion", and "C-section, a surgical intervention associated with decreased labor pain". Six sub-themes subsumed within these major themes were: vaginal delivery as a safe mode of delivery, fullfilment of maternal instinct, a natural process with a pleasant ending, and C-section as a procedure associated with future complications, a surgical intervention and sometimes a life saving procedure, and a painless mode of delivery. In the North of Iran, women's justified cultural beliefs overshadow their micsconceptions, so it is hopped that through implementing appropriate training programs for raising awarness and correcting miscomceptions, vaginal delivery could be promoted even in regions with high rates of cesarean section
Subject(s)
Humans , Female , Pregnancy , Women , Natural Childbirth , Cesarean Section , Anthropology, Cultural , PerceptionABSTRACT
Pregnant women rely heavily on informal information while making a decision about the mode of delivery they would rather have, either as normal vaginal delivery [NVD] or cesarean section [CS]. Through recognition of social attitudes towards different modes of delivery, societies can be directed towards a positive understanding of vaginal delivery, which can ultimately lead to maternal health promotion. Thus, this study aimed to explore the common beliefs, values and traditions surrounding women's preferred mode of birth in the North of Iran. Using a focused ethnographic approach, twelve pregnant women, 10 women with previous experience of childbirth, seven midwives, seven obstetricians, and nine non-pregnant women were included in this study through a purposeful sampling in health clinics of Tonekabon in the North of Iran. Semi-structured interviews and participant observations were used for data collection. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using Braun and Clarke thematic analysis [2006] and MAXqda software. Through analysis, three major themes and 10 subthemes emerged. They included: 1] sociocultural childbirth beliefs with five subthemes: a] CS as protector of genital tract integrity, b] blind imitation in choosing mode of birth, c] NVD as a low cost type of delivery, d] CS as a prestigious mode of birth and, e] NVD as a symbol of woman's power and ability; 2] traditional health beliefs with two subthemes: a] NVD as a guarantee for woman's health, b] traditional childbirth facilitators; 3] religious beliefs and values with three subthemes: a] NVD as a symbol of God's power, b] call for help from the Mighty God, and c] NVD as a sacred phenomenon. The results of this study indicated that cultural beliefs, values and traditions can significantly affect individuals' attitudes towards modes of delivery, their definitions of different modes, and the decisions they make in this regard. In order to develop a positive cultural and religious attitude towards vaginal delivery, women's awareness has to be raised through various ways and the existing misconceptions need to be corrected
ABSTRACT
The aim of amniotomy is to speed up contractions and shorten the length of labor. However, there are concerns regarding unintended adverse effects on the mother and neonate. The aim of current study was to compare maternal and childbirth outcomes of early and late amniotomy with premature rupture of membranes [PROM]. This cohort study was carried out among 200 term pregnant women with singleton fetus and cephalic presentation at shahid Raajaee hospital, Tonekabon, Iran. Statistical analysis was performed by Chi-square, exact Fisher test and ANOVA using SPSS. version 17.0. Duration of the first stage of labor was significantly longer in the early amniotomy group [15.29 +/- 14.22 hours] as compared with the late amniotomy group [10.27 +/- 5.58 hours] and the PROM group [10.81 +/- 5.30 hours] [P<0.0012]. Higher rates of Cesarean section were found in the early amniotomy group [17.38%] as compared with the others [4/2% in late amniotomy group and 2.37% in PROM group, P<0.018]. Regarding abnormal fetal heart rate [FHR], there was significant differences between early amniotomy group [15.01%] and PROM group [3.36%] [P<0.0001]. There was no significant difference in other neonatal and maternal outcomes between three groups. Regarding current findings, cervical ripening techniques in order to improve the Bishop scores should be applied before amniotomy