[Effect of oxytocin plus propranolol on the success of labor augmentation]

Labor augmentation with intravenous oxytocin is a common method of midwifery in dealing with delivery dystocia and considering the dangers of using high dosage or wrong prescription, the Institute for safe medication has added intravenous administration of oxytocin to the list of high alert medications and recommended creating programs to minimize fetal and maternal injury by reducing the dosage of oxytocin. One method to reduce the dosage of oxytocin is propranolol administration. It has been observed that low dosage of propranolol during the active phase of labor can increase the uterine contractions and cause delivery and reduce the cesarean section significantly without causing maternal and no neonatal complications and cesarean rate. The comparison between the effects of oxytocin with propranolol and oxytocin with Placebo on the labor augmentation. A double-blind randomized clinical trial was performed on 118 nulliparas 38-41 weeks in active phase of labor and failure to progress. Exclusion criteria: Multi-parity with History of surgery on the uterus, malpresentation [non-cephalic], cephalopelvic disproportion[CPD], Fetal distress, macrosomia, polyhydroamnius, IUGR, HTN, Cardiac disease, lung disease, Patients with kidney or liver dysfunction, diabetes, patients prone to hypoglycemia, myasthenia Gravis and Wolf - Parkinson - White. The patients were divided randomly into two groups.The first group was given Oxytocin with propranolol and the second group oxytocin with placebo. Pregnancy outcomes including maternal complications including uterine atonic, complications during labor including hyperstimulation, fetal distress, meconium and placental abruption and neonatal complications including Apgar 1 and 5 minutes of birth, admission in NICU and birth weights in two groups were compared. Duration of the active phase of labor in propranolol group 325.74 +/- 71.57 was significantly less than that in the placebo group 406.04 +/- 80.32 [p<0.001]. Duration of the second stage of labor in propranolol group 23.03 +/- 8.31 was significantly less than that in the placebo group 33.83 +/- 12.33 [p<0.001]. Cesarean section in propranolol group 9 [15%] was significantly less than that in the placebo group 15 [25.9%] [p<0.001]. Failure to progress in propranolol group 2 [3.3%] was significantly less than that in the placebo group 5 [8.6%] [p<0.023]. Propranolol may shorten the duration of the active phase labor and the second stage of it and reduce the dosage of oxytocin and also Cesarean section rate

[Complete hydatidiform mole in triple pregnancy with coexistent two live fetuses [a case report]]

With the widespread use of ovulation induction regimen multiple pregnancy may occur more often and, thus, attention has been drawn to the increased possibility of multiple pregnancy with one or two normal fetuses and placenta and the other appearing as a complete or partial mole following a variety of different methods of assisted reproduction. Management of this condition is extremely challenging, especially when the pregnancy is highly desired and there is a significant risk of severe complications. A 28-yearold female, gravida1- para0 who presented with 8 years of primary infertility [as a result of ovulatory dysfunction] was referred to Alzahra Educational Center at 34 weeks of gestation with the ultrasound diagnosis of a twin pregnancy [the fetuses were female]. The current pregnancy had been conceived during the 2-3 cycle of superovulation with clomiphene- HMG and IUI. She had a history of hypothyrodism for 8 years and was controlled with levothyroxin. At 34 weeks of gestation due to active uterine contractions that made further conservative management impossible, the pregnancy was terminated by cesarean section. Two female fetuses both without malformations were delivered. Following delivery of fetuses, one placenta had normal appearance and was completely removed. The second one, molar tissues containing numerous vesicles, were delivered and microscopic examination confirmed the diagnosis of hydatidiform mole and placental hemangioma. In pregnant women following infertility treatment, close surveillance is certainly needed to evaluate the probability of coexistence of molar pregnancy

Association of some working factors and menstrual function among nurses

A regular menstrual cycle is the result of regular feedback systems, involving the hypothalamus, anterior pituitary and ovaries. Some factors including age, smoking, weight, exercise, race, psychotic condition, work-time hours, work stress, life satisfaction, menarche age, education, marital status and diet may affect menstrual function. Association of menstrual function with working factors among nurses. This is a cross-section survey among nurses of Poursina, Razi, Heshmat Hospitals. 330 questionnaires were given them. It was include of menstrual function [such as: menstrual cycle length, bleeding days, regularity of menstrual cycle, dysmenorrheal] and some working factors [such as: work hours, shift work, working place]. Questionnaires were collected in two consequentive months, and then the data were analyzed by SPSS 14; ANNOVA and Chi-square test. 307 questionnaires filled, 259 nurses had dysmenorrheal [86.04%], 51 abnormal bleeding days [17%].59abnormal cycle length [19.6%] and 60 irregular cycle [19.9%] in our study work -time hours was associated with dysmenorrhea [p=0.004], working place and shift work with bleeding day [p=0.001], and other factors were not associated. Dysmenorrhea and bleeding days were influenced by some factors such as work hours, work place and shift work

[Iron deficiency anemia and some associated factors in childbearing age women in Guilan province]

Iron deficiency anemia [IDA] is the commonest disorder due to malnutrition, and is an important health problem. This research determines IDA prevalence and some associated factors in childbearing age [CBA] and non-childbearing age women in Guilan. Sample; comprised of 995 CBA women [15-49 years], selected in a multistage cluster-random sampling from the population mentioned. Data materials included a questionnaire, and blood examinations, and statistical analysis was performed by means of paired t-test. Anemia prevalence was 11.1%, IDA 7.6%, which was similar in both the urban and rural population, and showed significant correlation with parity [P<0.0l] and age [P<0.0001]. Ferrous sulfate has significant effect to increase hemoglobin in IDA subjects. IDA prevalence in Guilan is less than previous estimates, and Ferrous sulfate administration is effective in increasing hemoglobin levels