ABSTRACT
Normal birth is still highly valued, but the majority of pregnancies end with medical interventions or caesarean section. Rates of normal birth have been declining steadily over the past 20 years in Iran, despite the evidence of the benefits to mother and baby. According to the World Health Organization, the standard rate for caesarean is 10-15%. In 2013, Iran Ministry of Health introduced the “Promoting Normal Birth Program”. This study examines the views of experts about factors affecting the implementation of “Promoting Normal Birth Program”.METHODSA qualitative study with framework analysis was used to determine the factors affecting implementation of the “Promoting Normal Birth Program” by examining views of 15 gynaecologists, anaesthesiologists, midwives and managers in 2018 at Zabol Medical Sciences University. Professionals participated with informed consent in this study. Data was collected from individual and group semi-structured interviews to reach saturation. MAXQDA 12 was used for analysis.RESULTSSeven categories were identified: (1) Leadership of Ministry, (2) Education, (3) Create Culture for a Normal Birth, (4) Optimization and Pleasure of Birth, (5) Normalization: The Essence of Birth and Midwifery, (6) Support, and (7) Empowerment.CONCLUSIONSThese findings create a challenge for education, performance and health policies. In order to achieve program goals and improve women's health, the following actions are recommended- provide adequate infrastructure and financing to improve the birth environment, increase midwifery force, and promoting the culture of Normal birth, especially through the education for community, women, and caregivers, correcting rules and guidelines and detailing job descriptions and professional status.
ABSTRACT
Background: Designing a valid and reliable questionnaire that allows a fair evaluation of sexual knowledge and attitudes and develop a proper sexual educational program is necessary
Objective: The present study was designed to develop and psychometric evaluation of the sexual knowledge and attitudes scale for premarital couples
Materials and Methods: An exploratory mixed method study was conducted in two phases; in the first, in order to develop a questionnaire an item pool was generated on sexual knowledge and attitudes through focus group discussions and individual interviews. In the second phase, the psychometric properties of the questionnaire were examined. For this purpose, face validity, content validity as well as construct validity were conducted. Reliability was assessed by the Cronbach's alpha coefficient to assess internal consistency and test-retest reliability
Results: In the first phase an item pool with 88 questions was generated [sexual knowledge 45 items and sexual attitudes 43 items]. In the second phase, the number of final items reduced to 33 and 34 items of sexual knowledge and sexual attitudes respectively, through exploratory factor analysis [EFA]. Five factors for sexual knowledge and six factors for sexual attitudes identified by EFA. The Cronbach's alpha coefficient for two sections was 0.84 and 0.81 respectively. The test- retest correlations for sexual knowledge and sexual attitude was 0.74 and 0.82 respectively
Conclusion: The findings suggest that the Sexual Knowledge and Attitudes Scale for Premarital Couples is a valid and reliable instrument. Further studies are needed to establish stronger psychometric properties for the questionnaire
ABSTRACT
The aim of this investigation was conducted to proteomic analysis of plasma obtained from pregnant women who destined to develop late-onset preeclampsia without intrauterine growth restriction [IUGR] during 16[th] week of gestation. Plasma was obtained from primiparous women during 16[th] week of gestation. 2-DE proteomic analysis was done for plasma from 11 healthy pregnant women and 11 women who developed preeclampsia later. Using bioinformatic analysis with Progenesis SameSpots ver4.0 software and ANOVA test, expression of 2 spots were statistically different between two groups. In preeclamptic state, expression of both were decreased, one of these spots was vitamin D binding protein [p-value: 0.047], the other one will be discussed in another paper. According to results, we concluded that during 16[th] week of gestation, occurance of late-onset preeclampsia without IUGR is predictable. During this week, pathology of disease is present and may be the process of placental degeneration and impaired placentation are include in disease pathology
ABSTRACT
Objective [s]: This study aimed to assess the relationship between type of delivery and changing in quality of life scores after delivery
Method: A sample of 150 mothers with caesarian section and 150 mothers with vaginal delivery attending a health center in Kashan, Iran were entered into the study. Mothers completed a specific life quality questionnaire 2 to 4 months after delivery. Mean changes in scores compared in each group and between two groups. Data were analyzed using chi square, independent t- test, pair t test and Mann-Whitney U test
Results: Findings showed that the mean score for feeling for sexual intercourse [p=0.005], economic status due to delivery [p=0.02] and willingness to choose method of delivery for future pregnancy [p=0.007] improved significantly in 2-4 months interval in normal delivery group and decreased for feeling [p=0.001] in caesarean section group. In comparing mean score differences between two groups in 2-4 months interval, there were significant differences in feeling for sexual intercourse and feeling toward one's husband [p=0.007, p=0.04] respectively
Conclusion: There were no significant differences in quality of life scores in each group and between two groups but the mean score for some aspects improved in two months interval in normal delivery group
ABSTRACT
Third stage of labor has been defined as the most dangerous stage. Due to the importance of the third stage, this study was performed in order to determine its length and related factors. This research is a cross sectional study which was carried out on 1000 deliveries in Shabihkhani Hospital [Kashan-Iran]. Inclusion criteria consist of gestational age of higher than 20 weeks, singleton pregnancy, and vaginal delivery without any instrument. The mean, median and standard deviation of the third stage of labor were 6.03, 5 and 5.15 minutes respectively. The finding also showed that there was a significant association between Para, Induction of labor, use of analgesic drugs during labor [pethidin], and umbilical drainage for third stage management [p < 0.05]. There was no significant association between a history of Abortion, Gestational age and Third stage management [Oxytosine]. The use of Induction, analgesic drugs during labor and umbilical drainage prolonged the third stage of labor, but multiparity decreased the duration of this stage. The diagnosis of these factors is recommended in order to predict and prevent the occurrence of the third stage dangers.
ABSTRACT
Objective [s]: Physical, emotional and social change occurred in postnatal period which can affect the quality of life. In this study the postnatal quality of life subscales after normal vaginal delivery and caesarean section was compared
Methods: An analytical cohort study was conducted on mothers with caesarian [n=150] and normal vaginal delivery [n=150]. The mother's referring to health centers in kashan city filled the Sf-36 questionnaire 2 and 4 months after delivery. Questionnaire aspects compared between two groups and in each group .Data was analyzed by SPSS software by using chi square, independent t- test, and Mann-Whitey U test
Results: Findings showed higher score in physical health and physical role limitation 2 months after delivery in normal vaginal delivery group and higher score in physical health, social function and emotional health 4 months after delivery in normal vaginal delivery. The mean scores for social function and emotional health improved significantly in two months interval in vaginal delivery group
Conclusion: The quality of life in many of dimensions did not show significant different in two groups, Nevertheless there was a better quality of life especially in physical health, 2 months after delivery and physical and emotional health, 4 months after delivery in vaginal delivery group
ABSTRACT
Objective [s]: To compare between the quality of life in menopausal and non menopausal women in Kashan, Iran
Method: In this cross sectional study, 200 women aged 40-60 in Kashan city with purposeful sampling were investigated. Menopausal Specific Quality of life questionnaire [MENQOL] was used for estimation of QOL. Then mean score of different domains were comprised between two groups and data were analyzed with SPSS software package and statistical tests X², paired t- test and Mann witheny U
Results: Results showed that mean scores of quality of life in vasomotor, psychosocial, physical and sexual domains was higher in menopausal women versus non menopausal women and a statistically significant difference between two groups quality of life scores in four domains were seen [P=0.0001]
Conclusion: The quality of life in menopausal periods is poor, therefore it is necessary to pay attention to women in these periods and emphasized on teaching about menopause, its symptoms and its adverse effects
ABSTRACT
The most important problems after episiotomy is perinal pain which has more severity in the first day of postpartum. The aim of this study is to investigate the efficacy of 2% lidocaine gel versus diclofenac suppository in reliving of pain after episiotomy. In a randomized, double-blind, controlled trial, 130 women who had mediolateral episiotomy received 2% lidocaine gel [n = 65] or diclofenac suppository [n = 65] at Shabihkhani hospital in Kashan [Iran]. Two groups were matched for age, gestational age, parity, education, nationality, infant sex and weight, type of episiotomy, consumption of pethedin in labor. After episiotomy repaired we administered 5cc lidocaine gel every 4 hours for women in lidocaine group and 100 mg diclofenac rectal suppository for women in diclofenac group. Using a verbal rating scale, pain ratings were recorded before the administration of the drugs and at 6 and 12 hrs after the first dose. Data were analyzed with t-test, chi[2] and fisher test. Although there weren't any significant differences between pain severity in two groups at 6 hours [P=0.4] and 12 hours [P=0.6] after episiotomy repair, but women using diclofenac suppository had lower pain, Also there weren't any significant differences between two groups in consumption of analgesia in postpartum [P=0.2]. There weren't any adverse effects with lidocaine gel or diclofenac suppository uses. This study suggests that lidocaine gel and diclofenac suppository have similar efficacy on episiotomy pain relief in the first day of postpartum