Assessment of effect spontaneous pushing in second stage of labor on maternal and fetus outcomes

Background and Aim: In more than 75% of delivery nursing staff members encourage prolonged Valsalva-type pushing during the second stage of labor. The objective of the present study is to the assessment of effect Spontaneous Pushing in second stage of labor on maternal and fetus outcomes

Methods and Materials: In this quasi-experimental study was completed on 160 pregnant women in second stage of labor and average 18-35 years old. The participants were allocated in two groups spontaneous pushing [n=80] and Valsalva pushing technique [n=80]. In group spontaneous pushing, used the spontaneous pushing method [open glottis pushing while breathing out] and in other group, used the Valsalva pushing technique [closed glottis pushing while holding their breath] during the second stage of labor. Duration stage of delivery, perineal tears, 1- and 5- minute APGAR score were evaluated in both group .Data were analyzed by SPSS

Results: Rate intact perineum in spontaneous pushing group was higher than Valsalva pushing technique group [p<0.001]. Moreover, first-degree and second-degree tears were not significant difference between two group. Rate the need for episiotomy was less in spontaneous pushing group [%33.8 versus %66.2] [p<0.001] that the group were significantly different. The baby fared better with spontaneous pushing, with higher 1 minute APGAR score

Conclusion: It seems that spontaneous pushing method during the second stage of labor is associated with less perineal trauma and improved newborn outcome

[ effect of lavender essential oil on anxiety of intra uterine device insertion]

Intra uterine device is a safe, effective and reversible method of family planning. Unfortunately, IUD insertion associated with anxiety. The lavender essential oil has anti-anxiety and analgesic effect however it's anti anxiety efficacy before intra uterine device insertion is to be evaluated. The present study was conducted to evaluate the anti-anxiety effect of lavender essential oil before intra uterine device insertion. Total 135 Iranian women candidate for intra uterine device insertion that had eligible criteria were randomly recruited into three lavender, placebo and control group. Data was collected by demographic questionnaire, spiel Berger questionnaire. The candidate apparent and acute anxiety was determined according to 20 questions present in Spiel Berger Questionnaire before and after aromatherapy just before intra uterine device insertion. The 20 questions were given four options including slight, moderate, high and very high with score 20 to 80. The women were given a box containing a cotton ball soaked with three drops of lavender essential oil or sesame oil. The women's were asked to inhale the box for 5 minute from 7 to 10 centimeter from nose. The apparent and acute anxiety was determined in all three groups before and after aromatherapy just before intra uterine device insertion compared to each other. Data analysis was performed by SPSS software and descriptive and analytic statistics methods. The average anxiety score was decreased in lavender group after aromatherapy compared to before aromatherapy [p<0.001] and also as compared to placebo and control groups [p<0.001]. The Results of this study suggest that aromatherapy with inhalation of lavender essential oil is effective as anti- anxiety before IUD insertion

[Effect of halogen light stimulation on nonreactive pattern of nonstress test [NST]]

The Non Stress Test [NST] is a main assessment tool for fetal wellbeing; however, it has a high rate of false-positive results. External stimulation with halogen light has been recommended to aid in provoking fetal response, decreasing false-positive results and promoting the test. This study aimed to assess the effect of halogen light stimulation on nonreactive pattern of NST. From 850 women who underwent NSTs, 50 women with singleton and cephalic fetuses who had nonreactive NSTs were allocated to receive halogen light stimulation through a halogen light source of 1,000,000 candle power. The light was applied to the lower abdomen above symphysis pubis over fetal head for 10 seconds. Results were compared to BPP scores as a backup test. We used mean +/- SD, chi-square Test and Fisher's Exact Test. The alpha<0.05 was considered as significant level. Following stimulation, 68% of nonreactive results changed to reactive patterns. In half of the cases, first acceleration occurred in less than two minutes. Almost 90% of fetuses had reactive pattern within nine minutes. Halogen light stimulation decreased the incidence of non reactive tests and testing time. Halogen light stimulation is safe and efficient in fetal well being assessment

[Effect of education designed based on health belief model on choosing delivery mode]

High rates of cesarean delivery have worried health policy makers. One of the main reasons for cesarean section in Iran is cesarean election. Health Belief Model [HBM] is one of the most powerful models used in health education programs. The objective of this study was to determine the effect of education designed based on HBM on choosing delivery mode among pregnant women. In this experimental study, 128 nulliparous women were recruited from Shahrood health care centers and private gynecologists' offices. Samples were randomly allocated into two equal groups. Women in the experimental group participated in two 40-minutes educational classes which were designed based on HBM. Data were gathered both before and after the classes, and then were analyzed using SPSS. The results indicated that there were no significant differences between two groups in demographic characteristics, infertility history, disease history, perceived susceptibility, and perceived benefits and barriers. After the intervention, significant differences were found between perceived susceptibility [P < 0.001], perceived severity [P < 0.001], perceived barriers [P=0.004], with practice [choosing the delivery mode] [P < 0.001]. The results showed that using HBM in program designing was effective in the pregnant women's decision-making toward delivery mode

Effect of simultaneous educational program for mothers and daughters on osteoporosis preventive behaviors among girls

Osteoporosis is a metabolic disease which results from gradual destruction of bone mass. Prevention of Osteoporosis should be started from childhood by getting adequate calcium and doing weight-bearing exercises. Participating of mothers in health education interventions is likely to promote longer-lasting health behaviors in their daughters. The aim of this study was to investigate the effect of simultaneous education of mothers and daughters on Osteoporosis preventive behavior among high school female students. In this interventional study, 400 female students were randomly selected via a two-phased sampling method. At first stage, four schools were selected randomly. At the second stage, 400 students were divided randomly into two groups. Their Osteoporosis preventive behaviors were measured using a two-sectioned questionnaire: demographic section, and Osteoporosis preventive behaviors assessment section. The first group participated in the educational programs with their mothers and the other group participated without their mothers. The educational program had two sessions, each one lasted 45 minutes. The second stage of the study was performed three months later. Data analysis was carried out using t-test and chi squared test. Results showed that in both groups, Osteoporosis preventive behaviors scores increased significantly after intervention. It was higher in case group [P<0.001]. Eating behavior was significantly different in two groups [P=0.003]. Results showed that simultaneous educational program for mothers and daughters promotes eating behavior in the girls

Evaluation of knowledge and practice of newly graduated midwives in normal vaginal delivery in hospitals affiliated to Tehran University of medical sciences

Evaluating the knowledge and practice of newly graduated midwifery students can reflect to some extent the results of midwifery educational planning. This study was done to assess knowledge and practice of newly graduated midwives in Normal Vaginal Delivery [NVD] in hospitals affiliated to Medical Sciences Universities in Tehran. In a survey study, all newly graduated midwives [n=30] employed in hospitals affiliated to Med-ical Universities in Tehran and graduated in the past two years were selected through census sampling method. A self-administered questionnaire containing 40 multiple-choice questions for measuring knowledge was completed by midwives. Then the practice of midwives while performing normal vaginal delivery and episiotomy was observed using a 109 item checklist. The data was analyzed by SPSS software using freque-ncy distribution, mean and standard deviation. Pearson Correlation Coefficient was used to measure the correlation between knowledge and practice scores, and age and experience of midwives. Most of the subjects had an average knowledge [90%] and desirable practice in all stages of NVD including first stage [60%], second stage [73.3%] third stage [73.3%] and forth stage [60%]. In immediate care of the new born 86.7% and in episiotomy 80% had a desirable practice. This study showed that graduated midwives were competent enough to perform a safe normal vaginal delivery

[Effects of emergency contraceptive methods education on the knowledge and attitudes of the health care staff]

According to Iranian national statistics, every year 400 to 500 thousand unwanted pregnancies occur in Iran. The emergency contraceptive methods are easily accessible and affordable for the women of this region. Regarding the important role of health care providers in representing these methods, this study is to determine the knowledge and attitudes of these staff toward required contraceptive methods. In this semi-experimental study, 216 health personnel working in south of Tehran health centers were randomly selected. Two 30- minute educational sessions were presented to the staff. The methods of education included face to face, and group discussion. At the end of each session a pamphlet was given to the staff. Data were gathered using a questionnaire before and 2-6 weeks after the education. Statistical analysis was carried out using statistical package for social sciences [SPSS]. The results showed that there were significant statistical differences between the knowledge and attitudes [P<0.001] of personnel about the emergency contraceptive methods before and after education. There was no significant relationship between demographic characteristics and attitudes of personnel. There was a significant relationship between sex [P<0.001], educational level [P<0.003], educational major [P<0.001], with knowledge after intervention. Knowledge and attitudes toward emergency contraceptive methods increased significantly after education. This finding reveals the importance of continuous education for health care staff such as midwives and physicians to facilitate successful guidance of their patients towards effective family planning

[Frequency and intensity of depression during menstrual period and it's relation with religious attitudes in Karaj High School Girls 2003]

One the most critical life periods of a girl is beginning of puberty and menstrual period .Depression is one the psychological disorders of puberty period which is prevalent among adolescent girls. Performing religious duties is one the important prevention factors of mental disorders especially depression. This research is performed with the aim to determine the frequency and intensity of depression during menstrual period and its relation with religious attitudes in Karaj high school girls in 2003. This research is a cross sectional descriptive-analytical study in which 264 students of ages 13-18 were randomly selected as samples. The instrument of data collection was questionnaire. To analyze data, descriptive and inferential statistical methods and SPSS software were used. The results indicated that, most of samples [64.8%] suffered from different degrees of depression and remaining 35.2% showed no depression. 63.7% of depressed students had mild, 30.5% moderate and 5.8% had severe depression. 14.4%, 68.6% and 17.0% of cases had high, moderate and low religious believes respectively. Moreover, results showed a meaningful and significant negative correlation between frequency and intensity of menstrual depression and religious believes [p<0.001]. Considering the research results, this disorder can be minimized through enhancing religious believes by families and educational centers and also enjoying the help of midwives and health centers as counselors

[Graphic analysis of labor progression]

Pregnancy and delivery are special events in women's and their family's life. Although pregnancy is a natural phenomenon and not a disease, sometimes it can be associated with several dangers to the mother and her fetus. Maternal death is a global finding and its five most important causes are bleeding, infection, hypertension, prolonged labor and abortion in unsanitary condition. Early diagnosis of abnormal labor progression and prevention of prolonged labor can reduce the risk of postpartum bleeding and infection. The chart of labor called [Partograph] has been introduced and applied since 1970 to help diagnosis of the abnormal labor and cephalopelvic disproportion. Partograph is an early alerting system which can prevent probable difficulties in different stages of labor through recording of all of the observations and examinations on one chart, so that mother can be referred as soon as possible to higher levels of health services