[Relationship between human chorionic gonadotrapin [HCG] level in second trimester pregnancy and preeclampsia]

Many researches have shown a relationship between levels of beta HCG in pregnancy and preeclampsia, which can be used as a method for early diagnosis. The aim of this study was to determine relationship between levels of HCG in second trimester of pregnancy and preeclampsia. This study was conducted as a Nested case control study. Blood samples were taken from 1200 pregnant women who were in their second trimester of pregnancy and were admitted for prenatal care in Arak prenatal clinics. After isolation of serums, blood samples were stored in-20°C until delivery time. Finally serum HCG levels, blood pressure, proteinurea, edema, seizure and neonate statue were analyzed in 50 preeclamptic women [case group] and were compared with 50 normotensive women [control group]. All women were complicated with mild preeclampsia. The mean of the beta HCG in preeclamptic women was 43.08 +/- 32.56 Iu/ml and means of HCG in normotensive women was 27.48 +/- 25.97 mu/ml [P<0.05], the mean of systolic blood pressure in case and control groups were 144.09 +/- 11.30 mmHg and 110.26 +/- 8.13 mmHg, respectively [P<0.001]. The mean of diastolic blood pressure in preeclamptic women was higher than normotensive women [90.45 +/- 4.34 mm/hg and 70 +/- 9.80 mm/hg] [P<0.001]. Our data showed a significant relationship between mean levels of HCG preeclampsia in second trimester. Therefore, screening of high risk group with HCG hormone and careful prenatal care should be considered during pregnancy

[Effect of perineal massage during second phase of labor on episiotomy and laceration rates among nulliparous women]

Routine episiotomy is often considered unnecessary. Episiotomy is associated with short- and long-term morbidities such as suturing, possible bleeding, infection, urinary and fecal incontinences, and dyspareunia. It has also adverse effects on self-esteem and mother-infant bonding. This study aimed to determine the effect of perineal massage during second stage of labor on perineal outcome among nulliparous women. This was a randomized controlled clinical trial. At 38-42 weeks of gestation, nulliparous women expecting normal vaginal delivery of a singleton were asked to join the study. Two hundred and four women were randomly allocated into the intervention and control groups. Participants signed the consent forms. In the intervention group, during the pushing time in the second phase of labor, the midwife inserted two fingers inside the vagina and used a sweeping motion gently to stretch the perineum. The control group received routine care. The rates of episiotomy and laceration were calculated. In the intervention group, the rate of intact perineum, episiotomy, and laceration were 43.5%, 16.5%, and 40%, respectively and in the control group, they were 2.4%, 80% and 17.6%, respectively [P<0.001]. In the intervention group, the first- and second-degree lacerations were 28.2% and 11.8%, respectively; but, the third and fourth degree lacerations were not seen. In the control group, first, second, and third degree lacerations were 4.7%, 7.1%, and 5.9%, respectively [P<0.001]. The fourth degree laceration was not seen. The mean duration of the second stage of labor in the intervention and control groups were 40.06 +/- 20.74 and 51.06 +/- 21.23 minutes, respectively [P=0.003]. The Mean of the first minute Apgar score was 8.51 +/- 0.76 and 8.73 +/- 0.60 in the intervention and control groups, respectively. The mean of the five minute Apgar score was 9.58 +/- 0.62 and 9.78 +/- 0.47, respectively [P=0.102]. This study showed that perineal massage reduces the rate of episiotomy and the degree of lacerations in the second stage of labor. Massage may increase blood flow, elasticity, relaxation, and softness of the perineum

[Comparison of the effect of fennel essence and gripe water syrup in infantile colic]

Excessive crying in healthy infants due to abdominal colic is a common problem during the first month of life and usually occurs in infants of less than 4 months of age. Various plants have been used to relieve infantile colic including chamomile, dill, fennel, catmint and others, among them fennel is most frequently recommended by herbologists. Since the cause of infantile colic is unknown and chemical drugs have different side effects we designed this study to compare the effect of fennel essence with that of gripe water syrup in infantile colic. This was a randomized clinical trial and encompassed 81 infants up to 4 months of age in Arak. The patients were divided into 2 groups. Before intervention, diagnosis of colic was made by a pediatrician and mean duration of crying was assessed for all infants and was classified into 3 groups; less than 60 minutes, 60-120 minutes and more than 120 minutes. In the experimental group fennel essence with doses of one teaspoonful TDS and one dessert spoonful TDS were prescribed for patients of less than one month of age and patients of 1-4 months of age respectively. The control group received gripe water syrup with the same doses for similar age groups for one week. On the 3rd and 7th days of treatment the mean duration of crying in 24 hours was determined again and compared with the previous values. Data were registered in questionnaire, introduced into SPSS soft ware and analyzed by means of X[2], Mann-Wittny, Leven and K.S. tests. Before intervention the mean values for duration of crying in fennel group were: in 56.1% less than 60, in 36.6% 60-120 and in 7.3% of cases more than 120 minutes; and in gripe water group: in 63.4% less than 60, in 29.3%. 60-120 and in 7.3% of cases more than 120 minutes which revealed no statically significant difference. But after treatment on the 3rd and 7th days comparison of the pre and post treatment values for duration of crying in fennel group showed a significant difference [p=0.004, 0.05]. On the 3rd and 7th days of treatment in gripe water group we also noticed a significant difference between pre and post treatment values for duration of crying [p=0.037. 0.002]. None of the infants cried more than 2 hours in the 2 groups. No statically significant difference was noticed between the two groups after treatment. The essence of fennel is effective as much as gripe water syrup in relief of infantile colic, so it can be used as a safe, effective and inexpensive herbal drug for infantile colic

Effect of prophylactic antibiotic on the prevalence of pelvic inflammatory in women using IUD

Intra uterine device [IUD] is a highly effective contraceptive method but concerns about the risk of upper genital tract infection, often limits its use. Scientist believed that prophylactic antibiotic administration around the time of inserting IUD significantly reduces the risk of IUD related pelvic inflammatory disease [PID]. This study is designed to investigate the effect of prophylactic antibiotic on pelvic inflammatory disease associated with IUD insertion. This is a randomized clinical trial. A total of 500 prospective IUD [TCU-380A] users were randomly assigned in two groups. The first group received 200 mg of Doxycycline one hour before IUD insertion and the second did not. Then, 20 days after IUD insertion, the two groups were examined for PID. Data was analyzed using Mann-Whitney and Chi square tests. The mean of age, gravida, para, live children and abortion in case and control groups were not statistically significant. The rate of PID was 2.1% in case group compared to 1.9% in control group, which was not statistically significant. Vaginal infection in control group was more than case group but not significant. We concluded that the use of prophylactic antibiotic did not have a significant effect on preventing IUD induced PID. Regarding the side effects of unnecessary antibiotic consumption it is suggested to reinforce the need for implementing aseptic techniques during IUD insertion

[Determination of relationship between father's cigarette smokingand sex ratio in children]

Sex ratio is referred to male, female ratio which is usually 1.06. This ratio is decreased during the last few years. One of it's reasons seems to be poisons and environmental pollutions such as cigarette smoke. In this investigation we studied the relationship between father's cigarette smoking and sex ratio in children.This is a historical cohort study. Study population were neonates born in Arak hospitals during summer and autumn 1383. Sample size was determined 710 neonates, based on alpha = 5%, beta = 10%. Sampling method was census in which all newborns with inclusion criteria were selected and questionnaires were filled. Samples were divided into three groups. 1- Newborns with nonsmoker fathers 2- Newborns with smoker fathers [less than 20 cigarettes a day] 3- Newborns with smoker fathers [20 or more cigarettes a day][Father's cigarette smoking at least 3 months before conception in second and third group]. Newborn's sex ratio was determined in each group and caparisoned. Data analysis was done by frequency, ratio, mean and standard deviation indexes and K-S, leven, t, mann-whitney, chi square tests and relative risk, using SPSS software. At all stages of the study Helsinki declaration was regarded.Overall sex ratio was 1.04. This ratio was 1.272 for neonates with nonsmoker fathers and 0.77 for neonates with smoker fathers. Also sex ratio in newborns with smoker fathers using less than 20 cigarettes a day was 0.846 and for those with fathers using 20 or more was 0.60. Based on chi square there was a meaningful relationship between the three groups[p<0.00001]. Relative risk in low cigarette group was 1.23 and in high cigarette group 1.42.Based on findings it seems that father's cigarette smoking near conception results in decreasing sex ratio and the increased use of cigarettes the decreased born of male neonates

[ effect of maternal position in active phase on duration of labor and newborn's Apgar score]

It seems that mother's position and activity during labor can affect labor process and it's outcomes. This investigation aimed to investigate maternal position's effect in active phase on labor duration and newbom's Apgar. This is a quasi experimental study which is done on 256 mothers referring to Taleghani hospital in Arak city. Sampling was convenience and sample size was determined based on alpha =5% and beta =20%. Mothers were divided into two primi and multipara groups and each mother chose one of the lying on left side, semi ambulatory and ambulatory positions based on her own intent. The duration of first, second and third stages of labor and also the newborn's Apgar score in first and fifth minutes after birth was determined in each group. Data was analyzed using Shefe test. Results showed that more than half of mothers [55.5%] preferred semi ambulatory position. 98.8% of deliveries were normal vaginal delivery and most of newborn's Apgar score in first and fifth minutes after birth was 9 and 10 respectively. There was no significant difference between labor complications and maternal position and also between Apgar score and maternal position. It was found that the duration of first, second and third stages of labor in primiparas of ambulatory group were shorter than the other two primipara groups. But the difference was only significant in first stage[p<0.001]. In multiparas of the ambulatory group the duration of first and second stages were significantly shorter than the other two multipara groups [p<0.001].Overall findings showed that the duration of first stage of labor in ambulatory primiparas and first and second stages of multiparas were significantly reduced so it seems that ambulation of mother during labor can improve labor process