Use and attitude on herbal medicine in a group of pregnant women in Tehran

While the use of herbal medicines is common in Tehran, there is scant data regarding various aspects of the use of such medicines during pregnancy. The frequency of the use of herbal medicines in a group of pregnant women in Tehran and their attitude to the use of such medicines were evaluated. In this cross-sectional study, 600 pregnant women were studied. A researcher-made questionnaire was used to explore the demographic and pregnancy related data, the extent of use of the herbal medicines, the subjects' sources of information and their attitude regarding such medicines. The data were analyzed using student t- and chi-square tests. Logistic regression was used to determine the predicting factors. 402 [67%] participants had used at least one type of herbal medicine during their current or previous pregnancies, with a mean of 2.71 +/- 1.94 herbs per individual. Two commonly used herbs were peppermint [32.8%] and olibanum [26.3%]. Maternal and Gestational age, family size, children number, frequency of having medical insurance and positive attitude in users were significantly higher than non-users [P values were 0.02, 0.02, 0.001, <0.001, 0.04 and <0.001 respectively]. The score of attitude was the only predictor for taking herbal medicine with the odds ratio 0.89 [95% confidence interval: 0.86-0.92] of logistic regression model for negative attitude. Considering the high frequency of herbal medicine use during pregnancy, pregnant women need appropriate sources of information about these medicines. Further, health care providers should ask pregnant women about taking herbal medicines

[ effect of intravenous cefazolin on infectious complications following low- risk cesarean]

Cesarean section is one of the most common surgeries in modern obstetrics. Infectious complications such as fever, wound infection, endometritis and urinary tract infection are the most serious complications following cesarean. Nevertheless, there are no uniform recommendations regarding the application of prophylactic antibiotics. Since inappropriate application of antibiotics could impose high costs as well as drug side effects and emergence of resistant microorganisms, this study was carried out with the aim of evaluating the effect of prophylactic antibiotics on infectious complications following the low-risk cesarean section. This prospective, clinical trial study was performed on 257 patients who underwent low-risk cesarean section. The patients were randomly divided into treatment [A] and control [B] groups. The patients in group A received 2gr intravenous cefazolin at cord clamping, while the control group received no antibiotic. The patients were evaluated during the first 48 hours, the first week, the second week, and the sixth week following the surgery and infectious complications were compared in two groups. Out of 257 patients, 16 cases [6.2%] developed infectious complications of whom 6 patients [4.7%] were in group A and 10 patients [7.8%] fell into group B. Complications included fever [2.3% in each group], endometritis [0.8% in group A and 2.3% in group B], urinary infection [1.6% in group A and 3.1% in group B], wound infection [1.6% in group A and 2.3% in group B] and wound dehiscence [1.6% in each group]. No significant difference was observed between the administration of prophylactic antibiotic and the complications. Moreover, the duration of hospital stay following cesarean section was not statistically different in each group. Based on the study findings it can be recommended that prophylactic antibiotic be restricted only to the high-risk cesarean section individuals

[Evaluation of the risk factors for ectopic pregnancy in laparotomy patients during 1991-2001]

Ectopic pregnancy [EP] is one of the major causes of maternal death during pregnancy. This study was designed to determine the risk factors of EP in Mahdiyeh Hospital over 10 years. This case-control study included 200 women who underwent laparotomy with the diagnosis of EP in Mahdiyeh Hospital between the years 1991 and 2001. Also, 400 randomly selected pregnant women with normal vaginal delivery were included as controls. A direct relationship was found between EP and history of abortion, previous EP, PID, pelvic surgery, appendectomy, infertility, using clomiphene, current IUD and IVF. The chance of developing an EP [odds ratio with 95% confidence interval] was 26.7 [9.01-79.06] in women using clomiphene, 21.16 [2.71-164.8] in women with a previous history of EP, 3.29 [1.94-5.58] in those with prior appendectomy, and 9.63 [5.24-17.67] times greater in women who got pregnant while having an IUD. It is concluded that among outpatients, previous abdominal or pelvic surgery, current IUD, history of previous EP, and history of using clomiphene increase the risk of developing an EP. This study did not find any association between EP and previous usage of IUD, mini-pill or age

[Risk factors associated with forth-degree laceration during vaginal delivery]

To identify the risk factors of fourth-degree laceration during vaginal delivery. This is a retrospective, case control study. We reviewed 131802 records of vaginal deliveries within 14 years period from 1990 to 2004 in two obstetric center. Cases were 93 vaginal deliveries with fourth-degree laceration and 7 cases were delivered at home, control subjects were 200 vaginal deliveries without third- or fourth-degree lacerations and were identified with the use of random selection. We studied the effects of: maternal age, nationality, parity, gestational age, hour of delivery, birth attendants, episiotomy use and duration of second stage of labor, use of oxytocin, use of forceps or vaccum, Infant birth weight, presentation and postion of fetus, previous severe perineal injury, maternal medical illness and place of delivery. We found 93 cases [%0.07] of documented fourth-degree laceration in 131802 deliveries This study identified several factors associated with fourth-degree laceration. Median episiotomy should be avoided. Nulliparity, fetal macrosomia and OP position are significant risk factors that require caution by birth attendants during delivery

[Evaluation of anxiety and fear of labor in postpartom period]

Pregnant women are exposed to biological, physiological, and psychological changes. Furthermore in many patients referred to the medical care [as pregnant women], psychiatric problems are the main causes or complications. Our aim in this descriptive study is to determine the prevalence of fear and anxiety of childbirth in pregnant women referred to four educational hospitals in Tehran; this study was performed from Mar 2003 to Jul 2003. 300 pregnant women who were in 20 to 40 days after childbirth completed 4 questionnaires. Prevalence of the fear of childbirth in our study was 59.7%. And prevalence of anxiety of childbirth was 14.7% mild, 26% low moderate, 23% high moderate, 23.7% slightly severe and 12.7% severe. Also demonstrated was that an increase of age, decrease of the rate of fear and anxiety of childbirth. The rate of fear and anxiety of childbirth in employed women is more than unemployed [housewife's] women, and it was demonstrated that increase rate of gravidity and parity of pregnant women, decreased the rate of fear and anxiety of childbirth . The rate of fear and anxiety of childbirth in women who had difficult labor in the past is more than other women. Also the rate of fear and anxiety of childbirth in women with cesarean section delivery is more than in women with vaginal delivery