Evaluation of selected thrombotic factors among pregnant women with preeclampsia and normal pregnant women

Preeclampsia is one of the common complications during pregnancy with considerable maternal and fetal mortality and morbidity. Hypercoagulability due to thrombophilic factors is discussed as the etiology involved in this disease. The aim of this study was to evaluate selected thrombotic factors among pregnant women with preeclampsia and normal pregnant women. This case-control study was performed on 200 pregnant women at third trimester of pregnancy between 2012 and 2013. 100 pregnant women admitted to Qaem and Imam Reza hospitals of Mashhad, due to preeclampsia, were selected as case group and 100 pregnant women without preeclampsia referred to OB/GYN clinic of these hospitals as control group. Blood samples were taken from two groups for evaluation of the coagulation factors including factor V Leiden, protein C, protein S, antithrombin III, anti-cardiolipin antibodies, and lupus anticoagulant antibodies. Two groups were not significantly different in terms of maternal age and parity [p>0.05]. Levels of factor V Leiden, protein C, protein S, antithrombin III, anti-cardiolipin antibodies and lupus anticoagulant antibodies were compared between two groups. The number of patients with abnormal factor V Leiden and protein C was significantly higher in case group than in the control group [p<0.01 respectively], but other factors were not significant different between two groups. Thrombophilia disorders were significantly more in case group compared to control [p<0.001]. The risk of thrombophilia disorders is higher in preeclamptic patients than normal pregnant women

Impact of Computer-Based Pregnancy-Induced Hypertension and Diabetes Decision Aids on Empowering Pregnant Women / 대한의료정보학회지

OBJECTIVES: We designed a computer-based decision aid (CDA) for use by pregnant women at home to investigate and participate in solving their pregnancy problems related to pregnancy-induced hypertension (PIH) and gestational diabetes (GD). The system cannot and is not intended to replace visits to physicians; rather it can help women focus on the most important symptoms and provides guidance on when to see a doctor. METHODS: The study is a randomized controlled trial, which is performed among Iranian pregnant women. For subjects, 420 healthy pregnant women have been recruited from two private and two public prenatal centers. The intervention group will receive the CDA for use at home, and the control group will receive care as usual. The CDA relies on knowledge extracted from the national guidelines on PIH and GD. RESULTS: The two primary outcomes for the study are self-efficacy and knowledge. Self-efficacy will be measured by the Stanford self-efficacy scale and knowledge will be evaluated by 15 binary (true/false) questions provided by the researchers. Secondary outcomes include type and frequency of doctor and/or medical center visits; blood pressure and blood sugar changes based on the national guidelines and according to pregnancy records, and anxiety will be assessed by the state component of the short Spielberger anxiety scale. CONCLUSIONS: This paper describes the design of a CDA and a protocol for a randomized controlled trial to study the effects of the CDA on self-efficacy and knowledge of pregnant women pertaining to PIH and GD. Differences in the primary outcomes will be analyzed using 'intention-to-treat' principles.

Effect of late-pregnancy consumption of date fruit on cervical ripening in nulliparous women

Cervical ripening before the onset of labor is an important factor for the prediction of delivery mode, and is directly associated with vaginal delivery. The search for a safe, inexpensive, and easy method of cervical ripening is of great significance. Few studies have focused on the effect of date fruit on uterine contractions and cervical ripening. Therefore, the purpose of this study was to determine the effect of late pregnancy consumption of date fruit on cervical ripening in nulliparous women. This randomized clinical trial was performed on 210 women with a singleton pregnancy, cephalic presentation, and gestational age of 37-38 weeks. The study was conducted at Omolbanin Hospital, Mashhad, Iran in 2013. The subjects were randomly assigned into two groups of 105 women [experimental and control groups]. Since the 37th week of gestation, the experimental group consumed date fruit [70 to 75 gr per day] until the onset of labor pain, and the control group received routine care.Data were collected using demographic questionnaires, fetal movement record form, and the checklist related to daily consumption of date fruit. Data analysis was performed using SPSS version 14, and Chi-square, t student, and Mann-Whitney test. P-value less than 0.05 was considered statistically significant. The mean Bishop score at admission was higher in the experimental group [7.67 +/- 2.28], compared to the control group [5.12 +/- 2.77] [P<0.001]. Mean cervical dilatation at admission was 4.05 +/- 1.63 cm in the experimental group and 2.97 +/- 4.63 cm in the control group [P<0/05]. Also the success rate of labor induction was higher in the experimental group compared to the control group [P=0.006]. Mean cervical dilatation was higher in women consuming date fruit, compared to the non-consuming group. Since date fruit is full of energy and nutrients, it is recommended for pregnant women to help with cervical ripening, particularly in the last weeks of gestation

Comparing diagnostic accuracy of purple line with transverse diagonal of michaelis sacral to predict labor progress in nulliparous and multiparous women

One of the key aspects of maternal care is observing labor progress. Careful assessment of labor progress could provide mothers to be referred on time and could minimize the maternal and neonatal morbidity. This study aimed to compare diagnostic accuracy of purple line with transverse diagonal of Michaelis sacral rhomboid to predict labor progress in nulliparous and multiparous women who referred to Om-ol-banin Hospital, Mashhad, Iran from April to August 2012. In this double-blind diagnostic accuracy study, 350 nulliparous and multiparous women with a single pregnancy in vertex presentation and gestational age of 38-42 week who admitted in state hospitals of Mashhad were selected using convenience sampling. The transverse diagonal of the Michaelis sacral rhomboid area was measured in cervical dilatation of /= 98.5 millimeter was accompanied with normal labor progress with 86.5% sensitivity, 59.45% specificity and 79.65% validity. Transverse diagonal of the Michaelis sacral is better predictor for observing labor progress in comparison with purple line

Efficacy of rectal misoprostol for prevention of postpartum hemorrhage

Postpartum hemorrhage is an important cause of maternal morbidity and mortality after delivery. Active management of postpartum hemorrhage by an uterotonic drug decreases the rate of postpartum hemorrhage. The aim of this study is to evaluate the efficacy of rectal misoprostol for prevention of postpartum hemorrhage. This double blind randomized clinical trial was performed on full term pregnant women candidate for vaginal delivery, referred to Zahedan Imam Ali Hospital during 2008-2009. They were randomly divided into two groups of rectal misoprostol and oxytocin. The women in misoprostol group received 400 micro g rectal misoprostol after delivery and the women in oxytocin group received 3 IU oxytocin in 1 L ringer serum, intravenously. Rate of bleeding, need to any surgery interventions, rate of transfusion and changes in hemoglobin and hematocrite were compared between two groups. A total of 400 patients [200 cases in misoprostol group and 200 in oxytocin group] entered to the study. Rate of bleeding > 500 cc was significantly higher in oxytocin group than misoprostol group [33% vs. 19%] [p = 0.005]. Also, need to excessive oxytocin for management of postpartum hemorrhage was significantly lower in misoprostol group than oxytocin group [18% vs. 30%] [p = 0.003]. Decrease in hematocrite was significantly more observed in oxytocin group than misoprostol group [mean decrease of hematocrite was 1.3 +/- 1.6 in misoprostol group and 1.6 +/- 2.2 in oxytocin group]. Two groups were similar in terms of side-effects. Rectal misoprostol as an uterotonic drug can decrease postpartum hemorrhage and also can prevent from decrease of hemoglobin as compared to oxytocin

effect of early post cesarean feeding on women's satisfaction

Satisfaction and postoperative care of women who undergo cesarean secaon is an important aspect and demand due attention. Hunger and thirst are frequently encountered after cesarean delivery. These increase distressing symptom and unsatisfaction. The aim of this paper was to detect the effect of early post cesarean feeding on mothers' satisfaction. This study was a controlled trial. The research population was women delivering by cesarean section in Ommolbanin hospital, Mashhad, Iran. The samples consist of 82 women randomly assigned in two groups of study and control. The study group started oral fluids 4 hours after surgery, followed by regular diet after return of bowel sounds. The control group started oral fluids 12 hours after surgery and solid food was allowed after defecation. The groups were compared about satisfaction rate before discharge with VAS scale. Data were analyzed using chi-square, Fisher exact test, Kruskal walis test, t test and Mann Whitney. The mean of women's satisfaction was 96.2 in early feed group and 56.7 in the control group. There was a statistically significant difference between two groups [p=0.000]. This study showed that early feeding increases women's satisfaction. It is a safe, easy and enforceable intervention that can be usual in surgical units