[Comparing the effects of spontaneous pushing versus Valsalva pushing technique on outcome of delivery in primiparous women]

The valsalva pushing technique is used routinely in the second stage of labor in many countries, and it is accepted as standard obstetric method in Iran. The purpose of this study was to determine the effects of spontaneous pushing, versus, valsalva pushing technique in birth on outcome of delivery in primiparas. This clinical trial study was conducted on 100 primiparas. Samples were randomized to either a spontaneous pushing group [open glottis pushing while breathing out] or a valsalva type pushing group [closed glottis pushing while holding their breath]. The length of stages of delivery, perineal tears, postpartum hemorrhage and satisfaction were evaluated in mothers and apgar scores at 1 and 5 minutes were evaluated in newborns. Data were analyzed using statistical Mann-Whitney, Chi-square and independent t-test. The duration of expulsion phase of the second stage of labor was significantly longer in valsalva-type pushing [P=0.004]. The result indicated that the incidence of episiotomy in spontaneous pushing group [P=0.003] and postpartum hemorrhage in valsalva pushing group [P=0.002] was more. The baby fared better with spontaneous pushing, with higher 1- minute apgar score. After the birth, women expressed greater satisfaction with spontaneous pushing. Educating women for the spontaneous pushing technique in the first stage of labor and providing support for spontaneous pushing in the second stage result in a shorter second stage without interventions and in improved newborn outcomes

[Immunization following hepatitis B mass vaccination in the 18 years old students in Chaharmahal va Bakhtyari province in Iran]

Background and aims: The main objective of immunization by hepatitis B vaccine is to generate adequate concentration of anti hepatitis B antibody [HBsAB] in the serum. This study was aimed to determine the effectiveness of hepatitis B vaccination campaign in 18 years old students in Chaharmahal va Bakhtiari province

Methods: In a cross- sectional study, 360 students with 18 years old [born in 1989] and have taken 3 doses of hepatitis vaccine in national vaccination campaign in 2007, were selected by cluster sampling. This study was performed in 2008 in Chaharmahal va Bakhtiari province in the central of I.R of Iran. The level of hepatitis B antibody was detected by quantitative ELIZA method using Dialab Kit. The collected data was analyzed using SPSS 16.0 software by X[2] and t-test

Results: Of 360 students, 164[45%] cases were male and 174 [48/3%] cases were from urban areas. Just 349 students [96/95%] have acceptable immunization responses, [In those anti hepatitis B antibodies were more than 20 IU/ml]. There was no significant relationship between the level of antibody and variables such as: sex, born places, smoking, contact history, previous disease and Hejamat [P>0.05]

Conclusion: Considering the results of the present study and previous researches from others countries, we can emphasize that the mass vaccination has been effective in those 18 years old students and we can be sure that the vaccination has been performed perfectly in Chaharmahal va Bakhtiari province

[Effects of acupressure at the Sanyinjiao point [SP6] on labor pain and delivery time in nulliparous women]

Analgesics and anesthetic pain relief in labor often have unwanted sedative effects in the mothers and their newborns. It seems that using non-pharmacologic methods, such as acupressure, affect on labor pain and delivery time. The purpose of this study was to evaluate the effects of SP6 acupressure on labor pain and delivery time in nulliparas women in Iranshahr hospital in 2008-2009. A randomized clinical trial study was performed on 60 eligible nulliparas women who were at the beginning of active phase of labor [4 cm dilatation of cervix]. The women were randomly assigned to one of the two groups: SP6 acupressure or SP6 touch. The participants, received acupressure or SP6 acupoint, 3 Kun above the tip of the inner malleous just posterior to the border of tibia above the ankle, for 20 minute during contractions on two feet. Labor pain was measured four times with visual-analogue scale [VAS]: before and after the intervention in 4,6, 8 and 10 cm cervical dilation. Length of delivery time was calculated in two stages: from 4 cm cervical dilation to full cervical dilation and full cervical dilatation to the delivery. The data were analyzed using SPSS software and descriptive statistical, paired t-test, chi square and independent t-test. There was a significant reduction in the severity of pain in 4, 6 and 8 cervical dilatation in case group compared to control group [P<0.001]. The length of delivery time in active phase was less in case group compared to control group P<0.001, but there was hot difference in second place of delivery. SP6 acupressure may be applied in a non-invasive and easy to use fashion for pain control in the labor