Effect of oral carbohydrate intake on labor progress: randomized controlled trial

Lack of information regarding biochemical changes in women during labor and its outcomes on maternal and neonatal health still is an unanswered question. This study aims to explore the effectiveness of oral carbohydrate intake during labor on the duration of the active phase and other maternal and neonatal outcomes. A parallel prospective randomized controlled trial, conducted at the University Affiliated Teaching Hospital in Gonabad. Totally, 190 women were randomly assigned to an intervention [N=87] or control [N=90] group. Inclusion criteria were low-risk women with singleton cephalic presentation; and cervical dilatation 3-4 cm. Randomization was used by random number generator on every day. Odd numbers was used for intervention and even numbers for control group. Intervention was based on the preferences between: 3 medium dates plus 110 ml water; 3 dates plus 110 ml light tea without sugar; or 110 ml orange juice. The protocol is only run once but women ate and drank gradually before second stage of labor. Control group were fasted as routine practice. Neither participants nor care givers or staff could be blinded to group allocation. Differences between duration of the active phase of labor were assessed as primary outcome measure. There was significant difference in the length of second stage of labor [P <.05]. The effect size for this variable was 0.48. There were no significant differences in other maternal and neonatal outcomes. Oral intake of carbohydrate was an effective method for shortening the duration of second stage of labor in low-risk women

[Determining learning style and its relationship with educational achievement in nursing and midwifery students]

The health care system and the method of teaching are very dynamic. Awareness of students learning styles provides information for teachers to observe the variation in training methods and help students to facilitate learning. The purpose of this study is to determination of the learning styles of nursing and midwifery students and its relationship with their educational achievement. In this cross-sectional study, the undergraduate nursing and midwifery students of Tehran University of Medical Sciences in third and first academic year were investigated in 2008. Data were collected through the learning style questionnaire and demographic information. Gathered data were analyzed by statistical tests included t-test, ?2 and kruscal - valis through SPSS software The dominant learning styles of students, is the diverging style. Significant relationship between their learning style and educational achievement was not observed. There was significant correlation between their learning style and average scores in general courses [P=0.045]. Considering the dominant diverging styles and diversity in learning styles of nursing and midwifery students under study; consideration of individual differences and different learning styles of students in designing various methods of teaching using the existing infrastructure facilities and information technology is proposed

[Effect of trained female relative on active phase length during labor among low risk pregnancies]

One of the most serious and stressful event in womens life is laber. They need comprehensive support to enable them to encounter with the stress of labor. Prolonged labor is associated with maternal and neonatal complications, prenatal morbidity and increase cesarean danger. To study the effect of trained female relative on active phase length during labor among low risk Pregnancies in Astara Shahid Beheshti hospital in 2009. This randomized control trial study was carried out on 90 low risk pregnant women. They were randomly divided to two 45 members groups. Both the case and control groups had socio- demographic characteristics. The case group got a support from trained relative during labor until 2 hours after delivery and control group received routine care. Data was collected by using restructured questionnaire which included length of labor, use of Oxytocin and type of delivery. Data was analyzed by x[2] and T test in SPSS [11.5]. Finding showed there is no statistically significant difference between demographic characteristics: [mean of age was 24.3- 24.6 years old, mean of number of Pregnancy was 1.6, mean of number of delivery was 1, mean of term of Pregnancy was 273.7- 273.9 days, mean of cervix spasm was 3.44-3.7 cm, length of second stage] and kind of delivery in two groups [p<0.663]. The mean duration of active phase in case group was 143.5 minute versus 253.5 minute in control group [p<0.001].The 24.5% of case and 55.5% of control groups used oxytocin [p=0.046]. Labor support by a minimally trained female friend or relative who selected by the mother can be reduce the mean duration of active phase of labor

effect of Entonox on implication of painless labor and delivery satisfaction rate among pregnant women

Labor pain is regarded as one of the most intolerable pains which women experience during their life. Although there are many alternatives which can effect on person's response and perception to pain and suffering, the pain is felt especially more severely and longer by primogeniture. Annually thousands of selective cesarean operations are performed just because of delivery pain frightening as the main reason. The pain can produce diverse and unwanted effects on delivery procedure and mother-fetus condition. So finding a method to relieve the pain and suffering is one the policies intently considered by health care systems. The aim of present study is to determine the effect of Entonox on implication of painless labor and woman's satisfaction in a Hospital in Orumieh in 1385. This research is a single blind clinical trail. Samples were consisted of women [160 persons], in two groups [each group 80 persons], which selected randomly. The intervention group used Entonox and the control group inhaled Oxygen. All subjects were instructed to use Visual Analogue Scale [VAS] and to inhale gases correctly. Due to emergency need for caesarean operation 2 members of the intervention group and 3 ones from the control group leaved the study. Data gathering tool were consisted of data registration form, VAS scale, mother vital sign recorder, and fetus heart rate recorder. The data were analysed using descriptive [relative and absolute frequencies, mean, and standard deviation] and inferential statistics [t-test, Mann-Whitney U, Chi-squared, Kolmogrove-Smirnov test] by SPSS computer software. According to the findings pain severity rate among the intervention group significantly was lower than the control group in the different hours of delivery procedure [P<0.001]. Using Entonox made no effect on mother's vital signs, labor process, fetus heart rate, first and fifth minute Apgar and bleeding rate after delivery. Also it was shown that probable side effects of Entonox inhalation such as drowsiness and mouth stiffness were more common in the intervention group [P<0.001], but no significant difference was seen in other complications. Meanwhile delivery satisfaction rate was higher in the intervention members. It seems that Entonox inhalation might come in useful as an effective and safe method to alleviate labor pain and suffering along side with fewer likely risks for fetus and mother in clinical centers

[Effects of lecture presentation and presenting educational packages on girls' knowledge about adolescence health]

Adolescents have important role in building the societies. Some deficits were observed in students' knowledge regarding puberty health. This study aimed to compare the effect of two educational methods [lecture-educational package] on girl students' knowledge about puberty health. In this interventional study, 200 students were randomly selected through a multi stage sampling method. Data were collected using a questionnaire. One group received a self-learning educational package and the other group took part in two lecture sessions which totally lasted about four hours. The post test was taken 6 weeks later. Data analysis was performed using Descriptive and inferential statistics. Results of this study showed that after intervention, both groups' knowledge mean scores increased significantly. Also the average of package group's score after the education was more than the other group's score [P < 0.001]. The difference in knowledge mean scores before and after the intervention was significantly higher in the package group than in the lecture one. The comparison of scores in both groups before and after the education was significantly different [P < 0.001]. Both educational methods can be considered to be effective in promoting students' knowledge; however, the educational package was more effective than the lecture

[Prenatal care utilization rate and patients satisfaction]

Studies show, clients' satisfaction is an important indicator for service quality assessment. Finding causes of dissatisfaction helps to promote health care services quality. High quality prenatal care services and clients' satisfaction decreases maternal and neonatal mortality and morbidity. The perceived quality of the prenatal care by the mothers can not be effectively evaluated unless considering the opinions, demands and satisfaction rate of mothers who receive the care. The objective of this study is to measure prenatal care utilization rate and patients satisfaction in the clinics of Tehran University of Medical Sciences in 2005. In this cross-sectional study, 380 pregnant women who had received prenatal care services in two hospitals and eight health centers were selected randomly and interviewed. Data were gathered using a questionnaire including demographic characteristics and satisfaction questions. Data were analyzed using SPSS and tested with chi-square and Pearson exact test. According to the results, 53.4% and 14.8% of the pregnant women had received complete and incomplete prenatal care, respectively. Most of the pregnant women [54.7%] were completely satisfied, 23.7% and 21.6% were moderately and poorly satisfied, respectively. There was a significant relationship between the utilization rate and satisfaction of mothers [P<0.001]. 53.4% of mothers in health centers and 46% in hospitals had received complete prenatal care. Satisfaction with prenatal care in health centers and hospitals were 57.5% and 47%, respectively. This difference was probably related to the amount of emotional and physical care received by the patients in the different settings and the characteristics of the centers in which these services are provided. The kind of setting had significant relationship with the utilization and satisfaction rates [P=0.003, P=0.005, respectively]. The results showed that the utilization and satisfaction rates in the health centers in which health-care providers were midwives were better than the hospitals in which health-care providers were medical and midwifery students. But in both settings it was lower than 60%. As a result, the utilization rate and satisfaction of mothers were inadequate in health centers and hospitals [lower than 70%]. In the hospitals, they were lower than the health centers. The standardization of prenatal care and improvement of educational programs in hospitals should be considered

[Comparison of quality of life and depression among women with normal and high risk pregnancies]

Women with high risk pregnancy experience changes in their personal, family, and social life that affect their quality of life and mental status. The aim of this study was to determine the effect of type of pregnancy [normal or high risk] on quality of life and depression levels in pregnant women. In this case-control study, a total of 100 women [50 women with normal pregnancies and 50 women with high risk pregnancies] who referred to the prenatal clinics of Kashan Medical University were studied. Subjects were randomly selected and then allocated in the normal [control] or high risk [case] groups. Data were gathered using a three-part questionnaire that included demographic characteristics, the Short Form 36 Health Survey [SF-36] to assess the quality of life, and the Beck Depression Inventory [BDI] to assess the levels of depressive symptoms. In this study, the results revealed that the mean score of the quality of life was lower in the women with high risk pregnancy [53/20 +/- 16/83] in comparison with the women with normal pregnancy [62/18 12/48]. The mean of the BDI scores in high risk pregnancies [15/34 +/- 9/15] were significantly higher than in normal pregnancies [9/8 +/- 5/44]. Depression has strong negative correlation with quality of life in both women with high risk and normal pregnancies [P<0.001]. To sum up, it is very important to identify women that are at risk and help them to promote their quality of life

[Age at menarche and it's relationship with body mass index]

Menarcheal age is an important indicator of puberty development in girls and is influenced by a wide variety of factors including race, socio-economic status and etc. The relationship between age at menarche with weight, and BMI is controversial. The present study was designed to determine the relationship between age at menarche and BMI. This was a cross-sectional study. The sample size was 580 primary and secondary schoolgirls of Tehran/Iran by using cluster sampling. The data was collected by completing questionnaire and measuring height [cm] and weight [kg] by one trained person and analyzed by Pearson and one way ANOVA. 580 schoolgirls participated in this study. The mean menarcheal age was 12/1[1/2], mean weight 45/6 [8/2] kg and the mean BMI was 18/4 [2/4] kg/m2. This result indicated that there were a statically significance difference in mean height [p<0/0001] and mean weight [p<0/006] at different age of menarche and no significance difference in mean of weight. The Pearson test, show linear positive correlation between age of menarche and height but reversed linear correlation between age of menarche and BMI. According to this finding appears menarcheal age has significant correlation with BMI and height. Therefore as menarcheal age decreases, BMI increases

[Effect of magnesium sulfate on bleeding time in pregnancy]

According to some studies, pharmacological concentrations of Mg[2+] have anti-thrombotic effects and interfere with platelet aggregation in vitro and in vivo. The study group consisted of 50 pregnant women who required magnesium sulfate for mild pre-eclampsia or preterm labor. In all patients, a platelet count, magnesium level, bleeding time and mean arterial pressure were obtained before and 2 hours after magnesium sulfate infusion. Magnesium sulfate was started with a 6 gr intravenous bolus, followed by 2 gr/hr infusion. Bleeding time was measured by Duke Method. Data were analyzed with Mann Whitney U and Wilcoxon rank tests. Thirty one patients [62%] received magnesium sulfate for preterm labor and 19 [38%] for mild pre-eclampsia. Analysis of the entire study group revealed a rise in the magnesium level [p<0.0001], a lowering of the mean arterial pressure [p<0.0001] and no significant difference of the bleeding time and platelet count. Comparison of platelet count, magnesium level and bleeding time before and 2 hours after magnesium sulfate infusion revealed no significant difference in two groups. According to this study, magnesium sulfate with usual dosage has no effect on bleeding time in pregnancy

[Evaluation of Midwifery students' clinical decision making]

Introduction: Quality evaluation and clinical decision making education are two important elements in health personnel's decision-making status. PMP [Patient Management Problem] is one of the clinical decision making methods in which some clinical conditions are taken from a disease and are put forward in the form of a multi stage question. This study has tried using computerized PMP to evaluate midwifery students' clinical decision making

Methods: In a cross-sectional census study, 40 Senior BS midwifery students from Tehran, Iran and Shahid Behshti Medical Universities were studied. Computerized PMP questionnaire, including 9 imagined clients referring for preconception care designed in a software program was given to the subjects to fill. The data were analyzed by descriptive, and multiple regression in SPSS software

Results: The mean score taken by the studied students was 35.62+/-7.01 out of 100 scores. Most of the subjects had average clinical decision-making. The acquired mean score of the subjects in risk assessment, in education and counseling and in intervention were as 40.17 +/-9.14, 31.87+/-10.23 and 31.42+/-13.77 respectively. Most of the subjects had average clinical decision making in these three fields

Discussion: Since clinical decision making as a major element in enhancement of health team services as well as midwifery students' services can be evaluated and taught by PMP and as most of the studied subjects regarding preconception care were not in an appropriate level, more precise education in this field seems essential