A survey on Iranian midwives' knowledge about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding.

INTRODUCTION: The COVID-19 pandemic has impacted the care that maternal and newborn health professionals, especially midwives, provide. If they know how to care for COVID-19 patients during pregnancy, delivery, and postpartum, they can manage these cases better. The study aimed to identify the knowledge of Iranian midwives about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding. AIM: The study aimed to identify the knowledge of Iranian midwives about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding. METHODOLOGY: This cross­sectional study was conducted on 438 Iranian midwives from March to April 2021. Personal data and knowledge of them were gathered using an electronic web-based questionnaire. The statistical analysis was performed using the SPSS software version 18. RESULTS: The mean age of participants was 31.8 ± 2.3. The mean knowledge score of midwives was 11.2 ± 2.8, which was moderate. 91.55% of Midwives were more knowledgeable about COVID-19 infection symptoms in pregnant women. 34.93% and 31.05% of midwives had correct knowledge about vaccination against COVID-19 during pregnancy and breastfeeding, respectively. Results showed no statistically significant relationship between personal characteristics and knowledge of them (p > 0.05). CONCLUSIONS: Midwives' knowledge about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding was moderate. RECOMMENDATIONS: Continuing educational programs are needed by the Ministry of Health and Medical Education to design and implement for improving healthcare professionals' knowledge about COVID-19 during pregnancy, delivery, postpartum, and neonatal feeding.

The effect of maternal intravenous hydration on amniotic fluid index in oligohydramnios.

OBJECTIVE: Assessing amniotic fluid determines an important dimension of fetal health. Significant relationships of oligohydramnios, which occurs in 1-2% of pregnancies, with abnormal pregnancy outcomes such as intrauterine growth retardation (IUGR), fetal anomalies, umbilical cord compression, fetal distress, preterm childbirth, meconium-stained amniotic fluid, perinatal mortality and cesarean section necessitate the measurement of amniotic fluid volume in many prenatal fetal health assessments. Amniotic fluid volume may significantly fluctuate between different gestational ages. Reduced uteroplacental perfusion can cause oligohydramnios by decreasing fetal renal blood flow and urine output. The appropriate management of isolated term oligohydramnios (ITO) is controversial. This study was performed aimed to assess the effect of maternal intravenous hydration on amniotic fluid index in oligohydramnios. RESULT: Forty-eight hours after completing fluid therapy, statistically significant differences were observed in the mean AFI in the intervention group (4.06 ± 0.33) and the control group (3.61 ± 0.35) (P < 0.0001) and also between the intervention group (0.532 ± 0.45) and the controls (-0.036 ± 0.18) (P < 0.0001). CONCLUSION: The results of the present study suggested that maternal intravenous hydration significantly increases AFI in women with oligohydramnios.

Effect of lubricant gel on the length of the first stage of labour and perineal trauma in primiparous women.

The objective of this study was to investigate the effects of obstetric gel application on the length of the first stage of labour and perineal trauma in primiparous women. This randomised controlled trial included 110 primiparous women. Women were randomly assigned to the two groups: lubricant gel group and control group. In the intervention group, during cervical dilatation of 4 cm until complete cervical dilatation, 5 ml of water-soluble lubricant gel was used at each vaginal examination. In the control group, routine care was performed. Mean duration of the total length (p = .025), the first (p = .012), and second stage (p = .022) of labour was significantly shorter in the obstetric gel group than control group. Perineal health was significantly better in the gel-applied pregnant women (p < .001). Using obstetric gel at the beginning of the first stage could shorten the total length, the first and the second stage of labour and could protect perineal health.IMPACT STATEMENTWhat is already known on this subject? Prolonged labour and perineal injuries are a major problem in natural childbirth for primiparous mothers.What the results of this study add? The first (p = .012), and second stage (p = .022) of labour was significantly shorter in the obstetric gel group than in the control group. Perineal health was significantly better in gel-applied pregnant women (p < .001). Using obstetric gel at the beginning of the first stage could shorten the total length, the first and the second stage of labour and could protect against perineal injury.What the implications are of these findings for clinical practice and/or further research? Obstetrical gel lubricant usage in the first stage of labour during the active phase of nulliparous women could shorten the total length, the first and the second stage of labour and could protect perineal health.

Treatment of Hydatidiform Mole Suspected to COVID 19.

The aim of this study was to report a case of the treatment of hydatidiform mole in Coronavirus pandemic in Iranshahr. A 17-year-old primiparous woman with gestational age of 14 weeks presented with unilateral leg swelling and sudden abdominal distension beginning in the night before referring to the health center. In the abdominal examination of the patient by a healthcare provider, the baby's heartbeat was not heard and a mismatch was observed between gestational age and fundal height, which corresponded to approximately 24 weeks of gestation. She was conscious and pale with hematuria and uterine contractions. After inserting two IV lines, the patient immediately underwent monitoring and was visited by a gynecologist. Complete molar pregnancy was diagnosed with an enlarged heterogeneous uterus 180 cm × 90 cm in size and containing 170 mm × 80 mm cysts. The treatment began with vancomycin AMP, hydrocortisone AMP, oseltamivir CAP 75 mg, kaletra CAP 200 mg, and meropenem AMP.

Preeclampsia and the crucial postpartum period for Covid-19 infected mothers: A case report.

The early postpartum period is crucial for mothers who have a complicated delivery due to preeclampsia. In mothers with symptoms of COVID-19, there may be severe and sometimes fatal consequences. We report the first maternal death in Balouchestan (Iran) due to complicated delivery with preeclampsia concomitant with COVID-19 postpartum. The patient was asymptomatic for COVID-19 during the delivery and rapidly progressed to severe respiratory distress and coagulopathy in the early postpartum period. Mothers with preeclampsia features may be at risk for severe COVID-19, and detailed assessments are essential for these patients during the COVID-19 pandemic.

Attitudes of Mashhad Public Hospital's Nurses and Midwives toward the Causes and Rates of Medical Errors Reporting.

INTRODUCTION: Patient's safety is one of the main objective in healthcare services; however medical errors are a prevalent potential occurrence for the patients in treatment systems. Medical errors lead to an increase in mortality rate of the patients and challenges such as prolonging of the inpatient period in the hospitals and increased cost. Controlling the medical errors is very important, because these errors besides being costly, threaten the patient's safety. AIM: To evaluate the attitudes of nurses and midwives toward the causes and rates of medical errors reporting. MATERIALS AND METHODS: It was a cross-sectional observational study. The study population was 140 midwives and nurses employed in Mashhad Public Hospitals. The data collection was done through Goldstone 2001 revised questionnaire. SPSS 11.5 software was used for data analysis. To analyze data, descriptive and inferential analytic statistics were used. Standard deviation and relative frequency distribution, descriptive statistics were used for calculation of the mean and the results were adjusted as tables and charts. Chi-square test was used for the inferential analysis of the data. RESULTS: Most of midwives and nurses (39.4%) were in age range of 25 to 34 years and the lowest percentage (2.2%) were in age range of 55-59 years. The highest average of medical errors was related to employees with three-four years of work experience, while the lowest average was related to those with one-two years of work experience. The highest average of medical errors was during the evening shift, while the lowest were during the night shift. Three main causes of medical errors were considered: illegibile physician prescription orders, similarity of names in different drugs and nurse fatigueness. CONCLUSION: The most important causes for medical errors from the viewpoints of nurses and midwives are illegible physician's order, drug name similarity with other drugs, nurse's fatigueness and damaged label or packaging of the drug, respectively. Head nurse feedback, peer feedback, fear of punishment or job loss were considered as reasons for under reporting of medical errors. This research demonstrates the need for greater attention to be paid to the causes of medical errors.

Factors Related to Return to Work in Women After Breast Cancer in Iran.

BACKGROUND: Most women are diagnosed with breast cancer (BC) when they are still at the appropriate age for employment. The increasing survival rates of patients with BC call for more attention to their ability to return to work. OBJECTIVES: The aim of this study was to identify factors related to the return to work in Iranian women underwent BC treatment. PATIENTS AND METHODS: A total of 175 women with BC, who met the inclusion criteria, were enrolled in this cross-sectional study. The subjects were recruited from four hospitals affiliated to Mashhad university of medical sciences. These hospitals are oncology referral centers in eastern Iran. All records of employed women with BC were studied in four hospitals of Mashhad city, Iran, during 2000 - 2010. The researchers designed a questionnaire, which consisted of questions regarding social/demographic, health/disease, and work characteristics. The questionnaires were completed through interviews. Data were analyzed using SPSS software, version 11.5. RESULTS: The mean age of the patients at the time of interview was 44.3 ± 6.72 years. Mean age of "Return- to-work" group was 42.71 and "No return-to-work" group was 51.06. Most women (80%) were married. At the time of the interview, 80% had returned to work after a BC diagnosis. Older patients (OR = 0.796; 95% CI, 0.625 - 0.907, P = 0.002), and those with a great deal of work experience (OR = 0.861; 95% CI, 0.752 - 0.986, P = 0.030) were less likely to return to work. Also, women who had no pain or surgery scar (OR = 23.03; 95% CI, 4.53 - 117.02, P < 0.001) as well as those who had no lymphedema after the BC treatment were more likely to return to work (OR = 22.373; 95% CI, 4.04 - 23.892, P < 0.001). CONCLUSIONS: The results of this study show the factors related to the return-to-work after BC treatment in working women in Mashhad city, Iran. These predictors should be taken into account in order to improve the patient's life quality.

Self-disclosure of breast cancer diagnosis by Iranian women to friends and colleagues.

BACKGROUND: Breast cancer (BC) is the most common form of cancer in Iranian women, and it remains a major health problem. An increasing number of young women are being diagnosed with BC, and therefore, there is an increasing likelihood that more women will survive breast cancer for many years. Many opine that self-disclosure of BC diagnosis is important because talking about cancer helps people to make sense of their experiences; in fact, self-disclosure appears to play an important role in many health outcomes. However, this has not yet been studied in BC patients in Iran. Therefore, this study aimed to explore the status of self-disclosure of BC diagnosis by Iranian women to friends and colleagues. MATERIALS AND METHODS: All BC records for 2001-2011 of employed women were studied at five hospitals in Mashhad. Data about the self-disclosure of BC diagnosis were gathered through telephone interviews, and the participants filled out a questionnaire about their status of self-disclosure of BC diagnosis to various groups of people. RESULTS: The mean age of employed women at the time of diagnosis was 44.3 ± 6.7 years. Over 60% self-disclosed to work colleagues and over 90% to bosses/managers. Seventy per cent reported that they had support from their family and husband's family, while 95% reported that they had support from parents, siblings, children and friends. CONCLUSIONS: Most employed women self-disclosed freely to family, friends, colleagues and bosses/managers. Apparently, self-disclosure of breast cancer diagnosis may have negative effects at work. About half of patients reported that they had support from family, managers and colleagues; however, for nearly 28% of employed women, disclosure had less positive effects. In particular, it altered their perception of others, produced difficulties with work and family and diminished closeness with the people who were told. However, the stigma of BC is far less than it once was.