The effect of counseling based on health promotion awareness on mental health and self-esteem in women with ectopic pregnancy: a randomized controlled clinical trial.

OBJECTIVES: In all types of pregnancies women experienced changes in their mental health and self-esteem condition. The aim of this study was to determine the effect of counseling on mental health and self-esteem following an ectopic pregnancy (EP). STUDY DESIGN: This was a randomized controlled clinical trial on 68 pregnant women with EP referring to Al-Zahra hospital in Tabriz, Iran in 2018. The participants randomly allocated to counseling and control groups. Intervention group received four sessions of counseling including 1) providing medical information about EP and its physical and psychological complications; 2) explaining the syndrome of sadness after losing a pregnancy; 3) mental health and ways to improve it after pregnancy loss; and 4) self-esteem and how to increase it after losing a pregnancy and control group received only routine care. Before and 2 weeks after the end of the intervention, data were collected by the General Health Questionnaire-28 and Rosenberg self-esteem questionnaires. Data were analyzed using SPSS software. The registration number was IRCT20100109003027N41. RESULTS: There was no significant difference between the two groups in terms of sociodemographic characteristics and the scores of mental health and self-esteem before the intervention. Two weeks after the end of the intervention, the mean (SD) total score of mental health of women in counseling and control groups were 20.1 (5.0) and 32.9 (9.8), respectively. When compared with the control group, a significant reduction in the total score of mental health (adjusted difference = -11.27; 95% confidence interval: -15.19 to -7.34; p < .001) was observed in the counseling group. In counseling group compared with the control group, a significant increase in the total score of self-esteem (adjusted difference = 4.79; 95% confidence interval: 3.07-6.51; p < .001) was observed. CONCLUSIONS: Providing counseling based on health promotion awareness by the midwife can help reduce mental health problems and increase self-esteem. For this reason, counseling should be considered as part of care after losing a pregnancy.

The effects of intravenous dextrose 5%, Ringer's solution, and oral intake on the duration of labor stages in nulliparous women: a double-blind, randomized, controlled trial.

Background and objectives: Childbirth consists of a three-stage period beginning with uterine contractions and ending in the expulsion of the placenta. The present study was conducted to compare the effects of Ringer's solution, dextrose solution 5%, and oral intake on the duration of total labor and labor stages (primary outcome) and the frequency of oxytocin administration and prolonged labor (secondary outcome) in nulliparous women with spontaneous vaginal delivery.Materials and methods: The present randomized clinical trial was conducted on 201 nulliparous women in labor assigned with a randomized block design to three groups, each receiving either Ringer's solution plus oral fluids, dextrose solution 5% solution plus oral fluids or oral fluids alone. The solutions were intravenously administered at a rate of 125 ml/h in the groups receiving the solutions and the subjects in the oral fluids group could consume liquids of their choice (water, orange juice, and apple juice). The duration of total labor and labor stages (the active stage, the second, and third stages of labor) were recorded by the researcher in minutes. Furthermore, the frequency of oxytocin administration and prolonged labor were recorded by the researcher by using a checklist. Data were analyzed using the Kruskal-Wallis test, Mann-Whitney's U-test, chi- square test and Fisher exact test.Results: The mean (±SD) duration of total labor was 301.2 (±50.0) minutes in the Ringer group, 171.9 (±36.4) in the dextrose 5% group, and 524.8 (±103.4) in the oral fluids group, suggesting a statistically significant intergroup difference (p < .001). The mean (±SD) duration of the active stage of labor was 276.7 (±91.3) minutes in the Ringer group, 150.6 (±78.5) in the dextrose 5% group, and 302.4 (±136.8) in the oral fluids group, suggesting a statistically significant intergroup difference (p < .001). A significant difference was also observed between the three groups in terms of the duration of the third stage of labor (p < .001); however, no significant differences were observed in terms of the duration of the second stage of labor (p = .058). Furthermore, a significant difference was observed between the three groups in terms of the need for oxytocin administration (p ≤ .001) and the frequency of prolonged labor (p = .001).Conclusion: The results suggest that the consumption of dextrose solution by nulliparous women reduces the duration of labor, the need for oxytocin administration and the frequency of prolonged labor compared to when Ringer's solution and oral fluids are used.

The relationship between delivery mode and children's growth from birth to 6 months.

BACKGROUND: Children's growth is one of the important components of health affected by various environmental factors like delivery type. This study aimed at determining the relationship between delivery mode and children's growth from birth to 6 months. METHODS: In this prospective cohort study, the growth indices were studied among 526 children (272 Natural Vaginal Deliveries (NVDs) and 254 Caesarean sections (C/S) who were only breastfed. The primary samples consisted of pregnant women referred to Yasuj and Gachsaran Hospitals and health centers in 2014-2015. Data were collected using questionnaires and health records. RESULTS: The results showed that there was no significant difference (p > .05) between the groups at birth, 2, 4 and 6 months in the mean (SD) of "weight, height and head circumference". CONCLUSIONS: Attention to growth trend in NVD group was better, this is better for mothers that were encouraged to choose physiological and vaginal delivery.

Effect of Education through Support -Group on Early Symptoms of Menopause: a Randomized Controlled Trial.

INTRODUCTION: Menopause is one of the most important crises in the life of women. The control of menopause symptoms is a main challenge in providing care to this population. So, the aim of present study was to investigate the effect of education through support -group on early symptoms of menopause. METHODS: In this randomized controlled clinical trial 124 postmenopausal women who had a health records in Valiasr participatory health center of Eslamshahr city were participated. These women were allocated by block randomization method into support group (62 women) and control group (62 women).Women in support group was assigned into 6 groups. Three 60-minutes educational sessions were conducted in 3 sequential weekly sessions. Early menopausal symptoms were measured before and 4 weeks after the intervention by using Greene scale (score ranged from 0 to 63). Data analysis was performed by ANCOVA statistical test. RESULTS: There were no statistical differences between two groups in demographic characteristics and the total score of the Greene scale before intervention. The mean score of the Greene scale in support group was statistically less than control group 4 weeks after intervention. The number of hot flashes in the support group was significantly lower than control group, 4 weeks after intervention. CONCLUSION: Education through support group was effective in reducing the early symptoms of menopause. Thus, this educational method can be used as an appropriate strategy for enhancing women' health and their dealing with annoying symptoms of menopause.

The effect of acupressure on sanyinjiao and hugo points on labor pain in nulliparous women: a randomized clinical trial.

INTRODUCTION: Most women have experienced child birth and its pain, which is inevitable. If this pain is not controlled it leads to prolonged labor and injury to the mother and fetus. This study was conducted to identify the effect of acupressure on sanyinjiao and hugo points on delivery pain in nulliparous women. METHODS: This was a randomized controlled clinical trial on 84 nulliparous women in hospitals of Ardebil, Iran. The participants were divided by randomized blocks of 4 and 6 into two groups. The intervention was in the form of applying pressure at sanyinjiao and hugo points based on different dilatations. The intensity of the pain before and after the intervention was recorded by visual scale of pain assessment. To determine the effect of pressure on the intensity of labor pain, analytical descriptive test was conducted in SPSS (version 13). RESULTS: There was a significant decrease in mean intensity of pain after each intervention in the experimental group with different dilatations (4, 6, 8, and 10 cm). Moreover, the Student's independent t-test results indicated that the mean intensity of pain in the experimental group after the intervention in all four dilatations was significantly lower than the control group. Repeated measures ANOVA test indicated that in both experimental and control groups in four time periods, there was a statistically significant difference. CONCLUSION: Acupressure on sanyinjiao and hugo points decreases the labor pain. Therefore, this method can be used effectively in the labor process.