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Showing 17 results for Obstetric

Amir Vahedian Azimi , Somaye Ghasem Kashani , Azar Avazeh, Mansore Sepehri Nia , Mahin Rohani,
Volume 1, Issue 1 (9-2011)

  Background and Objectives: Patients’ rights are the patients’ expectations from health services. Patients’ rights declaration is to protect individuals’ rights in order to be ensured, in case of being sick they will receive enough qualified care in a respectful context regardless of their age, gender, and economic situation. The purpose of this study was to determine the level of nurses’ awareness from patients’ rights and the extent to which they respect such rights in Mashhad’s hospitals.

  Material and Methods: This was a cross-sectional study. The participants were 486 nurses who were selected based on the random simple stratified sampling . The instrument used for data collection was a questionnaire including two main sections: 1) demographic information and 2) situational rights of the patients. Data were analysed in the SPSS.

  Results: The results of the study revealed that the level of awareness and the degree to which the nurses observe patients’ rights were at excellent level in more than 50% of the cases. The study also demonstrated that awareness and observation of the patients’ rights were not significantly correlated to age, experience, and educational level ( P>0/05) .

  Conclusion: According to the results of the study, observation of the patients’ rights were at excellence level in more than half of the cases however, regarding the importance of the issue in question, it is essential that policymakers set legislating rules which protect patients’ and nurses’ rights, so as to expect improvements in the quality of health and clinical services.

Maryam Sakkaki, Khadije Hajimiri,
Volume 1, Issue 2 (3-2012)

  Background and Objectives: Normal vaginal delivery is the best type of delivery in most cases and cesarean section is restricted to cases in which vaginal delivery is accompanied with risks for mother and baby. The aim of this study was to determine rate and causes of cesarean delivery in an educational hospital in 2009.

  Material and Methods: This was a cross-sectional study. Data were gathered using 467 patients' medical files and interviews with 391 women who underwent cesarean section and were recorded in a data sheet. Data were analyzed using the SPSS.

  Results: The rate of cesarean section was 31.5% of all live births. The most causes of cesarean section were repeated cesarean section (29.6%), mecuneum staining (15%), breech presentation (14.1%), and placenta previa (10.9%).

  Conclusion: The findings of the study showed that the rate of cesarean section in our selected hospital was more than the reported rates by the WHO. Based on the results, we should decrease the rate of the first cesarean sections. In order to achieve this goal, it is essential to implement interventional programs in order to change women’s attitudes towards benefits of vaginal delivery. Moreover, we should admit low risk mothers in active phase of labor.

Fateme Saremi, Shamsi Taran, Azam Malekia,
Volume 1, Issue 2 (3-2012)

Background and Objectives: Health status, lifestyle and previous history of pregnancies significantly affect pregnancy outcome however, many adverse pregnancy outcomes are preventable. This study aimed to investigate causes of hospitalization of pregnant women in delivery unit of Zanjan Ayatollah Mosavi hospital. Material and Methods: In this cross-sectional study, the causes of hospitalization of 4830 women with gestational ages more than 20 weeks were investigated during 2009-2010. Data were collected using a check list including patients' chief complaint, women’s demographic characteristics and delivery history. Data were analyzed using descriptive test, chi square, and t-test in a confidence level of 95 %. Results: From 4830 hospitalized women, 1278 were hospitalized due to obstetrics complications. The mean age of women was 26.52±6.26 year. The mean gestational age was 264.24±21.40 days. The most common causes of hospitalization were rupture of amniotic membranes (49.1%), preterm labor (29.3%), meconium staining (15.5%), and hypertension (11.8%). The rate of caesarian section, male baby, APGAR score lower than six in the 1st and 5th minutes of delivery, hypertension, and twin pregnancies were high in preterm labors. Meconium staining and rupture of amniotic membranes were common in term and post term deliveries. Conclusion: Findings showed that the most common causes of hospitalization were rupture of amniotic membranes and preterm labor. It is necessary to conduct more research on the causes of these complications

Abdulaziz Aflakseir, Somaieh Jamali,
Volume 3, Issue 2 (2-2014)

Background and Objectives: Mother-child bonding is vital for psychological development of children. Previous studies have shown that mothers' mental health can impact mother-child bonding. The purpose of this study was to investigate the relationship between postpartum depression with mother-child bonding in a group of mothers in Shiraz. Materials and Methods: In this correlational study, 140 mothers referred to health centers to check their children's health status were recruited using convenience sampling method. Participants completed the questionnaires including the Postpartum Bonding Questionnaire (BPQ) and the Edinburgh Postnatal Depression Scale (EDPS). The statistical indexes including means, standard deviation, Pearson correlation coefficient and logistic regression analysis were measured to analyses the data using the SPSS. Results: Findings showed that about 25% of mothers experienced symptoms of postpartum depression and 23% had mother-child bonding disorder. The results also indicated that mothers with symptoms of postpartum depression were more likely to have mother-child bonding problems. The findings also showed that postpartum depression predicted mother-child bonding problems significantly. Conclusion: The study showed that mothers with more symptoms of postpartum depression were more likely to have bonding impairment with their children.

Miss Malihe Nasiri, Dr Soghrat Faghihzadeh, Dr Hamid Alavi Majd, Ms Noorosadat Kariman, Miss Nastaran Safavi,
Volume 4, Issue 2 (3-2015)

Background and Objectives: Preeclampsia is the third leading cause of death in pregnant women. This study was conducted to evaluate the ability of longitudinal hematocrit data to predict preeclampsia and to compare the accuracy in longitudinal and cross-sectional data. Materials and Methods: In a prospective cohort study from October 2010 to July 2011, 650 pregnant women referred to the prenatal clinic of Milad hospital in Tehran were selected. The hematocrit level was measured in the first, second and third trimester of pregnancy and the participants were followed-up to delivery. The preeclampsia cases were recorded. The Covariance pattern and linear mixed effects models were applied for discriminant analysis of the longitudinal data. Statistical analyses were performed in the SPSS-20 and SAS-9.1. Results: The prevalence rate of preeclampsia was 7.2% (47 out of 650 women). The women with preeclampsia had a higher meanhematocrit values (difference=0.99 P=0.014). The sensitivities for longitudinal data and cross-sectional data in three trimesters were 91%, 54%, 72%, 51% and the specificities were 61%, 51%, 51%, and 47%, respectively. The positive predictive values were 70%, 52%, 59%, 49% and the negative predictive values were 87%, 53%, 64%, and 49%, respectively. Conclusion: The levels of hematocrit can be used to predict preeclampsia and to monitor the pregnant women. Measuring the hematocrit during the three trimesters regularly can help to identify women at risk for preeclampsia.

Fatemeh Rostamkhani, Raziyeh Moghadam, Efat Alsadat Merghati Khoei , Fatemeh Jafari, Giti Ozgoli,
Volume 6, Issue 1 (6-2016)

Background and Objectives: The sexual function of pregnant women might be affected by multiple changes during pregnancy e.g. biological, psychological and sociological changes. This study was conducted to determine the effect of counseling using the PLISSIT (Permission-limited Information-Specific Suggestion-Intensive Therapy) Model on Sexual Function of Pregnant Women.

Materials and Methods: This quasi-experimental study was conducted on 60 pregnant women who were randomly assigned to control and intervention groups. The intervention group were counseled using the PLISSIT model, and the control group received routine sexual consultation. Data was collected using demographic, obstetric, and the Female Sexual Function Index (FSFI) questionnaires. Sexual function scores were assessed before, two and four weeks after intervention. Data was analyzed using T-tests, x2, Mann Whitney, and Wilcoxon tests.

Results: The mean scores of sexual function in intervention groups were changed significantly from 24.76±4.36 before intervention, to 27.98±4.24 two weeks (p=0.001) and 28.12±4.50 four weeks after (p<0.001) intervention. No significant difference was found among the mean scores of sexual function before intervention (25.13±4.05), two (25.03±4/32) and four weeks (23.79±5.05) after consultation in control group. Although, there was no significant difference in mean score of sexual function between control and intervention groups before the intervention (p=0.796), a significant difference was revealed between two groups in two (p=0.004) and four weeks (p<0.001) after intervention.

Conclusion: Using PLISSIT model for sexual counseling could improve sexual function of pregnant women.

Katayon Vakilian, Shirin Mobaseri,
Volume 6, Issue 3 (11-2016)

Background and Objectives: Neonatal mortality rate is the most important index for assessing health, cultural and economical issuse in each society. This study assessed the prevalence of stillbirth and infant mortality related to maternal and neonatal causes in 1392-1391 at Arak .

Materials and Methods: This cross senctional study was conducted using data collected from patient files with stillbirths (dead fetuses older than 20 weeks) and dead neonate cases aged less than 28 days from 1391 to 1392 recorded in three hospitals at Arak. After getting written permission of the hospitals, data were collected from the files. The descriptive statistics (mean and percentage) and inferential statistics chi-square and t-test were used.

Results: The results showed prevalence of stillbirth was 19.8 and neonatal death was 19.1 per thousand live births. Asphyxia was the most prevalent cause of stillbirth 120 (45.2%) and premature birth was the most common cause of neonatal mortality 71(28.9%). In 173 cases (70.3) of neonatal deaths and 150 cases (54.6%) of stillbirths, mothers did not have any disease condition. Preterm labor was the most important obstetric complication in the two groups.

Conclusion: Neonatal mortality rate from 1391 to 1392 was higher than the neonatal death rate in 1386. Since most neonatal deaths happened due to preterm delivery; thus investigating the causes of premature delivery and the need for better maternal care is advised.

Mohammad Shariati, Raheleh Babazadeh, Khadigeh Mirzaii Najmabadi, Seyed Abbas Mousavi,
Volume 6, Issue 3 (11-2016)

Background and Objectives: Adolescence is the time of the transition from childhood to adulthood; but it is also a formative period of the life habits in which many of the lifestyles are learned and established. This study was done to explore the views and experiences of adolescent girls and adults in order to clarify characteristics of youth-friendly reproductive health services.

Materials and Methods: This qualitative descriptive study was conducted during the period February–November 2012. Data were collected by carrying out focus group discussions and semi-structured interviews with 247 adolescent girls and 14 key adults, including school counselors and  health providers in Mashhad and Shahroud cities. All interviews and focus group discussions were recorded on two digital recorders and were transcribed. Routine content analysis, data coding and categorization were performed by MAXQDA10.

Results: The characteristics of youth-friendly reproductive health services were classified in four categories: (1) personnel factors (2) physical and environmental factors of the services providers (3) management factors and (4) stimulus factors.

Conclusion: According to the results of the study, establishing centers of reproductive health services for female adolescents of this age group can play an important role in preventing reproductive health problems them.

Maryam Fathizadeh, Sedigheh Abedini, Shokroollah Mohseni,
Volume 6, Issue 3 (11-2016)

Background and Objectives: Delivery is a stressful event in a woman's life which is often accompanied by anxiety. Lack of awareness of unknown pregnancy problems is the cause of increase of mothers` anxiety and medical intervention. The present study was done to measure the effect of childbirth preparation training classes on the anxiety of pregnant mothers.

Materials and Methods: This was a semi-experimental study for which 98 pregnant women were selected from those who had referred to the Sirik health clinics by using convenience sampling. They were allocated into the experimental and control groups randomly. The experimental mothers` group were subjected to 8 sessions of preparation for childbirth courses and the control group only received a routine prenatal training. Data were collected using pregnancy anxiety questionnaire (PRAQ) in two steps of pre-test and post-test. The data were analyzed by SPSS software using chi-square, t-Test and ANOVA.

Results: The results showed that there was not a significant difference in anxiety level before the intervention between the two groups. However. There was remarkable decline in all aspects of pregnancy anxiety except fear of variations and common states of fear (p<0.05).

Conclusion: Our findings showed that mothers` anxiety decreased due to participation in preparation for childbirth courses. Thus, implementing this program as a continuous intervention process for pregnant mothers is recommended.

Hossien Izadirad, Shamsoddin Niknami, Iraj Zareban, Alireza Hidarnia,
Volume 7, Issue 1 (6-2017)

Background: Pregnant women need information, skills and social support for the effectiveness of pregnancy care. Health education patterns play a major role in educational needs assessment in designing and implementing educational interventions.
Objectives: The present study aimed to investigate the pregnancy care behaviors, based on the health belief and social support model among pregnant women.
Methods: This cross-sectional study was conducted in 2016 with the participation of 215 pregnant women under the control of faculty of Iranshahr Medical Sciences who were selected by multi-stage sampling method. The data were collected through a questionnaire based on the structures of the health belief and social support model, knowledge, behavior and demographic information. Data were analyzed by descriptive, Pearson correlation and multivariate regression tests in SPSS ver19 software.
Results: The highest rate of education among pregnant women (35.8%) was high school. The mean score of mothers' performance was 12.31 out of 22, and among the structures the perceived sensitivity score was the strongest, and the social support score was the weakest. Based on regression analysis, self-efficacy, perceived benefits, and social support were predictive behaviors which generally predict 27.5% of behavioral changes.
Conclusion: Based on the results, the structures of self-efficacy, perceived benefits and social support should be considered as the most important predictor of pregnancy care behaviors in designing educational interventions.

Najmeh Pourkhaleghi, Ghasem Askarizadeh, Masoud Fazilat-Pour,
Volume 7, Issue 2 (10-2017)

Background: The Postpartum depression has a negative effect on the infant’s developmental and behavioral performance, mother-child relationship and mother‘s health, and its etiology is also very complicated.
Objectives: This study was conducted to investigate the role of maternal emotional cognitive strategies and newborn gender preference in the postpartum depression in primiparous women.
Methods: This descriptive-correlational study was performed on 205 primiparous women referring to health centers in Kerman city the center of Kerman province of Iran from 1April to 31 June 2015. Primiparous women according to presence (n=103) or absence (n=102) of postpartum depression (PPD< 12: without depression) were selected using purposeful sampling. The measurement tools included the demographic questionnaire, Edinburgh postpartum Depression Scale (EPDS) and Cognitive Emotion Regulation Questionnaire (CERQ). The data were analyzed using SPSS software and the logistic regression method.
Results: The results showed positive cognitive strategies including acceptance, positive re-focus and re-focus on planning have a negative relationship with the postpartum depression (P<0.001). Also, the strategies of self-blame, catastrophizing, rumination and blame for others have a positive relationship with the postpartum depression (P<0.001). There was no significant relationship between dissatisfaction with newborn gender and postpartum depression (P>0.05).
Conclusion: According to the results of this study, postpartum depression can be predicted by emotional regulation cognitive strategies.

Soheila Davaneghi, Ali Tarighat Esfanjani, Abdolrasool Safaiyan, Zahra Fardiazar,
Volume 7, Issue 2 (10-2017)

Background: Primary dysmenorrhea (PD) is characterized by painful cramps of lower abdomen without abnormal pelvic pathology. PD begins some hours before or simultaneously with the onset of menstrual bleeding.
Objectives: The purpose of this study was to investigate the effects of separate and concurrent supplementation of fish oils (FO) containing n-3 fatty acids and Rosa damascena Damascena extract (RDE) on PD symptoms.
Methods: In this double blind clinical trial in 2015, through convenience sampling, 105 university students with primary menstrual pain in most recent years, without significant abnormal pathology, and with moderate/severe dysmenorrheadysmenorrheal symptoms according to visual analogue scale (VAS) were randomly assigned into one of four groups: 1. FO 1000 mg/day (n=26), 2. RDE 1000 mg/day (n=27), 3. FO and RDE concurrently, with the same dose (n=27), and 4. Control group (n=25). All measurements were performed three times, at the beginning, 30th day, and 60th day. Symptoms including nausea, vomiting, diarrhea, bloating, cramp, low back pain, headache, fatigue, anxiety, sweat, weakness, dizziness, drowsiness, and feeling cold were measured by VAS method.
Results: After 2-month treatment, supplementation with RDE significantly reduced severity of bloating (p<0.001) and sweat (p<0.001), but FO supplementation had no significant effect on PD symptoms. The concurrent use of FO and RDE significantly decreased severity of diarrhea (p=0.038), weakness (p<0.001), dizziness (p=0.003), and feeling cold (p=0.049).
Conclusion: Our results suggest that the concurrent supplementation of omega-3 fatty acids and RDE could be more effective than their separate use in decreasing PD symptoms; however, larger trials are warranted to confirm these preliminary findings.

Arezoo Safaei Nezhad, Mohammad Masoud Vakili, Loghman Ebrahimi, Roghieh Kharaghani,
Volume 7, Issue 3 (11-2017)

Background: Reproductive variables may play an important role on the correlation between irrational parenthood cognition (IPC) and destructive behaviors of infertile couple.
Objectives: The aim of this study was to determine the correlation between IPC and destructive behaviors by reproductive variables in primary infertile women.
Methods: The study was descriptive-analytic. 183 cases of primary infertile women living in Zanjan-Iran and attended to the Infertility Clinic in Ayatollah Mousavi Hospital were investigated from 2015 to the end of 2016. The instrument included a three-part questionnaire of individual and reproductive information, IPC, and the destructive behaviors of marital relationship based on Glaser's choice theory. Data were analyzed by SPSS software using descriptive and Pearson correlation test (P<0.05).
Results: There was a significant direct correlation between IPC and destructive behaviors of marital relationship in infertile women (r=0.47, p<0.001). Based on reproductive variables, the highest correlation was observed in the subgroups of less than 10 years elapsed from the diagnosis of infertility, less than 10 years from the onset of infertility treatment, and the expectation of pregnancy under 10 years, a history of twice unsuccessful in vitro fertilization, a tendency to pregnancy due to the pressure of the others and the cause of the unknown infertility (P<0.05). Correlation between IPC and all components of destructive behaviors was significant (p<0.001).
Conclusion: Identifying infertile women with high IPC and destructive behaviors is important to educate regarding life skills and provide counseling services.
Leila Ahmadi, Soghra Karami, Soghrat Faghihzadeh, Elham Jafari, Atousa Dabiri Oskoei, Roghieh Kharaghani,
Volume 7, Issue 4 (10-2018)

Background: Fear is an important factor that causes pregnant women to opt for cesarean section. Women with the fear of childbirth consider labor pain to be beyond their power. Basically, these women request cesarean section only to avoid normal vaginal delivery, which indicates their low self-efficacy in normal vaginal delivery.
Objectives: The present study aimed to investigate the effects of couples counseling based on the problem-solving approach on the fear of delivery, self-efficacy, and choice of delivery mode in the primigravid women requesting elective cesarean section in Zanjan, Iran.
Methods: This quasi-experimental study was conducted on 76 pregnant women in the second trimester of pregnancy and their spouses. The women were eligible for elective cesarean section and met the inclusion criteria. The intervention was based on the problem-solving counseling approach with the couples, which was performed in three weekly sessions at the clinic of Shahid Beheshti Hospital in Zanjan, Iran. Data were collected using the questionnaires of knowledge and attitude, Wijma delivery expectancy/experience questionnaire, and Louis’ self-efficacy scale at the baseline and after one month of the final session. Data analysis was performed using independent t-test, Chi-square, and one-way analysis of variance (ANOVA).
Results: Significant differences were observed in the mean scores of knowledge and attitude of women and men, and fear of delivery and self-efficacy of women between the intervention and control groups after counseling (P<0.001). The women in the intervention group were significantly more likely to do normal delivery compared to the control group (P<0.001).
Conclusion: According to the results, couples counseling based on the problem-solving approach could be effective in reducing the fear of delivery and increasing the self-efficacy of primigravid women. Furthermore, it could improve the knowledge and attitude of couples, thereby decreasing the rate of cesarean section and tendency toward this mode of delivery.
Marzieh Faghani Aghoozi, Sanaz Fayazi, Malihe Amerian, Amir Hamta, Najmeh Tehranian, Fahimeh Ramezani Tehrani,
Volume 7, Issue 4 (10-2018)

Background: Worldwide, half of women suffer from nausea and vomiting in early pregnancy which generally continues to the 20th week of pregnancy. Although pathogeneses of nausea and vomiting of pregnancy as well as hyperemesis gravid arum are still unknown, some believe that  nausea and vomiting of pregnancy is likely related to maternal serum leptin level.
Objectives: This study aimed to examine the relationship between leptin and pregnancy nausea and vomiting.
Methods: In this case-control study, 45 pregnant women at first and second trimesters were selected through convenient sampling. Mothers’ blood samples were taken in the 6th, 12th, 15th, and 20th weeks of pregnancy. The participants were devised into healthy, without nausea, (24) and with nausea and vomiting groups (21). The relationship among the variables was analyzed using independent t-test, Pearson correlation, regression tests, and Lambda statistic (P value <0.05).
Results: The mean age of the participants was 27.47±5.55 years, and Body Mass Index (BMI) was found to be 5.458±26.57. There was no significant difference between groups in this regard. Based on results, changes in maternal serum leptin had significant correlation with nausea and vomiting of pregnancy (p<0.04), meaning that the mean of leptin changes in patients with nausea and vomiting was significantly lower. Moreover, serum leptin at first and second trimesters of pregnancy did not have significant correlation with nausea and vomiting (p=0.5 and 0.3, respectively).
Conclusion: With regard to leptin peak level at second trimester of pregnancy, leptin changes at first and second trimesters can be a good index to predict the nausea and vomiting of pregnancy. Thus, further domestic studies are required in this respect.
Mahnaz Alizadeh, Naeimeh Akbari Torkestani, Behnam Oohadi, Fatemeh Mehrabi Razveh,
Volume 8, Issue 1 (6-2018)

Background: Given the importance of sex drive in marital satisfaction, evaluating the effectiveness of easy and cost-effective therapies in this regard is essential.
Objectives: The present study aimed to evaluate the effectiveness of cognitive-behavioral counseling (CBC) based on film therapy on the marital satisfaction of women with low sex drive.
Methods: This clinical trial was conducted on 300 women referring to health centers, and 50 women with low sex drive were selected based on the inclusion criteria via permuted block randomization. The selected subjects were allocated to the intervention (n=25) and control (n=25) groups. The intervention group received seven sessions of CBC based on film therapy, while the control group received no intervention. Data were collected using the marital satisfaction scale proposed by Afrooz before and after the intervention. Data analysis was performed in SPSS version 20 using Chi-square and MANCOVA.
Results: The results of Chi-square indicated that the groups were homogeneous in terms of demographic characteristics. In addition, the intervention and control groups had no significant difference in terms of marital satisfaction before the intervention. However, in the post-intervention phase, marital satisfaction significantly increased in the intervention group compared to the control group.
Conclusion: According to the results, CBC based on film therapy could improve marital satisfaction. Therefore, it is recommended that this therapeutic approach be adopted to enhance the relationship of the couples with low sex drive.
Azadeh Araste, Elham Jafari, Saeideh Zenoozian, Rhoghieh Kharaghani,
Volume 8, Issue 1 (6-2018)

Background: Despite the progress of family planning programs, a significant proportion of pregnancies are still unplanned which threatens the different dimensions of community health. Unplanned pregnancy affects parent's-child association. Maternal-fetal attachment provides a model for the child's mental-social function at present and in the future.
Objectives: This study was conducted to determine the prevalence of unplanned pregnancy and related factors of maternal-fetal attachment in pregnant women referring to Zanjan health centers in 2017.
Methods: This descriptive correlational study was part of a clinical trial that was performed on 184 pregnant women who referred to health centers for routine prenatal care from October to February 2017 in Zanjan, Iran. Using multi-stage sampling method, health centers of Zanjan were divided into three categories based on social and economic situation. Then, from each category, three centers were selected, randomly. The inclusion criteria comprised being pregnant, satisfaction to participate in the study, have at least reading and writing skills, lack of the history of obstetric complications, psychological disease and medicine use, lack of known psychological disease, lack of narcotic substances abuse, and living in Zanjan City. Data collection tool included demographic checklists and maternal-fetal attachment questionnaire, which completed in self-report method. The data of this study were analyzed by appropriate statistical tests by SPSS v.16 software.
Results: Among the participants 58.2% of women had planned pregnancy, 36.4% had unplanned pregnancy, and 5.4% had unwanted pregnancy. Maternal-fetal attachment scores were significantly higher in the planned pregnancy group 84(75-93) than the unplanned pregnancy group 57(54-60) and unwanted pregnancy group 56(48-64) (P˂0.001). The highest sub-scale in the planned pregnancy group was related to the attributing characteristics and intentions. Also, the most subscale in unplanned and unwanted pregnancies related to giving of self. There was a significant relationship between age, education, socioeconomic level, number of pregnancies, number of children and contraceptive method with type of pregnancy (P˂0.001).
Conclusion: Based on the results of the study, it seems that reduction in unplanned pregnancy will enhance the maternal-fetal attachment and will improve the mother role and social-psychological health of the child.

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