Vol 7, No 2 (June 2013)

Original Articles

  • XML | PDF | downloads: 338 | views: 692 | pages: 49-55

    Objective: The aim of this study is to further compare the efficacy of PGE2 suppository, the intracervical foley catheter and extra-amniotic saline infusion in nulliparous women referred for labor induction.
    Materials and methods: Totally 368 nulliparous women with a Bishop score ≤ 4 with singleton gestation, vertex presentation and intact membrane referred for labor induction were randomly assigned to 3 groups; Foley catheter alone, Extra-amniotic saline infusion (EASI) and PGE2 suppository. All women received concurrent dilute oxytocine infusion. The change in the Bishop Score, labor progress, various labor endpoints and outcomes of labor were assessed.
    Results: From 363 women studied after exclusion of 5, 119 were assigned to EASI, 121 to Foley and 118 to PGE2. Patients' demographics did not differ significantly between three groups nor did indication for induction (P = 0.0001). The EASI group had a significant improvement in Bishop Score 6 hours after induction. The mean time to active phase was 357±135min for EASI,457±178 for Foley and 609±238 min for PGE2 group respectively (P < 0.05).rate of spontaneous rupture of membranes was higher in the EASI group (P = 0.0001) and the mean time from the start of induction up to spontaneous rupture of membranes in the EASI group was shorter than other group(P < 0.05). The mean time to vaginal delivery was 14.8±6.1 in EASI group,11.4±4.8 in Foley and 18.9±6.4 in PGE2 group(P < 0.05).there were no differences in Apgar scores, mean neonatal birth weight and neonatal morbidity.
    Conclusion:
    Our study showed that pre-induction cervical ripening by EASI with concurrent oxytocin is better than Foley and PGE2 in Bishop score and various labor end point and outcomes.

  • XML | PDF | downloads: 366 | views: 691 | pages: 57-61

    Objective: To study the pregnancy outcomes in first trimester vaginal bleeding.
    Materials and methods: This cross sectional study was done on 60 pregnant women with first trimester vaginal bleeding referring to university hospitals affiliated to Islamic Azad University, Tehran, Iran. All women were evaluated for the outcomes including abortion, preterm rapture of membranes, preterm labor, second and third trimester vaginal bleeding, low birth weight and intra uterine growth retardation and the mode of delivery. Data were analyzed using SPSS- 11.
    Results:
    Placenta accreta, second trimester bleeding and preterm labor were significantly more prevalent in pregnant women with first trimester bleeding (P ≤ 0.05).
    Conclusion: According to results of present study vaginal bleeding in first trimester of pregnancy may predict further maternal and fetal complications. We recommend training pregnant women regarding those complications and their prevention.

  • XML | PDF | downloads: 376 | views: 354 | pages: 63-6

    Objective: To compare the hormonal status in postmenopausal women with and without metabolic syndrome.
    Materials and methods:In this cross sectional study 110 postmenopausal women were enrolled. Participants completed a questionnaire and underwent a medical exam and serum evaluation for serum lipids including cholesterol (Chol), high density lipoprotein cholesterol (HDL), low density lipoprotein (LDL), triglyceride (TG), fasting blood sugar (FBS), sex hormone binding globulin (SHBG), estradiol and testosterone. Metabolic syndrome was defined according to the definition of the National Cholesterol Education Program- Adult Treatment Panel III. In this study P value less than 0.05 was accepted as significant.
    Results:There were significant differences between the two groups of participants with and without metabolic syndrome in age, years after menopause, BMI, weight, SHBG and testosterone (p< 0.01).
    Conclusion: SHBG and testosterone are the most significant correlated factors to metabolic syndrome in postmenopausal women.

  • XML | PDF | downloads: 268 | views: 424 | pages: 67-72

    Objective: To evaluate reproductive health education which is essential to the prevention of sexual risk behavior and its associated adverse outcomes of unwanted pregnancy, AIDS and other sexually transmitted disease in adolescents. Little is known about youth educational needs about reproductive health in Iran. The aim of this study is evaluation of female youth educational needs about reproductive health in non-medical universities in the city of Qom, north central of Iran.
    Materials and methods: The study was descriptive-analytical type conducted in nine non-medical universities (400 students). A questionnaire was constructed to meet the purpose of the study based on similar studies of knowledge and attitude in different countries, yet it was modified according to Iranian culture and social norms.
    Results:
    The findings showed that a majority of participants have moderate knowledge about all components of reproductive health. Approximately, one - third of the participants reported difficulties to discuss about sexual health with mothers. The most of the participants believed insufficient female youth reproductive health services and low knowledge about reproductive health were the main barriers for female youth reproductive health aims.
    Conclusion:
    The participants in this study are representatives of an important subgroup in Iran in order to evaluate female youth reproductive health educational needs. The study identified many misconception and negative attitude that need to be addressed. A health education program through parents, peers, mass media campaign and more comprehensive family planning curriculum in universities are recommended to overcome misconception and spread awareness.

  • XML | PDF | downloads: 305 | views: 471 | pages: 73-86

    Objective: To examine the relationship between socioeconomic factors affecting contraceptive use among tribal women of Bangladesh with focusing on son preference over daughter.
    Materials and methods: The study used data gathered through a cross sectional survey on four tribal communities resided in the Rangamati Hill District of the Chittagong Hill Tracts, Bangladesh. A multistage random sampling procedure was applied to collect data from 865 currently married women of whom 806 women were currently married, non-pregnant and had at least one living child, which are the basis of this study. The information was recorded in a pre-structured questionnaire. Simple cross tabulation, chi-square tests and logistic regression analyses were performed to analyzing data.
    Results:
    The contraceptive prevalence rate among the study tribal women was 73%. The multivariate analyses yielded quantitatively important and reliable estimates of likelihood of contraceptive use. Findings revealed that after controlling for other variables, the likelihood of contraceptive use was found not to be significant among women with at least one son than those who had only daughters, indicating no preference of son over daughter. Multivariate logistic regression analysis suggests that home visitations by family planning workers, tribal identity, place of residence, husband's education, and type of family, television ownership, electricity connection in the household and number of times married are important determinants of any contraceptive method use among the tribal women.
    Conclusion: The contraceptive use rate among the disadvantaged tribal women was more than that of the national level. Door-step delivery services of modern methods should be reached and available targeting the poor and remote zones.

  • XML | PDF | downloads: 328 | views: 501 | pages: 87-93

    Objective: Sleep disorders are common complaints of women during pregnancy. These disorders are the result of physiological, hormonal, physical changes, affecting before, during, and right after pregnancy. This study aimed to evaluate the quality of life of pregnant women with sleep disorders in the second trimester.
    Materials and methods:
    In this cross-sectional study, data was collected with continuous sampling method. A total of 100 pregnant women with sleep disturbances in their second trimesters were recruited in this study. The participant referred to two elected health centers in West Azerbaijan University of Medical Science (One and three numbers of health care centers) in order to get prenatal care in the city of Maku, West Azerbaijan, Iran. The data was gathered using the personal information forms and the questionnaires, prepared by the World Health Organization Quality of Life (WHOQOL: BREF). To analyze the collected data, different statistical methods, like frequency tables, Pearson, Spearman and ANOVA were applied.
    Results:
    The results indicate that the mean sleep quality is 8.62 ± 2.81 in pregnant women with sleep disorders or poor quality of sleep in the second trimester. Quality of life (p ≤ 0.03) and one of domains, including psychological health (p ≤ 0.02) related to quality of sleep.
    Conclusion: Given that a large percentage of women suffer from sleep disorders in pregnancy, we hope during this period, in addition to usual care, codified programs is done to evaluate, detection and Diagnosis of this disorder.

  • XML | PDF | downloads: 605 | views: 348 | pages: 95-101

    Objective: To determine the value of random urinary protein to creatinine ratio (UPCR) for diagnosis of proteinuria in pregnant women with preeclampsia. Preeclampsia is the most common complication of pregnancy and one of the main causes of maternal mortality. So, early diagnosis of preeclampsia is very important.
    Materials and methods: In this cross-sectional study 66 pregnant women suspected preeclampsia at ≥24 week of gestational age and BP ≥ 140/90 mm/Hg were checked by two urine samples of 10am and 4pm to determine random UPCR, as well as a 24-hour urine sample to evaluate 24-hour protein excretion.
    Results: The result revealed that 74.2% of the studied population had significant proteinuria. There was a correlation between UPCR and 24-hour urine protein excretion. Pearson's correlation coefficient was 0.502 at 10am and 0.428 at 4pm. The best cutoff for the random urine protein to creatinine ratio at 10am was 0.470 with sensitivity and specificity equal to 87.5% and 84.2%, respectively. The best cutoff for the random UPCR at 4pm was 0.595 with sensitivity and specificity equal to 91.7% and 94.7%, respectively.
    Conclusion:
    Result of 24-hour urine collection showing random UPCR is considered as an appropriate situated method for emergency time.

Case Reports

  • XML | PDF | downloads: 263 | views: 464 | pages: 103-4

    Vaginal leiomyomas are uncommon benign tumour with variable clinical presentation. These tumours arise most commonly from anterior vaginal wall. We report a case of 50-year old postmenopausal woman who presented with urinary retention, profuse vaginal bleeding and mass protruding into vagina. Local examination revealed a pedunculated mass attached to the posterior vaginal wall with vascular stalk one cm below the cervix. Mass was hanging outside vulva and vascular pedicle was profusely bleeding. The pedicle was ligated and tumour was excised. Subsequent histopathology revealed a vaginal myoma.