Journal of Midwifery & Reproductive health
Volume:9 Issue: 1, Jan 2021

Fertility issues after cancer have recently received great attention. This study was designed to review the impacts of breast cancer treatment on fertility.

This study is a narrative review. Textbooks as well as electronic databases including ProQuest, Google Scholar, PubMed, Scopus, Web of Science, Science Direct, and MEDLINE were comprehensively searched for scientific literature. The search strategy was based on keywords: "Fertility", "Childbearing", "Breast Cancer Survivorship", "Reproductive Issues". A total of 270 titles and abstracts were recognized through searching. Studies, which focused on medical or biological consequences and included premenopausal women or subjects younger than 50 years, were eligible for review. After removing duplicates, studies focused on patients who were not in their reproductive age, and studies with stereotyped results, 30 articles met the inclusion criteria. The articles were screened with regard to their titles and types. The abstracts which best fitted the inclusion criteria were checked for eligibility, and then their full texts were read. To guarantee the consistency of the retrieved information, the data was independently extracted from each study by all the authors, and then was entered to the standardized tables.

Long-term fertility dysfunctions happen in most patients under cancer treatment. Also, breast cancer survivors of the reproductive age suffered greater distress over cancer-related infertility.

Counseling methods to obtain information about the risk of treatment on fertility and ways to preserve fertility should be presented early in the treatment.

The postpartum period is a time of extreme vulnerability to various psychiatric disorders, such as anxiety, which exert profound negative impacts on the health of neonates, mothers, and families. Therefore, it is necessary to perform some interventions to prevent and mitigate postpartum anxiety. The current study investigated the effect of counseling based on Gamble's approach on postpartum anxiety in primiparous women.

This randomized clinical trial was carried out on 60 primiparous women referred to Mashhad health centers in 2018. Participants in the intervention group received midwife-led individual counseling based on Gamble's approach during three prenatal and one postpartum session, apart from routine prenatal care. The control group only received routine prenatal care. A questionnaire to measure demographic and obstetric data as well as Depression, Anxiety and Stress Scale-21 (DASS-21) were used to collect data. The obtained data were analyzed in SPSS software (version 16) using Mann-Whitney, chi-square and independent t-test.

There was no significant statistical difference between the two groups before intervention (p <0.05). The mean and standard deviations of women's anxiety in the intervention and control groups were obtained as 7.5±1.1 and 8.6±2.4, respectively. The results of the Mann-Whitney test demonstrated that the level of anxiety in the intervention group was significantly lower, compared to that in the control group (P=0.008).  

Counseling based on Gamble’s approach reduced postpartum anxiety in primiparous women. Therefore, it can be used during pregnancy and postpartum period as an effective, simple, and adverse-effect-free method to reduce anxiety during the postpartum period.

Caesarean delivery is a lifesaving surgical procedure for both the mother and the infant in specific medically indicated circumstances, but unnecessary caesarean delivery can lead to increased medical risks. This research considers the rate, indications and contributing factors of caesarean delivery in the Durame Hospital, Southern Ethiopia.

This hospital-based, cross-sectional study examined the period from May 1 through June 1, 2019. Three hundred respondents were enrolled by consecutive sampling, and a structured tool and document review were used for data collection. Data entry and analysis were conducted with EpiData (version 3.1) and SPSS software (version 24). Multivariable logistic regression was employed to determine the contributing factors associated with caesarean delivery at a 95% confidence interval (CI).

The overall rate of caesarean delivery was observed to be 24.7%. Non reassuring fetal heart rate (n=13; 17.06%) and abnormal presentation (n=9; 12.2%) were the two most prevalent indications of cesarean delivery. The factors associated with cesarean delivery were previous cesarean delivery (AOR =7.3, 95 % CI: 2.02-26.65), post-term pregnancy (AOR=3.3, 95% CI: 1.268.67) and maternal age of ≥35 years (AOR=3.21, 95% CI: 1.19 -8.67).

The rate of caesarean delivery exceeded the recommended limit of the World Health Organization. To ensure the appropriate use of the procedure, women with a previous caesarean delivery must be meticulously evaluated for the possibility of vaginal delivery, and the hospital must regularly monitor caesarean delivery indications.

Empty nest syndrome reduces the quality of life and happiness among postmenopausal women, and it seems that counseling is one of the efficient approaches which can be used to manage this problem. Due to the scarcity of research in the field of counseling in postmenopausal women, the present study was conducted to assess the effect of the solution-focused group counseling approach on the happiness of postmenopausal women with empty nest syndrome.

This clinical trial was conducted on 75 postmenopausal women referring to health centers, Mashhad, Iran in 2019 Subjects were selected via convenience sampling and randomly assigned to two groups of solution-focused group counseling and control. In the intervention group, six 90-minute counseling sessions were held on a weekly basis. Data were assessed in two stages before and after the intervention using the Oxford Happiness Questionnaire. Data were analyzed in SPSS software (version 24) using Mann-Whitney, Chi-square, and Fishers' exact test.

Based on the results, no statistically significant difference was observed in the mean score of happiness before the intervention (P>0.05). Nonetheless, after the intervention, the mean happiness score in the solution-focused group counseling significantly differed from the mean score obtained in the control group (p <0.001).

As evidenced by the obtained results, it can be concluded that solution-focused group counseling can be used to improve the happiness of postmenopausal women due to the statistically significant increase in the mean total happiness score of postmenopausal women underwent this counseling approach.

Recent studies show that more research are needed on characteristics associated with prenatal distress. It was therefore aimed to examine the level of prenatal distress in Turkish pregnant women and its relationship with the women’s personal and obstetric characteristics. 

This was a cross-sectional study. A total of 221 pregnant women who admitted for prenatal care between 15th April and 1st June 2016 were recruited for this study. Nineteen individuals declined to participate; accordingly, 202 individuals with uncomplicated pregnancy in all trimesters were included in the study. Data were collected using a demographic-obstetric questionnaire and the Tilburg Pregnancy Distress Scale. Student’s t-test, and variance analysis were used to analyze the data. 

More than one third of the pregnant women (37.6%) were found to experience prenatal distress. Women with unplanned pregnancies (18.33±6.07) (p <0.05) had a risk of prenatal distress. Also, women whose husbands were primary school graduates (16.66±6.14) (p>0.05) and who had a low level of income (16.61±5.92) (p>0.05) were still at risk for prenatal distress, as their mean scores were above the distress scale cut-off point. 

The results emphasize that nurses and midwives may not contribute to the reduction of distress levels during pregnancy in the hospital settings. For this reason, a referral system seems to be the best solution to follow-up the healthy pregnant women in primary care settings and transfer them to the secondary care settings, when necessary.

Rapid-acting insulin analogs, such as insulin aspart, are used in type 1 and type 2 diabetes in pregnancy, and are approved for using in gestational diabetes mellitus (GDM). Nevertheless, there is a dearth of studies to compare their effectiveness with regular insulin. This study, therefore, compared the efficacy of aspart (NovoRapid) and regular insulin in managing GDM and their effects on delivery outcomes.

This retrospective record review was conducted on 150 pregnant women with GDM who were admitted to Shohada Tajrish Hospital,Tehran, Iran and managed with either insulin aspart or regular insulin (75 patients in  each group). The primary outcomes were insulin dose, hypoglycemic episodes, length of hospitalization at the initiation of insulin therapy, length of insulin therapy, and rehospitalization frequency. The secondary outcomes were delivery and neonatal outcomes. Data was extracted from patients’ medical records and analysed using Chi-square, Fisherʼs exact test, t-test, and Mann-Whitney U test.

Insulin dose and frequency of hypoglycemic episodes during the first hospitalization for the initiation of insulin therapy were significantly lower in the insulin aspart group. Also, the length of hospital stay and insulin therapy was significantly shorter in the insulin aspart group. In addition, the gestational age at delivery and frequency of normal vaginal delivery were significantly higher in the insulin aspart group.

Considering insulin dose, frequency of hypoglycemic episodes as well as length of initial hospital stay, insulin aspart was more efficient than regular insulin in controlling blood glucose in patients with GDM.

In the last three decades, fertility has undergone a significant decrease in Iran. It seems that women's employment could affect this declining trend. It might also affect the quality of marital relationship as well as fertility motivations. Given the dearth of research in this topic, this study designed to measure the relationship between the current and desired number of children with quality of marital relationships and fertility motivations among employed women and their husbands in Mashhad, Iran.

This cross-sectional study was conducted on 270 employed women and their husbands in 2018 who were selected through randomized cluster sampling technique. The data were collected through a demographic as well as Miller’s marital relationship quality and fertility motivations (1995) questionnaire. The collected data were analyzed in SPSS software (version 24), using Spearman, analysis of variance, least significant difference (LSD), Kruskal-Wallis, and regression analysis tests.

Current number of children had a positive relationship with positive fertility motivations in women (P=0.002) and marriage duration (p <0.001). Desired number of children also had a positive relationship with quality of marital relationship (P=0.008) and positive fertility motivations in employed women and their husbands (P=0.001).

As the findings indicated, the current number of children and positive fertility motivations was significantly associated with marital relationships quality and positive fertility motivations in women and their husbands. Therefore, a plan should be developed for improving marital relationships quality and positive fertility motivations in employed women and their spouses.

Menstrual health is a major part of adolescent health; nonetheless, the majority of girls do not have sufficient knowledge of menstrual changes. Therefore, current study aimed to assess effect of menstrual health education adopting the peer education method with the participation of mothers on adolescents' menstrual health behaviors.

This randomized clinical trial was conducted on 60 students with regular menstruation in two groups. Two high schools in Mashhad were selected by drawing lots as a random block. In intervention group, at first 10 students received the educational content and then were asked to train 4-7 of their classmates. Mothers of subjects received two 2-hour sessions with the same content. Control group received routine education by a health educator. Data were collected by a valid, reliable self-structured questionnaire of menstrual health behaviors, before intervention and also after the end of  the first and second menstrual cycles and were analyzed in SPSS software (version 16) using  Mann-Whitney, Friedman, and independent samples t-test .

Based on the results, mean score of menstrual health behaviors significantly increased in the two groups (p <0.001). However, mean score of menstrual health behaviors in intervention group was significantly higher, compared to the control group (after the end of the first and second menstrual cycles) (p <0.001).

peer education with participation of mothers was more effective in enhancement of adolescents' menstrual health behaviors, compared to the traditional routine method. It is recommended that health professionals apply participatory teaching methods for education of health issues, including menstrual health.

Failed oxytocin induction of labor increases the rate of cesarean section and associated complications. The present study aimed to identify contributing factors to failed oxytocin induction among women who gave birth at the referral hospitals of Amhara regional state, Ethiopia, in 2018.

This unmatched case-control study was conducted on a total of 336 parturient women (112 cases and 224 controls) at the referral hospitals of Amhara regional state, Ethiopia, within March 19 to May 18, 2018. Systematic and consecutive sampling methods were applied for the selection of controls and cases, respectively. Both the interviewer-administered questionnaire and medical chart review were utilized as tools for data collection. The validity of the tools was determined by content validity, and Cronbach’s alpha coefficient as a measure of tool reliability was rendered at 0.82. Data analysis was carried out by SPSS software (version 23) using multivariable logistic regression analysis.

According to the obtained results, primiparity (AOR=6.24; 95% CI: 3.32-11.73), intermediate Bishop score (AOR=11.77; 95% CI: 5.19-26.71), emergency oxytocin induction (AOR=2.47; 95% CI: 1.31-4.68), and age of ≤ 30 years (AOR=2.16; 95% CI: 1.13-4.16) were considered the determinants of failed oxytocin induction.

Considering the factors of primiparity, intermediate Bishop score (5-8) and the age of ≤ 30 years as determinants of failed oxytocin induction, it is recommended to use oxytocin induction after obtaining a favorable Bishop score.

The excessive increase in the number of cesarean sections is one of the problems of health care in all societies, including Iran. This study aimed to compare two groups of women based on their preferred mode of delivery in terms of their personality traits and beliefs toward the mode of delivery in Iran.

This comparative descriptive study was performed on 60 pregnant women in their last months of pregnancy, who decided for cesarean section or natural birth and were selected from doctors’ offices and healthcare centers through cluster sampling technique in Birjand, Iran in 2107. Data were collected through the Big Five personality questionnaire, and two other questionnaires to measure religious attitudes and beliefs toward delivery. To analyze the data, independent t-test, and multivariate analysis of variance were employed using SPSS (version 16).

Considering the personality traits, the mean value of extraversion was significantly different between the two groups (p <0.05), meaning that women who preferred the natural birth were more extravert. Furthermore, there was a significant difference in terms of attitude towards mode of delivery between two groups and those who decided for the cesarean section had more positive attitude toward cesarean and negative attitude toward natural birth (p <0.001).

Considering positive attitude of women toward cesarean section, it seems crucial that physicians, midwives, birth counselors, and the media design interventions focused on promotion of normal birth to change the misconceptions about cesarean section and to encourage mothers to undergo natural childbirth.

AIDS is an incurable, due to the presence of a latent viral reservoir, but preventable disease. Measuring awareness and attitudes towards AIDS in different populations in each region seems essential. Considering the vulnerability of pregnant women, this study aimed to investigate the awareness and attitude of pregnant women about AIDS.

This cross-sectional study was conducted on 200 pregnant women referred to medical centers, clinics, and health centers of Salmas, West Azerbaijan, Iran during eight months of sampling. To collect data self-structured awareness and attitude questionnaires were used. The data was analyzed using chi-square test and Spearman and Pearson correlation coefficient using IBM SPSS [version 24.0].

The results of the study showed that most of the women surveyed were from the urban population (60%), with high school education (39.5%), with a housewife job (70.5%), and their sources of information, were radio and television (35%). The level of awareness of pregnant women (61.5%) was assessed at the intermediate level. The positive attitude was observed in 76% of respondents. The attitude score did not show a significant relationship with the level of education and job, but it showed a significant relationship with their age.

The level of awareness and attitude of the pregnant women under study was moderate and so relatively adequate. It is expected that with the expansion of scientific knowledge about AIDS, the awareness of people in each society to be increased.

Utilization of family planning services among married women in India, especially postpartum family planning, is poor, with only around one fifth of currently married women using a spacing method. Women’s awareness about PPFP methods in India is also limited. This study aimed to assess the knowledge, attitude and utilization of family planning methods among postpartum women in India.

A cross-sectional survey of 284 postpartum mothers was conducted in a well-baby clinic of a tertiary care facility using convenience sampling. Respondents were interviewed using self-developed, pretested and validated tools. Data was analyzed with STATA software version 31.1 using descriptive statistical methods.

Almost two third of the mothers did not receive family planning counseling in the antenatal period (66.1%) and over half did not receive it in the immediate postpartum period (53.5%). The majority (66.6%) did not use any contraceptive method. The mean knowledge score was 7.823.90 out of a total score of 16 points, and the mean attitude score was 33.533.90 out of a total score of 50 points. Knowledge of postpartum mothers related to the family planning methods was significantly associated with their educational status, number of antenatal visits, and use of contraceptives, while the use of contraceptive methods was significantly associated with resumed sexual activity.  

Lower scores on knowledge about PPFP compared to attitudes to PPFP emphasize the need for innovative approaches to make postpartum women aware about healthy reproductive practices including adoption of FP methods of their choice.

The problem of dysmenorrhea has not yet been controlled despite the various managements available for it. Among those, a health-promoting lifestyle is recognized as a key factor to prevent the progression of many diseases since health promotion are directly related to lifestyle-related behaviors. This study assessed predictors of health-promoting lifestyle among university students with primary dysmenorrhea.

This cross-sectional study was conducted on 370 students with primary dysmenorrhea from October to February 2018. The subjects were selected from the students of the Islamic Azad University, Tabriz, Iran, using a proportionate stratified sampling method. The instruments used to collect data consisted of a demographic questionnaire, Beck Depression Inventory-II, General Self-efficacy Scale, and the Health-Promoting Lifestyle Profile II. The general linear model was used to estimate the impact of each independent variable on the dependent variables using SPSS software (version 21).

The mean scores of health-promoting lifestyle, general self-efficacy, and depression were obtained as 141.16±18.41, 57.81±8.1, and 11.8±10.5, respectively. There was a significant relationship between health-promoting lifestyle with self-efficacy and depression (p <0.001). Based on the general linear model, the relationship of the total score of a health-promoting lifestyle was significant with the general self-efficacy, depression, and regular physical activity (p <0.05). Students with high self-efficacy, low depression, and regular physical activity achieved higher health-promoting lifestyle scores.

It is recommended thatschools’ health policymakers should consider physical activities and psychological factors through offering educational and cultural programs, as well as paying greater attention than before to these dimensions.

Low birth weight is one of the most important reasons for neonatal mortality. Increased rate of low birth weight over the past five years in Kashmar has highlighted the importance of controlling and preventing this condition to reduce its incidence. This study was conducted to measure the frequency of some maternal factors affecting the incidence of neonatal low birth weight.

This cross-sectional study was carried out on all mothers who gave birth to neonates weighing less than 2,500g from 2015 to 2016 in Kashmar (n=327). To collect the data a self-structured and valid and reliable questionnaire using closed-ended interview questions was employed. The collected data were analyzed in SPSS software (version 11) using descriptive and analytical statistics.

Based on the results, neonatal weight had a relationship with maternal factors including history of hypertension, preeclampsia, infertility, the use of assisted reproductive techniques, and self-medication (p <0.05). Moreover, the family income had a significant relationship with neonatal weight gain (P=0.01).

It is recommended to adopt some measures to reduce the rate of low-birth-weight. Among such measures paying attention to the lower-income groups, providing pregnancy care packages, maternal training for not self-medicating, and devoting more concern to disease preventive behaviors, such as proper control of blood pressure during pregnancy is suggested.

Pseudopregnancy is a physical state whereby all the signs and symptoms of pregnancy are exhibited with the exception of the presence of a fetus. The detection of a pseudopregnancy is significant; however, as it may be associated with all pregnancy symptoms, it is important to differentiate between the two.

Case report: 

We report a case of pseudopregnancy leading to an emergency cesarean section. A 28-year-old woman claiming a 7-month pregnancy was referred to a rural health center by her in-laws complaining of vaginal bleeding. The woman was referred to an urban hospital by emergency medical services with a diagnosis of placenta previa. In the hospital, she underwent an emergency cesarean section due to a severe deceleration of fetal heart rate (FHR), prior to assessing by an ultrasound. No fetus or signs of uterine or abdominal pregnancy was observed. Wrong auscultation of the maternal heart rate instead of FHR seemed to be the main error.

It is required to pay more attention to the methods of differentiation of FHR from maternal heart rate. This report highlighted the significance of early detection of pseudopregnancy.