مجله زنان مامائی و نازائی ایران
سال چهاردهم شماره 7 (بهمن 1390)

Tubal factor is a very Common cause of infertility. This study was performed to assess the therapeutic effect of Intrauterine Insemination (IUI) in patients with unilateral fallopian tube obstruction and to reduce indications of IVF and ICSI. This case-control study was performed between years 2008-2009 in Fatemeh-Zahra infertility center of Babol on 60 patients with unilateral tube occlusion (case group) and one 120 infertile patients without tubal obstruction (control group) in HSG. Subjects were selected by sampling method. Demographic data were collected by a researcher-made questionnaire and analyzed by SPSS Software (version 16) using descriptive statistical methods and t-test and Chi-square test. Pregnancy was achieved in 4 patients (6.7%) of case group and 15 patients (12.5%) in control group but the difference was not significant (P>0.05). All 4 pregnancy cases had left ovarian tube obstruction and none of patients with right ovarian tube obstruction became pregnant, but the difference was not significant (P>0.05). Pregnancy rate had no significant difference base on site (distal or proximal) of involvement (p=0.99). Pregnancy rate after IUI has no significant difference in patients with unilateral tube obstruction and infertile women with patent ovarian tubes. Therefore, IUI can be suggested to patients with unilateral ovarian tube obstruction regardless of involvement site.

Neonatal mortality rate is a standard indicator for development of health care, educational and social systems which influences the mortality indicators of infant and children younger than 5 years of age, directly. Since the first step to reduce mortality and improve this indicator is to identify the causes of mortality so this study was conducted with the goal of evaluation of the causes and predisposing factors of neonatal mortality in Ghaem hospital in Mashhad. This cross-sectional, descriptive – analytical study was conducted from June of 2009 to June of 2010. Following neonatal death, epidemiological data, neonatal physical examination, diagnostic-therapeutic procedures and course of the disease before death, including the neonate’s and mother’s features were recorded and then predisposing factors and death causes were evaluated by an expert team (neonatal subspecialty, neonatal fellowship, resident of pediatrics and nurse who present at the time of death). The data was analyzed using SPSS software (version 11.5) and descriptive Chi square statistic test. Of 1630 hospitalized neonates in this center, 162 (9.94%) died and 63% of which weighted less than 1500 grams. The major causes of neonatal mortality in this study were severe prematurity (less than 32 weeks) 57.4%, asphyxia (5 minute Apgar less than 6- 30.86%), congenital anomalies (27.16%), infections (25.3%), respiratory complications (24.7%), hematologic disorders (6.8%) and cerebral disorders (6.2%). According to death patterns and most frequent causes of neonatal mortality in the present study, preventing preterm labour and low birth weight neonates, preventing delivery injuries and asphyxia, plans to prevent congenital anomalies and infection preventing plans, especially in neonates department could be effective in reducing neonatal mortality in our hospital.

Low birth weight and preterm labor are risk factors for infant mortality under one year of age. In spite of this, finding a way to reduce and prevention of them is one of most difficult challenges of health systems.

400 women who referred to community health centers of Kerman were interviewed and study forms were filled for them. The study tools were Family Violence Questionnaire and Demographic check list. SPSS 18 used to examine statistic data, chi-Square, T-test, ANOVA, and logistic regression used for data analyzing.

There was relationship between drug abuse and violence. Also Drug abuse was related to low birth weight. In 36.2% sex prediction was related to more violence. There was relationship between usage of Hookah, passive smoker status of mother and low birth weight.

This study showed relationship between drug abuse and poor pregnancy outcome. But there was no relationship between poor pregnancy outcome and violence

With respect to the side effects of antidepressants, most clients prefer dietary supplements to chemical drugs in lactation period. This study was conducted to identify the effects of Omega-3 fatty acids on postpartum depression This double blind clinical trial was carried out on 70 women with postpartum depression who referred to the selected health centers affiliated to Shahid Beheshti University in 2007. Subjects were randomly divided into two 35-member groups receiving Omega-3 (a 1 gr. Capsule daily) and receiving placebo. Edinburg’s standard test was used to diagnose depression and Beck’s standard test was used to identify the severity of depressive symptoms. The severity of depression was identified before the intervention and in the first, second, third and fourth weeks after it. Data was analyzed by SPSS software (version 10), using Paired T-test, variance analysis with multiple measurements, Mann-Whitney test and Chi-square test. Mean depression severities in the Omega-3 group were 18.1 before and 9.0 after the intervention with a significant difference (P<0.001). The corresponding figures in the placebo group were 17.5 and 17.2 with no significant difference (p=0.3). The decreasing trend of postpartum depression severity in the Omega-3 group was significantly different from the other group (P<0.001) Omega-3 is a suitable compound with no side effect for mothers and their infants in decreasing postpartum depression. Further studies with longer durations to identify its remission patterns are warranted.

Human milk is the optimal primary nutritional source for premature infants. The strongest evidence of the benefit of human milk for premature infants is the reduced incidence of necrotizing enterocolitis. But one of the frequent problems that cause decreased milk production is mother’s stress. Therefore we decided to evaluate of metoclopramide effect on increase of milk production in mothers of preterm infants. The randomized double- blinded case-control study enrolled women who planned to breastfeed and delivered in 28-34 weeks of gestation. They were randomized to receive 10mg of metoclopramide or placebo 3 times a day for 10 days starting within 48 hours of giving birth. Breast feeding education was standardized for all women. They recorded the volume of milk expressed at each pumping for 10 days. 60 women were enrolled and 49 women completed the study. 25 women received metoclopramide and 24 were included in placebo group. Two groups were similar in age, race, education, gestational age, and neonatal weight. There was no significant difference between milk volumes in the two groups in first days (P>0.16). But mean volume production in metoclopramide was significant higher than placebo group in the last 5 days of study (P<0.007). Metoclopramide increases volume of breast milk in women with preterm infants.

Preterm labor is a major risk of public health and important neonatal morbidity and mortality factor in world. Despite introducing its several risk factors, in 50% of cases, its etiology is unknown. From biological point of view, preterm labor and primary dysmenorrhea share common triggering mechanisms so primary dysmenorrhea can be considered as a preterm labor's predictive factor. In this study the relation between primary dysmenorrhea and spontaneous preterm labor is looked through in primiparous women in Rafsanjan. This case control study was conducted on 412 primiparous women was referred to Rafsanjan’s Nick Nafs hospital in 2010. In this Case-Control study, 205 women in control group (term delivery) and 207 in case group (spontaneous preterm labor) was enrolled in Rafsanjan’s Nick Nafs hospital. Two groups were matched in age, socio-economical status, smoking and BMI. Data were collected with questionnaire and analyzed in SPSS software, student's t-test, X2 test, adjusted odds ratio and Logistic Regression. Logistic Regression test did not show statistically increased risk of preterm delivery in women with history of primary dysmenorrhea (odds ratio=1.12). The risk of preterm labor in women with history of mild or moderate and severe dysmenorrhea was slightly strengthened (1.26) but statistically non significant (P value=0.45). The exact biochemical mechanisms that cause primary dysmenorrhea and spontaneous preterm labor are unknown.

Labor is one of the pains experienced by women during their life and fear of unknown causes increases pain and affects the selection of cesarean section modality of labor. This study aimed to determine the effect of imagination of the pain of vaginal delivery and cesarean section on the selection of normal vaginal delivery in pregnant women attending clinics in Kerman University of Medical Sciences. This descriptive and analytical research included 400 pregnant women in Kerman by random cluster sampling. The survey tool consisted of three parts: 1- Individual features 2- Conception of the pain of childbirth and 3- Questions related to the tendency of choosing the type of delivery. After acquiring the appropriate validity and reliability, data was analyzed, using simple frequency tables, central distribution criteria t-test, one-way ANOVA, Mann-Whitney U and Pearson correlation analysis. The mean and standard deviation of responses to the attitude of pregnant women to vaginal delivery pain was 11.7±1.82 and the mean and SD of pregnant women attitude to cesareandelivery pain 2.18±10.94 (P value=0.046). Average negative attitude to labor by vaginal delivery was more than cesarean group. Mean and SD scores of pregnant women who selected cesarean delivery was 19.38±3.6 compared to those who selected/vaginal delivery (18.56±3.18) There was significant difference between the two group (P value=0.02). Between perceived pain intensity and desire to vaginal delivery there was a significant inverse correlation. Imagination of the pain of childbirth can affect the preference of the type of delivery. Based on research results significantly increase negative perceptions of the natural childbirth tend to have decreased. So it is necessary to decrease anxiety and fear caused by misconceptions of vaginal delivery through education and increasing of awareness of pregnant mothers and thereby encouraging mothers to select normal vaginal delivery.

The availability of alternative therapies of abnormal gynecologic bleeding has prompted a reexamination of the impact of hysterectomy on a woman’s quality of life. This paper examines the evidence about the impact of hysterectomy on quality of life and sexual function. Electronic searching of English language literature was conducted using the search terms: sexuality, sexual satisfaction, sexual function, hysterectomy, sexual desire and orgasm in PubMed, EMBASE, Science Direct and Scopus. Additional papers found in the bibliographies of these papers were also reviewed. 23 studies were found: 11 prospective, 5 retrospective and 7 RCT. With few exceptions, the methodologic quality of the studies was poor, but we continued to review all of the studies given the paucity of data on this important subject. The studies were evaluated for methodologic quality using a scoring system described in the paper. Outcome measures were usually not validated and most studies did not consider important confounding factors. Most studies in this review showed either no change or an enhancement of sexuality in women who had undergone hysterectomy. The majority of researches evaluating the effect of hysterectomy on sexual function were poorly designed. The available evidence showed that quality of life is improved for most women who had hysterectomy and that hysterectomy did not adversely affect sexual function. A number of confounding factors with the potential positive or negative impact on sexual function, independent of hysterectomy, should be taken into account in future studies.