فهرست مطالب رقیه رحمانی بیلندی

The first trimester of pregnancy is associated with unpleasant experiences for mothers. One of these unpleasant experiences is breast pain, which leads to a low quality of life in pregnant women, so the present study was conducted with aim to investigate the effect of vitamin B6 as a safe and available supplement on breast pain in the first trimester of pregnancy.

This randomized controlled clinical trial study was conducted in 2019-2020 on women with a gestational age of 6-10 weeks who had breast pain with start of pregnancy for 5 days or more in Gonabad city. Pregnant women were divided into two groups of 42 people, control and intervention. The control group was given a placebo daily and the intervention group was given a 40 mg vitamin B6 pill for 1 month. The visual pain scale questionnaire was given to the research units before and one month after the intervention. The amounts of vitamin B6 received from the diet of the groups were obtained through a 24-hour food reminder questionnaire and N4 software. Data analysis was done using SPSS software (version 20) and independent t-tests, Mann-Whitney, Chi-square, Fisher, Wilcoxon and regression. P<0.05 was considered significant.

There was a statistically significant difference between the two groups regarding the gestational age (p=0.04), but other pregnancy variables were homogeneous in the two groups (p>0.05). According to Mann-Whitney test results, there was no significant difference between the two groups regarding the mean score of breast pain after the intervention (p=0.2).

The effect of oral vitamin B6 compared to placebo is not effective on reducing breast pain score in the first trimester of pregnancy. Further studies with a larger sample size, different doses of vitamin B6 and measuring the serum level of vitamin B6 are suggested.

Polycystic ovary syndrome (PCOS) is the most common cause of ovulation disorder in women of childbearing age, with a prevalence of 20% worldwide. Due to the increasing tendency to use herbal medicines, this study was performed aimed to investigate the effect of Vitex Agnus-Castus pill on the number and size of follicles in infertile women with polycystic ovary syndrome.

This triple-blind clinical trial study was performed in 2020-2021 on 60 infertile women with polycystic ovary syndrome. Subjects were randomly assigned to the intervention (Vitex Agnus-Castus) and control (placebo) groups. The intervention group used two Vitex Agnus-Castus tablets and one Folic Acid daily and the control group used two placebo tablets and one Folic Acid tablet for two months. In the second month, in addition to the mentioned drugs, all participants from the third to the seventh day of menstruation used 2.5 mg Letrozole for five days and on the 13 day of the cycle, they referred for ultrasound. Data were analyzed using SPSS software (version 16) and Chi-square and Mann-Whitney tests. P<0.05 was considered statistically significant.

After the intervention, the mean number of follicles in the Vitex Agnus-Castus group was significantly higher than the control group (2.73 ±0.90 vs. 2.06 ± 0.98, P = 0.008). Also in the Vitex Agnus-Castus group, the mean size of follicles was significantly higher than the control group (19.71± 1.98 vs. 17.73 ± 3.44, P = 0.009).

The use of Vitex Agnus-Castus tablets along with Letrozole in comparison with Letrozole alone can improve the quality of follicles.

Today, the field of health is trying to reduce the pain in the delivery process, which is one of the most excruciating pains, so the present study was conducted with the aim of investigating the effects of virtual reality on pain Stages of natural delivery through a systematic review Study.

In this review study to access international documents English databases like PubMed, Google Scholar, Scopus, Cochrane, Web of Science and Science Direct using English keywords based on Mesh: "Virtual Reality", "Labor pain", "Pain", "Parturition" and for Persian databases from SID, Google Scholar, IRAN DOC and Magiran with Persian keywords "virtual reality", "labor pain", "pain" and possible combinations were performed and all published studies were included in the study until March 2022. Consort scale was used to evaluate the quality of articles included in the study.

According to the initial search, 932 articles were found, and finally 8 articles meeting the inclusion criteria were included in the study. Of these 8 studies, 7 studies reported labor pain and one study referred to episiotomy repair pain. The results of studies showed that virtual reality reduces pain during labor.

Considering the positive effect of virtual reality in reducing labor pain and ease of use, it is recommended to use it to reduce pain in different stages of labor.

The most common mental disorder to be reported in the 21st century is anxiety disorders and the effect of indoor plants on anxiety levels has got more attention recently. Therefore, the present review study was conducted with the aim of reviewing the impact of indoor plants on anxiety.

In this study, a review to obtain studies published by April 2021 english databases like Pubmed, Scopus and Web of science and Persian Iran Medex, SID and Magiran using Persian and English keywords such as "anxiety", "stress". "Indoor plants", "Houseplants", "Pots", "Nature" and "Indoor" and "Angst", "Nervousness", "Hypervigilance", "anxiety", "Foliage", "indoor plants", "Indoor planting", "indoor flower", "Nature base environment", "potted plants", "house plants" were searched with all possible combinations.

Out of 46 studies found, 10 studies were reviewed based on inclusion criteria and the results were extracted. The results of 9 studies have significantly shown that indoor plants reduce the level of anxiety in individuals. One Study refutes this finding and shows that indoor plants have no effect on anxiety levels.

The result of most studies has been shown to reduce the effect of indoor plants on the level of anxiety in individuals and plants can be used as a non-pharmacological method to reduce the level of anxiety in indoor environments. However, due to the small number and many limitations in related studies, it is recommended that more research be done in this area.

Dysmenorrhea is one of the most common disorders of the female reproductive system that causes the inability of a person to perform daily activities and disorders in communication with family members. Therefore, this study was performed with aim to evaluate the effect of leech and cupping therapy in comparison with LD contraceptive pill on the improvement of dysmenorrhea.

This randomized clinical trial study was performed in 2020-2021 on 40 women with primary dysmenorrhea. The subjects were divided into two intervention groups. In the intervention group1, after menstruation, leeches and cupping therapy for 3 sessions (each week) in each month was performed for two months.  In the intervention group 2, the LD pill was taken for 21 days from the first day of menstruation and after 7 days, the next pack was started. Pain levels before the intervention, first, second and third months after the intervention were measured using a VAS questionnaire. In this study, the intervention was performed for two months, but the subjects were followed up for three months. Data were analyzed by SPSS software version 16) and Mann-Whitney, Friedman, Chi-square and Independent t-tests. P<0.05 was considered statistically significant.

The mean pain intensity in the first, second and third months after the intervention was higher in the LD contraceptive pill group than the leech and cupping therapy group and the two groups were significantly different in the second (P=0.048) and third (P=0.022) months, but in the first month after the intervention, there was no statistically significant difference (P=0.061).

The use of leeches and cupping therapy in specific areas of the ankle, back and uterus in comparison with LD contraceptive pills reduces the severity of menstrual pain.

Preterm labor is a common concern of the World Health Organization. Studies have shown that Potassium and sodium channels in the smooth muscles of the uterus are involved in causing uterine contractions. Therefore, this study was performed with aim to evaluate the serum levels of sodium and potassium in preterm labor.

This case-control study was performed on 86 pregnant women referred to Gonabad Allameh Behlool Hospital in 2019-2020 in two groups of preterm and term delivery. The two groups were matched in terms of body mass index in early pregnancy, number of pregnancies and deliveries, level of education, income, and employment status. Blood sample was taken from the mothers after obtaining the inclusion criteria at the time of admission in labor to assess serum sodium and potassium levels. Demographic and midwifery information were collected using a questionnaire and patient's file. Data were analyzed by SPSS statistical software (version 26), and Mann-Whitney, Chi-square and Fisher tests. P< 0.05 was considered statistically significant.

The mean serum sodium level in the case group (123.98±21.11 mEq/L) was lower than the control group (131.43±11.39 mEq/L) and the mean serum potassium level in the case group (4.66±5.92 mEq/L) was more than the control group (3.82±0.34 mEq/L) but these differences were not statistically significant (p> 0.05).

There is no relationship between serum sodium and potassium levels with preterm delivery. To investigate the relationship between maternal serum sodium and potassium and preterm delivery, further research is needed to evaluate the intracellular level of sodium and potassium.

Coronavirus has become a worldwide epidemic and can spread rapidly. Pregnant women and infants are more vulnerable due to weak immune systems. This study was performed with aim to review the clinical manifestations, maternal, fetal, and neonatal outcomes in pregnant women with COVID-19.

In this review study, to find the related studies, databases of Pubmed, Scopus, Medrxiv, and Web of Science were searched from the first of 2019 until January 30, 2021 using the keywords of Corona virus, pregnancy outcomes with all possible combinations and their English equivalents. Boolean operators (AND, NOT, OR) were used to search the databases. According to Strobe criteria, the studies which received high and medium quality evaluation were included in the study and reviewed.

Out a total of 3771 studies, 17 were included in this review. 4494 pregnant women were corona positive in 9 different countries. The most common symptoms of corona virus in mothers were fever and cough, and the neonatal complication of the virus included preterm delivery and respiratory distress. Most deliveries were by cesarean section and most patients used antibiotics and antiviral drugs for treatment. There was not much evidence to support the vertical transmission of Covid-19 through vaginal delivery. The most common diagnostic test for Covid-19 disease was PCR.

In most studies, the increase in cesarean delivery was due to fetal distress. However, due to the vulnerability of these two groups, preventive and precautionary measures should be considered and more emphasis should be done on educating people.

Pregnancy is one of the most important events in marital life. One of the remarkable aspects of this period is marital burnout, which has a significant impact on mother and child. This study aimed to investigate the marital burnout status and some associated factors among pregnant women referring to comprehensive health service centers in Gonabad, Iran, during 2017.

This cross-sectional study included 261 pregnant women who were selected randomly from those referring to health centers in Gonabad, Iran, during 2017. The data were collected using the Pines Marital Burnout and Demographic characteristics form. Furthermore, the data were analyzed in SPSS software (version 25) through the Mann-Whitney and Kruskal Wallis tests. A p-value less than 0.05 was considered statistically significant.

The total mean±SD score of the marital burnout in pregnant women was estimated at 2.63±0.79. The corresponding values were determined at 2.28±0.71, 2.51±0.84, and 2.42±0.88 in physical, psychological, and emotional dimensions. According to the results, the levels (percentage) of marital burnout in pregnant women were very low (21.5%), low (45%), moderate (24.9%), high (7.3%), and very high (0.4%). Regarding demographic and midwifery characteristics, marital burnout correlated significantly with variables, such as husband's education level, number of pregnancy, marriage duration, number of children, and number of male children (P˂0.05); however, there was no significant association between marital burnout and other variables (P˃0.05).

The present study showed that more than half of the pregnant women burned out or were susceptible to the risk of marital burnout. Given the adverse effects of this condition on family, it is of utmost importance to develop effective interventions and programs to deal with this issue.

Cervical ripening is of great importance in gynecology. Evening primrose is one of the medicinal plants used for cervical ripening and softening before midwifery and labor interventions. The present study aimed to review the clinical trials on the effect of evening primrose on cervical ripening and labor.

In this narrative review, search was done in Scopus, PubMed, Library Cochrane, Embase, Magiran, SID, Web of Science, and Google Scholar to find relevant studies published until May 2020. Clinical studies and quasi-experimental trials published in Persian and English were included. Persian and English keywords including Bishop Score, cervix, evening primrose and their combinations were used. The Jadad scale was used to assess the quality of articles.

A total of 283 articles were found and finally 10 interventional studies, including clinical trials and quasi–experimental studies that met the inclusion criteria were reviewed. Among these studies, three were performed on women candidates for gynecological interventions and indicated positive effects of evening primrose on cervical ripening. Other studies were done in pregnant women, but there was not enough evidence on the effect of evening primroses and its effects in pregnancy.

No reliable evidence was found on the positive effect of evening primrose on cervical ripening. Therefore, further studies are needed before using this medicinal plant in clinical practice.

The effects of air pollution on gestational hypertension and preeclampsia have been reported in a number of studies. Exposure to air pollutants is associated with adverse maternal and fetal consequences. In the present study, we conducted a systematic review on the relevant studies with the aim of determining the relationship between air pollution and gestational hypertension or preeclampsia.

In this study, a review systematic was conducted to obtain relevant studies from the English databases Pubmed, Scopus, Web of science, , Cochrane library, Embase from the beginning of 2014 to the end of31 december 2019 with English keywords air pollution,hypertension during pregnancy and preeclampsia with all possible search combinations. Inclusion criteria: Cohort or case control articles, the target population of pregnant women, is considered one of the air pollutants and its relationship with preeclampsia or gestational hypertension. Exclusion criteria: review and meta-analysis, animal and genetic studies The quality of the articles was evaluated using the Strobe checklist.

out of 581 articles, 21 articles that had inclusion criteria were examined. 8 studies considered gestational hypertension only, 5 studies considered preeclampsia, and 8 studies both considered outcome. Each of these studies has considered a range of pollutants to be exposed and their relationship to pregnancy inducted hypertension or preeclampsia were investigated. Which had 18 articles good and excellent quality and 3 articles poor quality.8 studies reported gestational hypertension as outcome, 4 studies reported preeclampsia alone, and nine studies examined both outcomes.

The results ofmost studies showned association between gestational hypertension or preeclampsia. While a number of studies have reported conflicting results on the effect of some air pollutants with preeclampsia or hypertension during pregnancy(HDP).Therefore, it is suggested that further cohort or case control studies be conducted in this area, in different countries around the world.

Shoulder dystocia is an obstetrics emergency which could be prevented by identifying its predictors and taking effective measures. The aim of this study was to determine the relationship between maternal factors and interventions for shoulder dystocia.

In this descriptive correlational study, we studied 6520 delivery files in a hospital in Sabzevar, Iran 2017-2018. All vaginal deliveries at 37-42 weeks with cephalic presentation were investigated and data of deliveries with shoulder dystocia (n=212) and without this condition (n=6308) were extracted using a researcher-made checklist. Mann-Whitney, Chi-square and logistic regression were applied for data analysis.

Findings showed significant differences between the two groups in mean age (P<0.001), body mass index (P<0.001), maternal weight (P=0.002), spontaneous labor (P<0.001), oxytocin augmentation (P=0.001), and vacuum extraction (P<0.001). In multiple logistic regression analysis, the only independent risk factor for shoulder dystocia was vacuum extraction (OR= 2.52, 95% CI: 1.596-3.978, P<0.001).

According to this study, shoulder dystocia can be predicted in vacuum-assisted vaginal deliveries which could be prevented by reducing this procedure and using alternative methods such as Caesarean section.

The effect of environment on reproductive health and pregnancy outcomes has been expressed in some epidemiological studies. Exposure to green space has been shown to improve health as well as improve fetal growth and reduce the risk of pregnancy complications. This systematic review study was performed with aim to determine the relationship between green space and preterm birth.

In this review study, to obtain relevant studies, we searched the English databases of Pubmed, Scopus, Web of science and Persian databases of Iran Medex, SID and Magiran published until 8 April 2020, with the English and Persian keywords of green space and preterm birth and all possible combinations.

From 6964 articles, 18 (12 cross-sectional studies and 6 cohort studies) which met the inclusion criteria were included in the study. Most studies evaluated green space using the normalized Index of Vegetation Difference (NDVI), proximity to green space, and distance to the park. The results of 9 studies showed no relationship between green space and preterm birth, and other studies reported conflicting results on protective effect of green space on preterm birth.

The results of most studies showed no association between green space and preterm birth and gestational age at delivery time. While some studies reported conflicting results on protective effect of green space on preterm birth. Therefore, it is suggested that further studies be conducted in this area.

Menstrual disorders are common in puberty, but they are of great concern to patients when presented with primary amenorrhea. This paper reports the case of a 17-year-old single female with secondary sexual characteristics and a suspicious mass in pelvic floor. She also complained from chronic pelvic pain. In laboratory tests, the hormone levels were normal and ultrasound scan showed a 50 to 89 mm hypoechoic adnexal mass. Computerized Tomography scan and Magnetic resonance imaging also confirmed the ultrasound findings. Due to the suspicious nature of the mass and chronic pain, the patient was subject to laparotomy, but was unwilling to undergo surgery, so, she was treated with oral estrogen and progesterone for 21 days. After discontinuation of medication, the first menstrual bleeding occurred. After the bleeding period (nine days), ultrasound scan was performed and no lump or lesion were reported. In cases where the patient has primary amenorrhea, despite the presence of pelvic mass, in case of normal laboratory tests and physical examination, a short term period with contraceptive pills is recommended.

One of the surgical interventions in the process of natural vaginal delivery is episiotomy. Episiotomy pain is a stressful problem for mothers at postpartum. Nowadays, more attention has been paid to the use of pain reduction techniques in traditional medicine such as clove extract. Therefore, this study was performed with aim to evaluate the effect of hydroalcoholic extract of clove buds on the severity of episiotomy pain in normal vaginal delivery.

This triple-blind clinical trial study was performed on 80 mothers who had delivery in the hospitals of Ferdows, Gonabad and Mashhad in 2019. The subjects were divided into two groups of intervention and placebo using randomized blockade. The intervention group received clove extract and the placebo group received distilled water. The two groups received the solutions twice a day for 10 days after delivery. Demographic and midwifery checklists and pain visual standardized tool and McGill tool were used for data collection. Pain severity was measured in several stages (before intervention, on day 4 and day 10 after delivery). Data were analyzed by SPSS software (version 22) and paired t and Chi-square tests. P < 0.05 was considered statistically significant.

There was no statistically significant difference in pain severity between the two groups before the intervention (p = 0.77). There was significant difference in pain severity between the two groups at day 4 (p = 0.00) and 10 (p = 0.00) after delivery.

The use of clove extract reduces the severity of episiotomy ulcer pain after delivery. Therefore, it is recommended to use it for pain relief after episiotomy.

Dextrocardia an abnormal heart condition in which the heart in the right hemothorax axis apex is located to the right .Dextrocardia is a rare malformation with an estimated 1 in 10,000 people. The aim of this study is to report a case of a pregnant woman with dextrocardia with hemangioma of the liver.

A 30 year’s old woman, first pregnancy, gestational age 34 weeks - with a history displacement Heart and abdominal viscus. Examination of echocardiography, Mitral valve failure was mild. And ultrasound, spleen and liver in the area LLQ and Rightward stomach and in the middle position (Cetus Inversus) And an Photo of the echogenic mass، It suggests hemangioma in the medial and hepatic region. The size of the hemangioma in this ultrasound is unchanged from the pre-pregnancy ultrasonography. Also, NT ultrasound and anomalies of normal scans and embryos have no abnormalities or displacements.

Despite the rare incidence of dextrocardia, if you suspect such cases Full physical examination and ultrasound should be performed.

Tay–Sachs is a rare autosomal recessive and neurological disease caused by the accumulation of glycosphingolipid within cell lysosomes. Ganglioside accumulation is caused by a mutation in the beta-hexosaminidase (HEXA) gene and this mutation is reduced by HEXA. The study was to determine and report two cases of TS in a family confirmed by measuring the activity of beta hexosaminidase-A.

The first case was a 3-year-old girl whose developmental growth was approximately normal until she was 9 months old, after which she developed recurrence and had symptoms of swallowing problems, abnormal eye movements, distraction, irritability and growth retardation. On examination of the patient's eye, bilateral reddish-gray spots were observed. In the evaluation of the patient's blood sample, a defect in the activity of beta hexosaminidase-A was reported and accordingly the diagnosis of Tay–Sachs was confirmed, hence the child died at the age of three. The second case was a 1-year-old boy whose development was normal until 6 months of age, after which his development and growth delayed and had apparent symptoms including distraction, irritability, respiratory problems, muscle weakness and lack of limb control, constipation, deafness, mental retardation and finally regression evolved. On examination of the patient's eye, bilateral reddish-gray stains were observed. In evaluation of blood samples, deficiency in the activity of beta-hexosaminidase-A was reported and accordingly the diagnosis of Tay–Sachs was confirmed.

 In children with developmental disabilities, who may develop symptoms of progressive weakness, loss of motor skills, increased motor responsiveness, irritability, blindness and hearing loss, seizures and persistent red cherry spots in the eye after a period of time. the diagnosis of Tay–Sachs should be considered.

Performing Benson relaxation technique by the mother improves the labor and affects neonate. This research investigated the effect of Benson relaxation technique for mothers on infant’s umbilical arterial blood gases.

In this randomized clinical trial study, 60 eligible pregnant women were selected through convenient sampling, and randomly assigned to experimental and control groups. Data collection instruments were mother’s demographic information form and neonatal information form. Benson relaxation technique were instructed to the experimental group using videos and slide presentations, and after admitting to hospital, they were encouraged to implement the noted technique. Benson relaxation technique will not be instructed to the control group. After delivery, umbilical cord of neonate was clamped at two sites, and 0.5 ml of umbilical arterial blood was collected by a trained nurse in a syringe containing heparin (< 0.1 ml), kept in an icebox, and sent to the laboratory for testing partial pressure of oxygen (PO2</sub>) and carbon dioxide (PCO2</sub>). Statistical analysis were performed using SPSS software.

There was a statistically significant difference in terms of mean oxygen (P < 0.001) and carbon dioxide (P < 0.001) pressure in the umbilical artery between the control and intervention </em>groups; the markers of the umbilical arteries of the neonate were improved in intervention group.

 Using Benson’s relaxation technique by mothers improves neonate’s arterial blood gases; and can be recommended to the healthcare system as an effective method to improve neonatal outcomes.</div>

Dandy Walker syndrome is a rare congenital disorder which displays a wide range of symptoms due to intracranial abnormalities which is usually not diagnosed at birth, and the most important disorder of this disorder is the fourth ventricle of the brain and it is associated with a high incidence of disability and mental retardation. The aim of this study was to investigate the prevalence, clinical protests, prognosis, diagnosis, and treatment of a baby with Dandy Walker syndrome.  The child was a 7-yaer-old boy with Dandy Walker Syndrome. The boy was the first child of the family. The parents had no familial relationship and no suffering from anomalies or chronic illness was observed. The mother had no sign of infection or kidney disease nor hypertention before or during pregnancy; besides, no drug was used during her pregnancy. In the baby's birth exam, the following were observed:  weight 2200 grams, height 43 cm, and head circumference 28, all of which were below 100%. In the 32nd week of gestation, due to microscopic sonography, the magnitude of the posterior cavity of the brain and the heart problem were diagnosed beyond the gestational age for legal abortion. Child suffering from seizures, hypotonia, microcephaly, large posterior fossa brain and heart problem which were diagnosed by Ultrasound Microcephaly prior to birth and at the moment the baby was suffering from mental retardation, movement problems, and growth disorders and is under the treatment with medication to control the seizures. Dandy Walker's syndrome is a fetal abnormality which may occur without a family relationship and family history, and if diagnosed late in embryonic screening, a child is born which will suffer from physical, mental and mental disabilities for years, and there is no definitive treatment for it. Therefore, ultrasound screening of exact embryo in pregnant mothers without risk factors for fetal abnormalities is recommended.

Pregnancy is associated with many physical and psychological changes that cause anxiety in the mother. Therefore, this study was investigated to determine the effect of sending short messages on pregnant women's anxiety. This quasi-experimental study was conducted on 120 pregnant women covered by community health centers in Gonabad city in 2018. Mothers were selected by convenience sampling and were randomly assigned to two intervention and control groups (60 subjects each group). The Spielberger anxiety inventory questionnaire completed before and after and one month later the intervention by the mothers in an autoregressive manner. Data were analyzed by SPSS software version 16 using paired t-test, independent t-test and Chi-square tests at a significance level less than 0.05. Before intervention, there was no significant difference between the mean of anxiety scores in the two groups, but after the intervention, the apparent and hidden anxiety of the mothers was significantly different in the two groups )P <0.05(. Sending SMS to provide care during pregnancy as an effective measure can reduce the anxiety score of pregnant women. Therefore, the intervention is recommended along with the usual care during pregnancy.

Identifying the challenges which exist in clinical education and along with setting to solve them will lead to improve the quality of medical care. Hence, this study was conducted to identify and assess the problems of clinical education model in Ahvaz Jundishapur University of Medical Science. In this descriptive–analytic research which was carried out in 2015-2016 second semester, All the last year midwifery students (n=48) through questionnaires that included five factors; environmental (7 options), performance of clinical instructors (6 options), preclinical education (4 options), health care personnel (4 options), clinical evaluation (3 options) were evaluated and data was analyzed using descriptive statistics. Also, with the nominal group technique which included all clinical educators (n=6), the most important challenges were determined. The weaknesses of clinical education from the viewpoint of students were indicated the lack of appropriate facilities, not belonging wage to midwifery students and the lack of ability to perform physiological vaginal delivery (100 percent). Moreover, from the viewpoints of Clinical educators were the lack of physical space and suitable facilities with 105 points, failing to provide feedback to the students along with practical work (70 points), Lack of coordination of training programs (60 points), the large number of midwifery students in each group(44 points) and disharmony of transportation service on holidays (30 points). Educational planners should continue to evaluate the challenges of clinical education and be adjusted to reinforce the strengths and also to moderate weaknesses of their efforts.

Background and Iran is an earthquake prone country. Women are more affected when earthquakes occur. Understanding and addressing the women’s needs for menstrual hygiene is of great importance in improving women's health. This study aimed at clarifying the perception of women about menstrualhealth needs after earthquake. The participants in this qualitative content analysis were 14 single and married women aged 18 to 45 years of old and seven health service providers. All individuals were in Zohan, Iran when earthquake occurred there in November 2012. Purposive sampling was conducted until data saturation. Data was collected by deep interviews, and writing fieldnotes. Data analysis was performed using open code. Different categories and classes were formed based on common concepts. The categories were then classified into different themes according to hidden meanings. Five themes were extracted from 288 original code including 1- exacerbation of menstrual problems in earthquake stricken areas, 2 -absence of menstrual health services and counseling, 3- cultural taboos and beliefs in the community 4- modifying poor management attitude, and 5- self-neglect. The findings showed that menstrual hygiene needs of women in affected areas are exacerbated by indigenous beliefs and low self-care skills and remain unchanged due to the lack of appropriate health services and efficient management system. Therefore, identifying women’s needs for menstrual hygiene is crucial in crises.

Women commonly experience fatigue during pregnancyand postpartum period. The fatigue may be lead to postpartum blues. This study was accomplished to investigate the relationship between maternal fatigue during pregnancy with postpartum blues. This correlational study was conducted on 60 pregnant women who referred to health care centers in Mashhad، Iran، 2009. Cases were selected through a multi-stages sampling method. Fatigue was assessed by “Modified Fatigue Symptom Checklist” in 36th and 37th weeks of pregnancy and 5th day after childbirth. Postpartum depression was evaluated by Edinburgh scale and interview at 5th and 14th days after child birth. Data were analyzed using SPSS software version 14، Fisher''s exact test، t-student and chi-square tests، lambda correlation and logistic regression tests. P value less than 0. 05 was considered significant. There were significant correlation between fatigue in 37th week of pregnancy with postpartum blues in 5thday (r=0. 651، p=0. 038) and 14th day (r=1. 000، p<0. 0001) after childbirth. Also there was a significant correlation between fatigue in 36th week of pregnancy and postpartum blues in 14th day after childbirth (r=0. 80، p=0. 017). Logistic regression showed that postpartum blues was related to fatigue in 37th week of pregnancy (p=0. 015). Fatigue in the last weeks of pregnancy is correlated with postpartum blues. Therefore it should be considered as a predicting factor of postpartum blues in routine prenatal care.

The policy of fasting of pregnant women during labor is probably an unnecessary medical intervention. It may cause adverse consequences to mother and fetus. Therefore, the objective of this study was to assessthe effect of food intake on pain and anxiety of low risk pregnant women.

This is a semi-experimental study on 175 pregnant low risk women was elected at central hospital of Gonabad during1387-88. Women in the intervention group (n=87) got dates, orange juice and water; and women in the control group (n=88) underwent fasting. The investigators used visual analogue scale (VAS) and (PBI). Data was analyzed using t and chi-squared tests. P-value of less than 0.05 was determined significant.

Anxiety levels in 7-6 cm cervical dilatation and transition as well as pain during delivery in the intervention group were lower than control group (p <0.05). However, during active phase of labor and volume of vomitous do not have any significant difference in both groups (p>0.05).

We concluded that intake of food during labor could decrease pain and anxiety level during labor.

The “nil by mouth” policy of women during labor is an unnecessary medical intervention however no science evidence has supported it. Up to now the finding from trials, which examined the effecting during labor on birth outcomes, does not provide convincing evidence to change practice. Changing policy NPO for women during labor require many trials. This study examined the effect of food intake during the first stage of labor on maternal and fetal outcomes in the low-risk pregnant women. This study is a randomized clinical trial which was done in 22 Bahman hospital in Gonabad. 180 low-risk pregnant women in active phase of labor randomly were assigned to either an intervention or usual care group. Women in the intervention group (n=87) were selected and received one of the three diets (three dates and water or three dates and tea or 110 cc of orange juice) during the active phase of labor. Conversely, the control group (n=90) underwent fasting. The second phase of labor duration was smaller than that of the control (p=0.047). The incidence of vomiting and active stage labor length were unaffected by food intake. The intake of carbohydrate foods during labor cause the reduction of the second stage of labor duration in spit of lack of accelerated vomiting incidence.