جستجوی مقالات مرتبط با کلیدواژه « نخست زا » در نشریات گروه « پزشکی »

Anxiety is a common problem in caesarean section patients that can have adverse consequences. Benson relaxation can be useful as a complementary medicine method to reduce anxiety. The aim of this study was to determine the effect of Benson's relaxation on the anxiety level of primiparous pregnant women applying for cesarean section.

This semi-experimental interventional study was conducted among 132 primiparous pregnant women who had beeb referred to the Shahada Qain Medical Training Center for elective cesarean section in 2021. The participants in the study were selected by available sampling method and were randomly divided into two intervention and control groups. In the intervention group, the samples were given relaxation training through headphones. The Spielberger questionnaire was used to determine anxiety. Data were analyzed using SPSS software (version 16) and paired t-test, independent t-test and chi-square . The significance level of P<0.05 was considered.

Before the intervention, there was no significant difference between the demographic and background variables, the mean variables, overt, hidden, and total anxiety in the two groups (P>0.05). After the intervention, the comparison of the two groups showed that the mean scores of overt, hidden and total anxiety in the intervention group significantly decreased compared to the control group (P<0.05).

Despite the reduction of anxiety in the intervention group, the results indicated that the total and obvious anxiety in the control group also decreased significantly after the intervention. It seems that factors other than Benson's relaxation technique in this research, such as studying mothers, participating in pregnancy classes have been able to reduce anxiety among the research samples.

"Medicalization" is how non-medical and social problems are defined and managed as medical problems. Today, unnecessary medical interventions are used excessively in low-risk pregnancies and births, which leads to excessive intervention during pregnancy and childbirth. Research shows the connection between unnecessary interventions and fear of childbirth and childbirth experiences. Therefore, a study was conducted to determine the relationship between medicalized childbirth care and the fear of childbirth and childbirth experience in nulliparous women with natural childbirth..

This descriptive cross-sectional correlation study was conducted on 250 nulliparous pregnant women with natural delivery referred to Fatemeh Zahra Hospital of Miandoab in 2022. Participants were selected using convenience sampling. The data collection tools were the personal characteristics and midwifery records, the fear of childbirth questionnaire, the childbirth experiences questionnaire, and the checklist of medical care of labor and childbirth. Questionnaires were completed after the pregnant women had signed written consent forms. Data were analyzed in SPSS software ver. 16.0 using t-test, chi-square tests, analysis of variance, logistic regression, and correlation coefficient.

The results showed that the mean score of fear of childbirth was 74.93 ± 8.99, and the mean score of childbirth experience was 41.34 ± 3.42. The hospitalization before the onset of labor pains, continuous fetal monitoring, and premature rupture of the water sac were directly related to having a severe fear of childbirth. The results also showed that continuous fetal monitoring, labor pain strength induction, and fundal pressure during labor were significantly inversely related to having childbirth experience..

Some unnecessary midwifery interventions increase the fear of childbirth and the unpleasant experience of childbirth. It seems necessary to modify health policies for proper care for low-risk births.

This study aimed to evaluate the carcinogenic and non-carcinogenic health risks of heavy metals in seven types of tobacco widely consumed in the east of the country through inhalation exposure.

This descriptive-analytical study was conducted from April 2022 to October 2022 in the city of Bojnord, Iran on sook of seven popular tobacco brands. Metal concentrations in sook of tobacco were determined using inductively coupled plasma-optical emission spectroscopy. In order to analyze the data and ensure the accuracy of the results, the amount of metals in the samples was repeated three times, and their average was analyzed. Monte Carlo software was used to assess possible risks.

The results of this study showed heavy metal concentrations in sook tobaccos were, respectively, Fe>Zn>Mn>Ba>Pb>Ni>Cu>Mo>Cr>As>Cd. The concentration of heavy metals such as arsenic, cadmium and molybdenum in Alrah brand tobacco was higher than other types of tobacco. So that the amounts of heavy metals including arsenic, cadmium and molybdenum for this brand were 14.2±0.05, 10.4±0.06 and 11.6±0.04 micrograms per gram, respectively. The hazard index (HI) values for different types of tobacco, including Al-Rah, Amordadsub, Al-Fakher, Al-Rubi, Mazaya, traditional flavorless, and Nakhle, were 2.64, 2.41, 2.05, 1.7, 1.49, 1.46, and 1.44, respectively. The lifetime cancer risk (ILCR) for Amordadsub, Al-Rah, Nakhla, Mazaya, Al-Rubi, Al-Fakher, and traditional flavorless tobaccos was 2.8×10-3, 2.43×10-3, 1.72×10-3, 1.58×10-3, 1.43×10-3, 9.58×10-4, and 8.08×10-4, respectively. Lead in Alrah tobacco sook had the highest non-carcinogenic risk value with a value of 1.59.

According to the obtained results, Alrah tobacco sook has a higher cancer and non-cancer risk than regular tobacco and can cause non-carcinogenic and carcinogenic risks for consumers. Thus, it is necessary to regularly monitor the quality of prevalent tobacco to reduce delete human health risks.

Despite the adverse consequences of cesarean delivery, its incidence rate is increasing in many provinces of the country, especially Ilam city. For this reason, it is important to identify the causes of the increase in cesarean delivery in order to reduce it. Therefore, the present study was conducted with the aim of determining the frequency of cesarean section and its causes in primiparous women in Ilam city in 2016.

The present study was conducted cross-sectionally in the second half of 2016 in Ilam city, and the study population was all primiparous women referred to a single specialty maternity hospital (Ayatollah Taleghani Hospital). The sampling method was census and all cesarean deliveries were recorded in Ayatollah Taleghani Hospital. The inclusion criteria included all primiparous women. The data of the study was collected using a researcher-made questionnaire that included demographic and midwifery information. After collecting the data, the data was entered into the SPSS version 16 software Central indices were used to describe data in quantitative variables, and absolute and cumulative frequency and percentage of dispersion frequency were used for qualitative variables.

According to the findings of this study, out of 1738 births, 867 (49.88%) were natural births and 871 (50.12%) were cesarean. Among the natural births, 427 (49.25%) and among the cesarean births, 296 (33.98%) were primiparous. Among the maternal factors, lack of progress and among the fetal factors, fetal distress and among the maternal-fetal factors, head-to-pelvis disproportion was one of the most important causes of cesarean delivery in primiparous women. In general, fetal factors with more than 67% were the most important causes of caesarean section in primiparous women.

According to the findings of the study, 33.98% of cesarean births were primiparous. Considering the high statistics of caesarean section, especially cesarean section for first births , It is necessary to reduce the number of elective cesarean sections by increasing the number of physiological births and painless births, as well as increasing the awareness of families about birthing methods and the advantages and disadvantages of each of them.

 Postpartum blues is a transient period of increased emotional reactivity that occurs in approximately half of women in the first week after delivery. Due to the high prevalence of postpartum blues and its adverse effects on the mother, baby, and the family, as well as the acceptance of complementary medicine and aromatherapy, especially in women, and the sedative effects of rose essential oil, the present study was performed with aim to determine the effect of aromatherapy with the rose essential oil on postpartum blues in primiparous women.

This randomized clinical trial study with a placebo group was conducted in 2022 on 65 primiparous women admitted to Omolbanin Hospital in Mashhad. The data was completed through demographic-obstetrical information form, Stein postpartum blues questionnaire and Rosenberg's social support and self-esteem scale, Paswald scale, and Rothen fatigue intensity scale. Rose essential oil was used in the intervention group, and in the placebo group, sweet almond oil was used in the same way. The postpartum blues scores were measured on the 4th, 10th, and 14th days. Data analysis was done using SPSS statistical software (version 22) and Independent t-test, Man-Whitney, Chi-square and Fisher's exact tests. P<0.05 was considered statistically significant.

There was no statistically significant difference between the two groups in terms of the postpartum blues score before the intervention (P=0.246). But after intervention, the postpartum blues score in the intervention group was significantly lower than the placebo group on the 4th, 10th, and 14th days after delivery (P<0.001).

Aromatherapy with rose essential oil was effective and safe in reducing postpartum blues in primiparous women.

Satisfaction with married life depends on various factors. Also, among the effective factors for increasing breastfeeding, we can mention the level of self-efficacy of the mother in breastfeeding. This research was conducted with the aim of the relationship between marital satisfaction and breastfeeding self-efficacy in primiparous and multiparous mothers hospitalized in Qom city in 2022.
This study was of a descriptive-correlation type, which was investigated in 81 primiparous mothers and 49 multiparous mothers selected by convenient sampling method (available). Data collection was done using an ENRICH marital satisfaction questionnaire and BSES-SF breastfeeding self-efficacy questionnaire. The data was analysis by using SPSS statistical software.
mean and standard deviation of marital satisfaction in primiparous women (2.56±1.01) and in multiparous women (2.54±1.06) and breastfeeding self-efficacy in primiparous women (2.55±0.97) and in multiparous women (2.50±1.007). There was a significant relationship between marital satisfaction and breastfeeding self-efficacy in primiparous and multiparous mothers, respectively.
The results of this research indicate that the status of breastfeeding self-efficacy and marital satisfaction of the mothers who participated in this study was lower than the average level. Also, there is a relationship between marital satisfaction and breastfeeding self-efficacy in the primiparous and multiparous mothers in Qom's selected Hospitals in2022. Therefore, this research confirms the necessity of educating and informing parents about the importance of supporting the spouse and its effect on improving the family's breastfeeding self-efficacy.

Diastasis recti and structural changes in the abdominal muscles are among the important consequences of C-section delivery. Exercises have been proposed as a safe and pain-free solution to improve these symptoms. Therefore, the purpose of this research was to compare the effects of pilates exercises and core stability on diastasis recti and the structural characteristics of the abdominal muscles in primiparous women.

The current research is semi-experimental. A total of 20 primiparous mothers between the ages of 20 and 30 were included in the research based on the inclusion and exclusion criteria. They were randomly divided into two groups of core stability exercises and pilates exercises. In the pre-examination stage, diastasis recti and the thickness of the rectus abdominis and transvers abdominis muscles were evaluated by ultrasound. After that, the subjects of the training groups performed their respective exercises for 8 weeks. The exercises were 3 sessions a week and each session lasted 45 to 60 minutes. After the end of 8 weeks of exercises, all research variables were examined once again in the post-test phase. Two-way analysis of variance method was used to statistically analyze the research findings at a significance level of p≤0.05.

The results of the two-way analysis of variance test showed that after 8 weeks of exercises, diastasis recti (p=0.001) and the thickness of the rectus abdominis (p=0.001) and transvers abdominis (p=0.021) muscles improved significantly in both training groups. Also, the results showed that in the post-test, there is no significant difference between the average of the study variables in the two training groups (p≥0.05).

Because pilates and core stability exercises have a significant effect on the recruitment the motor units of the central muscles of the body, they can increase the strength and coordination of the rectus and transverse abdominal muscles and, as a result, create stability in this area. Therefore, they can be suggested as suitable options for improving diastasis recti and the thickness of the abdominal muscles of primiparous women.

Aim of the present study was to compare the effect of pilates and corestability exercises on diastasis recti, pain, functional disability and quality of life ofprimiparous mothers with nonspecific low back pain.

A total of 20 primiparous mothers between the ages of 20 and 30were included in the study based on inclusion and exclusion criteria. At the pre-teststage, subject's diastasis recti, pain, functional disability and quality of life wereassessed by ultrasound device, VAS visual scale, Oswestery questionnaire andSF36 questionnaire, respectively. Subjects in exercise groups then performed theirrespective exercises for 8 weeks. At the end of 8 weeks, all study variables wereexamined again in the post-test stage. Two-way analysis of variance was used tostatistically analyze the research findings at a significance level of P≤0.05.

The results of two-way analysis of variance showed that in both traininggroups, the variables of diastasis recti, pain, functional disability and quality of life ofthe subjects in the post-test improved significantly compared to the pre-test. Also,the results of two-way analysis of variance showed that in the post-test stage, thereis no significant difference between the mean of the studied variables between thetwo training groups.

Pilates and core stability exercises due to ongoing stimulation of sub-maximal contractions and correction of movement patterns by invoking andincreasing the strength and coordination of the body's core stabilizer muscles, playsa significant role in improving diastasis recti, pain, function and quality of life inprimiparous mothers with nonspecific low back pain.

One of the medical interventions in childbirth is episiotomy which is used to widen the pelvic outlet. Plantago is one of the oldest medicinal plants that have wound healing properties due to its flavonoids and phenolic compounds. The present study was performed aimed to determine the effect of plantago cream on intensity of pain and episiotomy wound healing in nulliparous women.

This triple-blind clinical trial study was performed in 2019 on 107 nulliparous women who had referred to Valiasr Hospital in Birjand for natural childbirth. The participants were randomly divided into two groups of placebo and drug. After delivery, mothers used 2-3 cm of prescribed cream on the sutures for 10 days and twice a day. The wound healing rate was evaluated on the third, seventh and tenth days after delivery using the Reda tool. Data were analyzed using SPSS 21 software and Chi-square and Mann-Whitney tests. P< 0.05 was considered statistically significant.

The mean of Reda score in the drug group was 3.433 ± 0.635 on the third day, and 0.773 ± 0.422 on the seventh day, but in the placebo group, it was 5.611 ± 0.492, 2.185 0 0.478, respectively. The two groups had significant difference on the third and seventh days in terms of wound healing (p<0.001).  The median McGill score in the drug group was 26 on the third day and 7 on the seventh day, but in the placebo group, it was 44 and 19, respectively, and the two groups had a statistically significant difference in terms of pain intensity on the third and seventh day (P<0.001)

The use of plantago cream in comparison with placebo increases the speed of improvement of pain intensity and episiotomy wound healing in nulliparous women.

Cesarean section is the most common operation in women's life and Due to the importance of mother's experiences of childbirth, the purpose of this qualitative study is to explain the stress factors according to the experience of mothers during this surgery.

In this qualitative study that was conducted using conventional content analysis method, 8 cesarean section nulliparity women were randomly selected in Shahid Akbarabadi hospital, Tehran. Then, in addition to observation and library study, deep and semi-structured interviews were arranged for the participants based on the stressors and anxieties faced during cesarean section in operating room and the data were analyzed by using Graneheim & Lundman method.

After the analysis, 8 sub- themes and 3 themes were obtained. The three themes included mothers' lack of knowledge, staff's communication problems, and mother's psychological needs which are considered to be the main stress-causing factors in cesarean section pregnant mothers.

The results showed that many of the needs of primiparous mothers who come to the operating room for caesarean section are not answered.

Dyspareunia is the most common sexual problem in the postpartum period. Considering the composition and properties of fennel (Foeniculum vulgare), there is a probability of its effectiveness in the prevention and treatment of postpartum dyspareunia. The present study was performed aimed to evaluate the effect of fennel on the prevention of postpartum dyspareunia in primiparous women.

This randomized clinical trial study was conducted on 76 primiparous women referred to Rafsanjan Comprehensive Health Service Centers from January 2017 to May 2018. They were randomly selected as available two weeks after delivery and divided into two groups (n=38 in each group) of receiving 500 mg fennel capsules twice a day for 8 weeks and placebo group. Four and eight weeks after the intervention, both groups were examined in terms of dyspareunia by the Marinoff scale. Data were analyzed by SPSS (version 21) and paired-T and Independent t-test and Chi-square test. P<0.05 was considered statistically significant.

The mean dyspareunia score 4 weeks after the intervention in fennel and placebo groups was 0.69 ± 0.61, 0.83 ± 0.69, respectively (p= 0.430) and 8 weeks after the intervention was 0.50 ± 0.57 and 0.70 ± 0.65, respectively (p=0.211). The difference between the mean dyspareunia scores 4 and 8 weeks after delivery was statistically significant in the intervention group (p=0.011). This difference was not significant between the two groups.

Taking 500 mg fennel capsules twice a day from the second week after delivery has no effect on the prevention of postpartum dyspareunia. Further studies are suggested in this area.

Assessment of progress of labor is a key primary healthcare during labor. The main goal of this assessment is to predict problems, such as abnormal progress of labor, so that the conditions of both mother and child could be improved using early interventions. Therefore, the goal of the present study was to effect of honey saffron syrup on the duration of labor of nulliparous women.

This single-blind clinical trial study was performed in 2019 on 126 nulliparous women referred to Beset Hospital in Sanandaj. Participants were selected by available methods and then randomly assigned using closed envelopes divided into honey saffron syrup group (63 person) and control group (63 person). Each participant received a maximum of 150 cc of honey saffron syrup or placebo syrup. The syrups were provided at the start of the study (4 cm dilation), and then, every 30-60 minutes until the end of the active phase of the first stage of labor based on patient's desire. Data analysis was performed using Chi-square and t-test with SPSS software (version 24).P value less than 0.05 was considered significant.

The results showed that the mean duration of the active phase of the first, second and third stages of labor after the intervention in the intervention group of honey saffron syrup (176.83±48.29, 35.92±13.85 and 13.55±7.26) compared to The control group (289.42±73.95, 74.92±29.35 and 18.92±8.7) was shorter (P <0.001).

Consumption of honey saffron syrup is effective in reducing the length of the active phase of the first stage of labor, the second and third stages of labor.

To solve any problem, it is necessary to first recognize that problem and examine the factors affecting that issue; therefore, a detailed study of stressors can help us improve the quality of education and mental health of students.

This cross-sectional study was performed at Mashhad University of Medical Sciences in the academic year 2020-2021. The participants were chosen from medical students studying in various grades using convenient sampling method. The instrument used was the standard MSSQ which consists of 20 questions including 6 different dimensions: Stress Related to Academic Issues, Intrapersonal and Interpersonal Stress, Teaching and Learning Stress, Social Stress, Desire Stress, Group Activity Stress.

A total of 463 people participated in this study out of whom 51.4% (236 people) were male. Overall, 49% of students were in high/severe condition. The highest level of stress among all dimensions belongs to the stressors related to academic issues (63.5%) and the least stressful factor for students was desire-related stress (8.20%). There was a significant relationship between total stress and gender (higher in women than men).

Considering that almost half of the students are in a high/severe state regarding stressful factors, effective training of students to manage stress and improve skills to reduce stress (e.g., by conducting workshops) would be promising.

Limited use of episiotomy and performing selective episiotomy versus conventional episiotomy has been recommended in various studies. But according to the statistics from developing countries, episiotomy is still the most common obstetric incision. The most common cause of episiotomy in low-risk mothers is maternal concern about severe perineal injuries. This study was performed with aim to compare perineal injuries in normal delivery of primiparous mothers with and without episiotomy.

This descriptive-analytical study was performed by reviewing 3602 files of primiparous pregnant women who had a normal delivery in Sabzevar Obstetrics and Gynecology Hospital during 2017 and 2019. Data collection tool was a researcher-made checklist. The maternal demographic variables, active phase length, neonatal weight, neonatal head circumference, labor mobility, induction or non-induction with oxytocin, and exposure to analgesia, neonatal hospitalization in neonatal intensive care unit (NICU), neonatal death and the degree of perineal damage including grade 1, 2, 3 and 4 laceration. Data were analyzed by SPSS software (version 21) and Chi-square and regression tests. P<0.05 was considered statistically significant.

In the delivery group without episiotomy, 317 mothers (37.8%) had healthy perineum, 324 (38.5%) grade 1 laceration and 56 (6.6%) grade 2 laceration, but in the delivery group with episiotomy, 1302 (99.3%) had grade 2laceration. Chi-square test showed a significant difference between the two groups in terms of perineal injuries (P= 0.0001). The rate of severe perineal injuries was not significantly different in the delivery group with and without episiotomy (p> 0.05). The NICU admission was not significantly different between the two groups (p> 0.05).
 

Delivery without episiotomy in primiparous mothers who don't have risk factors for maternal diabetes, instrumental delivery and infant weight > 4000 g, does not increase severe perineal injuries.

Schizotypal traits can lead to disturbance in social and personal functioning and are a prodromal risk factor for developing psychosis. Therefore, the present study aimed to investigate the mediating role of dissociative experiences and intolerance of uncertainty in relationship between traumatic childhood experiences and schizotypal personality traits.

The research was descriptive-correlational. The statistical population consisted of all students of Islamic Azad University of Birjand in the academic year of 2019-2020, whose number was 5200 people. The sample size was 400 people who were selected by cluster random sampling method. In order to data gendering, childhood trauma questionnaire (CTQ), dissociative experiences scale (DES), intolerance of uncertainty scale (IUS) and schizotypal personality questionnaire- Brief Form (SPQ-BF) was used. The present research data were analyzed using SPSS and LISREL software and structural equation modeling method.

The results of this study showed that dissociative experiences and intolerance of uncertainty mediated the relationship between traumatic childhood and schizotypal personality traits. In addition, this model has a good fit.

The results of the present study support of the mediating role of dissociative experiences and intolerance of uncertainty in relationship between traumatic childhood experiences and schizotypal personality traits. These results emphasize the need to pay attention to these structures and consider their role by specialists, therapists and planners when working with students and especially in counseling and treatment centers.

Fear of delivery in females can lead to negative side effects, such as the experience of long and hard labor. Reduction of delivery fear is one of the goals of natural delivery program, and hypnosis has been considered a way to reduce this fear. With regard to the contradictory results of the studies in this field, this study aimed to determine the effect of self-hypnosis on the experience of delivery fear and duration of labor in primiparity.

This clinical trial was conducted on 63 pregnant women who were divided into self-hypnosis (n=30) and control groups (n=33) using a blocking method in Mashhad, Iran, during 2019. The intervention group received two sessions of hypnosis at 37th and 38th weeks of pregnancy which consisted of listening to an audio file until delivery time. On the other hand, the control group received only the routine care. Fear was evaluated at 37th week of pregnancy and 24 h after delivery. Data were analyzed using SPSS software (version 16), and a p-value less than 0.05 was considered statistically significant.

The mean scores of delivery fear experience (P<0.001), as well as the duration of the second stage (P=0.013) and third stage of labor (P=0.009) were significantly lower in the self-hypnosis group, compared to the controls.

Self-hypnosis was effective in reducing the experience of delivery fear and duration of the second and third stages of labor in primiparity. Therefore, self-hypnosis is recommended to reduce the experience of delivery fear and duration of the second and third stages of labor in primiparity.

Striae Gravidarum is a skin physiological change in purple that many women experience during pregnancy and due to the accompanying problems, they suffer from stress and worries about beauty, low self-esteem and psychological problems. This study was performed with aim to determine the effect of aloe vera gel on prevention of striae gravidarum in nulliparous pregnant women.

This triple-blind randomized clinical trial study with a control group was performed in 2019 on 90 nulliparous women with gestational age of 18-20 weeks referring to the selected centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran. The subjects were randomly assigned to one of the three groups of aloe vera gel or placebo. The participants receiving aloe vera gel and placebo group daily massaged 3 cm of the gel for 2 minutes on the entire abdomen for 8 weeks, and the control group did not use any substances on the skin of the abdomen. After 8 weeks, the severity of striae was assessed by the Davy method, the severity of pruritus by the Kamini method, and the severity of the erythema by the Atwal method. Data were analyzed by SPSS software (version 20) and Kruskal-Wallis statistical test. P <0.05) was considered statistically significant.  

Three groups were not significantly different in terms of background and interventional variables at the beginning of the study (p >0.05). Kruskal-Wallis statistical tests showed that the incidence of striae (p = 0.001), the severity of pruritus and erythema (p = 0.001) at 28th weeks of pregnancy was significantly lower in the Aloe Vera gel group than the other two groups. Also, the chance of increasing the severity of striae in the placebo group and the aloe vera gel group were 75% and 95% lower than the control group, respectively.

Aloe vera gel has an effect on preventing striae gravidarum and reducing itching and erythema. Aloe vera gel can be recommended to pregnant women as a low-cost method for preventing striae gravidarum.

As the active phase of labor, prolongation of the latent phase is associated with risks for the mother and fetus. Cervical status, determined by Bishop's score, is one of the factors that influence the duration of the latent phase. This study was performed with aim to determine the effect of topical magnesium sulfate in latent phase on Bishop Score, latent phase duration and delivery outcomes in primiparous women.

This double-blind clinical trial study was conducted on 60 nulliparous women in Izadi hospital of Qom in 2018. The participants were randomly divided into two groups of magnesium sulfate and placebo (n=30 in each group). Before the intervention, vaginal examination was performed and Bishop's score was calculated. If Bishop's score was less than 5, the individual would be included in the study. In the intervention group, 10cc of magnesium sulfate 50% was administered during the examination and in the control group, 10 cc distilled water were poured on the cervix. Vaginal examination was done every 4 hours. Finally, the Bishop scores, duration of latent phase, and overall duration of latent phase until delivery were calculated and compared in the two groups. Data were analyzed by SPSS software (version 24) and Chi-square, Fisher, Independent t, and Mann-Whitney tests. P<0.05 was considered statistically significant.

Before the intervention, there was not significantly different between the two groups in mean Bishop score (p= 0.554). However, in subsequent examinations which were done 4 (p=0.001) and 8 (p=0.001) hour after the intervention, these differences were significant. Duration of latent phase in the intervention group was 636.87± 455.55 minutes and in the control group was 1209.17±688.52 minutes (p=0.004). Also, the total duration of labor was 1032.54±585.20 minutes in the intervention group and 1524.28±531.99 minutes in the control group (p=0.001). Two groups had no significant difference in terms of other delivery outcomes (p≥0.05).

The use of topical magnesium sulfate at the beginning of the latent phase improves Bishop's score, thereby shortening the latent phase duration and subsequently shortening the labor duration.

Effacement and dilatation are important factors affecting the progress and duration of labor. Impairment in their progression can disrupt the normal progress of labor and lead to maternal and neonatal complications. For many years, topical magnesium sulfate has been used experimentally for labor progression in Iran. Therefore, this study was performed with aim to determine the effects of topical magnesium sulfate on progression of effacement, dilatation and duration of labor in nulliparous women.

This double-blind randomized clinical trial was conducted on 72 nulliparous women with term pregnancy that had referred to Tehran Mahdieh hospital for delivery from March 2016 to September 2017. The participants were randomly divided into two groups of magnesium sulfate and placebo (n=36 in each group). In the magnesium sulfate group (intervention), 10 cc of magnesium sulfate 50%, and in the control group, 10 cc of distilled water was poured on the cervix in the beginning of the active phase, and the labor progress was assessed in two groups. Data were analyzed by SPSS software (version 17) and using independent t-test, Mann-Whitney, Chi-square and Fisher's exact tests. P<0.05 was considered statistically significant.

Mean duration of active phase of first stage of labor was 1.75±1.13 hours in magnesium sulfate group and 3.85±1.87 hours in placebo group, that was 2.10 hours longer than magnesium sulfate group (P=0.001). The drop-in hemoglobin levels was significantly lower in magnesium sulfate group than in the control group (P=0.022). The number of normal vaginal delivery was higher in magnesium sulfate group, but this difference was not statistically significant (P=0.429). There were no significant differences between two groups in terms of neonatal Apgar score, ruptures in birth canal and the mother’s postpartum conditions (p>0.05).

The use of topical magnesium sulfate on the cervix in the active phase improves effacement and dilatation and shortens the duration of labor. Since there are very few studies on this subject, performing further studies are recommended.

Episiotomy is of common surgical procedures in midwifery and is followed by complications including inflammation, edema, approximation of the wound and perineal pain. In past, Myrtus communis plant has been used to treat wounds and relieve pain. This study was performed with aim to investigate the effect of M. communis cream on wound healing and episiotomy pain severity.

This double-blind clinical trial was conducted on 100 nulliparous women in Zabol Amiralmomenin Ali Hospital from July to November 2018. The participants randomly received Myrtus Communis cream or placebo and used the encoded creams 2 times a day for 10 days. Demographic and obstetrics questionnaire, health status form, analgesic used, Numeric pain rating scale, Reeda scale and drug side effects table were used to assess the individuals. Then, the pain severity and recovery rate were examined on the first 2 hours, fifth and tenth day after delivery. Data were analyzed by SPSS software (version 23) and Mann-Whitney, independent-t, and Chi-square tests. P<0.05 was considered statistically significant.

There was no significant difference between two groups in terms of demographic and obstetric variables and pain severity in first 2 hours after delivery (p>0.05). The mean difference of pain severity on the fifth (p=0.009) and tenth day (p=0.012) after delivery was significant in M. communis cream and placebo cream groups, and the severity of pain was less pain in M. communis cream group. The mean of Reeda score group on the 5th day after delivery was 1.70 ± 1.09 in the M. communis cream group and 2.94 ± 1.51 in the placebo cream group (p<0.001), and on the tenth day after delivery was 1.04 ± 0.854 in the M. communis cream group and 2.06 ± 0.620 in the placebo cream group that was statistically significant (p<0.001).

M. communis cream due to its healing properties accelerates the healing of episiotomy wound and reduces the severity of pain.