مجله زنان مامائی و نازائی ایران
سال بیستم شماره 3 (خرداد 1396)

Childbirth is one of the most unique moments of women's life, however, if it's natural process is prolonged, then leads to intolerable phenomenon in mother, so that it is associated with undesirable maternal and fetal complications. Therefore, this study was performed with aim to evaluate the effect of abdominal massage along with breathing techniques on duration of uterine contractions in primiparous women.
This randomized control trial was performed on 64 pregnant primiparous women referred to Tehran Lolagar hospital in 2010. The subjects were divided into experiment and control groups through systematic random assignment. In experimental group (n=32), effleurage abdominal massage with breathing techniques was performed during 30 minutes of early active and transferal phase, and control group (n=32) received routine care. Features of uterine contractions and duration of childbirth stages were examined in both groups. Data was analyzed by SPSS software (version 17), and using Chi-square, Fisher, and independent t tests. P ≤0.05 was considered significant.
Based on the results, mean duration of first stage of childbirth after the intervention (70±254.74 vs. 311±63.05 min) was significantly less in experimental group than control group (P=0.002). Duration of second (p=0/952) and third (p=0/672) stages of childbirth was not significantly different between two groups. Mean number of uterine contractions was significantly higher in experimental group (P0/05).
Abdominal massage along with breathing technics increases the number of uterine contractions in labor while has no adverse effect on the delivery outcomes. Therefore, it is recommended this non-drug approach be used instead of drug-based methods which strengthen uterine contractions such as oxytocin.

Breast cancer is the most prevalent cancer in women. In Iran, %16 of all cancers in both male and female is related to breast cancer, and it has the first rank among Iranian women. Increasing levels of angiogenesis factors including NO, FGF, and VEGF is threatening in first stages of cancer, but it helps treatment and recovery in therapeutic level. Therefore this study was performed with aim to evaluate the impact of eight weeks of resistance training on some angiogenesis indicators in women with breast cancer.
This semi-experimental study was performed on 30 women with breast cancer who had undergone therapeutic level. They were randomly divided into two groups, control group (n=14) and resistance training group (n=16). The experimental group performed resistance training for 8 weeks, per week three sessions, with the intensity of 50-70 percent of 1RM. To study the variables of NO, FGF, and VEGF, 48 hours before and after the last session of training, the blood samples were taken of participants. Data were analyzed by SPSS software (version 19) and independent and dependent T test. P The eight weeks of resistance training significantly increased the levels of VEGF, FGF and NO in experimental group than control group (P=0.0001).
The eight weeks of resistance training increased the level of some angiogenesis indicators and this increase in angiogenesis indicators leads to increased muscle mass and reduced fatigue in patients with breast cancer.

The quality of clinical decisions made by on-call physician is totally dependent on the quality of medical information received from resident. Some factors such as type, number, format, quality and also the volume of such information may highly affect the quality of remote consultations. Therefore, developing a trusted standard model for such clinical communication seems to be necessary. This study was conducted with aim to design a clinical archetype (structure data) for remote decision making in high-risk pregnancies.
This multi-stage cross-sectional study was conducted by using Delphi technique for identifying of the most common high-risk pregnancies to design a archetype for clinical decision making in three obstetrics and gynecology departments of educational hospitals, Mashhad.
There were 5 common high-risk pregnancies (leading to delivery) including hypertension, third trimester hemorrhage, PROM, pre-term and post-term delivery. 161 clinically-important groups / items were extracted from scientific references and then hand-filtered to 158 items by the participating gynecology and obstetrics experts. The final items were categorized into five classes including general information, chief complaint / current problem, medical history, clinical examination, and paraclinic results.
Our findings showed that close interaction between clinicians and specialists in medical informatics may facilitate the improvement process of medical teleconsultations.

Bacterial Vaginosis is the most common cause of vaginitis that itself is responsible for 50% of all cases of vaginitis. Metronidazole is considered the first line for treatment, but it is reported that there is carcinogen and resistance to metronidazole. With regard to anti-bacterial effects of medicinal herbs such as Nigella sativa (the trade name of Phytovagex) on microbic organism, this study was done with aim to compare the remedial success percentage of Phytovagex vaginal suppository with Metronidazole oral tablet in women with bacterial vaginosis.
This triple-blind randomized clinical trial was done on 57 women with bacterial vaginosis referred to health centers subclass of health center No 2 in Mashhad at 2015-2016. The research units were randomly divided into intervention and control groups. The intervention group received Phytovagex vaginal suppository 1% once a day and placebo tablet twice a day for seven days, and control group received metronidazole tablet 250 mg twice a day and placebo vaginal suppository once a day for seven days. 7-10 days after treatment, the success percentage of treatment was investigated at each group by clinical standards. Data was analyzed by SPSS software (version 16) and independent t-test, Chi-square, Macnemar and Exact Fisher tests. P The success percentage of treatment of bacterial vaginosis was 74.2% in Phytovagex vaginal suppository group and 69.2% in Metronidazole tablet group that was not statistically significant (P>0.05).
Phytovagex vaginal suppository is as effective as Metronidazole tablet in treatment of bacterial vaginosis and can be an appropriate alternative to treat bacterial vaginosis.

Pain is a common phenomenon and an inevitable component of childbirth. Feel or experience of pain effect can lead to fear and anxiety in the process of childbirth. In conducted studies, the use of non-drug methods for decreasing pain has not been associated with maternal and fetal complications. This study was performed with the aim to compare the effect of two methods of massage therapy and aroma therapy with Jasmine oil in reducing childbirth pain.
This experimental clinical trial study was performed on 120 pregnant women referred to Abadan hospitals for childbirth in 2012. There were 40 women in the first case group (recipients of aroma therapy with Jasmine oil), 40 women in the second case group (recipients of massage therapy with Jasmine oil) and 40 women in the control group (recipients of routine care). Aroma therapy was performed by smelling a handy towel and pouring 5-10 drops of Jasmine oil and smelling the towel in three dilatation steps (4-5, 6-7, 8-10) during and after contraction until labor. For massage group, 20 minutes of regular and rotational massage was done in the areas (the scapula, both sides of vertebral column and the sacral area) in three dilatation stages (4-5, 6-7, 8-10) during and after contraction. After the end of pain and in case of the parturient desire, pressure applied on the sacral, or throughout the back and shoulders. Data was analyzed by SPSS software (version 16) and unilateral variance analysis test and Tuki statistical test. P Massage with Jasmine oil reduced the pain of first, second and third stages of delivery compared to control group (P Jasmine oil along with massage and aroma therapy methods with stronger effect of massage methods reduced pain in three stages of childbirth.

Dysmenorrhea is one of the most common gynecological problems in women which can be treated with chemical drugs, herbal medicines, acupuncture, acupressure, and massage therapy. With regard to the possible positive effect of Achillea-Millefolium (AM) on dysmenorrhea and lack of adequate studies in the area, this study was performed with aim to investigate the effect of extract capsule of AM on duration and severity of primary dysmenorrheal pain.
This triple-blind randomized controlled clinical trial was performed on 50 women referring to Valiears health center affiliated to Tehran University of Medical Sciences in 2015-2016. The subjects were divided into intervention and control group. During three first day of menstruation, the intervention group was treated with 150mg AM capsule for every eight hours and 250mg Mefenamic-acid capsules for every six hours, and control group was treated with AM placebo capsules and Mefenamic-acid capsules during two consecutive months. The study tools were demographic questionnaire and visual analogue scale (VAS). The severity of pain was measured by visual analogue scale (VAS) and duration of pain was measured by the day (one cycle before the study and two cycle during the intervention). Data was analyzed by SPSS software (version 22) and t-independent statistical tests, Mann-Whitney, Fisher and Friedman tests.
Before the intervention, two groups were similar in terms of pain severity and duration of pain. During two cycles of intervention, pain severity and duration of pain significantly decreased (P0.05).
Decreased dysmenorrheal pain was higher in the group of AM and Mefenamic-acid capsules compared to the group of Mefenamic-acid capsules that may be is due to the effect of AM on dysmenorrheal pain.

Since primary dysmenorrhea is one of the common gynecological disorder in women of reproductive which is sometimes associated with one or more systemic symptoms, this study was performed with aim to compare the effect of SP6 moxibustion and acupressure on the severity of systemic symptoms associated with dysmenorrhea.
This randomized clinical trial study was conducted on 100 students living in dormitories of Sabzevar Islamic Azad University in 2015. The subjects were randomly assigned into two groups of 50 cases in moxibustion and acupressure groups. The SP6 moxibustion group was asked to hold a burning moxa stick to the SP6 point, and the acupressure group was asked to press their thumb perpendicularly on the SP6 point (10 minutes of for each leg). The intervention was performed twice during the last week of cycle and the first and second day of menstrual bleeding. Severity of the systemic symptoms associated with dysmenorrhea was assessed with a verbal multidimensional scoring system before and during two cycles of the intervention. Data were analyzed using SPSS software (version 16), and using Mann-Whitney and Friedman test. P In both groups, all symptoms were significantly reduced compared with before the intervention (P Both moxibustion and acupressure methods reduce the severity of the systemic symptoms; however, moxibustion is more effective than acupressure.

Pregnancy is associated with extensive mental and physical changes in pregnant women. Stress, anxiety and depression are factors affecting pregnant women’s performance that lead to lack of attention to their own self-care. Orem's self-care theory is one of the most widely used theories in the field of self-care. This study was performed with aim to investigate the relationship of self-care behaviors in pregnancy based on Orem’s theory with stress, anxiety and depression in women at risk of preterm delivery.
This descriptive correlational study was done on 176 pregnant women in 24-26 week of pregnancy at risk for preterm delivery referring to health centers affiliated to Mashhad University of Medical Sciences in 2015. The research tools included Holbrook risk-scoring for preterm labor questionnaire, demographic and obstetric questionnaire, Hart prenatal care actions scale and DASS21 (stress, anxiety and depression questionnaire). According to Holbrook risk-scoring for preterm labor questionnaire, the subjects who met inclusion criteria were selected. Self-care behaviors were assessed according to Hart prenatal care actions scale, and stress, anxiety and depression were evaluated according to DASS21 questionnaire. Data were analyzed using SPSS software (version16) and using Pearson and Spearman correlation tests. P There was inverse linear significant relationship between prenatal self-care and stress (P =0.004) and depression (P =0.032). But no significant relationship was seen between prenatal self-care and anxiety (P =0.374).
The increasing stress and depression in women at risk of preterm delivery reduce self-care behaviors in these patients. Therefore, management and identifying of pregnant women at risk for stress and depression and planning for reducing their stress and depression will lead to increased self-care behaviors in women at risk for preterm delivery.

Previous studies and needs assessment indicate the need for youthon the verge of marriage to attend counseling classes in order to they can easily ask their sexual questions and receive their answers. Therefore, due to the lack of adequate information on the most effective way to provide counseling in this area, this study was performed with aim to compare the effect of group counseling and an integration of group and individual counseling on sexual knowledge and attitude in women on the verge of marriage.
This three-group interventional study was performed on 162 women referring to premarital counseling unit of Mashhad health centers in 2015-2016. The subjects were assigned into three groups of receiving integrated (individual and group) counseling, group counseling and normal education (control). Integrated group received two sessions of group counseling and one session of individual counseling, group counseling received three sessions of two hours of group counseling with one week intervals with objects of spouse relations and sexual and reproductive health. Data was collected using a standard questionnaire SKAS and were analyzed using SPSS software (version 16), and using ANOVA and Tukey, one-way ANOVA, Kruskal Wallis, and Chi-square tests. P After the intervention, the difference of knowledge score (P=0.001) and sexual attitude score (P=0.004) was significant between three groups, but there was no significant difference between knowledge (P=0.9) and attitude (P=0.4) of two intervention groups.
Sexual knowledge and attitude of women toward sexual relations increased following the both methods of group counseling and an integration of group and individual counseling, this increase was significant compared with control group. According to the available facilities, implementation of each of two methods of counseling is recommended.

Pregnancy and childbirth as a natural process at some points of women’s life is associated with mental and physical changes. Prpgancy low back pain which may last up to six months after delivery is related to multiple factors including muscle weakness and remained lumbar lordosis. Therefore, this study was performed with aim to determine the effect of core stability training on lumbar lordosis and low back pain after delivery.
This semi-experimental interventional study was performed on 32 nulliparous womenreferred to Shaid Mobini and Shahid Banoovani haspitals in Sabzevar city at the second half of 2015. The subjects were divided to training and control groups (n=16 in each group). The training group performed core stability exercises for 8 weeks (3 sessions per week). The control group had no exercise during this time. At the end of 8 weeks, lumbar lordosis and low back pain were measured. Data were analyzed by SPSS statistical software (version 20) and using independent t and paired samples t-test. P In this study, core stability trainings significantly decreased lumbar lordosis (P=0.034) and low back pain (P=0.003).
The core stability training is a good approach for correction of lumbar lordosis and back pain after childbirth.

Vitamin D deficiency is common during reproductive age. Recent data suggest that vitamin D deficiency is associated with poor reproductive function in women and men. Therefore, this study was performed with aim to determine the role of vitamin D on some reproductive function (such as polycystic ovary syndrome, endometriosis, myoma, premature ovary failure, male infertility, and in vitro fertilization (IVF).
In this review study, Persian and English articles that published during 1997 to 2016 with keywords of vitamin D, infertility, fertility were searched in PubMed, Magiran, Google Scholar, Iranmedex, Scopus, Irandoc and SID databases.
A total of 35 studies which were extracted from 302 articles related to the role of vitamin D on some reproductive function were studied. The results of latest research articles in this field were discussed and summarized.
Deficiency of vitamin D defined as serum concentration of