Journal of Midwifery & Reproductive health
Volume:7 Issue: 4, Oct 2019

Pelvic shape has important effects on obstetrical outcomes. Therefore, this study aimed to determine the etiologic factors that contribute to the formation of female pelvis and describe its variability.

This study was conducted on 131 women referring to Saint Joseph Hospital, Marseille, France, from March 29, 2011, to December 10, 2013. These women underwent a pelvic scan, and then completed a questionnaire to assess their exposure to several environmental influences, including adolescent physical activity, mode of acquiring an erect posture, diet, birthplace, socioeconomic status, presence of a spinal disorder, and age. A total of 43 pelvic variables were measured. Pelvic variability was analysed using principal component analyses (PCAs). Only the first two components of the PCA were analysed in this study.

Based on our results, the age of acquisition of erect posture was not associated with any pattern of pelvic variability. In addition, diet found to have no effect on the inlet shape. Spinal disorders, age, and physical activities did not exert any impact on pelvic shape. Geographic origin was found to be the only factor related to specific pelvic patterns.

The pelvic shape variability of our study population was not explained by the four categories previously proposed by Cadwell and Moloy in 1993. It is recommended that midwife teachers should be more cautious about adherence to this classification. Geographic origin seemed to be related to different pelvic shape patterns, suggesting the effect of the neutral population history in pelvic variability.

Inability in childbearing is considered a deviation from the norms; therefore, the stigmatized women need to develop some effective strategies to meet this tough challenge. The present study was conducted to determine the effect of infertility counseling programs on perceived stigma among infertile women who were candidates for intrauterine insemination.

This quasi-experimental study was carried out on 135 women referring to the infertility center, Zahedan, Iran, during July 7th to December 12th, 2018. The subjects in the intervention group were invited to take part in a three-session counseling program, whereas the control group received the routine care. The perceived stigma was evaluated using the Infertility Stigma Scale. The data analysis was performed in SPSS software (version 21) using Fisher’s exact test, Chi-square test, Mann-Whitney U test, and independent t-test.

Theresults indicated that women in the intervention group expressed less infertility stigma, as compared to the control group (P <0.001). Additionally, these women manifested less infertility stigma in subscales including public stigma (23.42±2.84 vs. 12.52±2.14; P<0.001), self-devaluation (19.58±2.04 vs.9.65±1.50; P<0.001), social withdrawal (14.04±1.65 vs.7.25±1.54; P<0.001), and family stigma (12.70±1.94 vs. 9.23±1.72; P<0.001) after the intervention.

Infertility counseling can help women to remedy their sense of self-devaluation. Additionally, establishment of close relationship with others and appropriate release of innermost feelings and thoughts can decrease the perceived public and social stigma.

Women's choice on the type of delivery mode is an important event in every pregnant women’s lifetime. Proper education is one of the most important factors that can help women to choose the delivery type. In this regard, one of the educational methods is peer education. Therefore, this study aimed to determine the effect of peer education on the choice of delivery mode.

This quasi-experimental study was conducted on 160 primiparous women at 34-36 week of gestation without indications of cesarean section section. The participants were selected from the health centers in Mashhad, Iran, during 2017 and randomly assigned into two groups of peer education and control group. In total, 10 participants were selected as peers and trained by a researcher. Then the peers were asked to train participants in eight-person groups, and the control group received routine care. A self-structured questionnaire was used to collect data in relation to mode of delivery. Moreover, the data were analyzed in SPSS software (version 19) using the independent t-test and Chi-square test.

There were no differences between the groups regarding the intention to choose the delivery methods before the intervention (P=0.73). However, the obtained results revealed higher levels of intention to choose vaginal delivery in the intervention group, compared to that in the control group (P<0.001).

The participants who were subjected to peer education acquired higher levels of intention to choose vaginal delivery.

Osteoporosis is considered as a chronic and progressive skeletal condition that might be associated with some alterations in lifestyle of different populations. Lifestyle of the students can highly affect the community due to the large young population in country. Therefore, the present study aimed to investigate the impact of education on modification of the lifestyle personality dimensions related to osteoporosis in female students.

This quasi-experimental trial was conducted on the female students of Islamic Azad University of Kazeroon, Iran in 2016. Sampling was performed using multistage random method through which a total of 133 students were selected. Afterwards, the subjects were randomly assigned to the two groups of intervention and control. The intervention performed as weekly lectures during two months with 40 minute session in each domain. The participants filled out the demographic and Health Promoting Lifestyle Profile II questionnaires pre- and post-intervention, as well as two months later. All the data were analyzed by repeated measures analysis of variance (ANOVA) to assess the changes in lifestyle scores using SPSS software version 24.

Results revealed that changes in the mean lifestyle scores regarding each of the related dimensions, including accountability, stress management, interpersonal support, and self-actualization were statistically significant in both groups. Moreover, the effect of time on improving accountability, stress management, and self-actualization was significant (P < 0.05).

The Findings of this study demonstrated that educational intervention might enhance the personality dimensions that are related to lifestyle and play role in prevention from osteoporosis. Consequently, it could be concluded that the training programs in this regard should be taken into consideration in policy making issues. Further studies on other aspects and health behaviors can be of great benefit and are recommended.

Health system responsiveness (HSR) addresses patient`s non-medical and logical expectations. Various working conditions lead to different levels of responsiveness. No research has been conducted on the responsiveness in the obstetrics and gynecology departments. Therefore, this study was carried out to measure health system responsiveness in obstetrics and gynecology departments of teaching hospitals in Mashhad, Iran

This cross-sectional study was conducted on 400 patients hospitalized in four teaching hospitals affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, in 2018. A total of 400 women were selected using simple random sampling technique. The data were collected by 32-Item Health System Responsiveness Questionnaire adopted by the World Health Organization. Data analysis was performed using SPSS (version 16) through descriptive statistics, Spearman and Pearson correlation coefficients, and linear regression.

The total mean score of responsiveness of the participants was 53.99±20.85 (Out of 100). Furthermore, 167 (41.8%) inpatients rated responsiveness as in good level. The highest to the lowest responsiveness score was related to the confidentiality, social support networks, prompt attention, dignity, communication, basic amenities, autonomy, and choice of a provider, respectively. Based on the Pearson correlation, dignity (rp=0.904, P<0.001), communication (rp=0.905, P<0.001) and autonomy (rp=0.834, P<0.001) had the highest correlation with HSR. Also a significant reverse correlation was found between age, level of education, and length of hospital stay with HSR.

Total health system responsiveness was found to be at a good level in obstetrics and gynecology wards of the hospitals under study. Given the high correlation of HSR with dignity, communication, and autonomy in the investigated wards, hospital managers should pay more attention to these issues to make their clients satisfied.

Individuals with differentiation of self will have healthy relationships with others, manage their emotions, take care of their own identity, and they suppose, feel, and act for themselves. Therefore, the present study aimed to examine the efficacy of self-differentiation training based on the Bowen’s theory on women’s self-differentiation and marital satisfaction.

This quasi-experimental study was carried out using a pretest-posttest design. The participants were randomly allocated into two intervention (n=12) and control (n=12) groups in Tehan from 15 September to 15 November 2018. Two questionnaires were used in this study, namely the Differentiation of Self Inventory and Marital Satisfaction Inventory, which were completed pre and post intervention. The intervention included ten sessions of self-differentiation training based on the Bowen’s theory. The control group received no training. The collected data were analyzed using multivariate analysis of covariance by SPSS software (version 23).

Mean scores of age were reported as 30.58±3.61 and 29.92±3.18 years in the intervention and control groups, respectively. Furthermore, both groups were homogeneous regarding the educational level. The obtained results showed that self-differentiation approach training could significantly increase self-differentiation (P<0.05) and marital satisfaction (P<0.05).

Based on the obtained results, the participants who apply appropriate self-differentiation in their lives would have enhanced ability to manage their emotions, to solve their social problems and to have higher levels of marital satisfaction.

Sexual dysfunction is common among women after childbirth, which could be associated with depression, anxiety and stress. The majority of these problems can be treated in early stages with different counseling approaches. The aim of this study was to assess the effect of counselling based on the PLISSIT model on depression, anxiety and stress among postpartum women with sexual dysfunction.

This clinical trial was carried out on 80 women referred to urban healthcare centers of Mashhad, Iran in 2017, who had a score ≤ 28 based on the female sexual function index, with no history of sexual dysfunction before and during the pregnancy. They were randomly assigned to two groups of PLISSIT and control group. The subjects in the PLISSIT group attended two counseling sessions in two consecutive weeks and those in the control group received routine care. A demographic questionnaire, FSFI, as well as DASS-21 were used to measure female sexual function as well as depression, anxiety and stress before and 4 weeks after the last session in both groups. Data was analyzed using independent t-test, analysis of covariance, and Mann-Whitney U test.

The mean scores of DASS-21 total score were 9.6±7.5 and 3.3±2.9 in the PLISSIT group and 9.2±9.5 and 8.7±4.3 in the control group at the baseline and 4 weeks after the last session, respectively. The difference between means in two groups was significant (P=0.026). By controlling the intervening variables, the DASS-21 score in the intervention group decreased, compared to that in the control group.

The PLISSIT model decreases the DASS-21 total score in women with sexual dysfunction after childbirth.

Dietary patterns have dramatically changed in all age groups, especially the teenagers in the Iranian population. It was needed to identify the prevalence of dietary patterns and its determinants in this age group. Health behavior is one factor that influence dietary patterns and self-efficacy is a strong factor for behavior improvement. Therefore, the aim of this study was to measure the relationship between dietary patterns and the status of self-efficacy induced dietary behaviors in teenage girl students.

This cross-sectional study was conducted on a total of 236 teenage girl students selected by cluster random sampling method in Mashhad, Iran, in 2016. Frequency food questionnaire and self-efficacy questionnaire were used to evaluate dietary patterns and dietary self-efficacy of each participant. Data analysis was performed using SPSS software (version 16) with unpaired t-test, Chi-square or Fisher’s exact test.

The prevalence of unhealthy dietary patterns was obtained as 65.3%. Overall levels of high, moderate, and low self-efficacy were 35.8%, 56.9%, and 7.3%, respectively. The mean score of dietary self-efficacy was higher in the group with healthy dietary patterns, compared to the group with unhealthy dietary patterns (14.12±4.25 Vs 13.88±4.71 respectively); however, the difference was not statistically significant (P>0.05).

Considering the high rate of unhealthy dietary patterns and undesirable status of dietary self-efficacy of teenagers, special attention of policymakers is needed for promotion of healthy dietary patterns and dietary self-efficacy in teenagers. It is recommended to carry out experimental studies to identify the effect of dietary self-efficacy on dietary patterns.

There are conflicting results regarding the benefit of gonadotropin releasing hormone (GnRH) agonist treatment on frozen embryo transfer (FET) outcome. No study was found to compare pregnancy outcome between patients undergoing short and long acting types of GnRH agonist for FET cycles. This study aimed to assess the effectiveness of short and long acting GnRH agonist on FET cycle outcomes.

The present retrospective study was conducted on 296 patients who underwent FET cycles between 2016 and 2017 at Mehr Medical Institute, Rasht, Iran. Pregnancy outcome were compared among three groups: Group A (n=103) received artificial hormone-mediated cycles without GnRH agonists, Group B (n=100) and C (n=93) received artificial hormone-mediated cycles with short and long-acting GnRH agonists, respectively. Also 16, 26, 12 polycystic ovarian syndrome (PCOS) patients (in group A, B and C respectively) were also assessed for ongoing pregnancy rate among three groups. Data were analyzed using analysis of variance, Kruskal-Wallis, Chi-square goodness of fit test and multivariate logistic regression.

No statistically significant differences were observed in terms of endometrial thickness (p=0.053), implantation (p=0.94), biochemical (p=0.67), clinical (p=0.82) and ongoing (p=0.96) pregnancy rates in three groups. Also, PCOS patients did not show significant differences in ongoing pregnancy rate among three groups (p=0.72).

The findings revealed that neither non- PCOS nor PCOS patients undergoing artificial hormone-mediated endometrial preparation benefit from the addition of short or long-acting GnRH agonist to FET cycles.

Sexual health education is an important part of health promotion services. Families including mothers have a major role  in boys’ sexual education so that they have to be equipped with enough knowledge regarding their young teens. The present study aimed to investigate the effect of group training on maternal knowledge and attitude toward sexual health education to boys within the age range of 12-14 years old

This randomized controlled trial was carried out on a total of 90 mothers with young teens in Mashhad in 2016. They were randomly divided into intervention (n=46) and control (n=44) groups. The data were collected using a demographic and a self-structured questionnaire for maternal knowledge and attitude. The intervention group received four training sessions once a week and the control group did not receive any training. The outcome variables were measured 15 days after the intervention and were analyzed using the Chi-square, Fisher’s exact, Kruskal-Wallis, Mann-Whitney U, and Wilcoxon signed-rank tests, as well as the independent and paired t-test.

There was no significant difference between two groups before intervention (P>0.05). However, a significant difference was seen between the two groups in terms of differences in the scores of knowledge (P<0.001)  and attitude (P<0.001)  at the beginning and end of the study .

Group training can result in significant changes in maternal knowledge and attitude with regard to the young teens’ sexual health education.

Given the importance of developing mother-friendly hospitals (MFHs) in order to promote normal delivery and respect mothers’ rights, the present study was conducted to evauate the implementation of MFH steps in the hospitals of Qazvin, Iran.

This cross-sectional study was conducted in all Qazvin hospitals (five public and four private hospitals) in Iran in 2017. The standard MFH checklist was used for data collection. The checklist included 10 steps and 110 items related to the places, equipments, facilities, records, hospital statistical data. MFH checklist was completed through observation, assessment of medical records and interview with 210 clients and staff. Expected level of MFH was considered at 80% in all steps. The data were analyzed by SPSS software (version 24).

Two hospitals obtained accepted scores at all steps. However, the achievement rates in steps 1 (i.e., current perinatal care), 3 (i.e., emergency services), 5 (i.e., preparation of labor classes), 7 (i.e., avoiding unnecessary care), 9 (i.e., trained doula), and 10 (neonate-friendly hospital) were 88.43%, 90.90%, 87.14%, 80.25%, 84.16%, and 100%, which were higher than the expected level (80%). In other steps, especially in step 8 (i.e., physiological delivery), the reported rate was very low (39.86%).

In order to obtain the MFH certificate in Qazvin hospitals, it was required to improve the access to specialized midwifery services, employing trained staff to respect clients, and using pharmacological and non-pharmacological methods for labor pain relief to increase the rate of physiological birth.

Mental health of medical students is important for working in clinical settings; therefore, it is necessary to know effective mediators in mental health. This study aimed to investigate the mediating role of coping strategies on the relationship between the thinking styles and mental health of nursing and midwifery students.

In this descriptive correlational study, a total of 180 nursing and midwifery students were selected from Islamic Azad University of Birjand, Iran in 2018. Data were collected using valid and reliable questionnaires including personal and social date, general health, as well as thinking styles and coping strategies of Lazarus-Folkman. The questionnaires were completed on a self-report basis by the students. Data were analyzed by AMOS software 20 version and statistical tests, including t-test and correlation matrix.

Legal thinking did not have a significant effect on mental health through a problem-oriented strategy (P=0.217); however, it had a significant negative relationship with mental health through an emotional-oriented strategy (P=0/006). The executive thinking had a positive effect on mental health through a problem-oriented strategy (P<0.001), and a negative relationship with mental health through an emotional-oriented strategy (P<0.001). Furthermore, judicial thinking had a positive effect on mental health through a problem-oriented strategy (P=0.046), and a significant negative relationship with mental health through an emotional-oriented strategy (P=0.048).

Thinking styles had a meaningful relationship with the mediation of coping strategies with mental health. Emotion-Oriented and problem-oriented strategies created negative and positive relationships between thinking styles and mental health of the students, respectively.

A number of studies have addressed the positive effects of parental gender preferences for children on fertility in Iran. However, new demographic situations have left two questions unanswered: whether parents demonstrate gender preferences for children in a modern low-fertility society and if so whether such a preference is a strong predictor of the probability of having another child.

This cross-sectional survey was conducted on 450 married men and women residing in Tehran, Iran in 2014. The Data collection tool included a self-structured questionnaire entailing a demographic information form, fertility intention, and gender preference-related data. The data were analyzed in SPSS Software (version 24) using cross tabulation estimation and logistic regression.

22.2% of men and 17.11% of women were reported to be in favor of having daughter, while 12.9% of men and 14% of women preferred son. Moreover, gender preference was found to have no significant effect on fertility intention. However, the women with same-sex children were 3.17 times more likely to desire another child, compared to those who have different sex composition (OR=3.178, P value= 0.000). Furthermore, the men in the age groups of ≤30 and 31-40 desired to have another child, compared to older men.

While a preference for son is rooted in Iranian culture, a new gender preference is emerging with a strong tendency toward having a girl. However, gender preference was not a driving force in the continuation of fertility in the context of low fertility of Tehran.

The integrative review is the methodology that provides synthesis of knowledge and its results could be applicable to practice. This is achieved by analyzing previous studies and generating new perspectives on the topic. This integrative literature review sought to review empirical and theoretical literature considering the ways in which health professionals’ knowledge, skills, and attitudes can be improved for the best maternal outcomes.

Keywords were identified, and medical subject headings were used to formulate the search strategy. The search strategy was adapted according to several databases, including Academic Search Complete, Health Source: Nursing/Academic Edition, CINAHL, and Google Scholar. The present review focused the period from 1996 to 2016. Review questions were designed, and inclusion and exclusion criteria were determined.

The initial search resulted in the extraction of 780 papers; however, after screening the titles, abstracts, and duplicates only 12 articles were included in the final review. Among all 12 articles, in-service training program was the main intervention to update health professionals’ knowledge, skills, and attitudes in order to achieve the best maternal outcomes. The reviewed articles focused on teaching methods, frequency or duration of the training programs, and setting of in-service training programs.

In-service training programs can improve the quality of healthcare among nurses and midwives by increasing clinical knowledge and skills, as well as changing health professional attitudes towards a more patient-centered approach.

Primary malignant lymphoma of the uterine cervix is extremely rare and can be misdiagnosed due to its different clinical presentations. The aim of this report was to introduce a case of primary malignant lymphoma of the uterine cervix which was misdiagnosed as an ovarian cyst on ultrasonography.

A 31-year-old female referred with a chief complaint of abnormal uterine bleeding. The ultrasound findings showed a suspicious malignant ovarian mass and the examinations demonstrated a large cervical mass which was considered as stage IB2 in the clinical staging of cervical cancer. However, a biopsy confirmed the presence of non-Hodgkin's B cell lymphoma of the cervix. Systemic chemotherapy followed by CHOP regimen (cyclophosphamide, adriamycin, vincristine, added to rituximab and prednisolone) was started based on the diagnosis. On the 14th month of serial follow-up, the patient was disease-free with no signs of a recurrence.

A pelvic examination in patients with vaginal bleeding, vaginal discharge, and pelvic discomfort should be considered as the first step after taking the patient's medical history.