مجله زنان مامائی و نازائی ایران
سال شانزدهم شماره 52 (هفته دوم خرداد 1392)

Cytomegalovirus (CMV) infection is the most common viral infection during pregnancy. Current recognition methods are including culture، PCR and ELISA. The aim of this study was to evaluate and compare the diagnostic value of culture and PCR in cytomegalovirus infection in spontaneous abortion. This cross-sectional study was conducted on 110 women with unintentional abortion who referred to educational hospitals of Tehran university of medical sciences during 2011 and 2012. For culturing، 15cc of mother’s blood was decanted in citrated tubes. 5cc of Ficoll was added and centrifuged for 5 min at 5000 rpm. After separating the buffy coat layer، it was mixed with DMEM medium and inoculated into MRC-5. Cell inclusion was evaluated after 72 hours. Samples also were evaluated by PCR for presence of DNA of CMV. The results of two methods were analyzed using chi-square test. P value less than 0. 05 was considered significant. Of 110 women، 5 cases (4. 5%) were positive in cultures on MRC-5 cell line (Human lung fibroblast cells)، however، in PCR test، 6 cases (5. 4%) were positive. Sensitive and specificity of culture was 83. 3 and 100%، respectively، and both sensitivity and specificity of PCR were 100%. Culture on cell line is not probably adequate in diagnosis of infection and PCR and ELISA are essential for exact evaluation of infection. PCR could be an alternative of culture method.

Assessment the quality of prenatal care can determine current status and be aware of effectiveness of measures taken in order to improve the quality of cares. Donabedian model is a good model of care in the health care field. Based on Donabedian model، the process of care is an important part of the trend of providing and receiving services that can assessed in technical and interpersonal interactions parts. The aim of this study was to assess the situation of presented prenatal care based on Donabedian model. This descriptive study was conducted on 320 women who referred to health centers for taking prenatal care in Mashhad، Iran، 2012. Method of sampling was multi-stage. Data was collected using a questionnaire contain information of care providers and participants and an observation checklist based on Donabedian model that divided into two parts of technical and interpersonal interactions. Data were analyzed using SPSS software version 16، Kruskal-Wallis and Chi-square. P value less than 0. 05 was considered significant. The overall mean of the process of care was 47. 92±8. 70. Results of divided of care process into two parts technical performance and interaction interpersonal showed that the average scores of technical performance was 23. 2±4. 71 and the interaction interpersonal scores was 22. 76±5. 02. Results of the study showed that the status care providing process was intermediate in 93. 7% of cases. Given the current level of quality of care، increasing the number of care providers per population covered in health cares، sensitization of prenatal care and giving information seems to be necessary.

There are strong temptation for admission of mothers in latent phase that its goals are reducing motherۥs pain and fear. Attention to admission time of women for labor can prevent from many of maternal and neonatal complications. This study was done to compare the maternal outcomes in women admitted in latent and active phase of labor.

This descriptive and comparative study was conducted on 500 pregnant women who were admitted for labor in Taleghani hospital of Tabriz، Iran in 2012. Samples were divided into two groups. First group was admitted in latent phase of labor (250 samples) and second group in active phase (250 samples). Data was collected with observation of labor process، interview with mothers and study of patient’s records. Collecting data tool was a questionnaire included samples characteristics and evaluation of maternal outcomes during 1، 2، 3 and 4th stages of labor، before discharge and 10 days after delivery. Data were analyzed using SPSS software version 13، t-test، chi-square and regression logistic tests. P<0. 05 was considered as the significant level. P value less than 0. 05 was considered significant.

Rate of oxytocin use for induction and augmentation of labor، amniotomy and prescription of Ampicillin، Hyoscine، Pethidine and Promethazine had significant differences between two groups (p<0. 05). In study of maternal outcomes during the second، third and fourth stage of labor، use of uterus compression during delivery، complications of fourth stage of labor and abdominal massage of uterus had significant differences between two groups (p<0. 05). Study of maternal outcomes before discharge and 10 days after delivery showed that there were significant differences between two groups in terms of post partum hemorrhage (p=0. 017)، hemoglobin (p=0. 007) and hematocrit (p=0. 008) and duration of stay in postpartum ward (p=0. 04).

Admitted in latent phase increase maternal complications، causes maternal invasive interventions and increases time of hospitalization. Therefore، it is recommended that physicians and midwives do not admit mothers in latent phase if there is no indication of admission.