Introduction: Cesarean section (CS) is more dangerous than normal delivery for mothers and neonates. Rates of CS in our country are very high, especially in Guilan province (57.6% in urban areas). The claim that a major reason for these high rates is maternal request, hidden behind of the routine medical diagnoses, was the basis of present study.

Materials and Methods: A total of 210 pregnant women in Rasht who were at 36-40 weeks of pregnancy and had chosen CS as their delivery method without previous history of CS or any medical reason were included in this study. Cluster sampling was performed at health-treatment centers of Rasht. Data were collected by interview and a questionnaire was completed by the investigators. Statistical analyzing was performed by descriptive and analytic methods (Chi square and Fisher exact test).

Results: The majority of participants (68.6%) had moderate knowledge about benefits and harms of CS and most had taken their information from relatives and friends. The majority of women (71.4%) had moderate attitude toward CS. More than 50% of the mothers had chosen CS for following reasons, in decreasing order of frequency: child&aposs health, fear of pain, stress and anxiety, prevention of genital tears, fear of vaginal exams, prevention of deformity and relaxation of genitalia and shortening of delivery time. There was a significant relation between some of the demographic factors or obstetrical history, level of knowledge and kind of attitude with some of the reasons of choosing CS for example, age, level of knowledge (both p<0.05) and kind of attitude (p=0) with fear of pain.

Conclusion: Reasons for choosing CS by the medically low risk mothers are not medically acceptable and midwives and the other health workers can successfully explain this to mothers. They can also support pregnant women informationally, emotionally and socially in different ways such as holding childbirth preparation classes. In this way they can influence women&aposs decision about method of delivery and promote mothers&apos and neonates&apos health by decreasing CS rates.

Introduction: According to some studies, pharmacological concentrations of Mg2+ have anti-thrombotic effects and interfere with platelet aggregation in vitro and in vivo.

Materials and Methods: The study group consisted of 50 pregnant women who required magnesium sulfate for mild pre-eclampsia or preterm labor. In all patients, a platelet count, magnesium level, bleeding time and mean arterial pressure were obtained before and 2 hours after magnesium sulfate infusion. Magnesium sulfate was started with a 6 gr intravenous bolus, followed by 2 gr/hr infusion. Bleeding time was measured by Duke method. Data were analyzed with Mann Whitney U and Wilcoxon rank tests.

Results: Thirty one patients (62%) received magnesium sulfate for preterm labor and 19 (38%) for mild pre-eclampsia. Analysis of the entire study group revealed a rise in the magnesium level (p<0.0001), a lowering of the mean arterial pressure (p<0.0001) and no significant difference of the bleeding time and platelet count. Comparison of platelet count, magnesium level and bleeding time before and 2 hours after magnesium sulfate infusion revealed no significant difference in two groups.

Conclusion: According to this study, magnesium sulfate with usual dosage has no effect on bleeding time in pregnancy.

Background & Aim: Menarcheal age is an important indicator of puberty development in girls and is influenced by a wide variety of factors including race, socio-economic status and etc. The relationship between age at menarche with weight, and BMI is controversial. The present study was designed to determine the relationship between age at menarche and BMI.

Methods & Materials: This was a cross–sectional study. The sample size was 580 primary and secondary schoolgirls of Tehran/Iran by using cluster sampling. The data was collected by completing questionnaire and measuring height (cm) and weight (kg) by one trained person and analyzed by Pearson and one way ANOVA.

Results: 580 schoolgirls participated in this study. The mean menarcheal age was 12/1(1/2), mean weight 45/6 (8/2) kg and the mean BMI was 18/4 (2/4) kg/m2. This result indicated that there were a statically significance difference in mean height (p<0/0001) and mean weight (p<0/006) at different age of menarche and no significance difference in mean of weight. The Pearson test, show linear positive correlation between age of menarche and height but reversed linear correlation between age of menarche and BMI.

Conclusion: According to this finding appears menarcheal age has significant correlation with BMI and height. Therefore as menarcheal age decreases, BMI increases.

Background & Aim: Women with high risk pregnancy experience changes in their personal, family, and social life that affect their quality of life and mental status. The aim of this study was to determine the effect of type of pregnancy (normal or high risk) on quality of life and depression levels in pregnant women.

Methods & Materials: In this case-control study, a total of 100 women (50 women with normal pregnancies and 50 women with high risk pregnancies) who referred to the prenatal clinics of Kashan Medical University were studied. Subjects were randomly selected and then allocated in the normal (control) or high risk (case) groups. Data were gathered using a three-part questionnaire that included demographic characteristics, the Short Form 36 Health Survey (SF-36) to assess the quality of life, and the Beck Depression Inventory (BDI) to assess the levels of depressive symptoms. 

Results: In this study, the results revealed that the mean score of the quality of life was lower in the women with high risk pregnancy (53/20±16/83) in comparison with the women with normal pregnancy (62/18 12/48). The mean of the BDI scores in high risk pregnancies (15/34±9/15) were significantly higher than in normal pregnancies (9/8±5/44). Depression has strong negative correlation with quality of life in both women with high risk and normal pregnancies (P<0.001).

Conclusion: To sum up, it is very important to identify women that are at risk and help them to promote their quality of life.

Background & Objective: Studies show, clients&apos satisfaction is an important indicator for service quality assessment. Finding causes of dissatisfaction helps to promote health care services quality.  High quality prenatal care services and clients&apos satisfaction decreases maternal and neonatal mortality and morbidity. The perceived quality of the prenatal care by the mothers can not be effectively evaluated unless considering the opinions, demands and satisfaction rate of mothers who receive the care. The objective of this study is to measure prenatal care utilization rate and patients satisfaction in the clinics of Tehran University of Medical Sciences in 2005.

Methods & Materials: In this cross-sectional study, 380 pregnant women who had received prenatal care services in two hospitals and eight health centers were selected randomly and interviewed. Data were gathered using a questionnaire including demographic characteristics and satisfaction questions. Data were analyzed using SPSS and tested with chi-square and Pearson exact test.

Results: According to the results, 53.4 % and 14.8% of the pregnant women had received complete and incomplete prenatal care, respectively. Most of the pregnant women (54.7%) were completely satisfied, 23.7% and 21.6% were moderately and poorly satisfied, respectively. There was a significant relationship between the utilization rate and satisfaction of mothers (P<0.001). 53.4% of mothers in health centers and 46% in hospitals had received complete prenatal care. Satisfaction with prenatal care in health centers and hospitals were 57.5% and 47%, respectively. This difference was probably related to the amount of emotional and physical care received by the patients in the different settings and the characteristics of the centers in which these services are provided. The kind of setting had significant relationship with the utilization and satisfaction rates (P=0.003, P=0.005, respectively). The results showed that the utilization and satisfaction rates in the health centers in which health-care providers were midwives were better than the hospitals in which health-care providers were medical and midwifery students. But in both settings it was lower than 60%.

Conclusion: As a result, the utilization rate and satisfaction of mothers were inadequate in health centers and hospitals (lower than 70%). In the hospitals, they were lower than the health centers. The standardization of prenatal care and improvement of educational programs in hospitals should be considered.

Background & Aim: Socio-economical changes have increased the women&aposs opportunity to take job in recent decades. The increased levels of women in work places, has resulted in a high interest in the potential adverse effects of work on pregnancy outcome. This study was conducted in order to surveying the association between occupational factors and preterm childbirth.

Methods & Materials: It is a cross-sectional study. Samples consisted of nurses and midwives (518 person) who working in Tehran&aposs universities of medical sciences hospitals. Also they delivered newborns in gestational age more than twenty weeks (term or preterm) in years 2001-2006. The subjects were selected using a multi stage sampling method. Data gathered using a self-administered questionnaire. Occupational factors labeled as fatigue score and working hours. The relation between Occupational factors and preterm birth was analyzed using descriptive and inferential statistics (Chi-squared, t-test and Mann-Whitney U test) by SPSS software.

Results: Based on the study findings, the prevalence of preterm labor was 17.2% (95%CI=0.14-0.20). Although the proportions of unfavorable working conditions include: working at acute clinical wards, standing up more than 3h per each working shift, physical exercise, working in cold or hot weather, working in busy environment with continuous noise, being checker of visual and aural monitoring signals, working hours equal or more than 40 hours per week, and working fatigue score equal or more than 3 were higher in preterm group but it didn&apost show any significant relation with preterm birth.

Conclusion: According to the research findings, it seems that occupational factors do not have explicit effect on preterm childbirth. Therefore more investigations are recommended.

Key words: Preterm Labor, Occupational Factors, Fatigue

Background & Aim: Labor pain is regarded as one of the most intolerable pains which women experience during their life. Although there are many alternatives which can effect on person&aposs response and perception to pain and suffering, the pain is felt especially more severely and longer by primogeniture. Annually thousands of selective cesarean operations are performed just because of delivery pain frightening as the main reason. The pain can produce diverse and unwanted effects on delivery procedure and mother-fetus condition. So finding a method to relieve the pain and suffering is one the policies intently considered by health care systems. The aim of present study is to determine the effect of Entonox on implication of painless labor and woman&aposs satisfaction in a Hospital in Orumieh in 1385.

Methods & Materials: This research is a single blind clinical trail. Samples were consisted of women (160 persons), in two groups (each group 80 persons), which selected randomly. The intervention group used Entonox and the control group inhaled Oxygen. All subjects were instructed to use Visual Analogue Scale (VAS) and to inhale gases correctly. Due to emergency need for caesarean operation 2 members of the intervention group and 3 ones from the control group leaved the study. Data gathering tool were consisted of data registration form, VAS scale, mother vital sign recorder, and fetus heart rate recorder. The data were analysed using descriptive (relative & absolute frequencies, mean, and standard deviation) and inferential statistics (t-test, Mann-Whitney U, Chi-squared, Kolmogrove-Smirnov test) by SPSS computer software.

Results: According to the findings pain severity rate among the intervention group significantly was lower than the control group in the different hours of delivery procedure (P<0.001). Using Entonox made no effect on mother&aposs vital signs, labor process, fetus heart rate, first and fifth minute Apgar and bleeding rate after delivery. Also it was shown that probable side effects of Entonox inhalation such as drowsiness and mouth stiffness were more common in the intervention group (P<0.001), but no significant difference was seen in other complications. Meanwhile delivery satisfaction rate was higher in the intervention members.

Conclusion: It seems that Entonox inhalation might come in useful as an effective and safe method to alleviate labor pain and suffering along side with fewer likely risks for fetus and mother in clinical centers.

Background & Aim: Adolescents have important role in building the societies. Some deficits were observed in students&apos knowledge regarding puberty health. This study aimed to compare the effect of two educational methods (lecture-educational package) on girl students&apos knowledge about puberty health.

Methods & Materials: In this interventional study, 200 students were randomly selected through a multi stage sampling method. Data were collected using a questionnaire. One group received a self-learning educational package and the other group took part in two lecture sessions which totally lasted about four hours. The post test was taken 6 weeks later. Data analysis was performed using Descriptive and inferential statistics.

Results: Results of this study showed that after intervention, both groups&apos knowledge mean scores increased significantly. Also the average of package group&aposs score after the education was more than the other group&aposs score (P<0.001). The difference in knowledge mean scores before and after the intervention was significantly higher in the package group than in the lecture one. The comparison of scores in both groups before and after the education was significantly different (P<0.001).

Conclusion: Both educational methods can be considered to be effective in promoting students&apos knowledge however, the educational package was more effective than the lecture.

Background & Aim: Pregnancy and post-partum period are accompanied by important changes in women&aposs quality of life. Patient counseling is an effective way to improve quality of life. This study aimed to assess the effect of telephone counseling on the quality of life among women with a normal vaginal delivery in Razi hospital in Marand.
Methods & Materials: In this randomized clinical trial, 260 women were recruited to the study. The participants who had met the inclusion criteria were randomly allocated in two intervention and control groups. The intervention group (n=130) received telephone counseling twice at the first week for 20 minutes and then once a week from the 2^nd week to the 6^th week. Moreover, we had provided a 24-hour hotline for women. The control group (n=130) received the routine care. Data were gathered using a demographic sheet, a postpartum problem&aposs checklist, and the SF-36 quality of life questionnaire. Data were analyzed using SPSS-13.
Results: The results showed no significant differences in physical and mental quality of life in the first day of post-partum between two groups. The women&aposs quality of life in both physical and mental dimension were significantly higher in the intervention group in the 42^nd day after childbirth (P<0.001).
Conclusion: Telephone counseling by midwives could help to improve women&aposs quality of life in post-partum period. More studies are recommended.

 

  Background & Aim: Breast cancer is the most common cancer diagnosed in women in both developed and developing countries. Long-term prognosis of breast cancer strongly depends on the stage of disease at diagnosis. More than three months after detecting breast symptoms by Iranian women, they go to visit a doctor. The understanding of life-threatening symptoms and the subsequent responses are differently affected by social interaction networks as well as cultural and social contexts. This study aimed to explore the role of social interactions on health-seeking behaviors among Iranian women with breast cancer symptoms .

  Methods & Materials: A qualitative study was conducted using purposive sampling method. Twenty Iranian w omen who attended the Cancer Institute in Imam Khomeini hospital at Tehran University of Medical Sciences and complained of symptoms of breast cancer were recruited to the study du ring 2012-2013. Data were collected through semi-structured and in-depth interviews. Interviews were transcribed and analyzed using conventional content analysis in the MAXqda . 

  Results: The results revealed three themes including: 1) effectiveness of social learning 2) seeking social support and 3) feedback with a supportive approach which included seven categories of informative social learning, reliable social learning, selective disclosure, seeking information, seeking emotional support , giving reassurance and social support for decision making .

  Conclusion: E ffective social learning and supportive interactions have influential role on health seeking behavior. Thus it is necessary to improve public awareness and correct clients' social beliefs about breast cancer to shorten the patients' delay .