مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 189 (هفته چهارم فروردین 1395)

More than 25% of pregnant women have bleeding at first trimester and first of second trimester that half of them will experience miscarriage. There are different causes and methods for diagnosis and treatment of bleeding during pregnancy. Regarding to relatively high prevalence of first trimester bleeding and recommended diagnostic and treatment methods, this study was performed with aim to evaluate the causes, diagnostic and treatment methods and pregnancy outcomes in patients admitted in the department of obstetrics, Semnan Amiralmomenin hospital.
This cross-sectional and prospective study was performed on 200 patients with first trimester bleeding admitted in the department of obstetrics, Semnan Amiralmomenin hospital during 2013-2014. Information of patients with approved pregnancy including the causes of bleeding, diagnostic and treatment methods and pregnancy outcome were studied and recorded in researcher-made questionnaire. Data was analyzed by SPSS software (version 16) and descriptive statistical methods. P Causes of abnormal bleeding were blighted ovum in 2 cases (1%), incomplete abortion in 52 (26%), missed abortion in 62 (31%), complete abortion in 24 (12%), threatened abortion in 54 (27%), ectopic pregnancy in 2 (1%), molar pregnancy in 1 (0.5%) and cervical polyps in 1 (0.5%). Treatment method was medical and surgery in 56 cases (48.27%), medical in 40 (34.48%) and surgical in 20 (17.24%). Among 54 (31%) of threatened abortion, 20 (37.05%) had abortion, 10 (18.5%) preterm delivery, and 22 (47.4%) term delivery. All cases had gestational age The causes of abnormal uterine bleeding which led to admission at first trimester of pregnancy were inevitable abortion, threatened abortion, ectopic pregnancy, molar pregnancy and cervical polyp, respectively. The most common causes of admission were inevitable abortion and the most common treatment methods were medical surgery. About half of the threatened abortion cases resulted in term delivery, 37 % abortion and 18% preterm delivery. Gestational age

Postpartum pain is the pain caused by uterus intermittent contractions after placenta leaves the uterus that sometimes needs narcotics to relieve it. Due to the harmful effects of the drugs, tend to use herbal medicines has been increased. This study was performed with aim to compare the effects of dill essence and Mefenamic acid on postpartum pain.
This clinical trial study was performed on 108 multiparous women who had vaginal delivery and postpartum pain in 2015. They were randomly divided into two groups of dill essence (n=54) and mefenamic acid (n=54). Two hours after delivery, postpartum pain severity was measured by pain ruler. If they had score≥ 3.1, they were studied and if the pain continued, they received dill essence (1.5 mg per kg of body weight/20) or mefenamic acid (250 mg) up to 4 times each six hours. Data was analyzed by SPSS software (version 22) and Chi-square, t-test and repeated measure tests. P Mean of postpartum pain decreased after the intervention, but no statistically significant difference was observed between two groups (P>0.05).
Dill essence decrease postpartum pain like as mefenamic acid, therefore, it can be used as an anti-pain plant in mothers with postpartum pain.

Primary dysmenorrhea is of the most common complaints in women. Patient assessment and successful treatment needs to assess the patient's pain. According to high and different prevalence of primary dysmenorrhea in various studies and to know the most accepted tools of dysmenorrhea pain assessment and to discuss the advantage and disadvantage of these tools, this study was performed with aim to assess the articles related to dysmenorrhea in dimension of menstrual pain assessment tools.
This review article was performed with aim to assess the articles related to dysmenorrhea in dimension of menstrual pain assessment tools. Therefore, databases of Cochrane, Embase, Pubmed Medline, and Google Scholar were searched to find the related references with keywords of dysmenorrhea, scale, … between 2003 and 2013. The contents of the articles were exactly and repeatedly studied and were analyzed with focus on qualitative and quantitative aspects of pain assessment tools.
Totally, 259 articles were obtained. 248 articles used subjective tools of dysmenorrhea and 11 articles used objective tools. The most used subjective tools were VAS and Multi dimensional Verbal scale and most used objective tools of dysmenorrhea was evaluation of prostaglandins level. Totally, 28 different tools were used to assess dysmenorrhea pain. 9 tools were used in Persian articles. Moreover, 199 articles (78.6%) had simultaneously used one scale, 48 (18%) two scales, 10 (2.8 %) three and 2 (0.4 %) four scales.
Generally, various and different tools are available for menstrual pain assessment, but there is not a gold standard, but VAS and Verbal multidimensional scale are used more than other tools. It is necessary to select an appropriate tool according to the aim of researcher of the study, the study's cost, characteristics of study population and scale properties.