مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 225 (اسفند 1395)

Pregnancy termination has been considered since the ancient times. Different communities have their own rules for abortion based on religion, culture and social norms which control the society. Currently, illegal abortion is one of the most common causes for hospitalization of women. On the other hand, the legislative institution and public opinions based on religion and common culture approve certain punishment for the people involved in abortion that is different in various communities based on maternal health. These punishments had considerable historical process regarding to valuing fetus life beside the mother's life.
Reviewing the historical documents and text books, particularly Vandidiad (Avesta), fascinating findings about pregnancy termination were found in that era. This review article looks at pregnancy termination from ancient times till present time and it also shows the recent developments until recent legislation which did not ban abortion for saving the mother's life in 1991.
It is searched all the old medical references from the past until recent century. It started from Avesta as an oldest writing that has a chapter with some points about pregnancy rules. So it is searched the other references as a librarian analysis and gathered all the ddatas about pregnancy and abortion rules. Therefore by performing research,we have come up with fascinating findings about pregnancy termination in that era. This review article looks at pregnancy termination from ancient times till present time and it also shows the recent developments until recent legislation which did not ban abortion in 1991.
Looking at the historical aspects of this topic shows that there was a humanitarian approach to mother, fetus and pregnancy in ancient Persia. Those specific approaches probably have had long term effects towards building a communal attitude to pregnancy termination based on importance of family, religious believes and health.

Gestational diabetes is a growing health problem around the world and is one of the most common complications of pregnancy which have many negative impacts on mother and fetus. This study was performed with aim to investigate the articles which have been published on gestational diabetes and the relationship of gestational diabetes with social determinants of health in Iran.
In this systematic review, the published articles in databases such as Iranmedex, Magiran, SID, Irandoc, Pubmed and Google Scholar were searched. Comprehensive search was done with the keywords of Gestational Diabetes, Risk factors, structural determinants, Intermediary determinants, Prevalence, Iran for Persian articles and their English equivalents for English article. After completion of searching and evaluation of the articles by a checklist, 42 articles which were performed from 2000 to 2015 in Iran were enrolled in study.
Among 42 assessed articles, 14 articles reported GDM related factors, 8 articles reported GDM related factors and prevalence of GDM and 20 articles only reported the prevalence of gestational diabetes. The prevalence of GDM has been reported between 1.25 to 29.9%. GDM related factors in the articles included structural determinants (education, occupation, income, social class and ethnicity), intermediate determinants (stress, social support, violence, food insecurity and incorrect health behaviors) and health cares.
Gestational diabetes is a common problem which is associated with several factors of social determinants of health. Therefore, adopting appropriate interventions in many cases including training, self-care and increasing pregnancy care seems to be necessary to reduce theses consequences and their following complications in high risk people.

Constipation is one of the most common complaints during pregnancy that significant percentage of pregnant women experience the onset or worsening of it during pregnancy. In this article, recommendations for constipation treatment during pregnancy were extracted from traditional medicine resources and conventional medicine databases and were compared.
In this review and library study, the recommendations related to pregnancy constipation were extracted from important textbooks of traditional medicine. Then, Persian and English articles of databases including Google scholar, Pubmed, Scopus, SID, Iranmed and Magiran were searched using the keywords of pregnancy, constipation, and the combination of two words and their equivalents in Persian with no time limitation. The results which were found in first stage obtained from traditional medicine sources were compared with the results which were obtained from the articles.
In Iranian traditional medicine, it is believed that constipation treatment and using of laxative if needed during pregnancy can reduce many of the pregnancy complications. Recommendations related to pregnancy constipation in Iranian traditional medicine textbooks included: nutritional recommendations such as eating fatty soups, medicinal recommendations such as Cassia fistula and Rosa damascene, non-nutritional recommendations such as mild walking and enema, and contraindications and cautions such as avoidance of spicy, bitter and astringent foods. In conventional medicine similar to traditional medicine, first-line treatment for pregnancy constipation is diet and lifestyle change, and medication use is prohibited as much as possible.
The general approach for treatment of pregnancy constipation in traditional medicine resources is similar to conventional medicine, but the details of recommendations in traditional medicine resources didn’t have desirable level of evidences. Also, importance of constipation treatment during pregnancy is emphasized in traditional medicine resources that is worthy to do more studies in this field.

Assisted reproductive technique is one of the methods to help the infertile couples. Need to the participation of a third person in the process of infertility treatment by surrogacy will have various human rights, legal, religious and ethical aspects. This review article was performed with aim to evaluate the studies about the human rights, legal, ethical, and religious aspects of surrogacy in Iran with an emphasis on counseling issues.
This study reviews the findings of published papers regarding different aspects of surrogacy in Iran between 2006 and 2016 in Persian databases of SID and Iran Medex and Medline, and English databases of Pub Med, CINAHL, Google Scholar. Data were collected using the key words of " surrogacy ", "surrogate mother", " Third party reproduction ", "infertility", "law ","religion " and, " ethics" alone or in combination of these words. Among 706 articles, 42 articles eligible for the study were selected.
In Iranian law, various aspects of surrogacy is not clear. Surrogacy is not accepted by the majority Sunni scholars and there is disagreement between Shia scholars. Due to legal issues such as inheritance and possible ethical dimensions including the risk for surrogate mother increase the need for continuous and comprehensive counseling.
Collecting comprehensive and accessible counseling guideline is essential to answer the medical, legal and religious questions of candidate couples before choosing this treatment method.

Streptococcus agalactiae can be colonized in rectovaginal of pregnant women and subsequently with transmission to infant's results in serious early neonatal diseases such as sepsis and pneumonia. To prevent these complications, antibiotic prophylaxis in pregnant women carrying the bacteria should be performed. There are various statistics about the colonization rate of these bacteria in Iran and the total prevalence is unclear. This review study was performed with aim to evaluate the bacterial colonization in Iran.
In this review study, colonization rate of Streptococcus agalactiae in pregnant women in Iran was evaluated by search in databases of Google Scholar, Scopus, PubMed, Iran Medex, ISC, ISI Web of Knowledge and MedLib by using the keywords of Streptococcus agalactiae colonization, group B streptococcus colonization, neonatal infection, pregnant women and Iran without time limitation. 32 articles were included in the study based on the rectovaginal colonization rate of pregnant women by Streptococcus agalactiae in different areas of Iran. Data analysis was performed using SPSS software (version 16).
A total of 10548 pregnant women in 17 cities at 32 studies were investigated. Among them, 1568 were colonized with bacteria. The total prevalence rate was estimated 15.5%; the highest and lowest prevalence of Streptococcus agalactiae was observed in Sanandaj (75%) and Kashan (7.6%), respectively.
Screening of Streptococcus agalactiae in all pregnant women at 35-37 weeks of pregnancy and providing epidemiological data to the health care system for preventive measures such as the development of vaccines based on common serotype would be useful. Also, the relationship between Streptococcus colonization and maternal and neonatal complications be evaluated in clinical studies.

Primary dysmenorrhea is one of the most common problem in women of reproductive age that negatively affect their quality of life. Since today using of complementary medicine for alleviation of primary dysmenorrhea has been considered, this study was performed with aim to review the clinical trials which evaluated the effect of acupressure at the Sanyinjiao point on relief of primary dysmenorrhea.
In this review article, electronic databases of SID, Iranmedex, Magiran, IranDoc, Cochrane Library, MEDLINE/PubMed, Scopus, Google Scholar and IRCT were searched up to September 24, 2016 to identify all the studies reporting the effect of acupressure at the Sanyinjiao point on relief of primary dysmenorrhea. The search was performed using the keywords of dysmenorrhea, painful menstruation, acupressure, Sanyinjiao Point, SP6 Point, Spleen 6 Point and Clinical trial. The quality of included studies was assessed using the Cochrane "risk of bias" tool. The results were reported qualitatively.
Among 475 articles found in the initial search, 16 randomized trials (1436 participants) were selected for this systematic review. The studies were conducted in Iran, China, Korea, Taiwan and Egypt. Most studies showed significant reduction in the severity of dysmenorrhea in acupressure at Sanyinjiao point group compared with the control group. Few studies were investigated the possible side effects of acupressure technique that no serious adverse effects were reported in these studies.
Acupressure at the Sanyinjiao point can be an effective method for alleviation of primary dysmenorrhea, but due to the poor methodological quality in the majority of trials, more studies with high-quality are needed to confirm these findings.

The relationship between maternal subclinical hypothyroidism during pregnancy and preterm birth is still not clear and the results of previous studies have been inconsistently reported. This study was performed with aim to assess the relationship between mother's subclinical hypothyroidism during pregnancy and preterm.
This study was conducted based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. Review and searching of the literatures were done by two researchers independently in databases such as Scopus, PubMed, ScienceDirect, Embase, Springer, Web of Science, CINAHL, Wiley Online Library, Cochrane Library, EBSCO and Google scholar till June 2017 with standard English MeSH keywords including Thyroid Disease, Hypothyroidism, Subclinical Hypothyroidism, Preterm Delivery, Preterm Labor, Preterm Birth, Premature Delivery, Premature Labor and Premature Birth. Random-effects size based on Cochrane test and I2 were used to pool relative risk (RR) and estimate 95% Confidence Interval (CI). Data were analyzed by Comprehensive Meta-Analysis software ver. 2 software.
Seventeen studies with 3,580 experimental and 64,885 control sample size were included. The RR of preterm birth for pregnant women with subclinical hypothyroidism compared with health group was 1.36 (95% CI: 1.09-1.68, P=0.005) and was statistically significant. RR for this relationship in Asian studies was estimated 1.60 (95% CI: 1.12-2.29, P=0.009) and was statistically significant, but this significant relationship was not found in American (P=0.576) and European (P=0.072) studies.
The incidence of preterm birth for pregnant women with subclinical hypothyroidism was higher compared to euthyroid pregnant women and this relationship was significant. Therefore, physicians should consider the management of these patients in terms of adverse pregnancy outcomes such as preterm birth.

Low birth weight of infants is one of the most serious health problems in many communities, especially in developing countries and is the second cause of infant's mortality which is affected by several risk factors, especially during pregnancy. This study was performed with aim to assess the relationship between maternal and neonatal factors during pregnancy and low birth weightas meta-analysis in Iran.
In this systematic review and meta-analysis study, by searching in databases of SID, Medlib, Irandoc, Google scholar, Pubmed, ISI, Iranmedex, Scopus and Magiran, using the keywords of low birth weight, mode of delivery, pregnancy weight gain, BMI, birth order and their compounds, all related articles from 1996 to 2016 were extracted. The results of studies were combined using the STATA software (version 11.2) and SPSS software (version 16).
A total of 22 articles with sample size of 34591 cases were entered to the study. Mother’s weight gain during pregnancy (OR: 3.13, CI 95%:1.18 – 8.32), Maternal BMI (OR: 2.19, CI95%: 1.33 – 3.46), pregnancy interval (OR: 2.13, CI95%: 1.65 – 2.75), and birth order (OR: 1.3, CI95%: 1.14 – 1.49) had statistically significant association with low birth weight.
Improper weight gain of mother during pregnancy, maternal body mass index

Infertility is a complex condition which affects the individuals and couple's life in different forms and causes serious problems in their marital and sexual relationship. The relationship between sexual dysfunction and infertility can be mutual and sexual dysfunction can cause infertility. This study was performed with aim to assess sexual dysfunction in infertile women.
In this review article, the related and appropriate article in Persian and English were collected from databases of PubMed, Scopus, Magiran, Google Scholar and SID using the keywords of infertility, female sexual dysfunction, sexual satisfaction, and sexual behavior from 2006 to 2016. Among 196 related articles, 24 article were included in final analysis.
The results showed that infertility and its diagnosis and treatment causes female sexual dysfunction and has negative effect on their martial and sexual satisfaction.
The infertile women experience more dysfunction in their relationship, but the relationship between infertility and sexual dysfunction is still controversial; it is recommended that more researches be done about the relationship between sexual function and infertility in infertile couples.