Journal of Midwifery & Reproductive health
Volume:3 Issue: 3, Jul 2015

Primary dysmenorrhea can be relieved via some medical and non-medical approaches. In this regard, the probable therapeutic role of zinc supplements has been recently emphasized. The present study was conducted to determine the positive effects of zinc supplements on relieving primary dysmenorrhea and premenstrual symptoms. The present double-blind, randomized, controlled trial was conducted on 66 students at Hamadan University of Medical Sciences. Students with the experience of primary dysmenorrhea in at least the last three menstrual cycles (ranging between 21 and 35 days) were included in the study. The participants were randomly divided into experimental and control groups. The experimental group received oral zinc supplements (50 mg) twice daily for four days before the onset of menstruation and the control group received placebo. For data analysis, t-test, Mann-Whitney U test, ANOVA and Wilcoxon test were performed (95% CI). The intervention led to a decrease in the severity of dysmenorrhea and menstrual bleeding in the experimental group, unlike the control group. The experimental group experienced a lower frequency of some premenstrual symptoms such as headache, vertigo, muscular pain, disability in performing daily activities and general weakness; however, these changes were insignificant in the control group. Lower rates of medicine use for improving dysmenorrhea and its side-effects were reported in the experimental group, compared to the control group. Moreover, the experimental group had a lower tendency to use thermotherapy. The intake of zinc supplements at therapeutic doses could effectively reduce the severity of dysmenorrhea, improve menstrual bleeding and premenstrual symptoms and prevent other premenstrual symptoms.

Men’s sexual and reproductive health is one of the most important public health issues. However, less attention has been paid to this matter, compared to women’s health issues. The aim of this study was to evaluate the educational needs of men regarding sexual and reproductive health in Ahvaz, Iran. This descriptive study was performed on 1,068 adult men (aged 20-60 years), selected via random cluster sampling in Ahvaz city in 2014. In order to determine the educational needs of men regarding sexual and reproductive health, a questionnaire consisting of three major sections (i.e., demographic data, sexual and reproductive health needs, and men’s attitudes) was designed. The validity of the questionnaire was determined by content and face validity. Its reliability was assessed by internal consistency (α=85%) and test-retest. For data analysis, descriptive statistics, t-test and ANOVA were performed, using SPSS version 19. The majority of men (75.1%) had poor knowledge and a moderate attitude (67.3%) towards sexual and reproductive health. The three most important educational needs of men regarding sexual and reproductive health were cancers of male reproductive system (83.8%), sexually transmitted diseases (STD)/HIV (77.4%) and religious attitudes toward sex (77%), respectively. Friends were the most important source of information in all aspects of sexual and reproductive health, while men preferred to receive information from a male physician or counselor. According to the results, men were dissatisfied with the amount of information they received about sexual and reproductive health. Based on the findings, men felt the need for sexual and reproductive health education; these needs were influenced by social and demographic factors, except marital status. If health policymakers pay attention to these educational needs, it is possible to implement suitable programs for improving men''s sexual health and knowledge.

The quality of communication between midwives and parturient women is a determinant of maternal satisfaction with midwifery care. Therefore, this study was conducted to determine the communication skills of midwives at maternity wards of Mashhad teaching hospitals in 2014. In this descriptive study, 49 midwives, working at Mashhad teaching hospitals, were randomly selected. All midwives worked rotating shifts at the wards. The midwives’ communication skills were assessed by the researcher, using the self-structured observation checklist of communicative performance. The mean age of midwives was 39.11±9.66 years and their mean work experience was 15.9±8.77 years. In total, 68.3% of the participants experienced childbirth themselves. 66.7% of midwives were moderately keen on midwifery as a profession. The mean score of the checklist obtained by midwives was 67.9±10.7. There was no relationship between midwives’ communication skills and work experience, childbirth experience, age or interest in midwifery. Considering the inadequacy of midwives’ communication skills, which could be the major cause of maternal dissatisfaction with delivery care, it is recommended that in-service training courses be held by applying new teaching methods. Moreover, the educational needs of midwives, including communication skills, should be considered in these training programs.

The present study aimed to evaluate the frequency and severity of nausea and vomiting during pregnancy (NVP) and to investigate the association between psychosocial health and the severity of NVP. This cross-sectional study was performed on 200 eligible pregnant women with nausea and vomiting at three prenatal care centers in Kashan, Iran. The participants completed demographic and pregnancy-related questionnaire, Beck Depression Inventory-Short Form, Winnfield Tiygmann social support questionnaire and Paykel scale of stressful life events. the severity of NVP was also recorded. ANOVA and Kruskal-Wallis tests were used to determine the relationship between different variables. P-value less than 0.05 was considered statistically significant. The frequency of NVP was estimated at 71.5%. In total, 19%, 45.5% and 7% of these cases had mild, moderate and severe NVP, respectively. The severity of NVP was significantly associated with depression level (P=0.01). However, there was no correlation between the level of social support and unpleasant life events with severity of NVP. According to the results of this study women with more severe NVP experienced a higher level of depression, compared to others. However, social support and other factors were not correlated with the severity of NVP.

Although pregnancy seems to be a pleasant experience in a women’s life, the accompanied physical and psychological changes lead to high levels of stress in mothers. Prenatal stress widely affects the physical and mental health of mothers and infants; therefore, adopting appropriate coping strategies are highly required. Considering the importance of coping strategies in psychological hardiness, we aimed to determine the relationship between psychological hardiness and prenatal coping strategies. This correlational study was conducted on 500 pregnant women, referring to the healthcare centers of Mashhad, Iran in 2014. The study subjects were selected via convenience sampling. Data collection tools included Kobasa Hardiness Scale, the Revised Prenatal Coping Inventory and Perceived Stress Scale. For data analysis, Spearman correlation coefficient and regression analysis were performed, using SPSS version 16. The significance level was considered to be 0.05. Psychological hardiness had a significant positive correlation with planning/ preparation (r=0.70, P<0.001) and positive/spiritual coping strategies (r= 0.75, P<0.001). However, a significant negative correlation was found between psychological hardiness and avoidance coping strategy (r=− 0.81, P<0.001). Considering that psychological hardiness was correlated with planning/preparation and positive/spiritual coping strategies, it is recommended to encourage pregnant women to adopt these adaptive strategies to overcome stress during pregnancy.

Neonatal resuscitation training is mandatory for the staff providing maternity and neonatal services in order to ensure competence during the academic period. This study was conducted to assess the neonatal resuscitation skills of nursing and midwifery students. In this study, the skills of 48 nursing and midwifery students were assessed, using Objective Structured Clinical Examination (OSCE), which consists of seven “stations”, lasting 28 minutes. In station 1, students’ knowledge was assessed. In stations 2-7, students’ skills in the initial steps of resuscitation, positive pressure ventilation, intubation, chest compression, medication prescription and management of cardiopulmonary resuscitation were assessed. Time management and students’ re-evaluation of the infant were also assessed. The total score of OSCE was calculated to be 236. Also, students’ self-evaluation regarding their competence in neonatal resuscitation and their satisfaction with OSCE were evaluated, using two self-structured questionnaires. The mean score of students’ skills in neonatal resuscitation was 97.85±23.15 out of 236. On average, students obtained 38%, 49%, 20% and 72% of the total score in the initial steps of resuscitation, positive pressure ventilation, intubation and chest compression, respectively. Also, the students obtained 45%, 29% and 56% of the total score in prescribing medications (drug dosage and route of administration), management skills in advanced resuscitation and knowledge on neonatal resuscitation, respectively. Students’ self-confidence was lower than half of the optimal score, and their satisfaction with OSCE was high. The students’ skills in neonatal resuscitation were lower than expected. As competence in this area is of high significance for the improvement of neonatal outcomes, holding training workshops through applying novel training methods is recommended.

Hepatitis B virus (HBV) infection is a major global health concern. According to the statistics, the prevalence of this infection is moderate in Iran. Pregnant mothers, who are infected with the virus (virus carriers), can transmit the infection to their fetus. This study aimed to determine the prevalence of hepatitis B surface antigen (HBsAg) and its influencing factors in pregnant women, referring to healthcare centers of Dehloran, Iran. In this descriptive, cross-sectional study, the sample consisted of all pregnant women with medical records, referring to healthcare centers of Dehloran city for prenatal care during 2011-2012. Census sampling was applied and subjects’ medical records were reviewed. Demographic and pregnancy-related data, and HBV test results were recorded. For data analysis, descriptive statistics, t-test and Fisher''s exact test were applied, using SPSS version 16.0. P-value < 0.05 was considered statistically significant. In this study, the medical records of 850 pregnant women were studied. The prevalence of positive HBsAg test results was 0.59% in the study population. Positive HBsAg was significantly correlated with parity (P=0.003) and abortion (P=0.04). However, there was no significant association between HBsAg results and other variables such as age (P=0.16), mother’s educational level (P=0.16), spouse''s educational level (P=0.66), place of residence (P=0.66), history of cesarean section (P=0.18), work experience at healthcare centers (P=1.0), blood transfusion (P=1.0) or HBV infection in the first-degree relatives (P=1.0). Although the prevalence of positive HBsAg was relatively low among pregnant women in Dehloran city, HBV screening during pregnancy is highly recommended.

Maternal mortality refers to the death of a woman who dies during pregnancy or within six weeks after delivery. A number of factors contribute to the high maternal mortality ratio around the globe, particularly, in underdeveloped countries. Pakistan has the highest mortality ratio (260 per 100,000 live births) in the region and is one of the developing countries which have committed to decrease maternal mortality by 2015, according to the millennium developing goals (MDG) 5. However, there are number of factors which made Pakistan unable to achieve the MDG 5 by 2015. In Pakistan there are many factors such as biological, socio-economic, cultural and poor quality of Reproductive Health Services (RHS), which contribute to the alarming figure of Maternal Mortality.. This paper aimed to do an in-depth analysis of the determinants of maternal mortality in Pakistan.

Uterine sarcoma is a rare tumor of mesodermal origin, accounting for 2-6% of uterine malignancies. Leiomyosarcoma (LMS) has been reported in only 1% of all uterine malignancies and is regarded as the most common primary uterine sarcoma. Herein, we present a case of LMS with unusual macroscopic features. The patient was a 61-year-old woman with LMS, which consisted of a large cystic mass (88×136 mm), containing six liters of brownish fluid on the right side of the pelvis and abdomen. The fundus of the uterus was ruptured by the solid part of the tumor. For treatment, total hysterectomy, salpingo-oophorectomy and the optimal resection of tumoral parts were carried out. Overall, the distinctive biological behavior and poor overall survival of uterine sarcoma challenge the post-operative management of this tumor. According to the one-year follow-up, the patient was disease-free. Unfortunately, no further information is at hand beyond this period.