فهرست مطالب فریده وزیری

Depression is one of the most common mental illnesses in different societies. Postpartum depression occurs in the first 4 weeks after childbirth. Touching and massaging the infant is part of the high interaction in the care model that improves the physical and psychological connection between mother and child. Therefore, the purpose of the present study was to investigate and determine the effect of infant massage by the mother on maternal depression.

The present semi-experimental study was conducted in 2017. The population of study consisted of 70 mothers with healthy infants, without addictions, without history of mental illnesses, who had mild to moderate depression, and were randomly divided into two intervention and control groups, the control group received routine care. A standard the Edinburgh Depression questionnaire was used before and after the intervention (4 weeks and 8 weeks after the intervention). In this study, field massage technique was used for intervention. The mother massaged the infant for 15 minutes every day for 8 weeks. The collected data were analyzed using t-test, repeated measures analysis, and chi-square test.

The data of 70 mothers were analyzed. The two groups had no statistically significant differences in the variables of age, occupation and literacy level of the mother, the number of living children and the sex of the infant. The average postpartum depression score in the experimental group was 10.57±1.59 before the intervention, 5.91±1.09 four weeks after the intervention, and 3.68±1.07 eight weeks after the intervention. The depression score in the control group was 10.60±1.40 before the intervention, 9.20±1.51 four weeks after the intervention, and 8.42±3.59 eight weeks after the intervention. In terms of the depression score before the intervention, no statistically significant difference was observed between the experimental and control groups, but at four weeks and 8 weeks after the intervention, a statistically significant difference was observed between the experimental and control groups.

Infant massage can be effective on mother's depression and is recommended as a low-risk, low-cost and time-saving method for mothers in the postpartum period.

Episiotomy has some complications such as inflammation, edema, dehiscence and perineal pain. The object of this study was comparison of the early complications of episiotomy repair with rapid vicryl and chromic catgut in the nulliparous women.
In this randomized clinical trial, 100 nulliparous women during labor were randomly selected and divided equally into two groups (50 in each group). Repair of episiotomy in the first group with rapid vicryl and in the second group with chromic catgut was done. The tools were questionnaires on demographic and midwifery characteristics, Reeda scale and visual analog scale. The participants were evaluated in 4 visits: 24 hours, 3-5 days, 2 weeks and 6 weeks after delivery, respectively. In each visit, the severity of pain, redness, edema, ecchymosis, discharge and proximity to the edges of the episiotomy wound and pain intensity score were assessed. The data were analyzed using SPSS software (v. 16).
Mean pain intensity scores in two groups showed no significant differences. But for Episiotomy wound healing at intervals of 24 hours, 3-5 days and two weeks after delivery, but the total score of Reeda scale in rapid vicryl group was lower than chromic catgut group and this difference was statistically significant (p Based on these findings, it seems that the use of synthetic sutures such as rapid vicryl is more effective than conventional natural sutures in episiotomy repair

In the second stage of labour, caregivers are faced with two important issues, especially in the nulliparous women. One of the two issues is severe pain and the other is most likely intentional and spontaneous perineal trauma. This study was conducted to explore the effects of warm perineum compress during the second phase of labor on first- birth outcomes In this randomized clinical trial study, 150 primiparous women referred to Shoushtari and Hazrat Zainab (SA) hospital in Shiraz city who had inclusion criteria selected and were randomly divided into an experimental and a control group. Warm compress on perineum was used in experimental group and control group received usual cares in the second stage. Check lists for determining episiotomy indication, perineum intact and place, grade and size of laceration were completed after delivery for two groups. Pain severity was determined immediately after delivery by using McGill Pain tool. Data were analyzed by SPSS version 15 and Chi-Square, Fisher Exact Test, Independent T Test, Mann Whitney U and Odds Ratio Statistical tests with 0.05 Significant level. Result showed 29 women (38.7%) in experimental group and 5 women (6.7%) in control in group no need to suture. OR=8.8 (CI 95%: 3.18-24.46) P<0.001. need for episiotomy in experimental group was significantly lower than control group OR=0.112 (CI 95%: 0.045-0.274), P<0.001.The mean of pain severity in second stage and perineal pain severity on the first day after delivery in experimental group was significantly less than control group (p<0.001). The result of the study showed that using warm compress in the second stage of delivery can decrease perineal trauma and relief of pain in this stage.

During the process of labor, women develop important experiences which will always remain with them through their lifetime. Quality of these experiences influences both mother’s and child’s health, their emotional connection and the mother’s sexual function in future. This qualitative study aimed at clarifying the primiparous women’s experiences regarding childbirth. The present qualitative study was conducted on the primiparous women referring to the educational hospitals of Shiraz University of Medical Sciences selected through purposive sampling. The necessary data was collected through Semi-structured interviews with 17 primiparous women having no complicated vaginal delivery. Demographic information was also gathered using a questionnaire. Interviews were conducted 24- 48 hours after delivery and the obtained data was analyzed applying content analysis. After data analysis, four themes related to labor experience were extracted. The first theme, difference between the experience and the expectation, means that some participants generally experienced their childbirth better than what was expected and to most of them it was worse than expected. The second theme, strategies for dealing with pain, meant that the participants attempted to confront the labor pain through spiritual-religious and physical approaches. The two other themes covered the need for labor support and a new insight into natural delivery. According to the results of this study, women who experience childbirth for the first time may not have a realistic expectation regarding natural childbirth, lose their control in facing labor, and ask for caesarean delivery. Therefore, more attention should be paid to childbirth preparation classes. Besides, more support for laboring women, in addition to concentration over maternal and fetal physical health, is recommended

There are different views on the time of admission in parturient woman. Most of the specialists and medical centers delay the admission of the low risk parturient women until the onset of the active phase of labor to preven any unnecessary intervention in the process of labor. This study was conducted to compare the outcomes of labor in the hospitalized nulliparous women in latent and active phase and some related factors. This is a cross-sectional study. The subjects were selected by convenience sampling method. 188 hospitalized women in the latent phase and 285 parturient women in the active phase who were nulliparos, had spontaneously started labor, were at 37-41 weeks of gestation, with cephalic presentation, singleton pregnancy, and intact membranes were enrolled. The related data were collected and analyzed in SPSS using Chi–square and T–test. 35.6% of hospitalized cases in the latent phase and 9.8% in the active phase had abnormal deliveries; a significant difference was shown by χ2 test (p=0.000). The mean age in the latent phase and active phase was 21.66±3.38 and 22.46±3.62 years, respectively, showing a significant difference (p=0.014). The mean of the time interval between the first exam to admission in the latent and active phase groups were 14.18±16.81 and 9.74±10.98 hours, respectively. The difference was significant by T-test. In the latent phase 18.1%(34) and the active phase groups 3.9% (11), there were meconium passing which resulted in abnormal delivery.(p=0.000) This study indicates that there is probably a difference in the nature of labor between hospitalized women in the latent and active phases that lead to increased abnormal delivery. Could the delivery phobia and anxiety mechanisms caused labor disorder associated with prolongation of the expectant birth time? This is the question which was not answered in this study. However, it is recommended that this question to answered by either our or another research team in further studies.