جستجوی مقالات مرتبط با کلیدواژه « Nulliparous women » در نشریات گروه « پزشکی »

Childbirth is not satisfactory for some women and is associated with pain, fear and suffering. The present study was conducted aimed to investigate the effect of Knee- chest position on pain intensity and duration of labor in nulliparous women.

This randomized clinical trial study was performed in 2020 on 100 nulliparous women admitted to the maternity ward in the south of Kerman province. Individuals were randomly divided into two groups of normal posture and Knee-chest position (n=50 in each group). For women who were in the Knee-chest position group, at the beginning of the active phase (dilatation 4cm), they were in Knee-chest position intermittently (for 15 minutes every hour) until the complete cervical dilatation. Data were collected by personal information questionnaire and pain visual scale and delivery progress form (partograph). Data were analyzed by SPSS software (version 26) and Independent t-test, chi-square and Fisher's exact test. P<0.05 was considered statistically significant.

according to independent t-test, chi-square and Fisher's exact tests, the mean pain intensity in the intervention group (Knee-chest position) was significantly lower than the control group (normal position) (p <0.001). Also, the progression of labor in the mothers of the intervention group was significantly faster compared to the control group; duration of delivery in the intervention and control groups was 4.48±1.04 and 7.16±1.7, respectively (p <0.001). The level of mothers' satisfaction with the position status during delivery process was higher in the intervention group than in the control group (p<0.001).

The Knee-chest position in nulliparous women during the active phase of labor is beneficial in reducing labor pain and accelerating labor progression. Therefore, it is recommended that this condition be used as a routine non-pharmacological care in maternity wards.

Length of delivery is among the factors affecting maternal and neonatal delivery outcomes. The effect of acupressure on decreasing the length of delivery stages has been recently evaluated. The aim of this study was to assess the effect of acupressure on gallbladder (GB21)  acupoints on the duration of delivery.

This clinical trial included 174 nulliparous women hospitalized in Mofateh Maternity Hospital in Varamin City who were eligible to enter the study. The women were randomly placed into three groups: pressure on GB21, pressure on inappropriate point (sham) and control groups. Intervention was applied during 3stages: at 3-5cm, 6-7cm, and 8-10cm dilatations at the first stage of labor and the lengths of delivery stages were measured. Data were analyzed using one-way ANOVA, Kruskal Wallis, Tukey, Bonfferoni and chi-square.

Mean values for duration of the first stage of delivery in GB21, sham and control groups were 257.67±72.86, 289.31±118.72, and 245.09±80.82 min (P>0.05) and for the lengths of the second stage of labor were 71.98±39.89, 64.31±22.91 and 71.50±32.02 min respectively (P>0.05). Mean values for the lengths of the third stage in the GB21, sham and control groups were 5.17±0.9, 5.43±1.4, and 6.29±2.2 min respectively (P>0.05). There was no significant differences among the 3 groups in regard to Apgar Scores (p<0.05). But the required dose of oxytocin and the mean value for the duration of oxytocin administration were higher in the sham and control groups than that in the GB21 acupressure group (P<0.003).

No statistically significant difference was found in the duration of labor in the three groups, but the required dose and duration of oxytocin administration in the acupressure group were much less in the GB21 acupressure group than in the other two groups.

Amniotomy is usually used to induce or strengthen labor, and can affect labor progression if it was at suitable time. This study was performed with aim to compare delivery outcomes on nulliparous women in two groups of early and late amniotomy.
  This clinical trial study was performed on 70 nulliparous women referred to Amol medical educational center of Imam Ali Hospital in 2016-2017. Nulliparous women with spontaneous labor were divided into two groups: early amniotomy (≤4 cm) and late amniotomy (>≤4 cm). Data collection tool was a checklist including the characteristics of the research units, the form of partogragraphy and assessment of first, second, third stages of labor and neonate. Individual characteristics, oxytocin infusion, stages of labor and neonatal Apgar score were collected by these tools. Data were analyzed by SPSS software (version 20) and independent t-test and Chi-square test. P<0.05 was considered statistically significant. There was significant difference between two groups in mean duration of first and second stages of labor (p <0.001, p = 0.025, respectively). Duration of first stage of labor was longer in early amniotomy group and duration of second stage was longer in late amniotomy group. However, two groups had no significant difference in mean of duration of third stage of labor (p = 0.078). First and fifth minutes Apgar score of neonates was not significantly different between two groups (p = 1). Although early and late amniotomy had same effect on neonatal outcomes, but late amniotomy (standard) decreased duration of labor in nulliparous women.

One of the major risk factors for the health of mother and child is cesarean section (CS) without medical reasons. This study aimed at addressing the causes associated with selecting delivery method in nulliparous women. A descriptive comparative study was performed in which the research population included all nulliparous women attending a health center in Mazandaran province, Iran 2017. Census method was used and 272 women with normal vaginal delivery (NVD, n=132) and CS (n=140) were selected. Data was collected using a researcher-made questionnaire. The reliability and validity of the questionnaire were confirmed by gynecologists and Cronbach's alpha 0.76, respectively. Data analysis was done in SPSS V24. Out of 140 CS delivery, 66 (46.5%) had no medical recommendations. The main causes were fear of vaginal pain and health and safety of the fetus. The chance of NVD improved by 1% increase in knowledge about the benefits of NVD (15%) and disadvantages of CS (12%) (P<0.001). Also, 1% improvement in socioeconomic status rose the chance of choosing CS 2.45 times (P=0.023). According to current research, informing nulliparous women about the disadvantages of CS and the benefits of NVD is necessary. Therefore, educational interventions are recommended for women planning pregnancy.

Breastfeeding is one of the main factors in the health and survival of babies and affects countless social and economic factors. The aim of this study was to determine the factors affecting breastfeeding self-care in nulliparous women who referred to the health centers in Hamadan city, Iran, 2017. This study was performed as a descriptive-analytic study. The study population consisted of all primiparous women who referred to health centers of Hamadan. Out of 220 nulliparous women who referred to health centers in Hamadan city due to having met the inclusion criteria were selected for the census. Data collection was done using a breastfeeding self-care questionnaire, and were analyzed using multiple linear regression using SPSS v.21 software (P<0.05). The findings showed that 38.6% of participants had poor self-care, 47.7% had moderate self-care and 13.6% had good self-care. The total satisfaction of the spouse, as well as the monthly income are related to the level of self-care (p <0.001). The full satisfaction of the spouse, as well as the monthly income, are related to the amount of breast feeding self-care. Therefore, the results of this study can be used to plan successful breastfeeding for lactating women in hospitals and comprehensive health centers.

post term pregnancy is associated with maternal and fetal complications, including sudden death of the fetus and low Apgar score after birth. Evening primrose oil has been used for cervical ripening. Despite the effects of evening primrose oil on prostaglandin precursor levels and the well-established role of prostaglandins in the reconstruction of cervical matrix. This study was performed with aim to evaluate the effect of vaginal consumption of evening primrose oil on cervical ripening in nulliparous women with post-term pregnancy.

This randomized clinical trial study was conducted on 60 pregnant women with post-term pregnancy who referred to the maternity of Ahvaz Sina Hospital in 2017. The study groups consisted of 2 groups: vaginal capsule of 1000 mg of evening primrose oil and placebo. Drug was administered after induction of labor with 10 unit oxytocin. In the intervention group, one vaginal capsule of 1000 mg of evening primrose oil and in the control group, gelatin capsule as similar as the drug were used. Then, the induction of labor was started with oxytocin with similar dose (10 unit in 1000 cc serum ringer) in both groups. Cervical ripening was measured based on regular examination (every one hour). Data were collected by demographic questionnaire, timing, and bishop-score checklist. Data were analyzed by SPSS software (version 22) and independent t-test and Chi-square test. P<0.05 was considered statistically significant.

The duration of the latent phase in both groups was 9-10.5 hour. The duration of latent phase (p=0.003) and bishop score (p=0.01) had significant difference between the intervention group and the placebo group; it means more cervical ripening in the intervention group. At second stage of measurement, bishop score ≥7 was 90% in the intervention group and 60% in the control group that was significantly more in the intervention group (P=0.01). However, no significant difference between the two groups in terms of the duration of the active phase, progression rate, severity of pain, and volume of bleeding.

The vaginal use of evening primrose oil reduces the duration of the latent phase and has a positive effect on the cervical ripening and Bishop score

Pregnancy and childbirth is one of the most important stages in women’s lives. One of the reasons for women’s desire to choose interest in cesarean delivery is lack of enough knowledge in choosing their birth method. This research studies the effect of group counseling on the type of delivery in Nulliparous women.
This is a controlled randomized trial will be conducted in 160 pregnant nulliparous women referred to Health Center from 95- 96 in Hamedan. The inclusion criteria were as follows: Women with gestational age 20-23 weeks. The exclusion criteria were as follows: maternal medical and Psychological diseases. The samples were randomly allocated to group intervention (n=80) and control groups (n=80). In both groups, mothers received routine prenatal care. The intervention group additionally received 8 sessions weekly group counseling. Data was collected by a checklist consisting of demographic, pregnancy, and delivery information and was analyzed by statistical testes such as T-test and chi squares. P A significant difference was also observed between two groups in the rate of normal vaginal delivery (P=0.04). The results indicated that the group counseling significantly increased the physiologic delivery (53.2%) in the intervention group compared by the control group (22/2%) (P=0/002).
The results of the study showed that the presence of nulliparous women in the group counseling increases the rate of physiologic delivery and is suggested as one of the methods of implementing pregnant women’s care program.

Maternal request for caesarean section due to fear of normal vaginal delivery is one of the main reasons for the high rate of caesarean section.
The aim of this study was to examine the effect of the presence of spouse in preparation class of delivery on fear of parturition in the nulliparous women.
This controlled randomized trial was conducted in 152 pregnant women nulliparous referred to delivery preparation class in Qazvin. We received informed consent from participants. The samples were randomly assigned to intervention (n=76) and control groups (n=76). Eight sessions of the childbirth preparation classes were held for the intervention and control groups with or without the spouse respectively. Data collection tools were demographic characteristics and childbirth attitude questionnaire. Statistical testes such as T-test, and repeated measure were used for analysis.
Findings: The mean age of the mothers participating in the study was 25.85±4.42 years. The decrease in mean of fear scores in the intervention group was significantly higher than the control group (28.58±6.47 and 32.82±5.79, respectively) (P The results of the study showed that the presence of a spouse in preparation class of delivery reduces the amount of childbirth fear and is suggested as one of the methods of implementing pregnant women's education program.

Health literacy is the capacity and the ability to access, understand and use of health information to maintain and improve health behavior. The current study aimed to assess the relationship between health literacy and postpartum depression among nulliparous pregnant women who referred to health centers in Karaj, Iran.
A prospective study was carried out among a convenient sample of nulliparous women in third trimester of their pregnancy. Health literacy was measured using the Health Literacy Inventory for Adults (HELIA) and depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). .Women completed the EPDS once again 8 weeks after delivery.
In all 348 nulliparous women were studied. The mean health literacy score among women was 67.30(±14.66) indicating that 39.6% of women had limited health literacy. The prevalence of postpartum depression was 21.6%. The results of multivariable logistic regression showed that in addition to depression during pregnancy (OR: 1.21, 95% CI:1.08-1.37, P=0.001) and cesarean section for medical reasons (OR: 5.58, 95% CI: 2.79-11.16, P The study results suggest that postpartum depression significantly is associated with limited health literacy in nulliparous women.

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

The most important part of marital relations is sexual relations which not only affects the health of individual and family, but also affects the public health. Delivery causes changes in sexual relationships and leads to significant problems in the marital life. This study was performed with aim to compared sexual problems after normal vaginal delivery and cesarean.
This descriptive and cross-sectional study was performed on 800 women during the first 6 months after delivery in Ramsar health centers in 2014. Data collection tools included a two-part questionnaire consisted of demographic information and questions related to sexual problems. The sexual problems during the first six months after delivery was evaluated. Data was analyzed by SPSS software (version 15) and independent t-test, Chi-square and Fisher exact test. PLack of libido (P=0.002), discomfort at the site of episiotomy (P=0.004), inadequate Lubrication (P=0.006), pain during intercourse (P=0.003) and fatigue (P=0.007) was higher in vaginal delivery group compared to cesarean group (P=0.007) that the significant relationship was observed.
The rate of sexual problems is higher in vaginal delivery group than cesarean group.

Pregnancy and childbirth as a natural process at some points of women’s life is associated with mental and physical changes. Prpgancy low back pain which may last up to six months after delivery is related to multiple factors including muscle weakness and remained lumbar lordosis. Therefore, this study was performed with aim to determine the effect of core stability training on lumbar lordosis and low back pain after delivery.
This semi-experimental interventional study was performed on 32 nulliparous womenreferred to Shaid Mobini and Shahid Banoovani haspitals in Sabzevar city at the second half of 2015. The subjects were divided to training and control groups (n=16 in each group). The training group performed core stability exercises for 8 weeks (3 sessions per week). The control group had no exercise during this time. At the end of 8 weeks, lumbar lordosis and low back pain were measured. Data were analyzed by SPSS statistical software (version 20) and using independent t and paired samples t-test. P In this study, core stability trainings significantly decreased lumbar lordosis (P=0.034) and low back pain (P=0.003).
The core stability training is a good approach for correction of lumbar lordosis and back pain after childbirth.

Postpartum period is associated with significant changes in women's quality of life can be a mother and baby to be effective. Due to this, the study examines the impact of various factors on the areas of quality of life were performed.
This descriptive-analytic study on 120 nulliparous women who referred to health centers Vdrmangahhay city Nvshhrkh were randomly selected using a vacuum Sh WHO quality of life in areas of physical, psychological, social, environmental and General (overall) evaluate information using SPSS software with descriptive statistics and statistical tests of ANOVA, t-test and Mann-whitney analysis was performed.
findings: Results showed that among the five Scope studied public Scope (overall) with an average of 92/12 ± 34/76 the highest score and the environmental Scope with an average of 29/8 ± 03/64 lowest scores quality of life based on education, type of delivery, newborn gender, occupation, age . significant difference in terms of education, social and public safety exists (P Based on the results of this study should be noted that factors such as education, type of delivery, newborn gender, occupation and age have an impact on quality of life nulliparous women after giving birth and knowing this Health care workers and officials can take In order to improve the quality of life for their positive nulliparous women.

Post-partum depression affects the mother's health, family relationships and child's training, negatively. Therefore, determining the related reasons, in especial in the women who have the first delivery and will experience the physical and mental changes of such event in their life is very important. Therefore, the aim of this study was to assess the role of social support as well as the kind of child delivery in order to predict the post-partum depression in such group of women.
The statistical population of this correlational-descriptive study consists of all women in the nulliparous women who have been referred to the medical centers of Kerman during 2016. Among them, 205 were chosen by a cluster and convenience sampling methods. The measurement tools were including demographic features questionnaire, Edinburgh postnatal depression scale (EPDS), and social support questionnaire (MOS-SSS). Data were analyzed with SPSS software using logistic regression and T-test method.
In total, 102 individuals have degrees of postpartum depression and the rest of the patients were non-depressed.The results showed that the possibility of depression emergence in these women, after child delivery based on the decrease of factors such as emotional - informational support, emotional support and positive social interaction support were about 40.18, 10.1 and 5.55%, respectively. Also, the possibility of depression in this group after delivery regarding the kind of delivery was 27%. As well, the women who had caesarian delivery significantly were more depressed rather than whom had natural delivery (p Based on the results of this study, more attention should be paid to increase social support for women who will go into the first labor; and also the preventive treatments must be considered for women give birth a child by caesarian section.

Delivery is potentially a stressful event. The maternal stress and anxiety, especially in the need for episiotomy, stimulates sympathetic system and leads to changes in vital signs which can have undesirable effects on maternal and fetal health. Therefore, this study was performed with aim to investigate the effects of entonox in comparison with lidocaine on vital signs during episiotomy incision in nulliparous women.
This randomized clinical trial was performed on 120 nulliparous women in 215. Intervention group received entonox two minutes before starting episiotomy incision and its repair and was stopped at the end of the incision procedure. Control group as routine received 5 ml lidocaine 2% before starting incision episiotomy. Vital signs were evaluated and compared before and after incision and episiotomy by pulse oximeter. Data were analyzed by SPSS software (version 18) and Mann-Whitney and Chi-square tests. PResuts: There was no significant difference between pulse, oxygen saturationbefore and after of incision and repair of episiotomy, respiratory rate after of incision and before of repair episiotomy and systole and diastole blood pressure before and after of incision and repair of episiotomy (P>0.05). There was significant difference between two groups in terms of respiratory rate before incision and after of episiotomy repair (P Eentonox gas same as lidocaine when is used correctly has no adverse effects on mother's vital sign.