مجله زنان مامائی و نازائی ایران
سال هجدهم شماره 174 (هفته چهارم آذر 1394)

The efficacy of screening programs in cytology of cervical cancer is dependent on the smear quality. The unsatisfactory smears are confusing to many physicians for deciding and lead to repeat the test. Assessment of the factors which may cause unsatisfactory smears would be useful in identifying the women who are at risk. Therefore, this study was performed with aim to assess the smear’s adequacy and its association with these factors and clinical symptoms. This prospective descriptive and analytical study was performed on 1557 women who had referred to gynecology clinic of Alborz Hospital of Karaj to do Pap smear tests from Aug 2011 to Jun 2013. The Pap smear samples were taken with conventional technique and their adequacy was determined based on Bethesda system 2001. The relationship between unsatisfactory smears with age, menopausal status, vaginal infection, cervicitis, and contact bleeding was assessed. Data was analyzed SPSS software (version 13) and Chi-square test and T-test. P < 0.05 was considered significant. The frequency of unsatisfactory smears was 7.2%. Old age (P= 0.001) and menopause state (P= 0.001) were related to the results of unsatisfactory outcomes. But, there were no significant difference between vaginal infection, cervicitis, and contact bleeding with unsatisfactory Pap smears (P=0.750, P=0.640, and P=0.848, respectively). Age and menopausal status increase the possibility of unsatisfactory cervical smears. For these cases, the optimal sampling techniques are suggested.

Cervical ripening is an essential technique for curettage in first trimester of pregnancy. In this regard, Prostaglandins such as Misoprostol or Dinoprostol are used.NO-releasing drugs are the other new ones. This study was performed with aim to compare the efficacy of NO-releasing drugs with Misoprostol as a known drug to determine the benefits and disadvantages of this method for cervical ripening in terms of surgical abortion. This randomized, double-blind clinical trial was performed on 60 pregnant women admitted at department of gynecology of Shahid Akbarabadi hospital in 2014. In this study, 60 pregnant women (14 weeks of gestation) were divided into group A (primigravid, n=30) and group B (multipar, n=30). Furthermore, group A was divided into 2 subgroups of A1 (treated with Glyceryl trinitrate) and A2 (treated with vaginal Misoprostol), and group B was divided into 2 subgroups of B1 (treated with Glyceryl trinitrate) and B2 (treated with vaginal Misoprostol). The efficacy of two methods for cervical ripening in two subgroups of A and B was separately measured through the cervical dilatation at admission and 6 hours later.Data was analyzed using SPSS software (version 22) and Fisher Exact test and Chi-square. P Based on the result of examination after using drugs, there was no significant difference between the efficacy of Misoprostol and Glyceryl trinitrate on cervical ripening in two main groups of studied patients (P>0.05). Glyceryl trinitrate can be an appropriate substitute for Misoprostol on cervical ripening.

Prolonged labor is associated with numerous problems for mother and baby. Exercise with labor ball is one of non-pharmacological and effective methods in delivery. Since the study which evaluated the effect of exercise with birth ball during pregnancy was not found in valid databases, thus, this study was performed with aim to determine the effect of exercise with special ball during pregnancy on duration of active phase of first stage of labor in nulliparous women. This randomized clinical trial was performed on 50 nulliparous women with gestational of 34 weeks referred to obstetric clinic of MashhadOmolbanin hospital from Aug 2013 to Feb 2014. They were randomized in two group of control (n=25) and intervention (n=25). The mothers in intervention group performed exercise regularly with birth ball for 6-4 weeks from 34 weeks of gestation for 16-24 session,and the control group received routine care. Then, length of first stage of labor in both group was measured with onset of active phase of labor in the maternity. Data were collected by Questionnaire forms, exercise record check list, observation and examinationof first stage of labor. Data were analyzed using SPSS software (version 16), and Mann-Whitney test, independent t-test, paired t-test and chi-square test. P The mean duration of active phase of first stage of labor was 409.52 ± 6.6 minutes in intervention group and 430.20 ± 0.37 minutes in control group that two groups were significantly different in terms of duration of active phase of first stage of labor (P=0.007). Exercise program with birth ball during pregnancy can help the patients as a useful and low cost method for reducing the duration of active phase of labor, and also decreases the complications of prolonged labor in mother and baby and consequently reduces the instrumental and cesarean delivery.