مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 215 (هفته دوم آبان 1395)

Recent studies have shown that high or low maternal weight before pregnancy is associated with pregnancy and neonatal complications. Birth weight is one of the most important indicators of growth in neonates. Therefore, this study was performed with aim to determine the association between maternal early pregnancy body mass index with some complications of pregnancy and birth weight.
This cross-sectional study was performed on 1642 pregnant women referred to the hospitals and maternities of 21 cities which were covered by Mashhad University of Medical Sciences in 2014. Data related to mother and neonate were collected through the questionnaire and hospital records. Data were analyzed by SPSS software (version 19) and Chi- square and Mann-Whitney tests. P
Early pregnancy body mass index showed that 119 mothers (5.6%) were weight loss, 942 (44.5%) natural, 426 (20.1%) overweight and 155 (7.3%) were obese. Mean body mass index was 23.9 ± 4.2 with minimum of 13.49 and maximum of 39.06 Kg/m2. Birth weight was significantly influenced by early pregnancy BMI. The frequency of macrosomia was significantly higher in obese mothers, also increased early pregnancy BMI led to increased stillbirth and caesarean section (P Abnormal BMI can lead to complications in mothers and fetuses. So, assessment of weight and body mass index before pregnancy and at the first visit and providing training and nutritional counseling and required care can play an important role to prevent complications and provide maternal and neonatal health.

Although performing cesarean section in specific condition can save life of mother and neonate, but has considerable complications. Reducing cesarean among primigravida is one of the best strategies to reduce cesarean. Therefore, this study was performed with aim to develop a tailored intervention to promote normal vaginal delivery (NVD) among primigravida women.
This formative research was done to develop an intervention based on assessment tools pattern and social marketing response to reduce cesarean section among primigravida women in Boyer-Ahmad city in 2015. The qualitative data were collected through individual interviews and focused group discussions. The quantitative data were collected by a questionnaire based on the constructs of Theory of Planned Behavior. Data was analyzed by SPSS software (version 16). The qualitative data were analyzed by content analysis method as manual and the quantitative data by routine descriptive statistics, logistic regression, Chi-Square and Mann-Whitney tests.
In qualitative part, the most important barriers for selecting NVD were: maternity being unpleasant, fear, other's recommendations, and negative experiences of referring to maternity and low level of knowledge among women. The main interventions recommended for increasing NVD were: education, counseling, making the process of NVD more pleasant. In the quantitative survey, we found that 25.2% of the women were intended to do cesarean. In quantitative part, 39 women (25.2%) had intention to perform cesarean section. The median and interquartile range of attitude was 18±4, subjective norms 16.5±3, and perceived control behavior 16±3. Attitude, subjective norms, place of residence, and the spouse's job were the main predictors in selecting the mode of delivery.
To design an effective tailored intervention to promote NVD among primigravida women, their wants and needs should be considered. Education, offering telephone counseling, and implement of brief interventions by physicians and midwives in health centers are the main elements of the tailored intervention.

Excessive vaginal discharge is one of the most common complaints of patients referring to gynecologic clinics. Leucorrhea is treated in different ways based on the causal factor, however drug resistance and recurrence often occurs in some cases. Traditional Iranian Medicine has reviewed the etiology and treatment of this disease with a holistic view. This study was performed with aim to compare the treatment methods of leucorrhea and vaginitis from traditional and conventional medicine viewpoints.
Data was collected after reviewing the Iranian traditional medicine textbooks on vaginal discharge, and revising several times in meetings with professional practitioners. The treatment methods of conventional medicine were also reviewed from textbooks and research reports in this field. Finally, an integrated treatment protocol on vaginal discharge was recommended and presented.
There are three main steps in treating vaginal discharge according to the Iranian traditional medicine point of view which includes: purging of body, purging of uterus and strengthening the uterus. It seems that considering this treatment process in the conventional medicine is effective in treatment of non-infection or recurrence leucorrhea resistance to treatment.
With regard to the traditional medicine hypothesis and the limited evidences from traditional medicine clinics on few patients with vaginal discharge, it seems that the use of this protocol is effective on increasing the treatment response rate and also decreasing the recurrence and resistance to treatment. Therefore, performing more clinical studies is suggested to approve this theory and confirm the effectiveness.