مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 217 (هفته چهارم آبان 1395)

Job satisfaction is one of the most important factors related to human capital¡ which plays a significant role in individual and organizational outcomes. Midwives play a key role as an effective component of health care system to provide midwifery services into two vulnerable groups of society: mothers and children. So¡ this study was performed with aim to determine the effectiveness of well-being interventions on midwives'' job satisfaction.
This randomized clinical trial was conducted in 2015 on 60 midwives working at health centers in Mashhad. Research units were randomly assigned to two groups: control and intervention. Intervention including Seligman Well-Being Education was performed once a week for eight weeks¡ each session lasting 2 hours. They were asked to fulfill the following questionnaires before and after the intervention: Minnesota Satisfaction Questionnaire¡ Oxford Happiness Questionnaire (1989)¡ Ryff Scale Psychological Well-Being(RSPWB 1995). Data were analyzed using statistical SPSS software (version 19) and Independent T-Test¡ Paired T-Test¡ Mann-Whitney¡ Wilcoxon and Chi-Square.
Job satisfaction mean scores of midwives were significantly different (P=0.008) in the beginning of the study (62.78 ± 11.14) and at the end of the study (78.82 ± 14.28) after the intervention. Also¡ there was a significant difference between two groups (control and intervention) in terms of job satisfaction after the intervention (P Well-Being intervention is effective on job satisfaction of midwives.

Anemia is defined by hemoglobin less than 13g/dl for men and less than for non-pregnant women and less than 11g/dl in pregnancy period. Behavioral and emotional instability and depression are also other complications of anemia which can affect on the success of postpartum breastfeeding. This review article was performed with aim to determine the effect of anemia on post-partum depression.
In this review article¡ the articles which were searched in Pubmed¡ Google scholar¡ SID and Magiran databases from 2000 -2015 were evaluated. The used keywords were “depression”¡ “anemia”¡ “Iron deficiency” which were connected by “and”. Finally¡ 8 articles were selected for evaluation.
There was a significant relationship between hemoglobin¡ Transferrin saturation and mean cell volume and cognition variables in post-partum period that can lead to postpartum depression.
Anemia can create somehow of depression after delivery and leads to no attention to her maternal roles. So it seems that through diagnostic and treatment protocols¡ we can mothers’ health level.­­

Thrombotic Thrombocytopenic purpura (TTP) is a life-threatening disease with high prevalence of 5% in pregnancy which causes Thrombocytopenia. Since pregnancy is a known trigger of TTP attacks¡ pregnant women are at risk of recurrence. Prompt diagnosis and treatment before 20 weeks gestation is important and is associated with positive outcomes. In this study¡ a pregnant woman with TTP in her second and third pregnancies is introduced. This study was performed with aim to introduce the patient and review the most recent management and treatment of TTP in pregnancy and prenatal counseling in patients who have a history of TTP.
The patient is a 28-years-old woman (g3p1d1ab1). Her first pregnancy was ended with spontaneous abortion at 6 weeks and in second pregnancy¡ she had a cesarean section at 28 weeks gestation due to HELLP syndrome and eclampsia. After the surgery with diagnosis of TTP¡ plasmapheresis was performed. In current pregnancy at 36 weeks gestation¡ cesarean section was performed with primary diagnosis of HELLP syndrome; due to a drop in platelet count after surgery and observation of schistocytosis in peripheral blood smear¡ with diagnosis of TTP¡ daily plasmapheresis was done until the platelet count achieved above 100000 and the patient was discharged with good general condition.
Since pregnancy is a known trigger of TTP episodes¡ follow-up of patients with TTP in next pregnancy and control of 13 factor and differentiating of congenital and acquired disease is essential; thus the risk of recurrence of maternal and fetal complications are greatly reduced.