مجله زنان مامائی و نازائی ایران
سال بیست و دوم شماره 4 (تیر 1398)

Preterm premature rupture of membranes (PPROM) is defined as the rupture of the membrane before the onset of a regular uterine contraction and prior to the 37th week of gestation, which indicates a serious perinatal problem. The purpose of this study was to evaluate the prevalence of cervical colonization by Mycoplasma hominis in patients with PPROM. In this case-control study, 160 pregnant women with PPROM who were within 25-37 weeks of gestation were studied at Alavi Center, Ardabil, Iran. The control group included 160 pregnant women with normal pregnancy without PROM. Cervical swabs were obtained and evaluated by polymerase chain reaction for Mycoplasma hominis. Data were analyzed using SPSS software (version 20), t-test, Chi-square and Mann-Whitney tests. P value less than 0.05 was considered significant. Mycoplasma hominis was detected in 17.5 % (28/160) of the patients with PPROM. In the control group, this bacteria was detected in 6.6% (10/160) of the pregnant women. The results of the odds ratio test showed that the odds ratio of Mycoplasma hominis infection in the patients with PPROM was 3.18 times more than that in the pregnant women without PPROM (95% CI: 1.4-6.8). In addition, the probabilityof developing respiratory distress syndrome in the infants of the mothers with PPROM was 3.71 times more than that in the neonates of the PPROM-free pregnant women ((95% CI: 1.9-7.12). Our results provided evidence regarding the presence of a significant association between cervical colonization with genital mycoplasmas and PPROM.

Happiness decreases during menopause periods due to mental disorders, reduced social activity, marital status and physical diseases. Saffron has joyful effect due to the presence of ingredients such as Crocin and Safranal. This study was conducted with aim to determine the effect of saffron capsule on happiness of postmenopausal women. This double-blind, randmized clinical trial study was performed on 67 postmenopausal women in the Imam Reza Women's Clinic in Bojnourd from 2015 to 2017. The subjects were randomly divided into two groups of intervention (30 mg capsule saffron) and control (30 mg placebo capsules). The subjects completed demographic questionnaire, midwifery and Oxford Happiness Inventory before using capsule and 4 weeks after consumption of capsule. Data were analyzed with SPSS software (version 16) and Chi-square, independent t-test and paired T-test. P The mean scores of happiness in saffron group were 45.5 ± 12.9 before consumption and 51.4 ± 12.8 after consumption. The results of paired t-test showed that happiness increased (p<0.001), but in control group, no change was found in happiness before and after the intervention (p = 0.347). Saffron has joyful property. Since happiness decreases during menopause, saffron is recommended to be used as a supplement in menopause.

Prescribing routine Iron supplementation during pregnancy has been done regardless of their need for many years. Considering the possibility of adverse pregnancy outcomes with unnecessary consumption of iron supplementation in pregnant women, this study was performed with aim to assess the effect of iron supplementation in pregnant women with high hemoglobin on neonatal jaundice. This double-blind controlled randomized clinical trial was performed on 140 nonsmoker healthy pregnant women with gestational age of 14-18weeks and singleton pregnancy with Hb > 13.2 g/dL and ferritin > 15 μg/l in Ardabil during 2016-17. Mothers were randomly assigned to 50 mg ferrous sulfate and placebo groups from 20th weeks of pregnancy. Also, 24 hour after delivery, the neonates were assessed in terms of bilirubin level (by photometric method using BT3500 device) and jaundice. Data were analyzed by SPSS software (version 16) and independent t-test, Chi-square, and exact fisher test. P < 0.05 was considered statisti cally significant. There was significant difference between two groups in Hb (P = 0.03) and ferritin (P = 0.04) levels after the intervention, but no significant difference was found between two groups in the incidence of anemia (Hb<11 g/dl) (P < 0.001). In addition, the incidence of neonatal jaundice was more in interventional group than placebo (P=0.005). The incidence of neonatal jaundice was associated with first-trimester ferritin (P=0.01). Iron supplementation in pregnant women with Hb > 13.2 g/dl is associated with increased risk of neonatal jaundice; therefore, routine prescribing of iron supplementation should be done with caution in pregnancy.

Childbirth is a physiologic but stressful event in women's life. Anxiety during labor can affect pregnancy outcomes and causes pain and fear of childbirth. So, reduction of anxiety during labor was strictly recommended in various studies. Acupressure, against pharmacological methods, is a simple and cost-effective method which is limitedly investigated in childbirth. This study was performed with aim to investigate the effects of acupressure at LI4, He7, SP6 and Neima points on anxiety during labor in nulliparous women. This randomized clinical trial was conducted on 130 mothers who were hospitalized in delivery wards of Qazvin Razi hospital in 2018. They were randomly assigned to intervention and control groups. In the intervention group, stimulation of SP6 and Neima points was started in cervical dilatation of 4 cm and continued for 30 minutes, then in cervical dilatation of 8 cm, stimulation of LI4 and H7 continued by TENS until the end of delivery. Control group received routine obstetrics cares. Spielberger’s State-Trait Anxiety Inventory (STAI) was completed at the time of admission to delivery room and one hour after delivery. Data was analyzed by SPSS software (version 24) and Chi-square, independent t-test, Paired t-test. P Acupressure had a significant influence on mean score of state anxiety in experimental (33.7 ± 9.5) compared to control group (40.1 ± 9.9) (P = 0.001). Difference in mean score of trait anxiety in experimental (35.5 ± 8.2) compared to control group (39.08 ± 7.7) was statically significant (p=0.04). Stimulation of LI4, H7, SP6 and Neima points is effective in decreasing state and trait anxiety in nulliparous women and is recommended as one of the methods for treatment of anxiety in pregnancy and childbirth.

Gestational diabetes mellitus (GDM) is the most common metabolic disorder in pregnancy. According to maternal-fetal complications of GDM, recognizing the related factors is crucial. There is evidence of association between some red blood cell indices such as hemoglobin and gestational diabetes. This study was performed with aimed to determine the relationship between level of red blood cells indices and risk of GDM occurrence. This case-control study was performed on 190 pregnant women with and without GDM referred to the prenatal care clinic of Tajrish Shohada hospital from October 2017 to March 2018. GDM screening tests was done by oral glucose tolerance test)OGTT) with 75-gr glucose and complete blood cell count measurement in gestational age of 24-28. Data was analyzed using SPSS software (version 16) and independent t-test, Mann-Whitney, Correlation, and logistic regression. P Except than mean cellular weight (p= 0.06), other red blood cell indices (including red blood cell, hemoglobin, hematocrit, mean corpuscular volume and mean corposcular hemoglobin) were associated with increased risk of gestational diabetes mellitus occurrence (p<0.05). According to Receiver Operating Characteristic (ROC) curve for significant variables and determination of sensitivity and specificity of cut points, the area under the curve was greater for hematocrit than other variables.  Elevated hematocrit level among all red blood cell indices in second trimester had the strongest association with increased risk of GDM occurrence. This important issue requires special attention to hematocrit levels when administrating iron supplements in pregnancy.

Some studies have shown the relationship between vitamin D3 deficiency, with primary dysmenorrhea and associated systemic symptoms. However, the relationship between pain severity and serum vitamin D level is not known. Therefore, this study was performed with aim to investigate the relationship between the severity of primary dysmenorrhea and associated systemic symptoms with serum levels of vitamin D. This cross-sectional study was performed on 143 students with primary dysmenorrhea in dormitories of Shahid Beheshti University of Medical Sciences in 2018. Data related to menstruation cycle and severity of primary dysmenorrhea were collected using demographic questionnaire, menstrual status and pain index. The serum level of 25-hydroxyvitamin D3 was determined by LIASON device, by Chemiluiminescence method and was analyzed in DiaSorin kit. Data were analyzed by SPSS software (version 24) and Mann-Whitney test and independent t-test. P No significant relationship was found between the mean score of primary dysmenorrhea and serum vitamin D levels (P>0.05). There was a significant relationship between severity of headache, fatigue, nausea and vomiting with serum vitamin D levels (P <0.001), but this relationship was not found with severity of diarrhea (P>0.05). There is no significant relationship between severity of primary dysmenorrhea and serum vitamin D levels, but significant relationship was found with severity of headache, fatigue, nausea and vomiting. Performing larger studies in a non-homogeneous society is suggested for closer evaluation of this relationship.

Lactation self-efficacy can be the strongest predictor of quality and duration of breastfeeding. This study was performed with aim to determine the effect of Ginger compression for treatment of breast engorgement on lactation self-efficacy. This clinical trial study was performed in 2018 on 76 lactating women with breast engorgement in Mashhad. The subjects were randomly assigned to two groups of Ginger warm compression and conventional care. The mothers of intervention group were treated with Ginger compression, three times daily for two days. The study tools included standard index of breast engorgement severity, standard dentist's self-efficacy questionnaire and demographic characteristics form. Data were analyzed by SPSS software (version 22) and Mann-Whitney, independent T-test, Chi-square and variance analysis. P There was no significant difference between two groups in mean scores of self-efficacy before the intervention (p = 0.320). After the intervention, mean score of self-efficacy was significantly higher in the intervention group than the control group (p <0.001). Ginger compression faster improves the symptoms of breast engorgement and consequently, significantly increases lactation self-efficacy score compared to conventional care.

One of the methods of reducing labor pain is continuous support for pregnant women during labor and delivery. Women's satisfaction from labor experience in terms of care providers, policy-makers of health-care system is considered as one of the important indicators in the quality of mother care. According to controversial results of the studies and lack of evidence which compare the effect of professional and non-professional presence on labor, this study was performed with aim to compare the effect of presence of midwife and non-midwife companion on labor pain, duration of delivery and amount of oxytocin use in primiparous women. This randomized clinical trial study was performed on 120 primiparous women including three groups of midwives, non-midwife and control group in 2017-2018. The outcome of the study included numerical scale of pain, duration of delivery stages and the amount of oxytocin drops. Data analysis was done using SPSS software (version 20) and Chi-square test, one-way ANOVA and repeated measures analysis of variance. P At the beginning of active phase, pain score in midwife companions group was 2.56 ± 1.83, in non-midwife companions group was 4.03 ± 2.46 and in control group was 4.03 ± 2.46, which showed statistically significant difference (P = 0.014). The effect of time (P <0.001) was significant, but the effect of group (P = 0.386) and the interaction between time and group (P = 0.538) were not statistically significant. According to the results of one-way ANOVA, the least length of delivery in both stages was related to midwife group (P <0.05). Also, midwife companions group had used less oxytocin compared with other groups (P = 0.004).   The presence of a midwife companion beside mothers is a non-invasive and effective intervention in creating physical and mental relaxation during labor and delivery.

One of the new assisted reproductive techniques is surrogacy, and the rate of using this technique is rising. However, the psychological and social consequences of this technique have not been thoroughly investigated. Therefore, this review study was performed with aim to investigate these outcomes following surrogacy in surrogate mother and child. In this review study, to find the related articles between1990-2018, Persian databases of SID and Magiran and English databases of Pubmed, Scopus, Elsevier, Wiley online library, Web Of Science, and Google Scholar search engine were searched. To access all articles in Persian and English, the Persian keywords including: surrogate mother, mother-child relationship, mother-fetus relationship, relationship, psychological outcome, social outcome and English keywords including Surrogate mother, surrogacy, Maternal -Fetal relationships, mother-child relationships, surrogates' family, bonding, attachment, psychology outcome, social outcome, with all possible combinations of these words were used. From 500 articles, 18 articles were eligible for research and were selected for this study. The results of various studies indicated that the birth of the child for surrogate mothers and applicant’s family is a stressful phenomenon that can lead to depression in surrogate mother. There was no significant difference between children born as surrogacy and normal children in terms of evolution, psychological and social dimensions. The results of personality tests and psychological variables were normal in most surrogate mothers and no serious psychological harms were observed. In general, surrogacy is considered to be a positive experience in most mothers. Born children also have a good feeling to their surrogate mothers and have no psychological differences with normal children. Of course, it's important to note that differences in the culture of the countries, their experiences and supportive systems may affect psychological and social consequences of surrogacy.

Human papillomavirus (HPV) is one of the most prevalent sexually transmitted viruses. HPV types 16 and 18, as the most common high-risk HPVs, cause malignant changes and cervical cancer. Since common diagnostic methods have many disadvantages, the development of novel diagnostic methods can be very promising as a useful tool with high speed and efficiency, as well as cost-effective. Electrochemical biosensors as new tools have advantages such as a wide range of diagnostics, low cost and simple laboratory equipment. This review study was performed with aim to present a summary of the development of electrochemical biosensors to diagnose HPV types 16 and 18. In this study, English and Persian articles were searched in scientific databases of Pubmed, Cochrane Library, Scopus, Science Direct, Goggle Scholar and two Iranian databases of SID and IranMedex using Mesh keywords from 2003 to 2008. In this study, we investigated the role of electrochemical biosensors in early diagnosis of HPV type 16 and 18 by using the published articles in scientific literature. A total of 11 articles were studied. By analyzing the newest electrochemical biosensors for diagnosis of HPV, we observed that the sensor platform developed by Wang et al. showed the lowest detection limit (1 Atto molar). The electrochemical biosensor with high sensitivity can be used as a suitable method.

Retrorectal tumors are relatively rare. Dermoid cysts are of the family of retrorectal tumors which are usually benign and found in young women. In this study, a case of retrorectal dermoid cyst is reported. The patient was a 25-year-old woman who had referred to Mashhad Mehr hospital with symptoms of nausea, vomiting, flatulence and change in bowel movements and pelvic pain. The physical examinations by laparoscopy revealed a mass measuring 74×62 in posterior uterus. The patient underwent surgery and the cyst was completely excised. The patient discharged after five days and no postoperative complications were reported in the follow up. Pathological results reported dermoid cyst. Surgery is the main treatment of retrorectal lesions and tumors. The use of imaging results such as MRI and CT-scan is recommended for more precise diagnosis of the nature and location of the lesion and to select the best surgery approach appropriate to the location of the mass.