Journal of Midwifery & Reproductive health
Volume:10 Issue: 4, Oct 2022

Auriculotherapy is known as a non-invasive and safe technique that can be used by health care professionals. The purpose of this review was to explore the effects of auriculotherapy in climacteric, menopause and old age.

This systematic review, which was conducted based on the PRISMA guideline, included  all clinical trials and quasi-experimental studies published in English databases of Web of Science, Scopus, PubMed, Science Direct, as well as Persian databases of SID, Magiran and IranMedex,  using the main English keywords including auriculotherapy, auricular, acupressure, auricular point pressure, ear acupuncture points, menopausal OR menopause, perimenopause, climacteric and their Persian equivalents without time restriction until May 2022. The quality of studies was assessed by two independent reviewers using Jadad scale and Effective Public Health Practice Project (EPHPP) criteria.

Out of 145 articles, 15 studies including 11 clinical trials with score of three and above based on the Jadad scale and four quasi-experimental studies with score of 1.51-3 based on the EPHPP criteria were examined. The results of relevant articles with a sample size of 1019 revealed that auriculotherapy reduce anxiety, intensity and frequency of hot flashes and improve the level of sex hormones, sleep disorders and quality of life in menopausal women.

Auriculotherapy could improve the problems of elderly and menopausal women and is suggested as a complementary and alternative method of hormone replacement therapy. Considering the limited number of studies in this field, it is required to do further research along with removing the limitations of previous studies.

Pregnancy with high blood pressure is one of the high-risk pregnancies and requires more healthcare to prevent maternal and fetal complications. Therefore, this study was designed to investigate the effect of self-care counseling on quality of life in pregnant women with hypertension.

This clinical trial was performed on 90 pregnant women with gestational hypertension referred to Sabzevar health centers between 2021 and 2022. Sample were selected by convenience sampling and divided into intervention and control groups by random assignment. In addition to receiving routine care sessions, the intervention group received four 45- to 60-minute sessions of self-care counseling according to the GATHER model each week. The control group received routine care. Data were collected using a quality of life questionnaire (sf-36) and analyzed by SPSS software version 25 using independent and paired t-test, Mann-Whitney and analysis of covariance.

There was no significant difference in the mean quality of life score in the intervention and control group (47/33 ± 5/65 vs 49/77 ± 5/55) before intervention. However, after the intervention, there was a significant difference between the two groups (p <0/001). The mean score of quality of life in the intervention group was 76/07 ± 5/01 and in the control group was 48/73 ± 6/75.

Considering the effect of self-care counseling on quality of life improvement in pregnant women with hypertensive disorders, it is recommended to tailor and implement such counseling interventions to increase quality of life in these vulnerable population during pregnancy.

The rate of unnecessary caesarean section are exceptionally high in some countries, including Iran. Though women may choose their mode of delivery, negative feelings of regret and hopelessness can occur in relation to decision-making following birth. Thus, this study aimed to compare regret and hopelessness in primiparous women following both vaginal and cesarean birth.

Overall, 300 participants were included in this descriptive comparative study. Participants were included following vaginal birth (n=100), birth via emergency cesarean section (n=100) and birth via elective cesarean section (n=100) between June and October 2019. Participants were recruited from comprehensive health centers in Zabol, southeast of Iran. Data collection tools included the demographic characteristics questionnaire, Decision Regret Scale, and Beck Hopelessness Scale which were completed eight weeks after childbirth. To analyze data independent-sample T test and one-way ANOVA were used.

Mean and standard deviation for scores in relation to regret eight weeks following vaginal birth and elective cesarean section were 29.70 ± 25.97, 43.20 ± 15.88, respectively. There was a statistically significant difference between the mean score of regret in the vaginal birth and elective cesarean section (P < 0.001). There was no statistically significant difference in terms of hopelessness among three groups of vaginal birth, birth via emergency cesarean section, and birth via elective cesarean section.

The higher scores in relation to regret in women who birthed via elective cesarean section in this study suggest that strategies are required to reduce rates of unnecessary cesarean sections.

The aim of this study was to investigate the relationship between mother-infant attachment and fear of childbirth in the postpartum period.

The data of this cross-sectional study were collected from 142 puerperal women who attended Kağızman Şahindere Family Health Center No. 1 and 2, Kars/Turkey and had a normal spontaneous birth between 2017 and 2019. The questionnaire developed by the researcher, WIJMA Birth Expectation/Experience Scale Version B and Mother-Infant Attachment Scale were used to collect data. Kolmogorov-Smirnov test for normal distribution eligibility tests, Shapiro-Wilk test, Independent Samples T test after eligibility, One-Way Anova Tukey test, Kruskal Wallis H test, Pearson Correlation, and Bonferroni post-hoc test in dependent and independent variables were used to analyze data.

While the total average score of puerperal women from the WIJMA Birth Expectation/Experience Scale was 86.83+28.23, the total average score they received from the Mother-infant Attachment Scale was 9.40+2.21. There was a moderately positive significant relationship between the scores puerperal women received from the WIJMA Birth Expectation/Experience Scale and the Mother-infant Attachment Scale (p<0.05). It was found that the higher the score on the WIJMA Birth Expectation/Experience Scale, the higher the score on the Mother-Infant Attachment Scale.

It was found that as the fear of childbirth increased, the mother-infant attachment decreased. So it could be suggested that the pregnant women should be directed to the childbirth preparation classes to prevent negative effects on the postnatal attachment level of women due to their fear of childbirth.

Changing lifestyle before pregnancy is necessary to avoid the consequences of obesity in pregnancy. This study was performed to investigate the effect of training based on extended parallel process model (EPPM) on the weight of women with high body mass index before pregnancy. 

In this two-group cluster randomized trial, 60 eligible women participated. Experimental and control groups were randomly selected from two comprehensive healthcare centers in Mashhad, Iran. Data collection tools included a questionnaire based on the constructs of the extended parallel process model and Baecke Physical Activity Questionnaire. The experimental group received the national nutrition guidelines based on EPPM constructs including threat as well as efficacy and the control group received the same content in a routine way. Participants' weight was measured before, two and four weeks after the intervention.

The two groups were homogeneous in terms of demographic and obstetric characteristics. The mean changes of construct of threat before, two and four weeks after the intervention in the experimental group compared to the control increased by 4.84 and 3.59 times, respectively, which was statistically significant (P<0.05). The mean changes of construct of efficacy before, two and four weeks after the intervention in the experimental group and also the mean weight loss four weeks after the intervention was not statistically significant.

Further studies are needed to confirm the effectiveness of this model for weight loss and its role in increasing the perceived efficacy of overweight women at the pre-pregnancy stage.

Midwives play an essential role in sexual counseling. The present study aimed to measure knowledge, attitude and self-efficacy towards providing sexual counseling among students doing the master of Counseling in Midwifery program in Iran.

This cross-sectional study was conducted on 148 midwifery students doing the master of Counseling in Midwifery, who selected via convenience sampling from universities across the country. Data collection was carried out using a researcher-made questionnaire including demographic characteristics, knowledge of sexual counseling (KSH), attitude towards sexual counseling (ASH), and self-efficacy to do sexual counseling (SESH) in 2021. Data analysis was done using the Student t-test, Pearson correlation test, and ANOVA using SPSS ver. 25.

Mean and standard deviation of the total score was 74.67 ±12 for knowledge, 80.8 ±76.98 for attitude, and 81 ± 16 for self-efficacy. Management of victims of sexual assault and counseling models had the lowest score on the knowledge scale. Students had poor self-efficacy when providing sexual counseling to the men and sexual minorities. There was a significant relationship between knowledge and attitude towards sexual counseling (P<0.001) A significant relationship was also seen between knowledge and attitude with self-efficacy of sexual counseling (p <0.001). 

Despite the optimal status of the overall sexual counseling knowledge, attitude, and self-efficacy scores, students still have low levels of competency in sexual counseling. It is necessary to improve the proficiency of students to communicate effectively with male clients, victims of rape, and sexual minorities through curriculum revision in terms of both theoretical and clinical issues.

Postpartum pain is a problem of women after delivery, which increase in multiparous women. Due to the side effects of chemical drugs to control postpartum pain and the individuals' tendency to use herbal medicine, the present study aimed to investigate the effect of evening primrose (Oenothera biennis) oil capsule on postpartum pain in multiparous women.

This triple-blind randomized clinical trial examined 90 multiparous women two hours after a normal vaginal delivery, who had a moderate to severe postpartum pain at maternity ward of Ommolbanin Hospital, Mashhad, Iran in 2021. The participants were randomly assigned to three groups including intervention, placebo, and control group. A capsule of evening primrose oil or placebo was given to the subjects every 8 hours for up to 4 doses. The control group received routine medication (acetaminophen). Pain severity was measured one hour before and after each intervention using the Visual Analogue Scale (VAS), and McGill Pain Questionnaire. Data analysis was carried out by Kruskal-Wallis, one-way analysis of variance (ANOVA), Chi-square and exact Chi-square tests using SPSS software (Ver. 16).

The mean severity of postpartum pain after intervention in the group received evening primrose oil capsule had a significant decrease versus placebo and control groups (P <0.001) and no side effects in the intervention group was observed.

Evening primrose oil was effective in reducing the severity of postpartum pain in multiparous. So it seems that it could be recommended as a safe medication for postpartum pain relief in multiparous women.

Mastectomy as the most common treatment of breast cancer has many effects on the quality of sexual life. Since there are limited studies on quality of sexual life in breast cancer, this study was conducted to compare the effect of counseling based on two models of PLISSIT and BETTER on quality of sexual life in women with breast cancer after mastectomy.

This quasi-experimental study was conducted at Mashhad, Iran in 2021. A total of 78 women who underwent mastectomy were randomly allocated into two equal groups and received 4 weekly sessions of individual counseling of 60-90 minutes based on two models of BETTER and PLISSIT. The research tools included demographic and sexual quality of life questionnaire (SQOL-F). The changes in the mean scores of quality of sexual life between the two groups before and 4 weeks after the intervention were measured. Data were analyzed using SPSS software (version 25) with Kolmogorov-Smirnov, independent t-test, paired t-test, Mann-Whitney and Chi-square test.

The mean change score of quality of sexual life before and after the intervention in the group who received counselling based on BETTER model (8.6±5.1) was significantly higher than the group were counselled by PLISSIT model (6.2±5.05) (P<0.001).

In cultures such as Iran, where the sexual problems of women with cancer are neglected and patients have a conservative approach to sexual issues, sexual counseling based on the BETTER model is more effective than the PLISSIT model in order to increase the quality of sexual life.

Extension of the incision, vulvar hematoma, infection, wound dehiscence and dyspareunia are some complications of performing episiotomy. Despite its adverse effects, the prevalence of episiotomy is increasing in some settings due to different factors. Therefore, this study aimed to determine the prevalence of episiotomy and its associated factors among mothers who gave birth at Gondar public health facility, Northwest Ethiopia.

This, cross-sectional study was conducted among 411 mothers from September 1 to November 1, 2021. Data were gathered using a structured questionnaire administered by an interviewer and supplemented with a delivery chart review at postnatal room. Binary and multivariable logistic regressions were performed to identify predictor variables. P-value ≤ 0.05 used to determine the level of statistically significant of outcome variable.

A total of 411 study participants were interviewed, with a response rate of 100%. The prevalence of episiotomy was found to be 52.8%, with a 95%CI of 47.7–57.4). Being a perimiparous mother (AOR = 8.95; 95% CI: 4.65, 17.20), labor complications (AOR = 3.03; 95% CI: 1.21, 7.62), fetal distress (AOR = 4.51; 95% CI: 2.71, 6.49), and fetal weight ≥ 4 kilogram (AOR = 3.42; 95% CI: 2.64, 6.62) were significantly associated with episiotomy.

The rate of episiotomy was higher than the World Health Organization's maximum limit of recommendation (10%). Therefore, as per our findings we recommend that clinicians emphasize on use of standard guidelines and clear indication of performing episiotomy to reduce the rate of unnecessary procedures.

Evidence now indicates insufficient knowledge about the quality of sexual life of older adults with symptoms of andropause. This study was therefore performed to measure the quality of sexual life of older adults with symptoms of andropause and its relationship with some socio-demographic characteristics.

This cross-sectional study was performed on 271 older adults with symptoms of andropause, who were selected by convenience sampling from health centers in Mashhad, Iran in 2021. The data was collected using a demographic questionnaire and the Men's Sexual Quality of Life Questionnaire. Data were analyzed using correlation tests, independent t-tests, and one-way analysis of variance.

The mean age of older men with andropause was 73.37±8.08 years. The quality of sexual life had a significant relationship with the underlying variables including age, education, type of employment, duration of marriage, age of spouse, education of spouse, type of spouse employment, type of sexual attitude of the spouse, number of sexual intercourse and chronic diseases (P<0.05). The results showed a significant inverse relationship between quality of sexual life and andropause severity in older adults (r = -0.36, P <0.001).

Based on the results, it can be recommended to the healthcare planners to improve quality of sexual life of older men with andropause by paying more attention to the role of changeable factors such as knowledge and type of sexual attitude of spouses, knowledge regarding andropause and sexual intercourse as well as monitoring some underlying diseases in planning health promotion programs.

The relationship between fetal biometric indices and pregnancy outcomes has always been discussed. It seems that understanding the relationship between these indices and maternal and neonatal complications can be useful in the proper management of labor and delivery. This study was performed to determine the value of estimated fetal weight (EFW) and head circumference (HC) measured by ultrasound to predict the cervical dilatation rate and mode of delivery.

In this prospective cohort study, all eligible individuals (n=60) selected by convenience sampling were evaluated. The participants were pregnant women with the gestational age of 37 to 42 weeks referred to Mousavi Hospital in Zanjan in 2019-2020. Data collection tools included a checklist to record clinical examination and ultrasound results, as well as reports on the labor and delivery processes. Data were analyzed by SPSS software (version 22) and using descriptive statistics and the student t-test Chi-square test.

EFW and HC were directly and significantly correlated with cesarean section and abnormal progression or cessation of dilatation (P<0.05). Linear regression analysis revealed that EFW could be a predictor of mode of delivery, while HC can be considered as a predictor of the rate of dilatation progression (p<0/05).

It seems that the sonographic estimation of EFW and HC prior to childbirth can be useful to predict mode of delivery and labor progression. However, it is suggested to conduct more comprehensive studies with larger sample size.

Breast cancer, the most common malignancy among women, affects many aspects of their lives. The present study was conducted to compare marital satisfaction in women with breast cancer and healthy women.

This descriptive comparative study was performed on 95 women with a definitive diagnosis of breast cancer and 95 healthy women who referred to the health centers and breast cancer clinics of Mostafa Hospital in Ilam, Western Iran in 2019.  Data were collected using demographic and Enrich Marital Satisfaction Questionnaires. Data analysis was carried out by SPSS software (version 20) using independent t-test and Chi-square test.

The mean total score of marital satisfaction in the healthy group was higher than breast cancer group (125.41± 10.17 vs 96.27 ± 9.46) (P˂0.001). The mean score of marital satisfaction dimensions including marital satisfaction (38.65± 4.70 vs 27.11± 4.16); communication (35.10 ±5.59, vs 28.91 ±6.41); conflict resolution (30.54 ±6.45, vs 25.74 ± 5.90) and ideal distortion (21.12 ±3.36 vs14.51 ± 2.79) was also higher in the healthy group compared with breast cancer group (P˂0.001).

Breast cancer can result in reduced marital satisfaction in different dimensions. Therefore, providing appropriate psychological counselling help women with cancer and their spouses to enhance their marital satisfaction.

Among the obstetric and gynecologic emergencies are paratubal or paraovarian cysts, which are generally detected in pregnancy, incidentally. Isolated torsion of a paratubal cyst, especially in late pregnancy, is extremely rare. Here, a case of isolated paratubal cyst torsion during pregnancy is introduced.

The patient was a 36-years-old woman with gestational age of 35 weeks of second pregnancy referred to the department of obstetrics due to severe crampy abdominal pain as well as nausea and vomiting. Ultrasound assessment revealed a 7×8 cm adnexal cyst. Regarding worsening of the patient's pain, despite the report of normal ovarian vascular flow, laparotomy was performed due to suspicion of ovarian torsion. An isolated paratubal cyst torsion was confirmed during laparotomy.

Nonspecific clinical features and uncommon objective findings are the main causes of misdiagnosis of ovarian torsion in pregnancy. Regarding the large uterus in pregnancy, the diagnosis of torsion is challenging. Therefore, there should be a high index of suspicion for firm diagnosis and appropriate management.