مجله زنان مامائی و نازائی ایران
سال سیزدهم شماره 4 (مهر و آبان 1389)

Low birth weight is the 2nd leading cause of mortality in infants. Since there are controversies in the effect of ionizing radiation of the mother on the birth weight of newborn so we tried to eliminate the effect of confounding factors observed in other studies, to assess the effect of dental radiographies in pregnant women on the risk of delivery of low birth weight infant. All mothers with their first term labor (vaginal or caesarean) between 2006-2008 (1385-1387; according to Iranian Calendar) whose newborns had been registered in the neonates’ screening program in Shiraz were interviewed and surveyed. and based on mothers’ history and dental or non-dental (head and neck) radiography, 1200 newborns were divided into two groups in a cohort study. First group consisted of the newborns whose mothers had dental radiography and second group consisted of those whose mothers had no dental radiography. All interfering variables such as exposure to non-ionizing radiations were controlled. The obtained findings were analyzed, using proper statistical tests as student’s t-test and chi square and ANOVA. Among them, only 19 mothers (1.58%) had been exposed to dental radiography.The mean weight of the newborns whose mothers had been exposed to ionizing radiation in dental radiographies was 2988.95 + 424.8 grams and that of the newborns with non-radiographed mothers was 3113.00 + 511.240. The difference between the means was not statistically significant. Furthermore, the difference between the mean weight of the newborns with mothers who had non-dental radiographies and those not exposed to any radiation during the pregnancy period was not statistically significant. This study found no clear relationship between dental radiography during pregnancy and birth weight. Due to the low frequency of dental radiography during pregnancy, it is necessary to do more long-term studies to investigate this phenomenon more accurately.

The relationship between Human T cell leukemialymphoma virus type1 (HTLV1) and adult T cell leukemia and tropical spastic myelopathy was documented but there are controversies about the role of HTLV1 and the other diseases especially cervical cancer. Since this virus is endemic in north east of Iran (Khorasan) and cervical cancer is the common genital tract cancer in Iran, this study was designed to evaluate probable association between HTLV1 and cervical cancer. This case – control study was done in 49 new cervical cancer patients and 100 healthy women who referred to the Ghaem and Omid Hospitals in two years. Presence of HTLV1 virus examined with Bio rad kit by Eliza method and the positive samples rechecked by Western blot test. Both groups were matched based on age and reproductive factors. 6.1% of cases and 2% of control group had positive tests for presence HTLV1. There was no significant difference between these 2 groups (P=0.362). HTLV1 is not a risk factor in cervical carcinoma in north east Iran (Khorasan).

The most common test used in third-trimester of pregnancy in order to check fetal wellbeing is the non-stress test (NST).One of the disadvantages of NST is its high rate of false-positive results. The most common cause of a nonreactive test is a period of fetal inactivity or quiet sleep. Many different methods have been tried to decrease the number of nonreactive NSTs. Probably the most common method of provoking fetal reaction is maternal ingestion of fruit juice as a source of glucose. The aim of this study is to determine whether maternal oral glucose ingestion influences non-stress test indices. A clinical trial study was performed at Amir-al-momenin hospital in Ahvaz on 35 primiparous non-laboring healthy women with normal singleton pregnancy at 37-40 weeks of gestation. All women had a normal oral glucose tolerance test at 24-28 weeks of gestation. The women were evaluated in a fasting state (last meal more than 3 hours before non-stress test). The NSTs were performed 1 hour after oral ingestion of 50g of glucose in 240ml of water in first day and an equal volume of water during second day. Statistical analysis was performed using a paired t-test and chi-square test and p<0.05 was considered significant. There was no significant difference in fetal heart rate baseline, number and amplitude of fetal heart rate accelerations, beat to beat variability and number of variable decelerations among women whether receiving glucose or water (p>0.05).However, there was an increase in duration of fetal heart rate acceleration followed by oral ingestion of glucose (p<0.01). Maternal oral glucose ingestion is not able to reduce the false-positive results of non-stress tests.

Cervical cancer is the second most common of cancer between women, it has long phase of preinvasive lesion. The aim of screening is diagnosis and treatment of precancerous lesion before produce of cancer. This study has been designed to assess if visual inspection with acetic acid 5% (VIA test) is a useful alternative for cytology as an accepted screening test for cervical cancer. The study population included woman attending gynecological clinic in Ghaem Hospital in one year. After obtaining informed consent from each woman, pelvic examination and VIA was performed. One hundred woman with a positive VIA and one hundred with a negative VIA were randomly selected for this study. Cytology and colposcopy examination was performed for all 200 cases, and cervical biopsies were conduct for those individuals showing abnormal colposcopic findings. Those with CIN1 or worse lesions diagnosed by histology were considered true positive. Sensitivity, specifity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each tests and compare. 69 women in VIA positive group and 61 women in VIA negative group had abnormal cytology. From biopsy examination 58 woman in VIA positive and 2 women in VIA negative group had final diagnosis of displasia, while they were 43 and 17 for abnormal and normal cytology respectively. VIA test sensitivity and specifity were 96% and 70% respectively, while they were 72% and 38% for cytology test. There was a positive predictive value of 58% for VIA and a positive predictive value of 33% for cytology. The result of this study indicates that VIA may be a useful and feasible alternative screening test for cervical precancerous and cancerous lesions.

Nowadays, different methods such as ice massage are proposed as decreasing labor pain factors. This study was carried out in order to examine the effect of ice massage in Hegu zone on severity of labor pain in pregnant women referred to selected hospitals in Tehran. In a case-control clinical trial, 60 pregnant women referred to selected hospitals in Tehran were allocated randomly into two groups, receiving ice massage and placebo. First severity of labor pain was measured in active phase by visual measurement scale and then ice massage was performed on Hegu zone in case group and placebo in control groups for 10 minutes. The severity of labor pain was compared in two groups before of intervention, immediately after intervention, half and one hour after intervention. Data was analyzed using independent t test, one way ANOVA and repeated measure ANOVA tests. Findings showed that mean of pain was significantly different before intervention and immediately after intervention, half an hour and one hour after intervention in ice massage group. Mean of pain was significantly different before intervention and immediately after intervention in placebo group (p<0.001). There was statistically significant difference between two groups half an hour after intervention (p<0.05). Being Iranian or Afghan does not influence the incidence of HELLP syndrome. However, further amount of proteinuria, lower gestational age at the time of onset of preeclampsia symptoms and also maternal risk symptoms like headache, epigastric pain and blurred vision are risk factors for HELLP syndrome.

Delayed onset of lactogenesis II is one of the reasons of poor lactation outcomes. Recently,obesity in mother is implicated in delayed onset of lactogenesis II. Therefore, this study was performed to assess the relationship between the onset of lactogenesis II and antropometric indices at 14±1 days following child birth. This descriptive and analytic research was conducted in Shahid Rajaee hospital of Tonekabon City and Imam Sajjad hospital of Ramsar City. The samples were 103 parturient women who were enrolled by purposive sampling. According to mother's report of latogenesis II,they were put into two groups,with lactogenesis II within 72 hours and beyond,respectively. Then anthropometric indices of mothers were registered on 14th day after delivery.Data gathering was done by interview, observation forms and file. Analysis of data was performed by student t-test, Chi square, Mann-Whitney, Fischer's exact test, Pearson correlation, and Multivariate-Logistic regression. Pearson coefficient test showed a direct meaningful relationship between anthropometric measurements at 14 days following child birth onset of lactogenesis II. There were relationship between onset of lactogenesis II and mid arm circumference (r=0.248, P= 0.012), skin fold thickness (r=0.233, P=0.018), Calf circumference (r=0.387, P< 0.001), body mass index (r=0.378, P<0.001). By using logistic regression, results of study revealed the role of BMI is more significant in delayed onset of lactogenesis II (P= 0.006), and R.O.C curve defined that mothers with BMI ≥ 29 are at risk for late onset of lactogenesis II (P< 0.001). All of the antropometric indices have direct and meaningful relation with onset of lactogenesis II, but Body Mass Index has more significant role in comparison to other factors.

Approximately 15% of all couples in the reproductive ages are infertile. The ability to reproduce and give birth to a child is an inherent part of life for most human beings and it is important from social and psychological aspects. So, one of the goals of marriage is fertility and reproduction. Thus the diagnosis of infertility causes severe anxiety in the individual. The purpose of this study was to explore women’s experience of female infertility. Descriptive phenomenological method was used to determine these experiences. The data was collected by deep interviewing of 14 interfile women. Data analysis was done according to Colaizzi’s steps. We obtained four general concepts: 1- Personal anxiety. 2- Challenge with interpersonal communications. 3- Effects of beliefs and religion. 4- Problems associated with treatment process. It seems that all aspects of infertile women’s lives are affected by infertility. Thus, designing and accomplishment of consultive and supportive programs play very important roles for giving better cares to infertile women.