مجله زنان مامائی و نازائی ایران
سال پانزدهم شماره 5 (هفته سوم خرداد 1391)

Gestational diabetes mellitus (GDM) refers to diagnosing of carbohydrate intolerance during pregnancy which may cause some serious fetal and maternal complications. GCT (fifty-gram glucose tolerance test) is the first test for GDM screening which is done without regarding of fasting condition. While prevalence of GDM is 2-5%, the result of this test is positive in 14-18% of pregnant women. Thus, those with positive results are screened by a three-hour hundred-gram glucose tolerance test (GTT). Execution of this test requires 8-14 hours fasting and four-times blood sampling in which the patient incurs a lot of time, cost and stresses. If GDM cases are reduced by execution of GTT after ten-hour fasting, a hundred-gram GTT is prevented in many patients. The aim of this survey is evaluation effects of fasting on results of fifty-gram oral glucose challenge test in GDM screening A total of 130 pregnant women who met the inclusion criteria with gestational age of 24 to 32 weeks and were hospitalized in Imam Reza hospital from 2008 to 2009 participated in this study. They were randomly entered into fasting group (80 cases) or non-fasting group (50 cases). After one hour receiving fifty-gram oral glucose, blood sampling was taken from all of them. Then, the level of blood glucose was measured and compared between two groups by T test, Mann Whitney, Chi Square tests and SPSS software version 13. P<0.05 was determined significant. T-test evaluation shows no statistical significant relation between fasting status and the result of screening (P=0.89). But, based on Chi Square test, fasting and non-fasting group were statistically different in terms of mean blood glucose (P=0.03). In GDM screening test, the mean level of blood glucose reduces in fasting status.

Multiple sclerosis (MS) is the most common cause of progressive neurological disability in young adults. MS has a deep impact on the social, economic, psychological, and sexual aspects of the patient’s life. Women with MS are 2-3 times more than men. Sexual problems are often experienced by people with MS and severely affect the quality of their life. The aim of this quantitative study is to examine female sexual performance and its association with life quality in MS patients. One hundred and thirty-two women with MS who referred to Iran MS Society of Tehran in 2010 participated in this descriptive study. They filled out “Multiple Sclerosis quality of life-54”, “demographic” and “medical History” questionnaires. Sexual performance was evaluated by sexual performance subscale of MSQOL_54. The study was conducted only in Iranian MS society. Data were analyzed by using SPSS software version 15 and Pearson correlation coefficient was used to examine relationships between variables. The mean ± SD age of patients was 36.9±8.3 year. Orgasm disorder was the most common complaint. Statistically significant positive correlations were found between the orgasmic problems and physical (p<0.001) and mental (p<0.001) health composite of quality of life. Frequency of intercourse was significantly and reversely correlated with age, age at onset of MS and disability age (p=0.003), age of onset of MS (p=0.043), parity (p=0.048), number of childbirth (p=0.018), ability (p=0.005), age of husband (p=0.001) and marriage education (p=0.008). Increasing the focus on sexual problems when consulting patients may help them improve the quality of their life.

Maternal-foetal attachment (MFA) is a term which describes the emotional relationship between a pregnant woman and her foetus.MFA is the most beautiful and amazing phenomena occurs long time before birth which causes a pleasurable relation between mother and her fetus after childbirth. The present study was conducted to determine the effect of training attachment behaviors on maternal-foetal attachment in primipara mothers. In this clinical trial, 84 primipara women were selected from two hospitals in Shiraz (Shoshtary and Hafez) in 2010. The participants were randomly allocated to the “experiment” and “control” groups. Data were collected from personal information and prenatal forms, and the maternal-fetal attachment questionnaire. Besides the usual pregnancy cares, the “experiment group” received four two-hour sessions of training course on attachment behavior in a month (once a week) and attachment behavior recording-forms were given to them every week. However, “control group” only received the routine prenatal care. Maternal-fetal attachment was measured before and after intervention in two groups. Data were analyzed using statistical tests such as Chi-square, T-test, and paired t-test. Before intervention, the mean score of MFA were respectively 60.8 ± 4.6 and 60.2 ±4.5 in experiment and control groups that showed no significant difference between the study groups (p=0/544). After intervention the scores changed into (64.1 ± 5.1 and 61.1 ± 5.1) respectively which significantly differed between the study groups (p<0.0001). Results indicated that training attachment behaviors increases the maternal-fetal attachment. So, simple tasks such as palpation of the belly cause more emotional relationship between mother and her fetus during pregnancy.

Nowadays, different techniques are used for increasing pregnancy rate in laboratories of in vitro fertilization (IVF). One of these techniques is laser assisted hatching (LAH) which help the embryo be separated from zona pellucida. Since there are contrast reports about the efficacy of LAH on pregnancy rate in embryo of thick zona, we decided to evaluate the correlation between zona pellucida thickness by LAH and increasing pregnancy rate in infertile patients under treatment of IVF at Mashhad Montaserieh Infertile Center. This case-control study was performed on 101 infertile couples (50 in case group and 51 in control group). Two groups were similar in terms of maternal age, number of oocytes, number of fertilized oocytes, and number of transferred embryos. Also, embryos with similar quality were used for both groups. Pregnancy rate was determined using β-HCG test and sonography. Data analyzing was performed by t-test, Chi-square, SPSS and Excel software (95% confidence coefficient). P value less than 0.05 considered significant. There was no significant relation between case and control groups in terms of maternal age, number of fertilized oocytes, number of aspirated oocytes, number and quality of transferred embryos (p=0.837). Pregnancy rate in case and control groups was 15.7%, 34%, respectively. Significant difference was observed between two groups in terms of pregnancy rate (p=0.33). Laser assisted hatching method on embryos of thick zona pellucida leads to increasing of pregnancy rate.Keywords: In vitro fertilization, Laser assisted hatching, Pregnancy rate, Zona pellucida thickness