مجله زنان مامائی و نازائی ایران
سال پانزدهم شماره 20 (هفته دوم مهر 1391)

This quasi-experimental study with pre-test and post-test design was held on 30 women with vaginismus in Ahvaz city from 2007 to 2009. Samples with high-level of anxiety were randomly selected based on: Cattle Anxiety Inventory، Rozen Female Sexual Function Inventory and، clinical interview. They were divided into two groups of experiment (n=15) and control (n=15). The experiment group was participated in a Course of cognitive-behavioral method individually and in group for 12 sessions of 2 hours a week. The control group received no intervention. Collected data were analyzed by ANOVA and repeated measures analysis. P value less than 0. 05 was considered statistically significant. There was a significant difference between two groups in anxiety after the final session of intervention (p<0. 001). Cognitive-behavioral methods significantly decreased the rate of anxiety in the experimental group in post-test stage and 12 months of follow-up (p<0. 001). Also، 13 women of the experimental group were treated after one year follow-up period. Cognitive-behavioral methods decreased the anxiety and fear of sexual intercourse in women with vaginismus after termination of therapy sessions and after 12 month follow-up period.

Cesarean section is vastly used for child bearing. Spinal analgesia is a preferable method in Cesarean because of its fewer complications. Adding opioid to the anesthetic medicine improves the analgesic potency and quality of spinal analgesia. The purpose of this study was to evaluate the effect of regular-dose of bupivacain (marcain) and low-dose of bupivacain plus fentanyl in spinal anesthesia on neonatal apgar score and time of regression of sensory block in elective cesarean section under. This clinical trial was performed on 100 pregnant women who had chosen elective cesarean section under spinal analgesia in 2010. Patients were divided into two equal groups of 50 persons: first group received 12 mg intra theca hyperbaric bupivacain and second group received 8 mg bupivacain with additional 25 microgram of fentanyl spinal injection. Considering parameters including: duration and level of sensory block، neonatal apgar score، hemodynamic stability، and other side effects; both groups were evaluated and compared. Gathered data were analyzed by SPSS software version 11. 5، T-Test، Man-Whitney and qui-square tests. P value less than 0. 05 was considered statistically significant. Mean age of all the participants were 28. 18±5. 4 (minimum age 16 and maximum age 41). Both groups were similarin age، weight، height، and hemodynamic condition. All patients had satisfactory anesthesia. The time of sensory-block regression was not statistically different in both groups (p=0. 482)، but the level of sensory block was higher than T4 in the first group. Median of blood pressure، pulse rate and PO2 saturation were similar in both groups (p>0. 05). Ephedrine requirement (because of decrease of blood-pressure) and nausea were significantly more in the first group، (p=0. 017 and p=0. 014، respectively). There was no significant difference between two groups in the first minute of neonatal apgar score، but the 5th minute apgar score was significantly less in the first group (p=0. 043). Adding fentanyl to low-dose of bupivacain provides good spinal anesthesia for cesarean section with fewer side effects، and satisfactory sensory block level but it has no adverse effect on neonatal apgar score.

There are strong temptation for admission of mothers in latent-phase in order to reduce mothers'' pain and fear. Determining the exact time of laboring، measuring the length of laboring and the length of latent phase are troublesome، and this may be the reason of different encounters with latent-phase. This study was held by the aim of comparing the length of laboring in women admitted in Latent and Active Phase in Taleqani hospital of Tabriz. This descriptive-comparative study was done on 500 pregnant women who were admitted for vaginal delivery at Taleqani hospital of Tabriz in 2011. The participants were randomly selected and divided into two groups of 250 persons. First group were admitted in latent-phase of labor (250 women) and second group were admitted in active-phase (250 women). Required data were collected based on observing labor process، interviewing mothers، and studying patient''s records. Collecting data tools were Questionnaire of samples'' characteristics، evaluation of 4 stages of labor and mothers'' pre-discharge examination. Data were analyzed by SPSS software version 13، t-test، chi-square، correlation، and regression-logistic tests. P value less than 0. 05 was considered statistically significant. The mean of latent-phase length was 3. 9±3. 8 hours in the first group. The mean of active-phase length was 2. 7±1. 9 hours in second group which was shorter than latent-phase group (3. 9±2. 5 hours). This difference was statistically significant between the two groups (p<0. 0001). While the length of second and third stages in latent-phase was more than in active-phase، there was no significant difference between the two groups. The length of postpartum hospitalization was statistically significant in two groups. (p=0. 04). The results showed that admission of women in Latent-phase is accompanied by increase length of Labor، length of postpartum hospitalization، other complications and interferences.

Birth-weight is affected by many factors. Some studies have shown that season of birth may be affected on birth-weight. However، there is less information about this effete mechanisms underlying. This study was carried out to define the relationship among birth weight and season of birth and some related factors. This analytical cross-sectional study was held on 808 children under one year old who were attended to health centers of west of Ahvaz in 2008. Samples were randomly selected in two stages. Data were gathered through questionnaire and were analyzed by the means of statistical SPSS software version 17، Chi-Square and Pearson correlation tests، ANOVA، and linear regression. P value less than 0. 05 was considered statistically significant. Mean birth-weight was 3273. 5±525. 4، 3251. 6±421. 3، 3280. 5±547. 6 and 3192. 9 ±518. 4 gram in spring، summer، autumn and winter respectively. Although there was no significant correlation between these variables، a seasonal rhythm in mean birth-weight was observed. The rates of low birth weight were 4. 9% with highest rate (6. 5%) in winter. The relationship between birth-weight and other variables such as sex، birth rank، maternal age، and weight gain in pregnancy were significantly positive (p<0. 05). In regards to the findings، improvement of proper and efficient prenatal care، educational and interventional programs focusing on gestational weight-gain and special care of nuliparous women can play an important role in increasing birth weight.