مجله زنان مامائی و نازائی ایران
سال شانزدهم شماره 45 (هفته سوم فروردین 1392)

Cesarean section is one of the most common obstetric operations and paying attention to incision complications and determining its effective causes in reducing the complications is under serious concern. The purpose of this study was to compare incision complications of two different incision closure techniques (interrupted versus continuous subcuticular) in cesarean section. The study was performed in 2010 as a single blind randomized clinical trial on 1044 women who were candidates for cesarean delivery. The women were randomly assigned into two groups. In the first group، the skin was repaired using percutaneous interrupted sutures and in the second group، subcutaneous continuous suture was performed. Skin was repaired by 2-0 nylon sutures in all women. Two groups were compared in term of incision complications including infection، dehiscence، erythema and pain intensity. Data were analyzed using SPSS software version 17 and statistical tests including t-test and chi-square test. P value less than 0. 05 was considered statistically significant. Mean age of patients was 27. 8±5. 8 years. Incision complications were seen in 28 patients (42. 42%) of continuous group and 38 patients (57. 57%) of interrupted group that the difference was not significant (p=0. 152). Incision infection was observed in 21 women (4. 1%) in interrupted group and 10 women (1. 9%) in continuous group (p=0. 034). 2 patients (0. 4%) of continuous group and 6 women (1. 2%) in interrupted group had skin dehiscence without significant difference (p=0. 140). Both groups had no significant differences in term of wound erythema (p=0. 382). Severe pain was less in continuous group (p<0. 001). TheContinuous subcuticular techniques of skin repair followed less pain and infection in compare of interrupted sutures and is considered as the preferred techniques.

Pesticide poisoning is common in Iran especially in rural communities. Amitraz is a formamidine compound that the prevalence of its poisoning is less common than organophosphate poisoning. In this study a case of pregnant women with brain edema due to amitraz poisoning is reported. A 15 years old female in 18th week of pregnancy was referred to Imam Reza hospital with history of deliberate consumption of about half a glass of liquid pesticide of amitraz، 5 hours before hospitalization. At first، she had nausea and vomiting then became confused in about an hour. Initial vital sign on arrival were: blood pressure: 90/60 mmHg، pulse rate 70، with Glasgow Coma Scale scores of 3/15. Both pupils were dilated and unresponsive to light. There was no evidence of trauma and no focal neurologic deficit signs. According to deep coma and moist mucous membranes، atropine and pralidoxime were prescribed assuming severe poisoning. Atropine and pralidoxime were discontinued when it became clear that was amitraz poisoning and treatment of cerebral edema was started due to cerebral edema was detected in brain CT-scan. Her consciousness gradually improved 3 days after admission. The patient was discharged after 3 days and 21 weeks later a healthy neonate was born by vaginal delivery. Amitraz poisoning has no known antidote and the symptoms improve with treatment in most of cases.

The Intrauterine Device (IUD) is the most cost-effective method of contraception. The use of the IUD in relation to other contraceptive methods is reported to low in some countries such as Iran. The factors that influencing IUD insertion behavior can be mentioned: individual، social and environmental factors. This study investigated the predictors of IUD insertion behavior in women of reproductive age in Mashhad using the theory of planned behavior. In this correlational study، 400 women who were referred to public health centers were studied in Mashhad، Iran، 2012-2013. A stratified cluster sampling method was used. Data were collected by a demographic questionnaire، the questionnaire related IUD knowledge and a researcher-made questionnaire. Reliability and content validity of questionnaires were assessed using Cronbach''s alpha coefficient (0. 75-0. 94). IUD insertion behavior was measured after 3 months. Data were analyzed by SPSS software version 11. 5 and descriptive statistical tests such as Spearman correlation coefficient and linear and logistic regression tests. P value less than 0. 05 was considered statistically significant. The mean age of women was 27. 8±5. 01 years. Structure of planned behavior predicted 36% and 14% of the variance of intention and IUD insertion behavior، respectively. Subjective norms (β=0. 213) and intention (β=0. 179) were the most significant predictor of IUD insertion behavior. Theory of planned behavior offered a good prediction of IUD insertion behavior intentions but falls short in predicting IUD insertion behavior.

Psychologists who are dealing with infertile couples try to plan intervention strategies to decrease the stress and increase their compatibility for better results and providing mental health care. To achieve this goal، the effective factors on their stress and mental health should be determine and planning to reduce their vulnerability should be done. The purpose of this study was to evaluate effective factors on depression in infertile women and causal relationships between stigma، coping strategies، social support and depression in infertile women population. This cross sectional study was conducted on 400 infertile women who were referred to Sarem infertility hospital، Tehran، Iran from October to December 2010. Sampling was accessible. Participants were assessed using social support questionnaire of Vax et al، coping inventory for stressful situations by Endler and Parker، Beck depression inventory-II and perceived stigma inventory. Data were analyzed by LISREL software version 8. 5. Spearman correlation test was used to determine the relationship between the structures and path analysis for the contribution of each component. The perceived social stigma in infertile women lead them to depression if it were associated with emotion-focused coping strategies and the loss of family support. In other words، emotion-focused coping strategies and family support affect as mediator in the relationship between stigma and depression in infertile women. Focusing on the coping strategies and family support in infertile women might play an important role (s) in decreasing their depression and vulnerability to stigmatization.