مجله زنان مامائی و نازائی ایران
سال شانزدهم شماره 60 (هفته دوم امرداد 1392)

Postpartum hemorrhage may cause anemia or deplete iron stores in women. Prevention of postpartum hemorrhage can play an important role in promoting women''s health. Some studies indicate the efficacy of tranexamic acid in reducing bleeding after vaginal delivery. This study was done to investigate the effect of intravenous tranexamic acid on hemoglobin and hematocrit level after vaginal delivery in women who were low risk in postpartum hemorrhage. This triple blind randomized controlled trial was carried out on 120 pregnant women referred to Alzahra hospital، Tabriz، Iran، 2012. Patients were divided into two groups of 60 cases using block randomization. Both groups got 10 units oxytocin after placenta delivery. After delivery of the anterior shoulder، subjects in intervention group received 1gr intravenous tranexamic acid and control group received 1gr placebo in 200 ml normal saline over 10 minutes. Hemoglobin and hematocrit levels were measured 1-12 hours before and 12-24 hours after delivery. Data were analyzed using SPSS software version 13، chi-square، Fisher، chi-square for trend، independent t-test and paired t-test. P value less than 0. 05 was considered significant. Before intervention، the mean of hemoglobin and hematocrit was respectively 12. 9±0. 9 g/dl and 38. 3±2. 3% in intervention group and 13. 0±0. 9 g/dl and 38. 8±2. 0% in control group (p>0. 05). After intervention، mean of hemoglobin loss was 1. 4±0. 9 g/dl in intervention group and 1. 7±1. 0 g/dl in control group (p=0. 11). The mean of hematocrit loss was 3. 7±2. 3% in intervention group and 4. 8±3. 0% in control group (p=0. 03). Administration of tranexamic acid had significant effect in reducing the mean of hematocrit loss. Thus، use of this drug may help promote maternal heath in the postpartum period.

Sleep disturbances during pregnancy are prevalent due to physical and hormonal changes. Insufficient sleep causes metabolic and neuroendocrine alterations that may contribute to impaired glucose metabolism and insulin resistance. There is little information about association between insufficient sleep and glucose metabolism during pregnancy. So، this study was done to investigate the relationship between sleep duration and results of glucose challenge test in pregnancy.

This descriptive-analytical study was conducted on 177 pregnant women who referred to Iran، Mashhad health center n: 3 in 2012. Participants were selected through available sampling method. All participants completed demographic questionnaire، depression، anxiety، stress scale 21 and Pittsburgh sleep quality index during 26-30 weeks of their pregnancy، then they undergo glucose challenge test. Short sleep duration was defined as less than 7 hours of sleep per night. Data were analyzed by SPSS software version 11. 5 and Pearson correlation test، Mann-whitney، independent t test and chi-square tests. P value less than 0. 05 was considered significant.

87 women (49. 2%) had short sleep duration. Variables such as stress، anxiety، diet and exercise had no significant differences between two groups (p>0. 05). There was a significant inverse correlation between sleep duration and results of glucose challenge test (r=-0. 19، p=0. 01). Impaired glucose challenge test was significantly more prevalent in participants with short sleep duration (p=0. 01).

Short sleep duration is associated with impaired glucose metabolism in pregnancy and health care providers are advised to screen for sleep duration and quality.

Pregnancy، breast feeding، child care and occupation are the factors that can affect sexual relationships. The aim of this study was exploring women’s sexual experiences during pregnancy and breast feeding. In this qualitative study، women’s sexual experiences during pregnancy and breast feeding were investigated. Using purposeful sampling، 30 mothers who had a child، 4-24 months old included in the study. Data were collected by semi-structured individual interviews and the participants were questioned about sex issues experienced during pregnancy and breast feeding periods. All of the interviews were recorded، transcribed verbatim and analyzed using qualitative content analysis methods. The main theme «change in sexual behavior» and sub-themes «loss of libido، loss of privacy، maternal tasks، and respect the wife''s needs» emerged from this study. Couples in this period، focused their attention to the fetus، breast feeding and newborn. Changes in sexual relations did not have negative effects on couple''s relationship. According to mothers’ focus was on fetus، breast feeding and newborn، decline in sex activity had no effect on couple''s relationship and their quality of life.