مجله زنان مامائی و نازائی ایران
سال شانزدهم شماره 87 (هفته اول اسفند 1392)

Breast cancer is the most prevalent cancer among women، and it is one of the important health issues. General Practitioners in Iran visit most of the patients with breast complaints for the first time، so the knowledge and skills of these physicians are the key point for the best approach to breast cancer. The aim of this study was to evaluate the attitude and skills of female physicians (general practitioners) with this common health problem in Mashhad، Iran. This prospective study was conducted on 50 female physicians that have office in Mashhad، Iran in 2011. Data tool was a 35 years old healthy woman who had normal sonography and mammography with no history of any diseases. She and the researcher have gone to the physician''s office with complain of a breast mass. The researcher filled out a check list immediately after the visit. 32 physicians (64%) knew the age of breast cancer، and 30 physicians (60%) knew its relation with pregnancy، but only 12 physicians (24%) asked about the risk factors of breast cancer. 7 physicians (14%) used inspection maneuvers of breast exam and 32 physicians (64%) used palpation maneuvers، but 33 physicians (66%) did not examine lymph nodes completely. 23 physicians (56%) diagnosed incorrectly a mass in the breast، and 19 physicians (38%) definitely exclude a mass in examination. The attitude of female general practitioners towards the breast problems is not sufficient، so better training and more feedback after education is recommended.

Maternal mortality rate is an important indicator of the development of any society. It indicates the effect of pregnancy healthcare، and on the other hand it is an indicator of the economic status of the society. The aim of this study was to determine the rate and related factors of maternal mortality in Hormozgan، Iran during 2005-2011. This descriptive-analytical، cross-sectional study was conducted on all pregnant women who died between April 2005 and march 2012 in Hormozgan province، Iran. Data gathering instrument was a questionnaire and the information regarding each case was obtained from the records of maternal mortality committee، perinatal healthcare reports، verbal reports and interviews. Data were analyzed by SPSS software version16 and chi-square and ANOVA. P value less than 0. 05 was considered significant. There were 91 cases of mortality and mortality rate was 39. 7 per 100000 live births. The highest maternal death cases occurred in 2010 (19 cases) and the lowest occurred in 2009 (10 cases). The majority of the deceased were observed in rural residents (60. 4%) and women who had at least one risk factor during pregnancy (74. 7%). 70 women (76. 9%) died during postpartum period. The most common cause of maternal death was bleeding (34. 1%). The causes of maternal mortality had significant relationship with the type of delivery (p<0. 001)، parity (p<0. 001) and risk factors during pregnancy (p=0. 022). To reduce maternal mortality after delivery، it is necessary to increase the quality of obstetric healthcare services provided in rural areas and pay special attention to mothers with high risk status، and provide efficient emergency as well as the follow-up healthcare of mothers in the postpartum period

Unplanned pregnancy is a major social and public health issue in Iran that has adverse impacts on mothers and infants'' health. The aim of this study was to explore women’s experiences of unplanned pregnancy in Mashhad health centers. This qualitative study was conducted with a phenomenological approach in 2012. Purposive sampling method was conducted till data saturation and sample size was 10 women with unwanted pregnancy. Data were collected by using in-depth interviews and by a semi-constructed questionnaire. All interviews were recorded، transcribed and then were analyzed by Colaizzi''s method. Exposure to stress (psychological reactions، coping، decision and attempt to abortion)، justification (causes of knowing of unwanted pregnancy، causes of unwanted pregnancy occurrence)، changing role (changing in maternal role، changing in role of spouse، changing in daily roles) and reaction of others were the main and subthemes in this study. Women with unplanned pregnancy have severe mental and psychological stress during pregnancy. Health personnel should help women and their partners through this critical period.