مجله زنان مامائی و نازائی ایران
سال هفدهم شماره 93 (هفته سوم فروردین 1393)

Premature rupture of membranes (PROM) may have serious problems for mother، fetus and baby. Determining antibiotic use is various in mothers with these problems due to common causes of maternal vaginal colonization. The aim of this study was comparing the efficacy of cefotaxime and ampicillin on neonatal infection after premature rupture of membranes. This clinical trial was conducted on 200 women with premature rupture of membranes who required to use antibiotics in Ghaem hospital، Mashhad، Iran in 2010-2012. Women were divided randomly into two groups: group A received conventional therapy (ampicillin) and group B received cefotaxime. Status of mothers and her fetus until birth and neonates in neonatal ward or neonatal intensive care unit (NICU) until discharge or death was controlled. White blood cell and platelet count، erythrocytes sedimentation rat (ESR)، C-reactive protein (CRP)، blood cultures، cytology of cerebral spinal fluid، cerebral spinal fluid culture and mortality rates were compared in neonates of both groups. All statistical analyses were performed using SPSS software version 14. 5 and chi-square، t-test and Mann-Whitney tests. P value less than 0. 05 was considered significant. The mean length of PROM until delivery (p=0. 78)، parity (p=0. 46)، gestational age (p=0. 150)، birth weight (0. 147) and sex (p=0. 431) were homogeneous between two groups. Definite infection (p=0. 034)، high ESR (p=0. 003)، CRP positive (p=0. 049)، require hospitalization (p=0. 001) and mortality (p<0. 05) was higher in neonates who received ampicillin. The risk of neonatal infection in mothers with PROM who receive cefotaxime is clearly less than mothers who receive ampicillin.

Polycystic ovary syndrome (PCOS) is associated with insulin resistance and hyperinsulinemia. Insulin as a growth factor induces cellular proliferation in all tissues such as thyroid. We studied functional tests and sonographic findings of thyroid in patients with PCOS and assessment the relationship between the level of thyroid-stimulating hormone (TSH) and insulin resistance. This cross sectional study was conducted on 98 patients with PCOS in the age range of 16 to 42 years in Mashhad, Iran in 2012-2013. Height, weight, thyroid function tests, fasting blood sugar (FBS), fasting insulin and thyroid sonography was measured for all patients. Data were analyzed using SPSS software version 11.5 and t-test, Mann-Whitney, chi-square and Fisher tests. P value less than 0.05 was considered significant. 10 patients (10.2%) had high level of TSH, 12 patients (12.24%) had high anti-TPO and 8 cases (8.16%) had high anti-TPO with thyroid heterogenicity in sonography. 5 patients (5.10%) had high anti-TPO and high TSH and 8 cases (8.16%) had high TSH and thyroid heterogenicity in sonography. 31 patients (31.6%) had decreased echogenicity and 25 patients (25.5%) had thyroid heterogenicity and 20 cases (20.4%) had thyroid nodule in sonography. There were no statistically significant differences between the level of TSH, anti-TPO, T3, free T4 and sonographic findings in PCOS patients with and without insulin resistance (p>0.05). Compare to general population, it is not recommended routine sonography in PCOS patients but it is recommend to measure of TSH for detection of thyroid dysfunction in these patients.

Episiotomy is a surgical incision of the perineum, which is done to prevent perineal tears but little studies were performed on the care of this common wound. Chamomile has the capability of healing wounds because of its α-bisabolol. The aim of this study was to determine the effect of chamomile cream on wound healing of episiotomy. This triple blind clinical trial was accomplished on 98 qualified women, who were candidate for normal vaginal delivery in Ommolbanin hospital in Mashhad, Iran in 2014. Women were randomly divided into two groups of intervention (chamomile cream) and control (placebo). Mothers used a phalanx of prescribed creams (chamomile or placebo) on the stitches site twice daily for 10 days after delivery. The wound healing was assessed at the days 1st, 7th, 10th, and 14th after the delivery using the REEDA scale. Data were analyzed with SPSS software version 16, Mann-Whitney, t-test, chi-square and Fisher exact tests. P value less than 0.05 was considered significant. There was no significant difference egarding REEDA score between two groups at the first day after delivery (p=0.115). The mean of REEDA scores were 1.90±1.29 at 7th day, 1.00±1.17 at 10th day and 0.56±0.92 at 14th day of postpartum in the case group and 3.10±1.05 at 7th day, 2.30±1.35 at 10th day and 1.10±1.80 at 14th day of postpartum in placebo group, that the two groups had significant difference in wound healing (p=0.001). Chamomile cream can be prescribed for primiparous women with episiotomy incisions as promoting healing of episiotomy.