مجله زنان مامائی و نازائی ایران
سال هفدهم شماره 105 (هفته سوم تیر 1393)

Pregnancy and childbirth is a great experience in a woman''s life. There are several factors that increase the rate of cesarean section such as patient unawareness، financial incentives and doctors'' preferences. The aim of this study was to investigate the factors influencing the duration of beginning delivery to hospital discharge using Cox regression model in Fatemiyeh Hospital of Hamadan، Iran. This study was a prospective historical cohort. Data on 11246 pregnancies were extracted by a researcher made checklist from the files in the records department of Fatemiyeh hospital of Hamadan، Iran during 2010-2012. The response variable was hospitalization duration due to childbirth. Data were analyzed using SAS (version 9. 2) and SPSS (version 19) softwares، Kaplan-Meier method، log-rank test، Cox proportional hazards، Cox-Snell residual and Schoenefeld residual. P value less than 0. 05 was considered significant. The mean age of women in normal vaginal and cesarean delivery groups were 25. 68±6. 27 and 27. 17±6. 23 years، respectively. The mean of birth weight in normal and cesarean delivery groups were 2984. 71±601. 92 and 3030. 60±554. 94 grams، respectively، Median of hospitalization duration in normal and cesarean delivery groups were 29. 84±18. 06 and 41. 46±24. 59 hours، respectively. Based on the log-rank test and Cox regression model، the differences of hospitalization duration were significant in the variables including maternal age، gestational age، birth weight، number of previous pregnancies and delivery method (p<0. 05). With increasing birth weight، duration of postpartum hospitalization increases. Also with increasing the number of previous pregnancies، duration of post partum hospitalization decreased. Finally duration of postpartum hospitalization in cesarean delivery method is more than normal vaginal delivery method.

Vaginal atrophy (VA) causes by estrogen deficiency and occurs in postmenopausal women. Today، clinical signs and symptoms are used for detection of vaginal atrophy. Laboratory techniques are other methods that can be used. The aim of this study was to compare the clinical and laboratory indexes for the diagnosis of vaginal atrophy in postmenopausal women. This correlational study was conducted in 2013 on 100 postmenopausal women who had attended tohealth centers number 1 and 3 and gynecology clinic of Ghaem hospital of Mashhad، Iran. Data were gathered by a demographic information form and observation and examination of vaginal atrophy form. Data were analyzed by SPSS software version 11. 5، descriptive statistics and Spearman correlation coefficients. P value less than 0. 05 was considered significant. There was not significant correlation between vaginal dryness (p=0. 08)، elasticity of vagina (p=0. 26)، color of vagina (p=0. 14)، rugae (p=0. 68) and vaginal petechiae (p=0. 52) with vaginal maturation value but there was positive correlation between petechiae (p=0. 00) and color of vagina (p=0. 03) with vaginal PH. There are differences between the clinical and laboratory diagnosis of vaginal atrophy. Recognition of vaginal atrophy based on clinical signs and symptoms is not enough and according to the adverse effects of hormone therapy، it is recommended that definitive diagnosis of vaginal atrophy should be made based on laboratory evaluation.

Postpartum urinary incontinence affects an average of 10 to 40 percent of pregnant women after childbirth. This problem leads to lowering of their quality of life and spending high cost for treatment. The aim of this study was investigation the relationship between the severity of postpartum urinary incontinence and parity in multiparous women. This cross-sectional study was conducted on 192 women who referred to AL-Zahra and Izadi clinic of Qom، Iran in 2012 for treatment of postpartum urinary incontinence. Data gathering tools were two questionnaires named UDI-6 (Urogenital Distress Inventory) and IIQ-7 (Incontinence Impact Questionnaire). Based on the research''s aims، variables such as delivery type، number of children and age were evaluated. Data were analyzed using SPSS software version 18 and Pearson Correlation Coefficient test. P value less than 0. 05 was considered significant. From 192 studied women، 105 women (54. 7%) experienced natural delivery، and 59 women (30. 8%) experienced cesarean section and the rest were experienced both types of delivery. 66 women (34. 4%) had two children، 35 women (18. 2%) had three children and the rest had more than three children. There was a significant relationship between the severity of urinary incontinence and quality of life (p<0. 001) and the number of children (p=0. 04). Increase in the number of children is not inconsistent with the quality of life، but causes some problems in woman urogenital system. Therefore there is a need to think about increasing the power of the pelvic muscles in order to maintaining the quality of life by exercises before increasing the number of children.