Evaluation of WHO’s partogram alert line for prediction of the APGAR score at the first minute after birth

Background and aim: The early diagnosis of abnormal progress of labour and prevention of long term delivery are the main keys to reduce fetal mortality rate due to hypoxia and tissue ischemia. One of the WHO’s proposed methods for prevention of abnormal delivery is using partogram. Therefore, this survey was conducted to evaluate WHO’s partogram alert line for APGAR score at the first minute after birth. Methods: This descriptive–analytical study was performed on 140 pregnant women under partogram in Shahrood Fatemieh hospital. Using the partogram alert line, the progress of labour, mother’s and infants condition started to be controled from 3 cm dilation of the cervix. Decision for resuscitation was made based on respiration, heart rate and skin color of the infant 20 to 30 seconds after the birth. Tools of this research were a questionare, inspection form consisted of WHO’s partogram and step by step resuscitation form. χ2, t–test and analytical methods of sensitivity, specificity and negative and positive values were used for data analysis. Results: The results showed that 68.8% of the subjects cervical dilatation remained on or to the left side of the alert line and 28.6% was on the right side and 2.9% was on or to the right side of the active line. According to χ2 test, there was a significant relationship between the first minute APGAR score after delivery and the location of cervical dilation. The value of alert line for surveying of APGAR score at the first minute after birth had a sensitivity of 25%, specificity of 96.87% , negative and positive predictive value of 75.6% and 76.92%, respectively. Conclusion: Our results showed that using WHO’s partogram prevents long term delivery, helps for on time diagnosis of fetal distress and reduction in stillbirth and fetal mortality. So, partogram should be a part and parcel of fetal and maternal health care

Evaluation and comparison of clinical and para clinical diagnosis of Candida vaginitis in women referred to Shahrood city health care centers years between 2004-2007

Background and aim: Candida vaginitis is the second common cause of vaginitis and Candida albicans is cause of 90 percent of vaginal fungal infections. Because antifungal drugs are among the cheapest vaginal drugs this study was performed to evaluate and compare clinical and paraclinical diagnosis of candida vaginitis in women referred to health care centers in Shahrood cityfrom 2004 to 2007. Methods: This deh1ive-analytic research was performed on 300 women with vaginitis infections who were referred to the Shahrood city health care centers. Two samples of secretions were taken from both endocervix and exocervix using speculum and spread on two glass slides and then one sample was taken from posterior culdesac secretions with a cotton soup and entered into a tube containing sterilized physiological serum. A questionnaire was filled out by a midwife for every patient. Standard laboratory methods (cultures Pap smear wet smear and etc.) were used to evaluate the samples and the second questionnaire was filled out by the midwife. Finally results were analyzed by statistical methods. Results: Based on clinical results 132 persons (44%) had candida infection but the infection was not proved by cell culture in 30 patients ((10%) and wet smear in 111 persons (37%). No candida infection was found in cytology survey. Based on clinical results vaginal pH was measured 5.01. The amount of pH was found 5.52 5.8 and 5.71 based on wet smear cell cultures and Pap smear respectively. The physical examination sensitivity for detecting vaginal candidiasis was 63.33% compared to the cell culture. Conclusion: The results of this study show that some para-clinical examinations should be considered for diagnosis of vaginal candidiasis. These para-clinical experiments help to prevent and reduce the side effects of some unnecessary medications