The Scope of Pre - Pregnancy Care Conducted at Health Centers of Tabriz, Iran: Women's Viewpoints

Pre-pregnancy care is considered as preventive medicine related to pregnancy and delivery. This Questionnaire based study upon 384 women in the first half of the pregnancy showedthe scope of pre-pregnancy care in the area of physical health was either weak (75%) or average (25%). All women declared that they had not received mental health-related care during the pre-pregnancy care. The scope of pre-pregnancy care in the area of life-style was categorized as weak, average, and good by 69.79%, 29.69%, and 0.52% of the studied women, respectively

Correlation between Body Mass Index and Central Adiposity with Pregnancy Complications in Pregnant Women

Background: The prevalence of obesity is increasing throughout the world. Obesity assessed by body mass index (BMI) has shown to be associated with gestational complications while the relationship using waist circumference (WC) is not clear yet. The present study was aimed to determine the relationship be-tween WC and adverse pregnancy complications.Methods: In this prospective cohort study, 1140 nulliparous pregnant women at 1st trimester of pregnancy referred to health care centers in Tabriz, Iran were enrolled in 2009-2010. Anthropometric indexes including (weight, height and WC) were measured using standardized measures and methods. BMI was clas-sified into normal, overweight and obesity based on WHO classification. Ab-dominal obesity was defined as WC ≥ 88 cm. Pregnancy complication including gestational diabetes, hypertension and preeclamsia. Data were analyzed using SPSS, version 16.Results: Mean of BMI and WC were 24.32±4.08 kg/m2, 81.84±9.25cm at 1st trimester of pregnancy, respectively. Prevalence of overweight (BMI=25-29.9 kg/m2) and obesity (BMI>29.9 kg/m2) was 27.6%, 8.8%, respectively. Abdo-minal obesity based on WC was 34.8%. Significant correlations were found between BMI and WC (r=0.73, P =0.0001). Women with BMI>29.9 kg/m2 and WC>88 cm were more likely to suffer from gestational pregnancy and hyper-tension, as well as preeclampsia and preterm delivery.Conclusion: Early maternal WC similar to BMI is related with pregnancy complications

The Effect of Counseling on Hemoglobin, Hematocrit and Weight Gain in Teenage Pregnant Women: A Randomized Clinical Trial

Background Pregnant women’s health is a major health priority in all countries. Teenage pregnancies can be high-risk. This study was conducted to determine the effect of counseling on hemoglobin, hematocrit and weight gain in teenage pregnant women. Materials and Methods This randomized, controlled, clinical trial was conducted on 120 teenage women with a gestational age of 20 to 24 months presenting to medical centers in Ardabil, Iran, in 2016 to 2017. The participants were assigned to a counseling (n=60) and a control (n=60) group through randomized blocked sampling. The intervention group received counseling on self-care, symptoms and risks of teenage pregnancy and methods for its prevention in five 60-minute sessions and booklets were distributed among them, too. Each woman and her husband received private counseling in the last session based on their questions and problems. The control group received routine care. Hemoglobin and hematocrit levels and weight at the beginning of pregnancy and before delivery were evaluated. The independent t-test and ANCOVA with adjusted baseline values were used to analyze the data. Results: The two groups did not differ significantly in terms of demographic details, except the mother’s age and baseline hemoglobin and hematocrit levels (P>0.05). There were no significant differences between the two groups after the intervention (with adjusted baseline values) in terms of hemoglobin (adjusted mean difference: -0.07, 95% confidence Interval: 0.31 to -0.46, P=0.710), hematocrit (-0.14, 0.76 to -1.05, P=0.747), and pregnancy weight gain (0.07,1.80 to -1.65, P=0.931). Conclusion The results showed that providing counseling to teenage women during pregnancy does not affect their hemoglobin and hematocrit levels and pregnancy weight gain

Comparison of Continuation Rates and Reasons of Discontinuation for Cyclofem and Depot -medroxyprogesterone acetate in Rural Areas of East Azerbaijan Province, Iran

Objective: In this study continuation rate and reasons for discontinuation of Depot-medroxyprogestrone acetate (DMPA)and Cyclofem have been compared. Materials and methods: A retrospective cohort study was conducted with 422 women (202 Cyclofemand 220 DMPA users)who had started using the methods 12-24 months before the study in East Azerbaijan health houses. Data were collected by reviewing the records and interview with the clients and analysed using Kaplan-Meier and Cox Regression. Results: The 3, 6, 9, 12 months continuation rate were 56%, 37%, 30%, 27% respectively for Cyclofem versus 75%, 59.5%, 48%, 42.5% for DMPA. Menstrual changes were reported significantly more by the DMPA users than the Cyclofem users (85% vs. 73%, P=0.008) as the main reason for the discontinuation, the difference mainly reflected of amenorrhea (50% vs. 23%, P=0.003). None of DMPA users and 11% of Cyclofem users claimed frequency of visits and lack of method supplies as their main discontinuation reason. Conclusion: Discontinuation rate was high for the both methods but it was higher for Cyclofem.The common side effects mentioned as the main reasons for discontinuation of the both methods are not health threatening. Therefore, health care providers may help to improve their continuation rate by appropriate consultation

Knowledge, Attitudes and Practice about Pap Smear among Women Reffering to A Public Hospital

Objective: The Pap smear is a reliable, inexpensive and effective screening test for cervical cancer; the second most common cancer among women worldwide. We aimed to determine women’s knowledge, attitudes and practice towards Pap smear and barriers for the screening in a public hospital. Materials and methods: This study, was carried out on 350  outpatient married women reffering for a visit at the clinics of the Alzahra educational hospital, Rasht- Iran, 2011. A questionnaire including demographic characteristics (24 questions), knowledge (14 questions), attitudes (11 statments) and practice (10 questions) towards Pap smear was completed by interview with the women. The data were analyzed using SPSS ver.13. Results: Mean age of participants was 32 (SD 12) years. Of the respondents, only 44.3% were aware of the Pap smear and 27.1% had had it at least once in their life. The most common  reason for having the test was physicians’ or other health workers’ advise and for not having the test was no recommendation by health providers and lack of knowledge about Pap smear. Embarrassing, fear of the test result or economic problems mentioned by only 12 (4.2%) as the main barrier. Mean (±SD) knowledge score of the women who had heard about the Pap smear was 59.4 (24.3) and attitudes score of all participants was 48.5 (11.6) from possible range score of 0-100. Women with a history of Pap smear had had higher awareness and attitudes score. Conclusion: The knowledge and practice of the women was inadequate and need to be promoted. Considering the main reason mentioned by the participants for not having the test, all health providers should educate and encourage women to do regular Pap smear

Diagnostic Value of Fetal Movement Counting by Mother and the Optimal Recording Duration

Introduction: Fetal movement counting is a method used by mother to quantify her baby's movements. However, the optimal number of movements and the ideal duration of counting them have not been recognized. The aim of this study was to determine the diagnostic value of the two common fetal movements counting methods by mother including "ten fetal movements counting in two hours" and "three fetal movements counting in one hour" and to compare the required mean time for counting fetal movements in the two methods. Methods: 300 subjects were selected by random sampling among clients with complains of decreased fetal movements referring to AL-Zahra educational curative center in Tabriz, Iran. Full training about how to perform the two methods of fetal movements counting and how to record in related tables was instructed by researcher. Immediately after counting movements, biophysical profile test was performed. Results: Among a total of 291 mothers in the two groups, 99.7% had active fetuses based on both methods of fetal movement counting. 96.9% of these active fetuses obtained score of 10 in biophysical profile. There was a statistically significant relation between the results of both two methods of fetal movement counting and the biophysical profile as the gold standard. Sensitivity, specificity, positive and negative predictive values of both methods were equally 100%, 96%, 10% and 100%, respectively. Conclusion: The findings of this study showed that fetal movement counting test can be used as an initial screening method in predicting fetal health

The Effect of Peers Support on Postpartum Depression: A Single-Blind Randomized Clinical Trial

Introduction: Postpartum depression and its consequences not only involve mothers and their children but it will also affect their families. Therefore, this study aimed to investigate the effect of mothers receiving peer support on postpartum depression. Methods: 100 eligible primiparous women participated in a randomized clinical trial. The intervention group received phone calls by their peers from the last three months of pregnancy until two months after delivery. The control group only had access to routine care. Both groups in the second month after delivery were checked regarding depression using Edinburgh Postnatal Depression Scale. Data analysis was performed using independent t-test, chi-square test and covariance analysis. Results: Mean depression score before intervention was 13.92 (3.23) in the control group and 14.06 (3.12) in the intervention group. In week 8 after delivery, mean score of depression in control group was 13.29 (4.08) but in the intervention group it was reduced to 10.25 (4.18). Difference in the reduction of mean postpartum depression score between the two groups showed statistically significant difference (p < 0.001). Conclusion: This study showed that peer support was effective in the prevention of postpartum depression, therefore, it is recommended to be used in the reduction of postpartum depression

Comparison of the Effects of Lanolin, Peppermint, and Dexpanthenol Creams on Treatment of Traumatic Nipples in Breastfeeding Mothers

Introduction: Traumatic nipple is among the most common problems of the breastfeeding period which leads to early cessation of breastfeeding. The study aimed to compare the effects of the lanolin, peppermint, and dexpanthenol creams on the treatment of traumatic nipples Methods: This double-blind randomized controlled trial was carried out on 126 breastfeeding mothers. The mothers had visited at the health centers and children’s hospitals in Sanandaj City. The selected participants were randomly divided into the following three groups of lanolin, peppermint, and dexpanthenol cream groups. Nipple pain was measured using the Store scale while trauma was measured with the Champion scale. Analyses were carried out through the Kruskal–Wallis test, Chi-square, ANOVA, and repeated measures ANOVA by using SPSS software ver. 13. Results: The result showed that the mean score of nipple pain and nipple trauma at the prior to intervention stage, third, seventh, and fourteenth days of intervention was not significantly different between three groups. But, repeated measures ANOVA showed a significant difference in comparison of the four time periods of intervention in each group. Conclusion: Results of this study revealed that the lanolin, peppermint, and dexpanthenol medicines had similar therapeutic effects on traumatic nipple