Comparison of the Effect of Pressure on Bladder-GV20 and Gallbladder-GV20 on Labor Pain Intensity among the Primiparous Women: A Randomized Clinical Trial

Background: The cycle of pain, fear, and anxiety may lead to prolonged labor and cesarean section. Acupressure is one of the methods for pain relief. Aim: Therefore,this study aimed to compare the effect of acupressure on bladder-GV20 and gallbladder-GV20 points on the labor pain in primiparous women. Method: This randomized clinical trial was conducted on 158 primiparous women, who referred to the Um Al-Benin Specialized Women Hospital, Mashhad, Iran in 2017. The first stage of labor included five and four pressure cycles on acupressure points in bladder and gallbladder in the intervention groups 1 and 2, respectively. In the second stage of labor one pressure cycle on the same points were completed. The control group only received the routine cares. The duration of uterine contractions was assessed by touching the uterus apex. Moreover, the pain intensity was evaluated by the visual analog scale. All the data were analyzed by the SPSS version 25 Results: The mean pain intensity in both stages of the intervention groups was significantly different from the control group and was significantly lower in the gallbladder group (

Assessment of the Relationship between Fear and Self-efficacy of Childbirth during Labor in Primipara Women

Fear of childbirth is an important and prevalent problem during pregnancy and delivery. Self-efficacy of childbirth is one of the factors playing an important role in the fear of delivery. This study aimed to determine the relationship between the fear and self-efficacy of childbirth during labor in primipara women. This descriptive and analytical study was conducted on 100 primipara women in Ommolbanin Hospital, Mashhad, Iran, during 2017. Data were analyzed in SPSS software using descriptive statistics and Pearson’s correlation coefficient. According to the results, the mean scores of fear and self-efficacy of delivery were reported to be 48.9±14.2 and 220.5±54.9, respectively. In addition, there was a reverse association between the scores of fear of childbirth and self-efficacy of delivery using Pearson’s results (r=-0.44,

Comparison of Helicobacter Pylori Infection in Normal Pregnancy and Preeclampsia

Preeclampsia is a hypertensive disorder that affects 2–7% of pregnancies, remaining a major contributor to maternal and fetal mortality and morbidity with uncertain pathogenesis.  Some evidence suggests the role of infectious agents in development of preeclampsia. This study assessed the potential relationship between H. Pylori infection and development of preeclampsia. This case-control study was conducted in one educational hospital in Mashhad, Iran, in 2021. Study participants were selected through convenience sampling. A total number of 34 normotensive and 34 women with preeclampsia in their third trimester enrolled in the study. We assessed serum levels of hemoglobin, hematocrit, platelets, creatinine, and serum levels of H. pylori (IgG and IgA) in all participants, comparing the infection rates between the study groups. There were no significant difference in age, BMI, number of previous pregnancies, hemoglobin, hematocrit, platelet count and creatinine levels among different study groups (P>0.05). The H. Pylori test was positive in 30 (88.2%) pregnant women in preeclampsia group and 23 (67.6%) in the control group (P=0.041). H. Pylori infection was significantly more prevalent in women with preeclampsia compered to healthy pregnant women in third trimester. This suggests a potential association between H. Pylori infection and the development of preeclampsia

Comparison of maternal and neonatal complications of fetal delivery by cesarean section in three methods: cephalic, breech and anterior shoulder in deeply engaged fetal head

Introduction: Caesarean section in deeply engaged fetal head is done by cephalic or breech method and these two methods are associated with maternal and neonatal complications. The present study was performed with aim to compare the maternal and neonatal complications of cesarean section in anterior shoulder method, cephalic and breech methods. Methods: This clinical trial study was carried out in 2020-2021 on 111 mothers referred for delivery in Omolbanin hospital of Mashhad. They had inclusion criteria and consent to participate in the study. Cesarean section was performed in three groups of 37 people: cephalic, breech and anterior shoulder method. The duration of surgery, amount of bleeding, extension of incision, bladder trauma, uterine vessels trauma, Apgar score, newborn's trauma, need to NICU admission, and duration of mother and newborn hospitalization were compared in three groups. Data were analyzed by SPSS software (version 25) and ANOVA, Kruskal-Wallis and chi-square tests. P<0.05 was considered statistically significant. Results: Among maternal complications, extension of uterine incision (p=0.008) and trauma to uterine vessels (P=0.033) was less in the anterior shoulder group than the other two groups and the difference was significant. There was no significant difference between the three groups in neonatal complications, only pH of the umbilical cord blood of the newborns was significantly different between the three groups (p=0.035). Based on the results of Mann-Whitney post hoc test, the cord blood pH of infants in the anterior shoulder group was significantly higher than the cephalic (p=0.023) and breech (p=0.037) groups. Conclusion: Cesarean section in deeply engaged fetal head with the anterior shoulder method had less maternal complication include extension of uterine incision and trauma to the uterine vessels. In this study, there was no significant difference between the three groups in neonatal complications, and only the neonatal cord blood pH in the anterior shoulder group was better than the other two groups, so it is safe to choose the anterior shoulder method in this type of cesarean section

Preventive and therapeutic effects of tranexamic acid on postpartum bleeding

Postpartum hemorrhage is among the leading causes of maternal mortality throughout the world. Severe blood loss contributes to  the increased blood transfusion risk with its concerned inherent adverse events and therefore increased rate of emergency re-operative interventions such as arterial ligation or hysterectomy. It also can lead to protracted anemia, particularly in low or median income countries. Extended application of antifibrinolytic agents such as tranexamic acid has been customary for long years to stop or reduce blood loss in postpartum period. However, there are not enough reliable evidence to approve the real efficacy of these drugs. In this brief and summary review, we pointed to a few conducted studies. The PubMed was searched for keyword including postpartum hemorrhage, tranexamic acid, cesarean section, vaginal delivery, and blood loss prevention. The articles with language other than English were excluded from our review.  We concluded that more convincing information is needed to determine the precise effects of tranexamic acid, and its benefits against adverse effects

Maternal, Fetal and Neonatal Outcomes in Pregnant Women with Systemic Lupus Erythematosus: A Comprehensive Review Study

Background:Systemic lupus erythematosus (SLE) is an autoimmune disease with multiple organ involvement and periods of relapse and remission that mainly affects young women of childbearing age. In this regard the reproductive health is an important issue. Although diagnosis, treatment and management of pregnancy in SLE women have been improved recently, but the main concern is effects of SLE on maternal, fetal and neonatal outcomes. This study aimed to investigate the maternal, fetal and neonatal outcomes in pregnant women with SLE. Materials and Methods: The databases of PubMed, Medline, Scopus and Web of Science as well as domestic database (Persian) such as SID, Magiran, Irandoc, and Google Scholar were searched with using keywords such as" Systemic lupus erythematosus"; "Pregnancy"; "Neonatal lupus"; "maternal, fetus or neonatal outcome";  and equivalent Persian words. Included were all Persian and English articles, published between 2000 and May 2017. Finally, a total of 77 studies were included. Results: Adverse perinatal outcomes increase in pregnancies with lupus. Outcomes include respiratory, cardiovascular, blood and skin disorders in mothers; stillbirth, spontaneous, and recurrent abortion in fetuses and neonatal lupus, prematurity, intrauterine growth restriction (IUGR), and small for gestational age (SGA) in neonates, respectively. Conclusion: Pregnant women with SLE are at high risk due to increased complications for both mother and fetus. It seems broad control of the women before fertilization, so that they be at full remission in the beginning of pregnancy and the disease activity be in complete control, it can help to improve outcomes of pregnancy and so better results can be expected

Intravaginal administration of isosorbide mononitrate for cervical ripening in prolonged pregnancy: a randomised clinical trial

Prolonged pregnancies are associated with foetal and neonatal complications. This study was performed to evaluate the efficacy of intravaginal isosorbide mononitrate (IMN) for cervical ripening in prolonged pregnancies. 122 pregnant women were recruited. Women were assigned to 25 µg sublingual misoprostol plus 40 mg isosorbide mononitrate or placebo. Statistical analysis was done using SPSS software (version 23) and T-test, Mann-Whitney and Chi-square test. p ≤ .05 was considered significant. The mean time between beginning of cervical ripening to Bishop score >6 was significantly shorter in IMN plus misoprostol group when compared to misoprostol plus placebo group (p = .02). The mean time from beginning of cervical ripening to the beginning of active phase of Labour was comparable between two groups (p = .274). The misoprostol plus IMN group had significantly shorter interval from the beginning of cervical ripening to the time of delivery. Isosorbide mononitrate in combination with misoprostol has a promising effect on cervical ripening and progress in labour.IMPACT STATEMENT What is already known on this subject? Prolonged pregnancy is associated with foetal, neonatal, and maternal complications. Because of these complications, many obstetricians tend toward the induction of prolonged pregnancies to reduce perinatal morbidity and mortality. Isosorbide mononitrate is a nitric oxide donor agent which is used vaginally for cervical ripening in term pregnancies resulting in various outcomes. What do the results of this study add? Isosorbide mononitrate in combination with misoprostol had a greater effect on cervical ripening and progress in labour than misoprostol alone in prolonged pregnancies. What are the implications of these findings for clinical practice and/or further research? According to results of the current study; using isosorbide mononitrate in combination with misoprostol could enhance successful vaginal delivery in prolonged pregnancy. Evaluation of maternal satisfaction by using this protocol is recommended in future studies

Serum heat shock protein 70 in preeclampsia and normal pregnancy: A systematic review and meta-analysis

Background: Preeclampsia, a severe complication of human pregnancy is one of the main causes of maternal, fetal, and neonatal morbidity and mortality with unclear pathogenesis. Heat shock protein 70 (HSP70) is one of the factors that can mediate cytoprotective, antiapoptotic, and immune regulatory effects. Objective: This meta-analysis was performed with aim to evaluate HSP70 in preeclampsia and normal pregnancy. Materials and Methods: The original publications reporting the serum HSP70 levels in preeclampsia and normal pregnancies published before November 2015 were identified by searching PubMed Central, Scopus, and ISI Web of Knowledge databases by two researchers, separately. The keywords were&rdquo; preeclampsia&rdquo; and &ldquo;HSP70&rdquo; or &ldquo;Heat shock protein 70&rdquo; Statistical analyses were performed using STATA software (version 11). Results: Out of 127 studies, seven eligible case-control studies were identified which consists of 350 preeclampsia and 429 normal pregnancies. Our pooled analysis of data from 7 studies which met the inclusion criteria, provides evidence that there is a significant association between HSP70 and preeclampsia. Cochran's test results showed the heterogeneity of the studies (p<0.001) and the I2 index was 91%. The standardized mean differences (SMD) based on a random effect model with trim and fill method was 0.92 (95% CI: 0.33-1.51); also there was a significant association between HSP70 and preeclampsia (Z=3.07, p=0.002). Conclusion: The results showed that serum HSP70 concentration was significantly higher in preeclamptic patients than the control group. Therefore HSP70 may be identified as a diagnostic factor