Severity of Striae Gravidarum and its relationship with perineal trauma and vaginal lacerations during vaginal delivery of pregnant women referred to Hajar Hospital of Shahr-e-Kord in 2010-2011

Background and Objective: Striae Gravidarum found during pregnancy may be an indicative of poor skin elasticity and may prone to tearing perineal and vaginal tissues during vaginal delivery. The aim of this study was to determine relationship between striae gravidarum and perineal trauma and vaginal lacerations in women referred to Hajar Hospital Labor Ward in Shahr-e kord city. Materials and Methods: This cross-sectional study included 587 women who referred to Hajar Hospital Labor Ward for vaginal delivery in 2010-2011. The study was conducted within the first and second stages of labor. Data was collected by using interviews, hospital files and physical examinations. Descriptive statistics and chi square test, t- student test, one-way ANOVA and step-wise multivariate logistic regression were used to analyze the collected data. Results: 82.8 percent of the participants developed stretch marks.14.5 percent of the pregnant women in this study experienced vaginal and perineal tears. There was a significant association of vaginal and perineal tears with conduction anesthesia (P0.05). Conclusion: Patients with breast striae gravidarum are at a higher risk of vaginal and perineal lacerations at the time of vaginal delivery. This finding suggests that midwives and obstetricians consider beast striae gravidarum score as a simple and non- invasive tool for assessment of vaginal and perineal lacerations in management of women during vaginal delivery

Knowledge of midwives, from Chaharmahal and Bakhtiary province to ward midwifery legal and religious commandments and some of the relevant factors in 2006

چکیده: زمینه و هدف: ماماها در حیطه کاری خود با مسائل قانونی و شرعی مختلفی مواجه می‌باشند. با توجه به پیشرفت های مامایی در زمینه‌های مختلف از جمله: موارد سقط درمانی، روشهای پیشگیری و روشهای نوین درمان ناباروری، احکام شرعی و استفتائات جدیدی نیز از ناحیه فقها و مراجع تقلید صادر گردیده است، که این امر موجب ضرورت آگاهی ماماها از احکام شرعی و قانونی فوق می گردد. این تحقیق با هدف بررسی میزان آگاهی ماماهای استان چهارمحال و بختیاری نسبت به احکام شرعی و قانونی حیطه مامائی و برخی از عوامل مرتبط با آن صورت گرفته است. روش بررسی: در این مطالعه توصیفی تحلیلی 151 نفر مامای شاغل در مراکز بهداشتی درمانی شهرهای استان چهارمحال و بختیاری از طریق نمونه‌گیری آسان انتخاب شدند. اطلاعات توسط پرسشنامه ای که شامل مشخصات دموگرافیک و سؤالات مربوط به احکام قانونی و شرعی بود جمع‌آوری و سپس با استفاده از آزمون‌های آماری کای اسکوار و t تجزیه و تحلیل گردید. یافته ها: میانگین سنی نمونه‌ها 8/7±9/26 سال و بیشتر افراد تحصیلات فوق دیپلم داشتند (2/66). فقط 7/12 نسبت به کل احکام شرعی و قانونی آگاه بودند. آگاهی کافی نسبت به احکام قانونی در 3/15 و نسبت به احکام شرعی در 3/11 افراد دیده شد. 9/60 افراد طی خدمت خود به مسئله‌ای برخورد کرده بودند که حکم آن را نمی‌دانستند. 1/78 معتقد بودند که آموزش حین تحصیل نیازهای حرفه‌ای ماماها را در زمینه مسائل قانونی و شرعی تامین نمی‌کند. 1/88 گفته بودند که در صورت برگزاری برنامه بازآموزی در‌ آن شرکت می‌کنند. بین هیچکدام از مشخصات دموگرافیک با آگاهی ارتباط معنی داری دیده نشد. نتیجه‌گیری: با توجه به آگاهی کم، اعلام نیاز به بازآموزی و تمایل به شرکت در بازآموزی در اکثریت نمونه‌ها، تدوین برنامه‌های آموزشی مستمر در این زمینه ضروری است. همچنین توصیه می شود جهت پربارتر کردن محتوی درسی دانشجویان مامائی در زمینه مورد بحث در سر فصل دروس دانشگاهی تجدید نظر گردد

Prevalence of apparent major congenital malformations and some associated factors, in terminated pregnancies in Hajar hospital of Shahrekord, 2005-2006, Iran

Background and aim: Congenital malformations are a major cause of morbidity and mortality and long term disability in infants. The aim of this study was to determine prevalence of apparent major congenital malformations and some associated factors in terminated pregnancies in Hajar hospital of Shahrekord in 2005-2006. Methods: In this cross-sectional and descriptive-analytical study, a total of 2854 pregnant women with gestation age of 16 weeks or more who referred to the hospital for termination of pregnancy or delivery was enrolled and interviewed using structured questionnaires. Congenital malformation and other information about their newborns were obtained from hospital chart. Data were analyzed using SPSS software, x2, T student and logistic regression model. Results: Congenital malformation was observed in 72 of 2854 (2.5%) of the neonates studied. The most common congenital malformation was neural tube defects (19.8%). There was significant relationship between herbal drug use in first trimester (P<0.001), chronic diseases )P<0.01) environmental smoke (P<0.05), history of malformation in close relationships (P<0.05), proximity to power station (P<0.001) and trauma (P<0.05). But there was not significant association with maternal and paternal age, parity, gestational age, sex and number of newborn, maternal and paternal jobs, high fever in first trimester, treatment of infertility, problem in pregnancy and congenital malformation. Conclusion: The present study showed a high prevalence of congenital malformation among our population. Therefore, primary preventive programs could be initiated to reduce congenital malformation particularly education of pregnant women to avoid herbal, synthetic drugs, and environmental smok

Research barriers from the viewpoint of faculty members and employees of Shahrekord University of Medical Sciences

Aims: Undoubtedly the power, development and real independency of countries have a straight relationship with their ability to produce science and developing research activities. This research was performed to determine the research barriers from the view point of Shahrekord University of Medical Sciences faculty members and employees. Methods: In this descriptive analytic cross-sectional study which was carried out on in 2006-07, 480 of the faculty members and employees of on Shahrekord University of Medical Sciences were selected by census (for faculty members) and randomize cluster (for employees) sampling methods. The instrument for data collection was a questionnaire consisting of 3 individual characteristics, organizational barriers and individual barriers in Likert scale. Data analysis was done by student’s T, Chi square and variance analysis tests. Results: 452 questionnaires were returned. The most important barriers of research were “inadequate incentives in researchers”, “inadequate time and lots of work”, “too much official red tapes”, “not using the research results” and “inability to translate Persian articles to other languages”, respectively. The least important barriers were “not interesting in research”, “difficulties in computer usage” and “limited benefit of research to patients”. The mean of organizational barriers was more than personal barriers (p<0.0001). There was a significant difference between the mean of organizational and individual barriers of research among faculty members and employees (p<0.0001). Conclusion: Removing these barriers by the research officials & hospital managers is necessary

The role of maternal diet on fetal sex selection: A Review

Introduction: The desire of the human to control the gender of fetus prior to conception has always been important. The aim of this study was to determine the role of maternal diet on fetal gender. Materials and Methods: In this narrative review study, a comprehensive review of databases including Pubmed, Scirus, Cochrane library, ScienceDirect, MD Consult, google scholar, Iranmedex, Magiran, and SID from 1982 to 2013 was performed. Key words to search databases included fetal sex, sex ratio, sodium, potassium, magnesium, calcium, fructose, eating disorders, sex selection, maternal diet, Ionic diet, fatty acid, calorie, and famine. Results: Results of studies on the effects of nutritional deficiencies and disorders on sex ratio were controversial. Studies showed that a combination of environmental factors such as stress, time of conception and maternal diet had effects on sex ratio. Preconceptional nutritional status of mothers was very important in changing sex ratio. Increasing the intake of K + + Na+/Ca 2 + + Mg2+ in diet and high calorie diet could increase the ratio of male offsprings. Conclusions: Preconceptional diet was important in fetal sex ratio. However, low sample size in most human studies and the complex mechanisms of sex determination make it difficult to conclude definitively on this issue. Further human studies with larger sample size in this field are suggested

Comparison of perineal repair techniques of continuous and standard interrupted suturing in normal vaginal delivery

Background and aim: Post-delivery surgical repair of the perineal region is frequently associated with pain and discomfort. The surgical technique may play a role in the intensity of pain and the wound healing process. This study was conducted to compare the influence of applying standard continuous versus interrupted suturing on pain sensation and the frequency of wound infection following episiotomy. Methods: In a randomized double blind clinical trial, 148 healthy women with normal vaginal delivery and sustained episiotomy were studied in the Hajar hospital, Shahrekord. In one group, perineal muscles, fascia and skin tissues were repaired with continuous non-locking sutures. Standard interrupted locking suturing was applied for the next group. Pain feeling and wound infection were evaluated at 2 hours, 10th and 40th days of post-delivery by Visual Analog Scale and the signs of discoloration of skin, edema, purulent discharge, and wound dehiscence, respectively. Data were analyzed by t-student, X2 and Mann-Whitney tests. Results: Pain intensity, the amount of consumed suturing material and the allocated time were less in the cases with continuous suturing (P<0.001). The mean of pain intensity was 2.66±2.5 versus 3.84±2.56 and 0.53±1.63 versus 0.6±1.04 at 10th and 40th days after delivery in continuous and standard interrupted suturing groups, respectively (P<0.05). Signs of wound infection were observed only in 4 cases (12.5%), all of which belonged to the standard interrupted suturing group. There was a statistically significant inter-group difference in terms of the frequency of observed wound infection (P<0.05). Conclusions: The pain intensity and the chance of wound infection is less in continuous suturing of episiotomy wounds. It also is a safer and more cost-effective method as it lowers the bedding time of the mother and needs for surgical material

Educational needs of midwife alumni work in health care centers

Abstract Aims: Determination of educational needs is the first step in educational planning and the first factor of ensuring the quality and efficacy of education process. Midwives’ sufficient knowledge and improvement of their decision-making will lead to performance progress. The aim of this study was determining the educational needs of midwives working in hospitals and healthcare centers of Chaharmahal & Bakhtiari province. Methods: This cross-sectional study was performed on 280 midwives and 50 healthcare center authorities of hospitals and healthcare centers of Chaharmahal & Bakhtiari who were selected by census sampling method in 2009. Data was collected by a researcher-made questionnaire containing three sections of demographic characteristics, educational needs related to their specialty or general domains and priority in educational needs. Data were analyzed by descriptive statistics and Chi-square, student T-test and one-way ANOVA using SPSS 15 software. Results: There wasn’t significant difference in the average scores of educational needs in specific and general domains from authorities and midwives’ point of view (p>0.05). There was a significant relationship between the average score of educational needs and work place in obstetrics (p=0.002), maternal and child health (p=0.038) and neonatal (p=0.025) domains. There was a significant relationship between the average score of educational needs and the academic level of education in general domains (p=0.025). Conclusion: Holding educational classes of English, use of Information Technology (IT) in obstetrics, resuscitation, research methodology, religious and legal commandments, abnormal uterine bleeding, hypertensive disorders, neonatal medical treatment and common gynecologic infections seems essential as educational priorities. Keywords: Midwife, Hea

INCIDENCE AND SOURCE OF ANXIETY OF MIDWIFERY STUDENTS IN CONDUCT THEIR FIRST VAGINAL EXAMINATION.

Background & Aims: The professional education can be a very stressful experience. Vaginal examinations are especially sensitive, both for the inexperienced midwifery student and for the pregnant woman being examined. This study aimed to determine anxiety of midwifery students when they conduct their first vaginal examination. Materials & Methods: In this cross- sectional study included 47 sophomore midwifery students of Shahrekord University of Medical Sciences. The students were asked to complete two questionnaires. Spielberger's ..