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Showing 18 results for Cesarean

Farnaz Ehdaivand ,
Volume 2, Issue 3 (9-2002)

 Endometriosis is a gynecologic disease. The prevalence of endometriosis in the reproductive age of women varies between 3-10%. Cesarean scar endometriosis is a rare event and rare cases have been reported in gynecologic and surgical articles. The incidence of cesarean section scar endometriosis is not accurately determined but ranges from 0.03% to 0.15% and in some other articles the incidence up to 1% has been reported. Frequently the cesarean scar endometriosis is not diagnosed until before surgery (80%) and usually the patients are operated on the basis of some pre-operative diagnoses such as kelloid, hematoma, suture granuloma, incisional herina and neoplasm. The most common symptom is cyclic and periodic pains in the area of operation which appear approximately 1-7 years after cesarean section. The accurate diagnosis is made by pathology. In this article a patient with cyclic and severe pain in cesarean scar area for 8 years is reported. The patient had been treated with anti- inflammatory drugs for several years without any diagnosis. The patient was operated with diagnosis of subcutaneous mass and probably suture granuloma and the final pathologic report was Endometriosis. The choice treatment for cesarean scar endometriosis is surgery, and awareness about this unusual complication of it will increase the probability of preoperative diagnosis.

Afshar Tamook, Nayereh Aminisani , Joubin Mogadam Yeganeh , Afrooz Mardi,
Volume 3, Issue 2 (6-2003)

  Background & Objective : When a cesarean is necessary, it can be a life-saving technique for both mother and infant. In recent twenty years, the cesarean childbirth rate has increased dramatically. Moreover a cesarean costs nearly twice as much as a vaginal birth. The world Health organization states that a cesarean rate greater than 10-15% cannot be justified. The aim of this study was to determine the cesarean rates and its indications in social security hospital of Ardabil.

 Methods: In this cross-sectional study was conducted all of the deliveries (both cesarean and normal delivery) in Ardabil social security hospital were investigated using a questionnaire including the characteristics of indication. The data were analyzed using SPSS software.

  Results : 45.4% of the deliveries were done using cesarean and 54.6% of them with a normal procedure. 55.8% of all the cesareans had an accepted indication. 44.2% of cesareans were controversial or elective, 22.7% were repeated cesarean, 8.4% were breech presentation and 2.3% were golden baby and 10.8% of the cesareans did not have a clear indication.

 Conclusions: The cesarean section rates in this study were higher than world rates. As a result the rising cesarean birth rate must be stopped and reversed with health interventions.

Mohammadreza Ghodraty , Ghodrat Akhavan Akbari , Firooz Amani , Shahnaz Rahimi , Nasrin Shahab ,
Volume 3, Issue 3 (9-2003)

  Background & Objective : Regional anesthesia is a method of choice in cesarean section. But in emergency cesarean sections general anesthesia is usually preferred. On the other hand, intravenous sedative drugs used in general anesthesia induction rapidly crosses the placenta and result in fetal depression. Because of higher prevalence of general anesthesia in Iran it is reasonable to conduct more researches in this field. This study set out to compare the effects of Propofol and Thiopental-Na as induction agents on the neonatal Apgar score and maternal hemodynamic status.

  Methods: In this double blind clinical trial 60 pregnant women with ASA class I & II were studied. In a random way 30 patients received 2mg/kg Propofol and the rest of them were given 4mg/kg of Thiopental-Na. All these subjects had full term and normal fetus. Pre and post-induction status of the patients was monitored noninvasively after tracheal intubations and during 12 minutes after that. Also time intervals between induction and birth (cord clipping) and between uterus incision and birth were measured. Apgar score of neonates was evaluated through clinical examination in 1st, 5th, 10th and 15th minutes after birth. The data were analyzed in SPSS software using descriptive and analytical statistics such as T-test, chi-square and ANOVA.

 Results: Apgar score in different times (1.5,10&15 minute) had no significant difference between two groups. (In the 1st minute Propofol was 7.1 ± 2.2 and Thiopental was 74 ± 1.8, in the 5th minute Propofol was 9.2 ± 0.7 and Thiopental was 9.1 ± 0.9) Maximum variation of heart rate and blood pressure in two groups were not significantly different. The time intervals between induction and birth (less than 8 minutes) on the one hand and uterus incision and birth(less than 130 seconds) on the other were similar in two groups.

  Conclusions : Thiopental-Na and Propofol can be used with similar results for induction of general anesthesia in cesarean section.

Farnaz Ehdaivand , Masoumeh Rostamnegad , Homayoun Sadeghi , Nayereh Aminisani,
Volume 4, Issue 2 (6-2004)

  Background & Objectives: Cesarean section is one of the most common surgeries in women. In developed countries the rate of cesarean section is reported to be 21.2%. In Iran, the rate of cesarean section is even higher than the international norms. In a study in Ardabil, in 2001, cesarean section rate came out to be 42.86%. Postoperative pain after cesarean is one of the complications that all mothers experience in one-way or another. Besides bothering mother it can disorder newborn feeding, ambulation of mother and bonding between newborn and mother if it is not controlled effectively. This study was conducted to compare the effect of intramuscular Methadone and Diclofenac suppository for pain relief after cesarean section in Alavi hospital, Ardabil.

  Methods: This study was a double blind clinical trial. 56 women who experienced cesarean section for the first time were randomly divided into two groups. Diclofenac suppository (100 mg every 8hr) was given to first group and Methadone (5 mg every 8hr) was injected to the second group for 24 hours. Then, the severity of pain was measured with numerical scoring in serial postoperative visits. The data were analyzed by SPSS software using descriptive and analytical statistics such as chi-square and ANOVA.

  Results: The findings indicated that the severity of pain in 2nd, 3rd and 4th postoperative visits was significantly lower in patients who received Diclofenac suppositories than the other group (p<0.05). But overall, there was no statistically significant difference between the pain severity in Methadone receiving group (Mean & SD= 5.85 ± 3.5) and Diclofenac receiving group (Mean & SD= 6.46 ± 2.9).

  Conclusion: There was no significant difference between Diclofenac suppository and Methadone in terms of decreasing the postoperative pain after cesarean section. However, regarding the restrictions in the use of opioids, Diclofenac can be a suitable replacement for these drugs.

Farnaz Moslemi Tabrizi, Soosan Rassooli , Simin Atash Khoii , Rasool Azarfarin ,
Volume 4, Issue 2 (6-2004)

  Background & Objectives: Nitroglycerin is found to have vasodilatory effect. It has also a relaxing effect on the smooth muscles of other organs including uterus. This study investigates the effect of intravenous nitroglycerin in emergency cesarean sections in which rapid and transient uterine relaxation for rapid and nontraumatic extraction of the fetus is necessary.

  Methods: Sixty pregnant women who were candidated for emergency cesarean and needed rapid uterine relaxation for different reasons were selected. These subjects underwent spinal anesthesia and at the time of uterine incision, 100 micrograms of nitroglycerin was injected to them intravenously. The time lapse between nitroglycerin administration and fetal extraction, the degree of uterine relaxation, the amount of intraoperative hemorrhage, uterine tone after fetal delivery and APGAR scores of the infants were all controlled and recorded. Also with regard to the vasodilatory effect of nitroglycerin and probably its resultant homodynamic problems, blood pressure, heart rate and arterial O2 saturation were recorded before and after nitroglycerin injection and throughout the surgery.

  Results: The results showed that in 53 (88.3%) of the patients the uterus was acceptably relaxed and the fetus was delivered very easily. Only in 7 patients (11.7%) uterine relaxation was not acceptable. The mean decrease in systolic and diastolic blood pressures after nitroglycerin administration compared with before injection BP was 12.97 mmHg (12.210 %) and 7.86 mmHg (12.208 %), respectively. There was not seen any prolonged effect of the drug such as uterus relaxation tone or abnormal bleeding. Also, none of the delivered infants had low APGAR scores. Besides, in patients with acceptable uterine relaxation the first and fifth minute APGAR score of infants were higher (p = 0.008, p = 0.000).

  Conclusion: This study shows that nitroglycerin can relax uterine smooth muscles very rapidly and transiently and in emergencies it can be an appropriate alternative to the other tocolytic agents with prolonged effect or onset time.

Farnaz Ehdaivand, Masoumeh Rostamnejad , Effat Iranijam ,
Volume 4, Issue 4 (12-2004)


Background & Objectives: Hypertension is the most common medical problem in pregnancy, with  an incidence rate of 6-8%. The patients with preeclampsia are exposed to more maternal and fetal  complications. This requires more intensive prenatal cares. The diagnosis in early stages of disease has an important role in decreasing maternal and neonatal mortality and its comsequent complications. This study was an attempt to determine the epidemiological factors and complications of preeclampsia among patients admitted to Alavi hospital, Ardabil.

Methods: This descriptive retrospective study was conducted on 176 women with preeclampsia. The data were collected using a questionnaire and medical records of patients. These data were analyzed using descriptive and inferential statistics.

Results: 75% of the patients had severe preeclampsia and 25% had mild preedampsia. Regarding the predisposing factors, history of preeclampsia was observed in 23.1% of the cases, mother's underlying diseases in 12.5%, twin in 2.3% and hydramnios in 4%. The method of delivery in 62.5% of the cases was cesarean section. 67.6% of preeclamptic patients had maternal and fetal complications (10.2% Maternal and 57.4% fetal). The maternal complications were: abruptio placenta, (44.4%), eclampsia (22.2%) and coma (11.1%). The fetal complications were: IUGR (42.4%), prematurity (39.6%) and  IUFD (9%).

Conclusion: In this study the incidence of severe preeclampsia was higher, which may be due to insufficient prenatal cares and delay in diagnosis. Further studies about the effect of prenatal cares on pregnancy outcomes in preeclamtic women are recommended.

Nasrin Fazel , Mahin Tafazoli , Mohammad Ramezani , Habibollah Esmaili ,
Volume 4, Issue 4 (12-2004)

  Background & Objective: Flatulence is one of the most common postoperative disorders, which leads to abdominal distension, respiratory disorders and the openning of sutures. Some of the drugs used to alleviate the abdominal flatulence are associated with complications and harmful effects, which gives us a hint to adopt herbal medicine. The present study investigates the effect of supermint on the flatulence intensity after cesarean section.

  Methods: This double-blinded clinical trial study was conducted on 107 women (47 cases as placebo group and 60 cases as drug group) who had cesarean section in shahid Mobini hospital, Sabzevar. After stopping the administration of IV fluid, the subjects in both groups received 40 drops of drug and placebo every 20 minutes for 3 days.

  Results: The intensity of flatulence in the first 20 minutes (p=0.042), in second 20 minutes (p=0.001), in the third 20 minutes (p<0.001) and 120 minutes after intervention (p<0.001) was lower in drug group compared to before intervention.

  Conclusion: Supermint is effective in reducing the postoperative flatulence in cesarean section and is recommended to be used in these cases.

Fariba Kahnamouei Aghdam , Farnaz Ehdayivand, Faride Mostafazadeh, Godrat Akhavan Akbary , Mohammad Sadeghi,
Volume 5, Issue 3 (9-2005)

  Background & Objectives: Respiatory Distress Synderome (RDS) is one of the major risks of elective cesarian section whose negative health and econemical outcomes are obvious. Maternal prophylactic injection of corticosteroid drugs can reduce RDS of neonate to some extent. On the other hand corticosteroid drugs have some side effects such as delay in the healing of the incision. This study considered the effect of betamethasone on surgical incision.

  Methods: This study was conducted on 60 primipara women divied into two equal groups that were candidate for elective cesarean. We injected betamethasone (IM) to trial group twice 48 hours poior to operation, (every 24 hours) and complication of surgical incision was clinically evaluated within 7 days after operation in both groups. The data were collected and analyzed by SPSS software chi-square and Fisher tests.

  Results: Most patients (60%) were 20-30 years old and the average age in both groups was 21. The relative frequency of patients with complication of surgical incision in trial group (betamethasone recipients) was 30% and in control group was 23.33% (the difference between them was not statistically significant). The most common complications were erythema and hyperemia. Other complications observed in 15% of the patients included serousal discharge, local warmness and enduration. Rgarding these complications also there wasn’t a statistically significant difference between two groups.

  Conclusion: Betamethasone does not increase early onest complications of surgical incision and we can safely use betamethasone prophylactically for fetal maturion in elective cesareans.

Sima Khavandizadeh Aghdam ,
Volume 6, Issue 4 (12-2006)

 Background & Objectives:Different studies have emphasized the psycho-social aspects of delivery, so that these aspects are no less important than medical and midwifery factors. This is a quasi- experimental study, the main objective of which was to evaluate the effects of the continuous labor support from a supportive companiom on the process and outcome of labor in primigravida.

 Methods: 50 women in supported group (case) and 50 without supporative companion (control) were selected. All women were between 18-30 years, and had term pregnancy, single fetus, cephalic presentatation or spontaneous onset of labor without any complications. The supportive companions were students of midwifery. The support consisted of talking, touching, reassurance, soothing, giving encouragement and physical comfort (e.g, helping to change position, keeping lips wet and cooling). The data were analyzed using student t-test, chi-square and Fisher test.

 Results: The findings showed that the continuous labor support by a companion reduced length of active phase (p<0.01), cesarean section (p=0.026) and increased APGAR score in the first minute (p=0.015) and led to the early onset of breast feeding (p<0.01). Duration of second labor and fifth-minute Apgar were not significantly different in two groups. Conclusions: This study showed that the continuous labor support can result in better outcomes in deliveries.

Farideh Mostafazadeh , Mehrnaz Mashoufi , Masoumeh Rostamnegad ,
Volume 6, Issue 4 (12-2006)

 Background & Objectives: Ceasarean section (CS) has increased in rate during the past years. Due to postoperative complications, long recovery time and high costs of surgery, normal delivery is recommended as a routine method. Regarding the increase in the number of CS and its acceptability on the part of the public, it seems that women’s as well as health personnels' attitudes play an effective role in selecting the termination method. The aim of this study was to evaluate and compare pregnant women’s and health personnels' attitude toward termination procedures.

 Methods: This was a descriptive and comparative study. 84 health personnels and 300 pregnant women who referred to Ardabil health centers in 2002 were selected. These subjects' attitudes were collected through Likert questionnaire and the collected data were analyzed by SPSS, using t-test.

 Results: The findings showed that 30.1% of women and 50% of health personnels had positive attitudes towards normal delivery. The findings also indicated that there was a significant difference between pregnant women and health personnels in their attitudes toward normal delivery and cesarean (p=0.001).

 Conclusions: Since health personnels had a more positive attitude towards normal delivery than pregnant women did, it seems that the young as well as the pregnant individuals in society need more education and awareness to be able to change their attitudes towards delivery methods. Health personnel, due to their high positive attitude towards normal delivery, can play a more beneficial role in this regard.

Hasan Anari, Farhad Salehzadeh , Ramin Mirmohammadi , Simin Monshari ,
Volume 7, Issue 1 (4-2007)

 Background & Objective: Developmental dislocation of hip (DDH) as an inherited joint disorder results from external location of the head of femora from the acetabulum.Early diagnosis of this disorder is very important and any delay may result in long life handicap. Nowadays new methods such as sonogrphy are recommended in diagnosis of this disorder. Radiology and physical examination are traditional methods. This study was designed to evaluate the results of sonographical, radiological and physical examination findings in 100 infants who were suspected to have DDH.

 Methods: This analytical-cross sectional study was done in private clinics from June 2004 to June 2005. The one hundred infants who were suspected to have DDH in physical examination entered the study. A questionnaire was completed for each infant, and then sonography and radioghray have been done for them. The data were collected and analyzed by statistical programs.

 Results: Among 100 infants 48% were female and 52% male, with mean age 42±7.23.In 44% they were the firstborn.58% had normal delivery and 42% cesarean section. 15% had breech presentation. In 28% radiological and 56% sonographical methods showed findings in favor of DDH.

 Conclusion: This study showed, simultaneous physical and sonographic examination especially during the first month result in early and precise diagnosis of DDH, on the other hand it does not have radiologic side effects.

Ali Mohammadian Erdi , Nahid Manochehrian,
Volume 7, Issue 2 (6-2007)

  Backgrond & Objectives: Perioperartive shivering is a common complication which interferes with monitoring of patients and it increases oxygen consumption (up to 500%) which can be life-threating in patients with a low cardio pulmonary reserve. This study compared the efficiency and complications of two perioperative antishivering drugs. (Tramadol and Meperidine).

  Methods: All of the 70 patients under went cesarean section with spinal Anesthesia, were categorized in two groups of 35 persons, and treated as clinical trial, double blind with tramadol and meperidine. Then they were compared in terms of the interval between administration of drugs and stoping of shivering and their complications.

  Results : The mean age in patient were 27 years, youngest one was 17 and the oldest was 39 years. The average interval of stopping of shivering during tramadol using (2.57 min) is less than meperidine (6.24 min). The frequency of nausea and vomiting in meperidine group was more than that of the tramadol group. Regarding the incidence of pruritus and sedation after using of drug in both groups, there was no considerable difference between them. Respiratory and pulse rate changes, and decreasing of arterial oxygen saturation in post injection period to preinjection period of meperidine, didn't show any significant changes. In systolic and diastolic blood pressure changes, there was no significant change in both groups.

  Conclusion: Perioperative shivering treatment by tramadol is better than meperidine because of its faster onset of stopping of shivering and its low complications in cesarean section with spinal anesthesia.

Hosein Najafzadeh, Mahmood Khaksari Mahabadi, Sareh Rezaie, Peghah Ardalani,
Volume 13, Issue 1 (4-2013)

  Background: Crocus sativus L., commonly known as saffron is used for different purposes such as an antispasmodic and expectorant. Recent studies have demonstrated that saffron extracts have antitumor, radical scavenger, hypolipidemic, anticonvulsant effects and it improves activity on learning and memory. The aim of the present study was to assess the effect ofaqueous saffron extracton weight, length, macroscopic and microscopic skeletal malformation in fetuses of rats.

  Methods: Study was carried on 3 groups of female Wistar rats. Group1 was kept as control and received normal saline with equal volume of extract Group 2 received saffron extract with 80mg/kg-IP on 10th and 11th day of gestation Group 3 received saffron extract with 200mg/kg-IP on 10th and 11th day of gestation. Rats were dissected on day 20 of gestation, embryos harvested by cesarean section. The living status and weight and length of fetuses were detected. After examination for determination of gross malformations, fetuses were placed in alcohol and stained by Alizarin red-Alcian blue method then evaluation was carried by stereomicroscope.

  Results: Saffron extract at dose of 80 mg/kg significantly increased the weights and body-lengths of fetuses in compare with saline and extract at dose 200 mg/kg. Macroscopic and Microscopic studies did not show any skeletal abnormalities by two above doses of saffron.

  Conclusion: The results show short time administration of saffron aqueous extract does not cause malformation on skeletal system.

Fatemeh Rahimikian, Forooq Talebi, Shahnaz Golian Tehrani, Abbas Mehran,
Volume 13, Issue 4 (12-2013)

  Background and Aim: Birth in the 21st century is characterized by interventions. That interventions increase the risk for mother and baby without improving outcomes. The aim of this study was to compare the effect of physiological birth and routine normal delivery on some of maternal and fetus outcomes.

  Methods: This quasi-experimental study was performed on 160 pregnant women. The participants were allocated in two groups of physiological birth (n=80) and routine normal delivery (n=80). Inclusion criteria were as following: Apgar score between one and five dilatation between three and four cm maternal age between 18-35 years gestational age between 37-40 weeks cephalic presentation and neonatal birth weight of 2500-4000 gr. Physiological birth care included labor begins on its own, freedom of movement throughout labor, continuous labor support, spontaneous pushing, no separation of mother and baby. Routine birth cares include routine interventions in labor or birth. Rate of cesarean, Apgar score and neonatal intensive care unit were evaluated in both groups. Data were analyzed by SPSS 16. The t-test, chi-square and Mann Whitney were the statistical tests of choice.

  Results: Rate of cesarean was significantly different between two groups (p=0.005). First minute Neonatal Apgar score was significantly different (p=0.011), but fifth minute Apgar was similar in both groups (p=0.470). The transmission to neonatal intensive care unit had also significant difference among two groups (p=0.029).

  Conclusion: The present study showed that the physiological birth is safe. It seems that the physiological birth decreases the rate of cesarean and transmission to neonatal intensive care unit, also improves the first minute neonatal Apgar scores.

Mahdi Saadati , Mahdokht Taheri , Mohammad Hadi Bahadori ,
Volume 14, Issue 4 (12-2014)

  Background & objectives : Infertility is a global problem affecting millions of men and women in developed and developing countries. In this regard, in-vitro fertilization (IVF) plays an important role in improving the quality of life in infertile patients. However, studies have shown that the implantation failure in IVF is the main challenge of this procedure. Melatonin can increase the survival rate of embryos and IVF success rate through eliminating free radicals and removing reactive oxygen species. So, this study is conducted to investigate the effects of different concentrations of melatonin on the rate of newborns of mice following transfer oftwo-cell embryos .

  Methods : In this study, female mice with average age of six to eight weeks were superovulated by administering pregnant mares serum gonadotropin (PMSG) intraperitoneally (7.5 IU. ip), and followed after 48h by human chorionic gonadotropin (hCG) (7.5 IU. ip). Two-cell mouse embryos were obtained from female mice oviduct after 48 h. The embryos transferred bilaterally into pseudopregnant mice of the same strain through surgical procedure and 8-14 embryos were transferred to each tube. The study included 4 treatment groups and one control group (6 mice in each group). The treatment groups were exposed to subcutaneous injection of concentrations of 100 µm , 10 µm , 1 µm and 100 nm of melatonin. After the cesarean on 18th day of pregnancy, the percentage of live births was assessed. The outcomes of the live birth rate were as­sessed using the chi-square test and statistical analyses were carried out using SPSS version 16.0. Percentage of live birth was calculated and compared with the control group.

  Results: A total of 701 two-cell mouse embryos were transferred into one control group and four experimental groups. The number and percentage of live births at concentrations of 100 µm and 10 µm of melatonin and the control groups were 21 (15.55%), 13 (9.15%) and 9 (6.47%), respectively. No infant was born at the concentrations of 1 µM and 100 nM of melatonin . The highest rate of live births was obtained at the concentration of 100 µM and showed a significant difference with the control group (p ≤ 0.01). There was no significant difference in live births at the concentration of 10 µm and control group.

  Conclusion : The results of this study indicated that subcutaneous injection of melatonin improves the two-cell mouse embryo growth and post implantation development of mice.

Mehrab Hojjat, Parviz Amri, Shahnaz Barat, Ali Bijani, Valiollah Amri,
Volume 15, Issue 4 (1-2016)

Background & objectives: This study was designed to compare the effect of general and spinal anesthesia on hemoglobin and hematocrit values in women following cesarean section.

Methods: This clinical trial study performed on 88 ASA class 1 pregnant women who were candidate for elective cesarean. Forty six patients received general anesthesia with isoflorane 0.75, N2O 50% and O2 and also 42 patients received spinal anesthesia with 12 mg of bupivacaine. The patients with a systemic disease or other causes of intraoperative excessive bleeding were excluded. All the operations were performed by same surgeon. Pre- and post-operative Hb and HCT values and Apgar score were recorded in both groups.

Results: Previous cesarean section history was the cause of surgery in 21 patients in group one and 22 patients in group two. Both groups were similar in age, weight, height and parity. The preoperative mean Hb or HCT values did not differ significantly between two groups. In both groups, postoperative mean Hb and HCT values were decreased significantly. Postoperative Hb and Hct reduction was significantly higher in general anesthesia group (p<0.05). There was no significant difference between two groups regarding Apgar score.

Conclusion: This study showed higher postoperative Hb and Hct reduction in general anesthesia than spinal anesthesia.

Maryam Khooshideh, Tiba Mirzarahimi,
Volume 17, Issue 1 (4-2017)

Background & objective:   One of the objectives of health reform plan in Iran is to reduce the rate of cesarean section delivery. This needs research and use of results to improve the maternal and neonatal outcomes. The aim of this study was to compare the maternal and neonatal outcomes after normal vaginal and cesarean section delivery in hospitalized low-risk mothers in Arash Hospital in Tehran, Iran.

Methods: In this prospective cohort study, 1900 low-risk pregnant women, with 37-40 weeks of gestational age, referring to the emergency department and being hospitalized for delivery were included. The data were collected from two groups of patients (normal vaginal delivery and cesarean section delivery). Data on wound infection, abnormal postpartum hemorrhage, decrease of hemoglobin, transfusion requirement, injuries to the genitourinary system, fever until 10 days after delivery, neonatal respiratory complications, NICU admission, jaundice and obstetric injuries were collected by a questionnaire.

Results: From 1900 pregnant women, 62.1% had cesarean delivery and 37.9% had normal vaginal delivery. The reasons for cesarean delivery included repeated cesarean (68%), failure to progress (18.1%), and fetal distress (13/9%). Wound infection (p=0. 004), abnormal postpartum hemorrhage (p=0.042) and low hemoglobin (p<0.001) were more frequent in cesarean delivery group than in normal vaginal delivery group. But obstetric injuries were higher in normal vaginal delivery group (p<0. 0001). There was no difference between the two groups in terms of fever ten days after delivery and blood transfusion requirement. For neonatal outcomes, transient neonatal tachypnea (p=0.032), neonatal respiratory distress syndrome (p=0.002), and NICU admission (p<0. 0001) were more frequent in cesarean delivery group than in normal vaginal delivery group. There was no difference between the two groups in neonatal jaundice rate and neonatal injuries.

Conclusion: Due to the high rate of cesarean section delivery in our country and higher rate of maternal and neonatal complications after cesarean section delivery, appropriate strategies are required to be applied to decrease unnecessary cesarean section delivery and increase normal delivery with minimum maternal and neonatal complications.

Saeideh Shakeri Hosseinabad, Gholamreza Shabanian, Sheida Shabanian , Mahmoud Rafiean , Souleiman Kheiri, Zahra Lorigooini, Koubra Masoodi,
Volume 17, Issue 3 (10-2017)

Background & objectives: Pain is one of the most common post-operative complications of cesarean section, which is very important for mother in nursing a baby and breastfeeding. Finding ways to overcome this pain has always been a concern for researchers. Considering the application of plants in traditional medicine as sedatives, this study evaluated the effect of Dill seed oil on post-operative pain in patients with spinal anesthesia.
Methods: This double-blind, clinical trial was conducted on pregnant women who met the inclusion criteria and referred to Hajar hospital in Shahrekord, Iran during 2015-2016.  By simple random sampling, the patients were divided into two groups. In the first group, 10 cc Dill (Anethum graveolens L.) seed oil was prescribed at intervals of half an hour and one  hour before spinal anesthesia and half an hour , one hour and two hours after spinal anesthesia. In the second group, placebos (standard treatment) were prescribed at the same intervals. Pain and vital signs, including blood pressure, nausea , vomiting, heart rate, bleeding , use of narcotics and NSAID and any additional medications (such as atropine and ephedrine)  were recorded and rechecked during surgery , thirty minutes after spinal anesthesia and  one hour, four hours and twelve hours  after cesarean section.
Results: The findings showed a significant difference between the two groups in the third stage of the study (4 hours after cesarean section) only in respiratory rate and in the fourth stage of the study (12 hours after cesarean section) in all vital signs (p<0.05). Also, the pain and nausea rate in the third and fourth stages of the study in the case group (Dill seed oil) were lower than those of the control group, indicating a significant difference in the pain level (p<0.05). The bleeding rate and use of NSAIDs and opioids twelve hours after caesarian section in the case group were significantly lower than those of  the control group (p<0.05).
Conclusion: considering the effect of Dill (Anethum graveolens L.) seed oil on reducing pain, bleeding rate and use of narcotics and NSIADs, it can be used in women undergoing cesarean section.

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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