Background & Objective: Perineal trauma usually occurs during childbirth and associates with short and long term complications for women. B lood loss, urinary, faecal and sexual incontinence are effects of after childbirth complications of perinal trauma. These can cause maternal and newborn morbidity. This study wanted to compare the effectiveness of two techniques for perineum protection " hands off" versus "hands on"(Ritgen) during childbirhtfrom view points of frequency, degree and suture of perineal trauma .

  Methods: This r andomized clinicaltrial study carried out on 70 nulliparous women thatexpecting normal birth of a singleton . They were randomly selected and divided in hands offand hands on (N = 35) groups. In the 'hands on' method, midwife put pressure on the baby's head and support ('guard') the perineum then lateral flexion is used to facilitate delivery of the shoulders, and in the 'hands off' method, midwife keep her hands poised, not touching the head or perineum, allowing spontaneous delivery of the shoulders . We analyzed data with descriptive statistical methods, t-test, chi-squer, mann whitney and non parametric tests by SPSS.

  Results: Rates of intact perineum was significantly higher in the 'hands off' group (50%, 40%, p = 0.48). The f irst and seconddegree tears were significantly lower in the 'hands off' group (40.6%, 50%, vs, 9.4%, 10%, p = 0.48). We did not observe any significant differences in the rate of lacerations in the anterior regions of the perineum and frequency of suture between the two groups

  Conclusions: The hands off technique in the second stage of�labour increases the likelihood of an intact perineum.

  Background & Objectives : Bacterial vaginosis is a condition which is determined by changes in microbial ecosystem of vagina and is considered as a preventable risk factor for preterm delivery. This study was conducted to assess the effectiveness of bacterial vaginosis screening program in routine prenatal care and its effect on decreasing preterm labor.

  Methods: This clinical trial study was conducted on 474 pregnant women at gestational stage between 2007 and 2008. The participants were randomly divided into 2 groups: intervention group and control group. Screening was performed in intervention group with Amsel's criteria (3 of 4 needed for diagnosis). Positive cases were given clindamycin cream (2%) for one week. The outcome of the delivery was assessed in both groups afterward. Data were analyzed by SPSS11 software using descriptive statistics.

  Results: There was no significant difference between two groups regarding pregnancy rank, wanted and unwanted pregnancy, insufficient weight gain, mother vaccination and complication of pregnancy. Bacterial vaginosis was observed in 17 out of 216 (8%) in the intervention group and then treated. Prevalence of preterm delivery in the intervention and control groups were 3 (1.4%) and 12 (4.7%), respectively. The relative risk was protective (RR: 0.3, DR: 0.033, NNT: 30).

  Conclusion: Screening and treatment of bacterial vaginosis in pregnant women could significantly decrease the rate of preterm delivery.