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Showing 12 results for Delivery
Afshar Tamook, Nayereh Aminisani , Joubin Mogadam Yeganeh , Afrooz Mardi,
Volume 3, Issue 2 (6-2003)
Abstract
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.
Mohammad Narimani , Parvin Nakhostine Ruhi , Mahnaz Yosefi ,
Volume 4, Issue 2 (6-2004)
Abstract
Background & Objectives: Postpartum depression, as a mental disorder, is seen in some women and can threaten their mental health as well as their infants. At least 7% of mothers suffer from this problem after parturition. Studies indicate that many variables are associated with this disorder during and after the gestation period. The aim of this study was to achieve the rate of postpartum depression and its relevant variables among women who referred to the parturition ward of Buali and Emam Hossein hospitals in Tehran. Methods: In this cross-sectional descriptive study a questionnaire construced by researchers as well as Beck 21- item depression inventory were used to collect the data. The subjects (100 cases) responded to the questions individually in the hospitals. According to the type of variables, X2 nonparametric test was used in the data analysis. Results: The results of this study indicated that 17% of the subjects were suffering from moderate and severe depression and among the 14 predictive variables of the postpartum depression four variables, namely, matrimonial dissatisfaction, unwanted gestation, unemployment and low economical status of family have significant relationship with the postpartum depression. Conclusion: In comparison with the previous studies, the prevalence of postpartum depression is in higher level therefore, it is necessary to increase the information of parturition ward staff about this disorder and inform them to refer any cases of depression to the counseling centers.
Sima Khavandizadeh Aghdam ,
Volume 6, Issue 4 (12-2006)
Abstract
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)
Abstract
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.
Fariba Sadeghi Movahhed , Farideh Mostafazadeh, Mehrnaz Mashoufi ,
Volume 7, Issue 4 (12-2007)
Abstract
Background & Objective: Obsessive-compulsive disorder is a common disease in psychiatry which increases anxiety in approximately 2% of the world population. Recent reports suggest that OCD starts in menstruation, Pregnancy, post-partum periods which causes failure in women's quality of life. The aim of study was to determine the onset of (OCD) in fertile women. Methods: In a descriptive study in 2006, 53 women with DSM-IV were interviewed for obsessive disorder at psychiatry clinic of Fatemi hospital. A questionnaire including two parts on demographic information and 8 questions on the onset of obsessive disorder in menstruation, pregnancy, puerperium periods was completed. Data were analyzed through SPSS. Results: In 3.8%, the onset of obsessive disorder was with the first menstruation period. In 12.5% it was during pregnancy. In 57.1% (4) of obsessive samples onset of obsessive was in second pregnancy. In 16.24% onset of OCD was after delivery. In 28.8% it was after first delivery and 30% after first delivery had affective disorders. Conclusion: The menstruation, pregnancy, post partum may be a periods of risk for recurrence or onset of obsessive compulsive disorder and women should be taken care of more in order to avoid disorders like depression. Midwife clinicians caring for women need to be aware of the impact of these symptoms and attention for mental health in women.
Maryam Saghiri, Niloofar Sattarzadeh, Nosrat Tabrizi, Zakariya Pezeshki,
Volume 8, Issue 1 (4-2008)
Abstract
Background & Objective: Labor pain is one of the most severe pains that mothers experience. Intense pain leads to stress and has unfavorable effects on the mother and fetus. This research was done to determine the effect of using Entonox (N2O) self administration on reducing labor pain in the active phase of labor& delivery, Mode of delivery, and newborn's Apgar score.
Methods: One hundred and twenty primiparous women in 29 Bahman Hospital in Tabriz were included it this randomly single-blind research. In the active phase of delivery, Entonox and Oxygen gases were used. The severity of the mother's pain was asked and was scored according to analogue criterion.
Results: There was a significant difference in frequency of pain intensity in two groups of Entonox and Oxygen. The Mean score of pain intensity in Entonex user, in the first & second stage of labor was 5.93% and 5.82% respectively, while for the oxygen users it was 6.99% and 6.74% which was significant. 41.7% of the mothers in the Entonox group had a severe pain and 11.7% had a very severe pain, whereas in the Oxygen group 58.3% of the mothers had a severe pain and 25% of them had very severe pain (p< 0.001). Meanwhile we found no significant difference between modes of delivery progress of labor and newborn's Apgar
score.
Conclusion: According to research results, Entonox reduces the intensity of labor pain more than oxygen and is effective during the first and second phase of delivery.
Mahnaz Azary , Elham Nasiri , Simin Molod , Mitra Manavi , Roghaiyeh Azezzadh ,
Volume 8, Issue 4 (12-2008)
Abstract
Background & Objectives: Delivery is a process with pain so one of the midwives duties is to decrease the severity of pain during delivery so decrease in labor period has been much of a concern. Atropine and Hyosine are two common drugs in decreasing time of labor and decreasing the need for labor stimulation with oxytosine. The aim of this study was to investigate the effects of hyoscine and atropine in the progress and time of labor. Methods:This study was double blind clinical trial on 200 primiparous women who had labor pain and were admitted in labor in Alavi hospital in 2008. Who were randomly divided into two groups .the case group infused 20 mg Hyoscine with Atropine in the onset of active phase of labor (4cm dilation, Ruptured membrane) and in the control group 2cc, Dextrose water was infused 0.05. Then, progression in dilatation and effacement, time of active labor, time of 2nd and 3rd stage of labor, fetal heart rate monitoring, infant APGAR score of the 1st and 5th minute were registered. The data were analyzed by SPSS software using descriptive and analytical statistics as chi- square. Results: The findings indicated that there was a significant difference in dilatation & effacement between two groups (5/2cm/h, 1/5cm/h) (p<0.05). Duration of active phase of labor was 105 min in case group and 251 min in control group (p<0.05), duration of stage 2 was 17 min in case group and 33 min in the control group (p<0.05). Total time of labor and deliver (121 min in case group, 274 min in control group).incidence of Tachycardia and bradycardia in FHR in 30 min after infusion 25%(15% Tachycardia and 10% bradycardia in case group) 20% (12% Tachycardia and 8% bradycardia in control group) and no difference in two group was seen. Conclusion:According to the finding s of this study Hyoscine and Atropine are effective in the progression of labor and delivery.
Mehrnaz Mashoufi, Robab Nazari, Roghayieh Shirinkam Chouri, Afshan Sharghi, Afrouz Mardi, Maryam Azari ,
Volume 12, Issue 3 (9-2012)
Abstract
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.
Fatemeh Rahimikian, Forooq Talebi, Shahnaz Golian Tehrani, Abbas Mehran,
Volume 13, Issue 4 (1-2013)
Abstract
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.
Rafat Kazemzadeh , Fahimeh Sehhatie-Shafaie, Firouz Amani, Reza Heshmat ,
Volume 14, Issue 2 (7-2014)
Abstract
Background & Objectives: Delivery is one of the most important events in a woman's life, and pain is an inevitable part of childbirth. The non-controlled pain leads to prolonged labor and multiple injuries to mother and fetus. This research was done to determine the effect of acupressure at the SP6 and LI4 points on the duration and pain of the labor in nulliparous women. Methods: This randomized controlled clinical trial was conducted on 84 nulliparous women who were attended hospital in Ardabil. The participants were divided into two intervention and control groups using randomized blocking. Pressure has been done on SP6- LI4 points in intervention group. Pain intensity was measured before and after the intervention using visual analog scales and length of active phase and second stage were recorded through vaginal exam in the checklist. Determination of the effect of pressure on the intensity of labor pain and delivery length performed using paired t-test, Student’s t-test and chi-square by SPSS v.16. Results: After the intervention the mean level of pain intensity in the intervention group was decreased. Also, there was a significant decrease in mean intensity of pain after each intervention in the intervention group with different dilations (4, 6, 8, and 10 cm) (p<0.001).The mean duration of active phase and second stage in intervention group was significantly less than the control group . (p<0.001, p=0.008). Conclusion: Since acupressure at the SP6- LI4 point in different dilatations leads to the reduction in labor pain intensity and delivery duration, therefore, this method can be used to reduce the pain and duration of labor.
Maryam Khooshideh, Tiba Mirzarahimi,
Volume 17, Issue 1 (4-2017)
Abstract
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.
Sadaf Khaki, Nastaran Hadizadeh, Leila Rezaie Shirmard ,
Volume 22, Issue 4 (1-2023)
Abstract
Background & objectives: Due to the existence of various issues and limitations associated with traditional buccal drug delivery systems such as the disability to consume food whilst using topical drugs in the mouth cavity, unpredictable drug release profile, undesirable taste, low patient adherence to therapy, and accelerated drug removal with saliva, these conventional methods are now rapidly becoming replaced with oral thin films as more precise and novel oral drug delivery platforms. The current study aims to discuss the design and characterization of betamethasone-loaded oral thin films with the aim of improved drug delivery in mouth cavity diseases.
Methods: In this study, oral thin films with and without betamethasone were fabricated through the solvent casting method as a common, fast, and affordable technique prior to being evaluated for different physiochemical characteristics including weight, width, surface pH, disintegration period in vitro conditions, and swelling rates as well as drug release profiles at different intervals.
Results: Obtained oral films were demonstrated to possess adequate homogeneity, flexibility, and mechanical resistance. Accordingly, the average surface pH for films without and with betamethasone was equal to 6.75 and 6.66, respectively, which are in notable compatibility with the neutral pH of the oral cavity. Betamethasone-loaded films’ disintegration duration appeared to be superior to that of films without betamethasone and was in close correlation with their higher swelling rates. Further experiments revealed 25-30% drug release in the initial 20 minutes, followed by more than 90% betamethasone release in 360 minutes in a sustained manner.
Conclusion: These results are indicative of betamethasone oral films’ satisfactory physiochemical properties and potential applicability as a sufficient oral drug delivery platform in mouth cavity diseases such as oral lichen planus or recurrent mouth sores. By sticking to the mouth mucosa, these films can significantly reduce drug removal with saliva and thus ameliorate sufficient delivery of therapeutic agents to specific mouth lesions. Moreover, they can alleviate some of the issues and limitations of traditional topical oral drug delivery and improve treatment or control of disease symptoms.
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