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Introduction: Despite the adverse consequences of cesarean delivery, its incidence rate is increasing in many provinces of the country, especially Ilam city. For this reason, it is important to identify the causes of the increase in cesarean delivery in order to reduce it. Therefore, the present study was conducted with the aim of determining the frequency of cesarean section and its causes in primiparous women in Ilam city in 2016. Methods: The present study was conducted cross-sectionally in the second half of 2016 in Ilam city, and the study population was all primiparous women referred to a single specialty maternity hospital (Ayatollah Taleghani Hospital). The sampling method was census and all cesarean deliveries were recorded in Ayatollah Taleghani Hospital. The inclusion criteria included all primiparous women. The data of the study was collected using a researcher-made questionnaire that included demographic and midwifery information. After collecting the data, the data was entered into the SPSS version 16 software Central indices were used to describe data in quantitative variables, and absolute and cumulative frequency and percentage of dispersion frequency were used for qualitative variables. Results: According to the findings of this study, out of 1738 births, 867 (49.88%) were natural births and 871 (50.12%) were cesarean. Among the natural births, 427 (49.25%) and among the cesarean births, 296 (33.98%) were primiparous. Among the maternal factors, lack of progress and among the fetal factors, fetal distress and among the maternal-fetal factors, head- to-pelvis disproportion was one of the most important causes of cesarean delivery in primiparous women. In general, fetal factors with more than 67% were the most important causes of caesarean section in primiparous women. Conclusions: According to the findings of the study, 33.98% of cesarean births were primiparous. Considering the high statistics of caesarean section, especially cesarean section for first births, It is necessary to reduce the number of elective cesarean sections by increasing the number of physiological births and painless births, as well as increasing the awareness of families about birthing methods and the advantages and disadvantages of each of them. [ABSTRACT FROM AUTHOR]

Background Toxoplasmosis is a common parasitic infection with high prevalence and worldwide distribution. It may cause severe disease in the fetus of newly infected pregnant women. Objective This study aimed to evaluate the seroprevalence of toxoplasmosis and its related risk factors among pregnant women in Ramsar city, Mazandaran province, north of Iran, from October 2017 to March 2018. Methods In this analytical-cross sectional study, specific anti-Toxoplasma gondii IgG and IgM antibodies were measured in 191 pregnant women by ELISA method. The length of T. gondii infection was estimated by the IgG avidity test. Demographic and behavioral information about pregnant women and possible risk factors of toxoplasmosis were collected through interviews. Results Specific IgG antibody against T. gondii was detected in 46.1% and IgM in 5.8% and both IgG and IgM antibodies were detected in 4.7% of pregnant women. The IgG avidity test did not show any acute case of toxoplasmosis. None of the demographic characteristics, such as age, occupation, place of residence, education, income, trimester of pregnancy, frequency of pregnancy, and history of abortion was correlated with toxoplasmosis. Moreover, behavioral characteristics, such as the source of consumed water, contact with soil, presence of cats in the household, consumption of vegetables, type of meat consumed, and the way of cooking meat had no significant correlation with toxoplasmosis seropositivity. Conclusion More than half of the pregnant women (54%) were toxoplasmosis-free and therefore at risk of acquiring this infection. Increasing the knowledge of pregnant women about toxoplasmosis prevention may reduce the risk of this infection during pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Multiple risk factors are associated with depression during pregnancy, but so far the effect of fetal sex on depression in pregnancy has not been investigated in Iran. Objective: Frequency survey and depression – related factors with emphasis on relationship between depression and fetal sex in pregnant women referred to Al-Zahra Rasht. Materials and Methods: This analytical cross-sectional study was done within a period of two months (June and July 2013) on 500 pregnant women referred (more than 20 weeks of pregnancy) to prenatal care of Al-Zahra hospital. The questionnaire consistingof two demographic data and midwifery sections and Beck standard depression inventory were completed by patients who had the inclusion criteria. Results: The prevalence of depression in 500 pregnant women was found to be 27.4%. Factors associated with depression in pregnancy using multiple Logistic regression models, maternal employment status, number of children, same sex of fetus with previous children, duration of notice from fetus sex, family history of depression, stressful event and satisfaction from spouse, and were identified as the most powerful variables affecting theincidence of depression in pregnancy. There was no significant relationship between depression and fetal gender. Conclusion: The high prevalence of depression among pregnant women in this study, compared with global studies suggests the need for more reviews and principal interventionalstudies in this field. The same gender of fetus with previous child and duration of knowledge of fetal sex had a significant relationship with depression during pregnancy. According to the results of this study, screening of the groups at risk of depression is recommended. [ABSTRACT FROM AUTHOR]

Background & Aim: Women’s satisfaction from prenatal care, can lead to increase using the services and ultimately improve pregnancy outcomes. The purpose of this study was to investigate the relationship between women’s satisfaction with prenatal care services and demographic characteristics of the pregnant women. Material & Method: This study used a descriptive correlational design. Data collection instrument was a questionnaire. The satisfaction dimensions were the accessibility, coordination, communication of the personnel, availability, and the received information regarding prenatal care, quality, and the cost of the services.The study subjects consisted of 530 Iranian women living in the west of Tehran, who gave birth and attended to the health clinics, at 6 week postnatal period. Results: Most of the women (69.8%) had good level of satisfaction with provided prenatal care and 21.9% were satisfied at the level of excellence. The women were more satisfied with accessibility, received information, communication, quality of services. There was a statistically significant positive association between education levels, economical status, and health situation during pregnancy and women’s satisfaction with prenatal care services (P

Background & Objective: The prevalence of cesarean section (C/S) has increased worldwide, as in Iran, in current years. This issue is more important for our country due to the change in the policy of family planning to increase population. Therefore, the objective of the present study is to determine the prevalence of C/S and its causes in Fasa in the year 2011. Materials & Methods: In this cross-sectional descriptive study, the data were collected from profiles of women who underwent C/S in Vali Asr hospital in Fasa University of Medical Sciences; Fars, Iran in the year 2011 by using a standard questionnaire containing socio-demographic data and its causes of C/S. The rates of Normal Vaginal Delivery (NVD) and C/S were obtained from vice-chancellor for health of Fasa University of Medical Sciences. The data were described by SPSS software version 16, prevalence and percentage indices. Results: There were 4376 deliveries in Fasa in the year 2011 that 2741 (62%) of them were cesarean section that 1540(56/7%) of them were rural and the rest of them (43.3%) were urban. The average age of them was 27.5 years. The most cause for C/S was previous section. Conclusion: The rate for cesarean section was four times more than the suggested rate by World Health Organization (WHO) (15%). This is also higher than the average rate of Iran that has increased during recent decades. [ABSTRACT FROM AUTHOR]

Background & Aims : Since normal vaginal delivery is concerned with the health of the mother and her child, different levels of the healthcare system is engaged in this process, and due to the high rate of c-sections, studying issues related to normal vaginal delivery is one of the priority areas in medical research worldwide. Function of normal vaginal delivery process- like many other clinical processes- is far from optimal in Emma Reza hospital, and needs improvement. This study was carried out with the aim of development and implementation of a clinical pathway for normal vaginal delivery to improve this process. In this paper we report the results of its implementation on unnecessary interventions in labor. Materials & Methods : This is a quality improvement study which is one of the effectiveness or on-line studies. In this study we used FOCUS PDCA as a model for clinical pathway development. At first current function of process was assessed by multidisciplinary team. Best practices for normal vaginal delivery were extracted from several data bases by using methods of evidence-based medicine. Then format and content of pathway was determined. Finally, the inclusion criteria, the main activities and possible variances from the pathway were determined. Evidence based necessary protocols and procedures were developed. In addition, a patient pathway's version was provided. Result : Assessment of current function showed that normal vaginal delivery process was far from standard, So that the rate of unnecessary interventions was more than standard limit. We used clinical pathway method and evidence-based medicine for standardization of normal vaginal delivery process. It was piloted for two months. Data was collected before and during pilot implementation. Unnecessary interventions in criteria of: episiotomy was 78%, taking IV line/serum therapy was 99%, and augmentation of labor was 46% before implementation of pathway. They changed to 63%, 54%, and 40% as a sequence during pilot implementation. Conclusion: Normal vaginal delivery clinical pathway was effective in reduction of unnecessary interventions in hospital. [ABSTRACT FROM AUTHOR]

Background and Objective: The child mortality is a index of development and plays an important role in determination of population growth. This study was done to determine the effect of sociol-economical conditions on mortality rate of under 5 years children, Khuzestan- Iran. Materials and Methods: This descriptive study was done on 372 women aged. 20-48 years with at least one child under 5 years whome were admitted to the health centers in urban and rural area of gotvand town in Khuzestan province, Iran during 2004. Individuals questionnaires included variables such as mortality, demographic, economic and social index were completed for each subject. Data were analyzed using SPSS-17, ANOVA, Chi-Square and Pearson's correlation coefficient tests. Results: Providing maternal health care during pregnancy and up-grading occupational status of parents significantly reduced child mortality rate (P<0.05). Child mortality rate increased in mothers of <18 and >35 years (P<0.05) and parents desire to have male infant (P<0.05). Conclusion: This study showed that up-grading occupational status of parents, maternal health care and maternal age and desire to have male infant play important role on the child mortality rate in Khuzestan province in south west of Iran. [ABSTRACT FROM AUTHOR]

Background: Advances in perinatal care have increased the number of premature babies who survive. We investigated the frequency of preterm delivery and its influence on the neonatal outcome in pregnancies at a perinatal center in Isfahan, Iran. Methods: This study was done among the preterm deliveries at a Shahid-Beheshti perinatal center in Isfahan, Iran. The data collected in checklists and were analyzed by Student-t, Mann-Whitneyt, and chi-square tests via SPSS software. Finding: In this study we evaluate 1402 delivery. There were 233 preterm deliveries (less than 37 weeks gestational age). Among 248 live preterm deliveries, 123 cases (49%) need NICU cares. The mean of NICU administration was 10.1 days. The rate of mortality in NICU was 25% (32 cases). Conclusion: Preterm deliveries are at a higher risk for an adverse neonatal outcome and thereby cause considerable costs. In this study, our findings were in the range of other studies; but more attention to premature neonates is recommended. [ABSTRACT FROM AUTHOR]

Background: Nausea and vomiting in early stages of pregnancy is a common complaint. In patients with HEG (hyperemesis gravidarum) adverse fetal outcomes, including abortion, preterm delivery, low birth weight (LBW) and maternal outcome (e.g. preeclampsia) are more common than in normal pregnancy. In this study, we evaluate the incidence of some adverse fetal and maternal complications among the patients with HEG. Materials and Methods: This study was performed on 70 patients (under 14 weeks of gestations) with HEG admitted in Yahya-Nejad hospital (Babol) as the study group and 100 cases referred to prenatal care as the control group. All the patients were followed up until the time of delivery. Results: The incidence of preterm delivery in the HEG and control group was 9.4% and 1%, respectively, considered statistically significant (P=0.015). The incidence of abortion in the HEG and control group was 8.6% and 1%, respectively, which was significant (P=0.02). The incidence of gestational diabetes in control and HEG group was 0% and 10.9%, respectively (P=0.001). There was no significant difference between the study group and the control one in terms of the type of delivery, weight / mortality of neonates and preeclampsia. Conclusions: Considering the high incidence of gestational diabetes, preterm delivery, abortion and morbidity of neonates in patients with HEG, close observation of patients with HEG during the pregnancy is recommended. [ABSTRACT FROM AUTHOR]