The effect of caring intervention (physical activity, diet and counseling) on gestational diabetes for pregnant women with metabolic syndrome.

OBJECTIVE: Metabolic syndrome and its indexes is one of the critical health problems during pregnancy. This study aimed to examine the effects of a care intervention program on pregnancy outcome in pregnant women with Metabolic Syndrome during 2017-2018. METHODS: This randomized clinical trial study was conducted in 120 singleton pregnant women with metabolic syndrome. The participants were selected using purposive sampling method from pregnant women referred to two health centers of Babol. They were randomly divided in two control and intervention groups (60 samples in each group). Intervention group received one motivational interview session for 120 min, two consultation sessions with expert for nutritional recommendations based on Nutrition Guidelines of Ministry of Health for Pregnant Women. They were also theoretically and practically provided by three training sessions for physical activity and pregnancy exercises combining pelvic floor muscles, bodybuilding, muscle strengthening, stretching, and relaxation and walking activities. To follow up on the intervention, the researcher made a phone call with the participants in intervention group every 10 days to two weeks. Pregnancy outcomes were assessed using SPSS software. RESULTS: The obtained results showed that there was a significant difference between the two groups in maternal complications including gestational diabetes, hospitalization due to gestational diabetes, nutritional diet for gestational diabetes, pregnancy weight gain and 2-hour post-prandial blood glucose test (p ≤ .01). There was no significant difference in terms of demographic, midwifery and metabolic syndrome indices between the intervention and control groups. CONCLUSION: The results of the study indicated that intervention program improved the maternal pregnancy outcome such as gestational diabetes and weight gain during the pregnancy in the intervention group. This program had no adverse effects for the mother who is consistent with pregnancy health objectives.

Relationship between paternal postnatal depression and its predictors factors among Iranian fathers

ABSTRACT Background: Paternal postnatal depression (PPND) is widely overlooked despite being the most common mental health disorder among fathers in the postpartum period, and it affects all aspects of family life, particularly the relationship with the spouse and children. Objective: To determine the predictor factors of PPND. Methods: A descriptive-analytical study was performed on 400 fathers of children aged six weeks to one-year referring to the healthcare centers. Data were collected using a demographic characteristics form and the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed using SPSS software version 22. Results: The mean EPDS score was 6/54± 4.3, the mean age of the studied fathers was 35 ± 5.4, and 57.7% had experienced more than one pregnancy with their spouses. There was a significant relationship (P>0.05) between the education level and the EPDS score. According to linear regression, the most influential factors on EPDS score included satisfaction with life and general health, as well as an unwanted pregnancy amongst maternal fertility characteristics. Conclusion: Determining the predictor/related factors with paternal postnatal depression helped us to identify at-risk fathers promptly, to manage earlier, and to prevent the adverse effects of PPND on family health and relationship.

The Effect of Intrathecal Meperidine on Maternal and Newborn Outcomes After Cesarean Section: A Systematic Review and Meta-Analysis Study.

CONTEXT: Spinal anesthesia is the most preferred method for cesarean section. This meta-analysis was performed to determine the effect of minimum and maximum intrathecal doses of meperidine (pethidine) [5 to 40 mg] on the maternal and newborn outcomes after cesarean section. EVIDENCE ACQUISITION: The data were collected through the systematic search in the ISI, PubMed, Scopus, Google Scholar, Barakat, MagIran, SID, Irandoc, and EMBASE medical databases. Eighteen clinical trial studies with 1,494 patients were included. RESULTS: Patients who had received intrathecal meperidine had experienced lower shivering, relative risk [RR] = 0.34 (95% CI = 0.23, 0.48) and longer analgesia, [standard mean difference (SMD)] = 7.67 (95% CI = 1.85, 13.49) after the surgery. Moreover, RR of nausea = 1.37 (95% CI = 1.13, 1.66), vomiting RR = 2.02 (95% CI = 1.28, 3.20), and pruritus RR = 9.26 (95% CI = 4.17, 20.58) was higher in the pethidine group than in the control group. There was no statistically significant difference in the Apgar score at one-minute RR = 0.99 (95% CI = 0.9, 1.09), at five-minute RR = 0.93 (95% CI = 0.87, 1.08), maternal hypotension RR = 1.00 (95% CI = 0.87, 1.15), and maternal sensory and motor blockade durations, SMD = -1.72 (95% CI = -3.78.0.34) and SMD = -4.38 (95% CI = -9.19, 0.44), respectively in the two pethidine and control groups. CONCLUSIONS: Intrathecal meperidine can reduce shivering and increase the duration of postoperative analgesia, though it increases the relative risk of nausea, vomiting, and pruritus. No significant difference was found both in the Apgar score, maternal hypotension, and duration of the motor and sensory block.

Claims about medical malpractices resulting in neonatal and maternal impairment in Iran.

BACKGROUND: Today even low incidence of complications for mothers or neonates during pregnancy, delivery or postpartum is unacceptable to the public and can result in claims because of greater expectation from patients and an increase in media coverage. The present study was conducted to investigate the reasons for medical malpractice claims on maternal and neonatal impairment, which are achieved in Iranian Legal Medicine Organization councils. MATERIALS AND METHODS: The present cross-sectional and retrospective study used convenience sampling to collect data of total claims from 31 provinces archived in the supreme council of the ILMO in 2 years. In this article, the medical malpractice claims on maternal and neonatal impairment during pregnancy, labour, delivery and early postpartum were reported. The data were collected through a validated researcher-made checklist and were analyzed in SPSS 16. RESULTS: Among total of 299 cases of impairment, cerebral palsy (33.34%), Erb's palsy due to shoulder dystocia (24.24%) and Down Syndrome (24.24%) were the main confirmed causes of malpractice for neonatal impairment and Retained Surgical Mass (20.5%), Salpingectomy and/or Oophorectomy Related to EP (17.2%), Hysterectomy (17.2%) and Episiotomy Related complication (17.2%) were the main confirmed causes of malpractice for maternal impairment. CONCLUSION: Considering this fact that medical malpractice was confirmed in a large proportion of some preventable and important complications, therefore, results of this study can be used for developing educational programs for related healthcare providers to prevent those complications.

Lavender fragrance essential oil and the quality of sleep in postpartum women.

BACKGROUND: Labor and delivery is a stressful stage for mothers. During these periods, sleep-related disorders have been reported. The problems of inadequate sleep include decrease in concentration, judgment, difficulty in performing daily activities, and an increase in irritability. Even the effects of moderate sleep loss on life and health quality can be similar to sleep deprivation. some research aggravated by aromatherapy on sleep quality in different periods of life so might be useful for the improve of sleep quality in postpartum women. OBJECTIVES: This study aimed to determine the effect of aromatherapy on the quality of sleep in postpartum women. The sample was recruited from medical health centers of Zanjan University of Medical Sciences. PATIENTS AND METHODS: This study was a randomized clinical trial with the control group. A total of 158 mothers in postpartum period (with certain inclusion criteria) were enrolled in the study and assigned randomly to two groups of control and intervention. Lavender fragrance (made by Barij Essence Pharmaceutical Co.) was used by participants in the intervention group nightly before sleeping. The fragrance was dropped on cotton balls, which were placed on a cylindrical container at mothers' disposal. Keeping the container at a projected distance of 20 cm, the participants inhaled 10 deep breaths and then the container was placed beside their pillow until morning. This procedure was done 4 times a week for 8 weeks. For the control group, the same intervention was done with the placebo. The instrument for collecting data was Pittsburgh sleep quality index, which was completed at the baseline, fourth, and eighth weeks after the intervention. Data were analyzed using independent t test and repeated measures analysis of variance calculated by SPSS16. RESULTS: Before the intervention, there were no significant differences between mothers in two groups (P > 0.05). After 8 weeks follow up, a significant improvement appeared in mothers' sleep quality in the intervention group. Aromatherapy increased sleep quality mean score (±SD) from 8.2911 (± 2.1192) to 6.7975 (± 2.3663) (P < 0.05), but in the control group sleep quality mean score (±SD) changes from 8.4557 (± 2.3027) to 7.5696 (± 1.1464) (P > 0.05). Comparing sleep quality between control and intervention groups after 8 weeks from the beginning of the intervention indicated that aromatherapy was effective in the improvement of mothers' sleep quality (P < 0.05). CONCLUSIONS: Considering the effects of aromatherapy on the improvement of mother's sleep quality during postpartum period, aromatherapy has been suggested as a non-pharmacological method for the improvement of the maternal health.