The Impact of Umbilical Cord Clamping Time on the Infant Anemia: A Randomized Controlled Trial.

BACKGROUND: Anemia during infancy causes irreversible physical, cognitive, motor, and behavioral development disorders. This study aimed to determine the effect of delaying umbilical cord clamping time on certain parameters regarding anemia during the infancy. METHODS: This randomized controlled trial was conducted at a university hospital in west of Turkey (Dec 2017-Dec 2018). Overall, 110 participants were evaluated for the research, 65 participants were randomized after excluding those who did not meet the inclusion criteria (intervention=32, control=33). Randomly assigned to delayed clamping (1 min after delivery) or early clamping (in 15 sec after delivery), and followed up until 4 months postpartum. 48th-hour hematocrit, bilirubin values, need for phototherapy and hematocrit, hemoglobin values, diagnosis of anemia at the postnatal fourth month were compared between two groups. The data showing normal distribution were assessed using the parametric tests. The level of statistical significance was determined as P<0.05. RESULTS: The 48th-hour hematocrit and bilirubin levels of the intervention group were significantly higher than the control (P<0.01 and P<0.05, respectively). No significant difference regarding the need for phototherapy due to postnatal hyperbilirubinemia was observed between the two groups (P>0.05). Means of the intervention group hematocrit and hemoglobin levels measured during anemia screening performed at the fourth month were found to be higher than those of the infants in the control group (P<0.05 and P<0.05, respectively). CONCLUSION: Delaying umbilical cord clamping had a positive impact on the haematological parameters of infants. Clamping the cord at least one minute in birth can be performed to prevent the iron deficit anemia that could be seen during the first years of infants' lives.

The effect of labor dance on perceived labor pain, birth satisfaction, and neonatal outcomes.

OBJECTIVE: This research was conducted to determine the effects of labor dance on perceived birth pain, birth satisfaction, and neonatal outcomes. DESIGN: This is an experimental study. Data were collected under three groups during the active phase of labor: the dance practitioner midwife group (DPMG, comprising 40 pregnant women), the dance practitioner spouse/partner group (DPSG, comprising 40 pregnant women) and the control group (CG, comprising 80 pregnant women). SETTING: This study was conducted between 1 April 2017 and 31 October 2017 in Turkey. PARTICIPANTS: This study was administered on pregnant women volunteers with no risk during the active phase of labor. INTERVENTIONS: During the active phase, pregnant women in DPMG danced with the midwife; pregnant women in DPSG, on the other hand, danced with their spouses/partners throughout the active phase. When vaginal dilatation reached 4 cm and 9 cm, labor pain was measured by employing the visual analog scale (VAS). In the postpartum phase, newborn babies' first, fifth, and tenth minute Apgar scores and oxygen saturation levels were measured and registered. In the first hour after delivery, the Mackey Birth Satisfaction Scale was administered. CG, on the other hand, received only the routine procedures offered in the hospital. FINDINGS: The mean scores of VAS 1 and VAS 2 in DPSG and DPMG were lower than in CG. The fifth and tenth minute Apgar scores and the first, fifth, and tenth minute oxygen saturation levels of the newborns in the experimental groups, as well as the level of birth satisfaction, were significantly higher than in CG. KEY CONCLUSIONS: The study showed a positive effect of labor dancing on the labor process.

Effect of delivery method on sexual dysfunction.

AIM: The aim of our study was to determine the effect of delivery on sexual dysfunction in women. MATERIALS AND METHODS: This is a cross-sectional, descriptive study. A total of 142 women who had given birth in the past year, are nursing at the moment and has not experienced postpartum depression participated in the study. Sociodemographic questionnaire and the Female Sexual Function Index (FSFI) were used for data collection. Data were analyzed by chi-square (χ2) tests, independent sample t-test, and logistic regression. RESULTS: Among the participants, 45.8% had given birth via vaginal delivery and 54.2% via cesarean section and 67.7% were experiencing sexual dysfunction. Early postpartum stage (0-6 months) was determined to affect the FSFI score and to increase the risk (odds ratio = 0.24; 95% CI = 0.08-0.72; χ2 = 7.20; p < .05). A comparison of the FSFI scores of women in the vaginal delivery group for the first and second 6 months following delivery has yielded a statistically different score across all subdomains of FSFI scores, excluding desire (p < .05). CONCLUSION: When evaluated with a consideration of the pelvic floor, this study is important in demonstrating that vaginal delivery and cesarean section do not differ except for a short period of time in terms of sexual functioning.

Prevalence of anemia and related factors among women in Turkey.

OBJECTIVE: To determine the prevalence of anemia and related factors among women in Turkey. METHODS: This descriptive study was conducted at the outpatient clinics of the Department of Internal Medicine, Ege University Medical School. Randomly selected women were given questionnaires regarding their socio-demographic and obstetric characteristics. The data were coded and analyzed using SPSS version 17.0 software. Statistical analyses with 95% confidence intervals were considered to be significant if p<0.05. RESULTS: The study results showed an anemia prevalence of 27.8% in the study sample. Among all anemia diagnoses among the participants, 56.0% were determined to have iron deficiency, 37.1% iron-deficiency anemia, and 6.9% severe anemia. It was observed that anemia was detected among women who were 15-49 years of age (p<0.05), menstruating (p<0.05), had a history of Cesarean section (p<0.05), and had not entered menopause (p<0.05). Based on forward-stepwise-logistic regression analysis, the most important parameter was concluded to be age group, which was followed by menopausal status. CONCLUSIONS: The study results suggest that the anemia prevalence rate is specifically higher among women of reproductive age. To prevent anemia at a low cost, it is recommended to provide women with relevant information and well-planned interactive educational programs.

Assessment of cervical cancer risk in women between 15 and 49 years of age: case of Izmir.

BACKGROUND: The aim of the study was to determine risk factors for cervical cancer for women in Izmir. METHODS: This cross-sectional, descriptive field covered a population of 4319 women of reproductive age (15-49) (household registration in the Mukhtar's office-2007). A total of 1,637 women were included in the sample given a four-part questionnaire through face-to-face interview by visiting the women in their homes in order to determine socio-demographic factors, obstetric history, genital hygiene and the use of family planning methods. In addition, during the data collection process, the women were given group training in order to raise awareness of cervical cancer. The number and percentage distributions of the data were calculated. RESULTS: While the average age of the women was 31.9±9.77 (Min: 15.00-Max: 49.00), education level of 43.4% of them was elementary school only. It was determined that 70.3% of the women experienced at least one pregnancy, 71.0% had vaginal delivery and 75.9% used a contraceptive method. In the study it was determined that among the cervical cancer related risks vaginal delivery, vaginal lavage and having three or more pregnancies had the highest rates, while having sexual intercourse before 16 years of age and having more than one sexual partner constituted lower rates. The rate of the women who stated not having a smear in the last three years was 82.4%. CONCLUSIONS: Considering the case in terms of having Pap smear test, women's awareness on the risk factors and early diagnosis of cervical cancer was found to be low. Due to this reason, awareness of women has to be raised through education.

Determination of knowledge of Turkish midwifery students about human papilloma virus infection and its vaccines.

Human papilloma virus (HPV) is one of the most common sexually transmitted agents and its infection is the most established cause of cervical cancer. Midwives play a key position in the implementation of cervical cancer. This descriptive study aimed to determine the level of knowledge concerning HPV and HPV vaccination among 268 midwifery students. Data were collected between November 15 and 30, 2011, through a self-reported questionnaire. The mean age of participants was 20.75 ± 1.60. Among all students, 44.4% had heard of HPV, while 40.4% had heard of HPV vaccinatiob. The relationship between the midwifery student knowledge on HPV and HPV vaccine and their current educational year was significant (p=0.001). In conclusion midwifery students have moderate level of knowledge about HPV and its vaccine and relevant information should be included in their teaching curriculum.

Comparison of inflammatory breast cancer and noninflammatory breast cancer in Western Turkey.

OBJECTIVE: The study was aimed at investigating the clinical and biological features and survival outcomes of patients who were treated for metastatic inflammatory and noninflammatory breast carcinoma. SUBJECTS AND METHODS: One hundred and sixty-seven metastatic breast cancer patients were enrolled into this study and divided into two groups: inflammatory (n = 46) and noninflammatory (n = 121). The clinical and hormone receptor status, c-erbB-2, Ki-67, and p53 expression, based on the immunohistochemical staining patterns, were compared between the two groups. RESULTS: The inflammatory breast carcinoma group had a younger patient population, higher rate of adjuvant anthracycline therapy, number of lymph node metastases, rates of extranodal extension and c-erbB-2 overexpression than noninflammatory breast cancer patients (p < 0.05). With regard to survival, there were slightly better outcomes in the noninflammatory breast carcinoma group (30 months) compared to the inflammatory breast carcinoma group (23 months), but the difference was not statistically significant (p = 0.08). While survival results of p53-negative inflammatory and noninflammatory breast carcinoma patients were similar, p53-positive survival was significantly worse (p < 0.05) in inflammatory breast cancer carcinoma patients. CONCLUSION: Because of c-erbB-2 overexpression in inflammatory breast carcinoma patients, treatment options including trastuzumab could have given better survival outcomes. Survival of inflammatory breast carcinoma patients with a low p53 immunohistochemistry staining appeared similar to that for noninflammatory breast carcinoma. For this reason, new treatment options are needed especially in inflammatory breast carcinoma patients with high p53 positivity.

Eating habits, knowledge about cancer prevention and the HPLP scale in Turkish adolescents.

BACKGROUND: Nutritional status and healthy lifestyle are important factors not only in cancer etiology but also for prevention efforts. A good nutritional status contributes to a healthy life with high economic, social and cultural level. Unhealthy eating habits are part of risky behavior seen from adolescence. The present study was therefore carried out to determine eating habits, level of knowledge about cancer prevention and behavior of a group of adolescents. METHODS: Data were collected using questionnaire covering eating habits and knowledge of adolescents on prevention from cancer, and special scale (HPLP) to determine the related behavior. Three hundred sixty six of 390 students volunteered for study. RESULTS: Eating habits and the level of cancer prevention knowledge were similar for both genders, except for the exercise issue. The mean total points of adolescents in the Health Promotion Behavior and Subscales was 113,63. While spiritual growth had the highest score in HPLP subscale, exercise had a minimal score. Exercise was the only HPLP subscale with a statistically significant difference between male and female genders. CONCLUSIONS: Although they have some information, the adolescents surveyed did not have preventive skills relative to their practical life. In general in order to ensure cancer prevention and a healthy life style social, cultural and sportive activities should be encouraged and educational programmes supporting these goals should be designed and applied for all stages of life, starting in early childhood.