The Effectiveness of Dialectical Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial.

Objective: Traumatic childbirth may expose mothers to physical and psychological postpartum disorders. The reduced rate of exclusive breast feeding is an essential consequence of this problem. The goal of this study was to see if dialectical behavioral therapy could help with the onset and duration of exclusive breast feeding after a traumatic delivery. Method : This clinical trial study included, 210 primiparous women with traumatic vaginal births were admitted to Bahar hospital in Shahroud. A standard protocol was designed and administered. The group allocation imbalance happened by chance and was averted by utilizing block randomization with a size of four and sequentially numbering the intervention or control groups with a sealed concealed envelope Participants in the intervention group had one individual session and four group counseling sessions by the researcher, while the control group participants obtained a routine care. Breast feeding self-efficacy was measured using a related questionnaire before the intervention, six and 12 weeks postpartum. Exclusive breast feeding was determined using a related form at the end of each month until the fourth month. Results: The outcome of repeated measure ANOVA Before the intervention, based on the greenhouse geisser test indicated no statistically significant difference in breast feeding self-efficacy (P = 0.07) or infant weight between the two groups. (P = 0.98). Nevertheless, a statistically significant difference between the mean score of breast feeding self-efficacy and infant's weight was discovered by a post hoc test utilizing the Bonferroni correction, (P = 0.001) between the two groups after the intervention. Therefore, in the intervention group, the level of exclusive breast feeding was higher than in the control group, and four months after birth, more infants in the intervention group were exclusively breastfed (58% vs 32%) (P < 0.001). The analysis of data using the GEE model showed that the odds of adherence to exclusive breast feeding in the intervention group were 3.4 (0.95 CI: 2.04-5.7). Conclusion: Dialectical behavior therapy is a powerful tool for minimizing the negative features of traumatic childbirth and increase the success of breast feeding mothers. Therefore, it can be used as a supportive method for mothers.

Effect of Continued Support of Midwifery Students in Labour on the Childbirth and Labour Consequences: A Randomized Controlled Clinical Trial.

INTRODUCTION: Childbirth experience is a process throughout women's life and the most important consequence of labour. Support is the key factor to have a positive experience of childbirth. In order to improve and reduce the stress and anxiety levels in women during labour and cope with the childbirth pain, the emotional, physical and educational support of doulas can be used. AIM: This study was aimed to evaluate the effect of continued support of midwifery students in labour on the childbirth and labour consequences. MATERIALS AND METHODS: The present study was conducted using a randomized controlled clinical trial design on 100 pregnant women referred to the maternity ward at Fatemieh Hospital, Shahroud, Iran. The participants were assigned to the supportive or non-supportive group based on allocation sequence using a randomized block design and table of computer-generated random numbers prior to beginning the study. Supportive care was provided by the trained midwifery students. Childbirth and labour consequences were analysed by chi-square test, Fisher-exact test, independent t-test, Mann-Whitney U-test using SPSS-21 software. RESULTS: The results showed a significantly lower duration of the first stage of labour in the supportive group, as compared to that in the non-supportive group (p <0.001). Moreover, Apgar scores in the supportive group, compared to those in the non-supportive group, significantly increased at minutes 1 and 5 (p <0.001 and p = 0.04, respectively). CONCLUSION: The findings of this study showed that the supportive care provided by the midwifery students shortens duration of the first stage of labour and improves the Apgar scores in the first and fifth minutes.

Effect of Massage Therapy on Duration of Labour: A Randomized Controlled Trial.

INTRODUCTION: Massage is an old technique that is widely used in childbirth and can decrease the childbirth pain by reducing the adrenaline and noradrenaline and increasing the endorphins and oxytocin and reduce the childbirth duration by increasing the uterine contractions. Therefore. AIM: This study is aimed to evaluate the effect of massage therapy on the duration of labour. MATERIALS AND METHODS: The present study was performed as randomized controlled clinical trial method on 100 pregnant women referred to maternity ward in Fatemieh Hospital, Shahroud. Subjects with inclusion criteria and who were interested to participate in the study were placed in one of the test or control groups based on pre-specified sequence. Questionnaires were completed in several stages. Data analysis was conducted using chi-square test, Fisher's exact test, independent t-test, Mann-Whitney test and multivariate linear regression in SPSS-21software. In data analysis, p < 0.05 was considered significant. RESULTS: The results of multivariate linear regression showed that the duration of the first and second stage labour in the massage receiving group is significantly decreased compared to the test group (p= 0.004 and p= 0.02, respectively). In addition, the Apgar scores at minutes 1 and 5 in test group is significantly increased compared to control group (p <0.0001). CONCLUSION: The findings of this study showed that massage therapy during labour will lead to shortening of the first and second stage labour duration and improve Apgar scores at the first and fifth minutes. By shortening the duration of labour, pregnant women tend to have more normal vaginal delivery.

Evaluation of the alert line of partogram in recognizing the need for neonatal resuscitation.

BACKGROUND: A major problem of the first moments of childbirth, especially in "prolonged labor," is perinatal asphyxia which necessitates neonatal resuscitation. This study aimed at evaluating the alert line of the partogram in recognizing the need for neonatal resuscitation 20-30 s after delivery. MATERIALS AND METHODS: 140 full-term pregnant women were kept under surveillance through using a partogram. In order to decide on the onset of resuscitation, the three indicators of fetal respiration, heart rate, and skin color were used 20-30 s after delivery. The findings from the evaluation of fetal conditions were compared to the position of the ultimate cervical dilatation graph to the alert line of the partogram, and through using appropriate statistical procedures, sensitivity, specificity, and positive and negative prediction values of the alert line to recognize the need for neonatal resuscitation were computed. RESULTS: There was a significant relationship between the need for neonatal resuscitation within 20-30 seconds after delivery and the graph of the cervical dilatations on the partogram (P = 0.001). The indices of the alert line for predicting the need for resuscitation 20-30 s after birth had a sensitivity of 97.5%, specificity of 80.2%, positive prediction value of 97.2%, and negative prediction value of 98.7%. CONCLUSIONS: In mothers who had normal vaginal delivery, with normal fetal heart rate, and with no oxytocin administration or omniotomy, the alert line showed appropriate sensitivity, specificity, and negative prediction value. So, it can assist in predicting the necessity of action for neonatal resuscitation 20-30 s after delivery.

Prevalence and risk factors of varicose veins among female hairdressers: a cross sectional study in north-east of Iran.

BACKGROUND: Venous diseases including varicose veins and chronic venous insufficiency are one of the most important pathogenic factors worldwide. High prevalence of varicose veins and its complications is an emerging problem in the twenty-first century. This study aimed to determine the prevalence and associated risk factors of varicose veins in female hairdressers in Shahroud, north of Iran in 2012. METHODS: In this cross-sectional study, 197 employed hairdressers, licensed by the Health Department of Shahroud University of Medical Sciences, Iran, were studied. Standard physical examination was used to check the condition of varicose veins of the lower extremities of participants. Data were collected by demographic information form. Proportional odds model for ordinal logistic regression was used to assess the relationship between risk factors and status of varicose disease in subjects. RESULTS: Prevalence of varicose veins was 47.7%. Varicose veins were significantly associated with age (OR=1.08; 95% CI: 1.03, 1.13); family history of varicose disease (OR=1.99; 95% CI: 1.03, 3.82), blood pressure (OR=4.41; 95% CI: 1.63, 11.90); and duration of standing (OR=2.34; 95% CI: 1.05, 5.22). CONCLUSIONS: Varicose veins in the legs of female hairdressers had a high prevalence, and it was associated with increasing age, family history of varicose disease, high blood Pressure, and prolonged standing.