Zeinab Zarabadipour, H. Pakniat, M. R. Niaraki, N. Azh
Postpartum hemorrhage (PPH) refers to the blood loss of more than 500 cc after completing the third stage of labor (1,2). Nonetheless, this estimation is generally only half of the actual blood loss based on the evidence (3). In addition, PPH is known as one of the major reasons for maternal mortality (4). In other words, 28% and 10% of maternal deaths in developing and developed countries are related to PPH, respectively (2,5,6). Further, PPH is characterized by a 10% drop in hematocrit levels and the need for postpartum blood transfusions (7). It could lead to hypovolemic shock, disseminated intravascular coagulation, and acute renal failure (8, 9). Treatments should address the causes of PPH. The possible causes of uterine postpartum bleeding are trauma, retained placenta, and uterine atony (10-12). Uterotonic drugs such as oxytocin, ergo derivatives, and misoprostol are used as the first line of treatments for PPH in Iran (7). Except for uterine massage, the other treatments of PPH have disadvantages on the mother (e.g., headache, vomiting, the elevation of blood pressure, and the like) or breastfeeding (1,13). Consequently, preventing PPH is highly important. Reducing hemorrhage is usually implemented by the routine active management of placenta delivery by drug using to contract the uterus such as oxytocin (11). Today, ice therapy is used as one of the new methods for the treatment of many diseases, even cancer by lessening pain, inflammation, and vasoconstriction (14). It can be one of the useful methods for preventing uterine atony and PPH (15). Based on the evidence, placing an icebag on the lower abdomen for cooling the uterus is one of the standard non-pharmacological prophylactic strategies to prevent PPH in low-risk women in Japan (15), and its argument is that cold compresses would contract the myometrium and decreases the amount of blood flow (16). In contrast, some studies have reported conflicting results about the effectiveness of icebag in preventing uterine atony in normal delivery (16,17). This study was designed to reduce maternal deaths as an important factor for children’s growth, specifically in poor countries (18) by using available methods such Abstract Objectives: Using uterotonic drugs to prevent postpartum hemorrhage is recommended in the health centers. However, the related studies are contradictory, thus the evaluation of non-invasive methods with minimal side-effects such as icepack would be useful. Traditionally, icepack has been applied, along with drugs in most deliveries in postpartum hemorrhage (PPH) in Iran although it has not evidenced yet. Therefore, the present study aimed to evaluate the effect of the icepack on blood loss. Materials and Methods: This study was a randomized controlled trial. The sample size included 58 women including 29 intervention and 29 control groups. The intervention group benefited from an icepack placed on the lower abdomen 2 hours after placental delivery while the control group
{"title":"Comparison of the Effect of Cooling the Lower Abdomen and Oxytocin on Postpartum Blood Loss in Vaginal Delivery","authors":"Zeinab Zarabadipour, H. Pakniat, M. R. Niaraki, N. Azh","doi":"10.15296/IJWHR.2021.19","DOIUrl":"https://doi.org/10.15296/IJWHR.2021.19","url":null,"abstract":"Postpartum hemorrhage (PPH) refers to the blood loss of more than 500 cc after completing the third stage of labor (1,2). Nonetheless, this estimation is generally only half of the actual blood loss based on the evidence (3). In addition, PPH is known as one of the major reasons for maternal mortality (4). In other words, 28% and 10% of maternal deaths in developing and developed countries are related to PPH, respectively (2,5,6). Further, PPH is characterized by a 10% drop in hematocrit levels and the need for postpartum blood transfusions (7). It could lead to hypovolemic shock, disseminated intravascular coagulation, and acute renal failure (8, 9). Treatments should address the causes of PPH. The possible causes of uterine postpartum bleeding are trauma, retained placenta, and uterine atony (10-12). Uterotonic drugs such as oxytocin, ergo derivatives, and misoprostol are used as the first line of treatments for PPH in Iran (7). Except for uterine massage, the other treatments of PPH have disadvantages on the mother (e.g., headache, vomiting, the elevation of blood pressure, and the like) or breastfeeding (1,13). Consequently, preventing PPH is highly important. Reducing hemorrhage is usually implemented by the routine active management of placenta delivery by drug using to contract the uterus such as oxytocin (11). Today, ice therapy is used as one of the new methods for the treatment of many diseases, even cancer by lessening pain, inflammation, and vasoconstriction (14). It can be one of the useful methods for preventing uterine atony and PPH (15). Based on the evidence, placing an icebag on the lower abdomen for cooling the uterus is one of the standard non-pharmacological prophylactic strategies to prevent PPH in low-risk women in Japan (15), and its argument is that cold compresses would contract the myometrium and decreases the amount of blood flow (16). In contrast, some studies have reported conflicting results about the effectiveness of icebag in preventing uterine atony in normal delivery (16,17). This study was designed to reduce maternal deaths as an important factor for children’s growth, specifically in poor countries (18) by using available methods such Abstract Objectives: Using uterotonic drugs to prevent postpartum hemorrhage is recommended in the health centers. However, the related studies are contradictory, thus the evaluation of non-invasive methods with minimal side-effects such as icepack would be useful. Traditionally, icepack has been applied, along with drugs in most deliveries in postpartum hemorrhage (PPH) in Iran although it has not evidenced yet. Therefore, the present study aimed to evaluate the effect of the icepack on blood loss. Materials and Methods: This study was a randomized controlled trial. The sample size included 58 women including 29 intervention and 29 control groups. The intervention group benefited from an icepack placed on the lower abdomen 2 hours after placental delivery while the control group","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"22 5 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2020-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82301693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Safdarian, A. Aleyasin, M. Aghahoseini, Parvaneh Lak, Sedigheh Hoseini Mosa, F. Sarvi, A. Mahdavi, Aida Najafian, Parvin Falahi, S. Khazaei
Objectives: The aim of the present study was to evaluate the effect of the intrauterine administration of platelet-rich plasma (PRP) before embryo transfer (ET) on pregnancy outcomes in women with repeated implantation failure (RIF). Materials and Methods: This randomized controlled trial included 120 RIF women who were candidates for frozen-thawed ET. In the PRP group (n=60), the intrauterine infusion of 0.5 mL PRP was performed 48 hours before ET, and the control group (n=60) underwent ET without intrauterine administration. Results: The implantation rate (28% vs. 11.9%, P<0.001), clinical pregnancy (51.6% vs. 26.6%, P=0.005), and live birth rate (58.3% vs. 28.3%, P=0.001) in PRP group were significantly higher compared to the control group. Based on the results, there was no significant difference with regard to miscarriage (12.5% vs. 12.9%, P=0.97) and multiple pregnancy rate (0.133% vs. 0.05%, P=0.11) between the two groups. Finally, preterm delivery was significantly higher in the PRP group (P<0.001). Conclusions: According to this study, the result revealed that PRP is effective in the improvement of pregnancy outcomes in RIF patients. Further studies are needed to identify the group of patients who would benefit from this intervention.
目的:本研究的目的是评估胚胎移植(ET)前宫内给予富血小板血浆(PRP)对反复着床失败(RIF)妇女妊娠结局的影响。材料与方法:本随机对照试验纳入120例冷冻解冻ET候选者的RIF妇女。PRP组(n=60)在ET前48小时宫内输注0.5 mL PRP,对照组(n=60)行ET,不宫内给药。结果:PRP组着床率(28% vs. 11.9%, P<0.001)、临床妊娠率(51.6% vs. 26.6%, P=0.005)、活产率(58.3% vs. 28.3%, P=0.001)显著高于对照组。结果显示,两组流产率(12.5%比12.9%,P=0.97)、多胎妊娠率(0.133%比0.05%,P=0.11)差异无统计学意义。最后,PRP组的早产率显著高于对照组(P<0.001)。结论:本研究结果显示PRP可有效改善RIF患者妊娠结局。需要进一步的研究来确定从这种干预中受益的患者群体。
{"title":"Efficacy of the Intrauterine Infusion of Platelet-Rich Plasma on Pregnancy Outcomes in Patients With Repeated Implantation Failure: A Randomized Control Trial","authors":"L. Safdarian, A. Aleyasin, M. Aghahoseini, Parvaneh Lak, Sedigheh Hoseini Mosa, F. Sarvi, A. Mahdavi, Aida Najafian, Parvin Falahi, S. Khazaei","doi":"10.15296/ijwhr.2022.08","DOIUrl":"https://doi.org/10.15296/ijwhr.2022.08","url":null,"abstract":"Objectives: The aim of the present study was to evaluate the effect of the intrauterine administration of platelet-rich plasma (PRP) before embryo transfer (ET) on pregnancy outcomes in women with repeated implantation failure (RIF). Materials and Methods: This randomized controlled trial included 120 RIF women who were candidates for frozen-thawed ET. In the PRP group (n=60), the intrauterine infusion of 0.5 mL PRP was performed 48 hours before ET, and the control group (n=60) underwent ET without intrauterine administration. Results: The implantation rate (28% vs. 11.9%, P<0.001), clinical pregnancy (51.6% vs. 26.6%, P=0.005), and live birth rate (58.3% vs. 28.3%, P=0.001) in PRP group were significantly higher compared to the control group. Based on the results, there was no significant difference with regard to miscarriage (12.5% vs. 12.9%, P=0.97) and multiple pregnancy rate (0.133% vs. 0.05%, P=0.11) between the two groups. Finally, preterm delivery was significantly higher in the PRP group (P<0.001). Conclusions: According to this study, the result revealed that PRP is effective in the improvement of pregnancy outcomes in RIF patients. Further studies are needed to identify the group of patients who would benefit from this intervention.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"17 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82887806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Dargahi, Zahra Bahrami-asl, A. Dorosti, F. Mallah
Objectives: The coronavirus disease 2019 (COVID-19) pandemic increased the severity of the psychological problems of pregnant women, which can have severe consequences. The current study aimed to investigate the effects of COVID-19 on the stress, anxiety, depression, self-care behaviors, and the quality of the life of women at the risk of preterm labor. Materials and Methods: The current descriptive-analytical study was conducted from March 20, 2020 to June 21, 2020. In total, 88 women who were at risk of preterm labor in Tabriz (Iran) participated in this study. The association between the Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire, Hart’s self-care behaviors during pregnancy, and SF-36 (for the quality of life) were investigated using Pearson and Spearman correlations in SPSS 20 at P<0.05. Results: Based on the results of the Pearson correlation test, stress and self-care scores (P=0.003, r=-482), self-care and depression scores (P=0.006, r=-396), as well as anxiety and self-care scores (P=0.001, r=-511) had significant inverse linear correlations. According to the regression model, only the stress variable had a significant association with self-care (P=0.039). There was a positive and significant (P<0.05) correlation between self-care behaviors and three dimensions of marital quality including physical function, mental function, and the feeling of pain and discomfort. Conclusions: The results of the current study showed the significant inverse association between self-care and depression and stress and anxiety during pregnancy in women at risk of preterm labor during the COVID-19 pandemic. Low quality self-care behaviors also led to a decrease in the quality of life of these women.
{"title":"Investigating the Effects of COVID-19 Pandemic on Stress, Anxiety, Depression, Self-care Behaviors, and the Quality of Life of Women at Risk of Preterm Labor","authors":"R. Dargahi, Zahra Bahrami-asl, A. Dorosti, F. Mallah","doi":"10.15296/ijwhr.2022.09","DOIUrl":"https://doi.org/10.15296/ijwhr.2022.09","url":null,"abstract":"Objectives: The coronavirus disease 2019 (COVID-19) pandemic increased the severity of the psychological problems of pregnant women, which can have severe consequences. The current study aimed to investigate the effects of COVID-19 on the stress, anxiety, depression, self-care behaviors, and the quality of the life of women at the risk of preterm labor. Materials and Methods: The current descriptive-analytical study was conducted from March 20, 2020 to June 21, 2020. In total, 88 women who were at risk of preterm labor in Tabriz (Iran) participated in this study. The association between the Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire, Hart’s self-care behaviors during pregnancy, and SF-36 (for the quality of life) were investigated using Pearson and Spearman correlations in SPSS 20 at P<0.05. Results: Based on the results of the Pearson correlation test, stress and self-care scores (P=0.003, r=-482), self-care and depression scores (P=0.006, r=-396), as well as anxiety and self-care scores (P=0.001, r=-511) had significant inverse linear correlations. According to the regression model, only the stress variable had a significant association with self-care (P=0.039). There was a positive and significant (P<0.05) correlation between self-care behaviors and three dimensions of marital quality including physical function, mental function, and the feeling of pain and discomfort. Conclusions: The results of the current study showed the significant inverse association between self-care and depression and stress and anxiety during pregnancy in women at risk of preterm labor during the COVID-19 pandemic. Low quality self-care behaviors also led to a decrease in the quality of life of these women.","PeriodicalId":14346,"journal":{"name":"International Journal of Women's Health and Reproduction Sciences","volume":"7 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82505487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}