Abstract Background: Mistreatment of women during childbirth is a global health challenge. Maternity healthcare providers have key roles in influencing women’s birth experiences. This study aimed to assess knowledge, attitudes and practices of maternity healthcare providers about mistreatment during labour and childbirth in public hospitals in Tehran, Iran. Methods: This cross-sectional study was conducted from October to December 2021 in five public hospitals in Tehran. All maternity healthcare providers (obstetricians, midwives) and students were invited to the study. Data were collected using a questionnaire consisting of four sections: socio-demographic characteristics (11 items), knowledge (11 items), attitudes (13 items), and practices (14 items) about mistreatment. Knowledge, attitude, and practice levels were determined using Bloom’s cut off point. Data were analyzed using descriptive and analytical statistics at a significant level of p < 0.05. Results: A total of 255 individuals participated (response rate: 94.5%). Most participants (82.7%) had poor knowledge about physical abuse, verbal abuse, poor rapport between women and providers, and failure to meet professional standards of care. Most participants (69.4%) were alright with physical abuse, verbal abuse, and discrimination. Self-reported practices of different types of mistreatment were not common and only 3.1% of the participants were in moderate level. However, shouted at women, applied fundal pressure, and slapped the thighs during birth were categories used by providers. Age, profession, field of study, employment status, monthly income, work experience, numbers of night shifts, and training history were significantly related with the participants’ knowledge, attitudes, and practices about mistreatment. Conclusions: Knowledge, attitudes, and practices of our participants were poor about maternity mistreatment. Findings of our study have important implications for program planners and decision makers on development of effective interventions to reduce mistreatment during labour and childbirth in Iran. These interventions should include designing and implementing continuing education courses and revising the educational curriculums to increase knowledge, strengthen positive attitudes, and modify practice of maternity healthcare providers, overcoming staff shortages, paying staff fairly, establishing support culture for mother-centered and respectful care, and increasing quality of maternity care.
Background: Several guidelines have been published regarding intrapartum oxytocin infusion for labor induction or augmentation; however, many of them lack specificity. Objectives: Therefore, this study aimed to assess oxytocin dose administered during labor and evaluate its association with maternal characteristics and short-term perinatal outcomes. Methods: This retrospective cross-sectional study was conducted on 162 term pregnant women who were admitted to the labor ward for vaginal delivery in two academic hospitals during 2021 - 2022. Maternal demographic features, obstetric and medical history data, labor process details (initial Bishop score, membrane status on admission and at the time of labor induction or augmentation, latent and active phase duration, oxytocin dose, delivery mode, and neonatal outcomes) were obtained and recorded. Participants were divided into two main groups based on the intrapartum oxytocin dose, and the desired outcomes were reported and compared between the groups. Results: The median maternal age was 28 years (range: 16 - 46). The median oxytocin dose administered during labor induction was 10 mU/min (range: 2.5 - 25 mU/min). Oxytocin dose was significantly correlated with gestational age (P < 0.001), cervical dilation and effacement (P < 0.001), fetal head station (P < 0.001), cervical consistency (P < 0.001), and cervical Bishop score before labor induction (P < 0.001). The cervical dilation at the time of membrane rupture was also positively correlated with the intrapartum oxytocin dose (P = 0.013). Higher gestational age was correlated with a higher required oxytocin dose (P < 0.001). The cesarean rate was 22.8% in the study population, and it was positively correlated with intrapartum oxytocin dose (P < 0.001). Conclusions: The cervical Bishop score and its components, except for cervical position, were correlated with the intrapartum oxytocin dose. In other words, the less favorable the cervix, the higher the likelihood of requiring higher doses of oxytocin and consequently experiencing a longer duration of labor. Additionally, the cesarean rate was higher in those who needed oxytocin doses of more than 10 mU/min; however, short - term neonatal outcomes were not different.
Infertility is a significant problem influencing many couples. Our purpose was to assess the field of infertility in Obstetrics and Gynecology from 1955 to 2022 reviewing 3575 documents found in the Web of Science database. Most articles were in the areas of Reproductive Biology, Fertility, Endometriosis & Hysterectomy, and Chromosome Disorders. We found publication has increased dramatically since 1989. Agarwal, Thomas, and Sharma; United States, England, and Canada; Fertility and Sterility, Human Reproduction, and AJOG were the most-cited authors, countries, and journals, respectively. We discovered five substantive clusters: male infertility factors, female infertility factors, causes and treatment of infertility, the consequence of infertility, and assisted reproductive techniques. Using bibliometric review (Co-citation analysis) six research areas were found: semen analysis and sperm morphology, regional differences in the psychological effects of infertility, unexplained infertility, endometriosis, diagnosis and treatment of infertility, and polycystic ovary syndrome. Despite advances in understanding infertility, further research is needed.
Objective: To assess maternal perception of fetal movement types and its association with maternal factors in normal pregnancies with good pregnancy outcome.Methods: This study was conducted on 729 normotensive singleton pregnant women with good pregnancy outcome who had referred for prenatal visit. After completing a questionnaire, the participants were asked to count fetal movements for 1 h/3 times/day. They were also asked to identify the type of fetal movement: general body movement (GBM) (rolling and stretching/strong), isolated limb movement (ILM; simple flutter or kicks/weak), trunk movement (TM) (strong jab, startle/strong), or hiccup movement (HM) (high frequency and rapid/weak). All the participants were followed till delivery to exclude pregnant women with preterm birth and/or small for gestational age from the study.Results: 90.8% of participants perceived GBM, which was independently associated with maternal unemployment (OR = 2.28, 95% CI = 1.18–4.4). 74.2% of participants perceived TM, which was associated with multiparity (OR = 1.69, 95% CI = 1.18–2.4). 86.3% perceived ILM, which was independently associated with maternal unemployment (OR = 2.67, 95% CI = 1.53–4.68), lower gestational age (OR = 2.17, 95% CI = 1.28–3.67), perception of fetal movements at night (OR = 2.05, 95% CI = 1.27–3.32), and multiparity (OR = 1.68, 95% CI = 1.04–2.72). 36.6% perceived HM, which was independently associated with higher gestational age (OR = 1.71, 95% CI = 1.2–2.44).Conclusions: Most pregnant women could discriminate changes in fetal movement type that follow a general pattern through the third gestational trimester, however this can be affected by maternal employment, parity and time of perception.
Preterm birth is a worldwide tragedy with a high incidence. Several medications are used to inhibit acute preterm labor, but tocolysis by these medicines do not extend pregnancy beyond 1-2 days.The purpose of this study was to discover new medications from plant extracts or their active compounds which inhibit the uterine contractions in order to treat preterm labor.PubMed, Google Scholar, Scopus and IranMedex databases were searched up to 1st February 2012 with the most relevant keywords.All studies in which plant extracts or their active compounds inhibited the uterine contractions both in vivo and in vitro were included.Of initial search, 259 records were reviewed and finally 72 were included among which only 31 studies isolated an active compound from the plants extract belonging mostly to classes of flavonoids and terpenes classes. Flavonoids have been known as a phosphodiesterase (PDE) and a protein kinase C (PKC) inhibitor. It seems that the uterolytic activity of reviewed flavonoids such as naringenin, kaempferol and quercetin, especially in a calcium free solution, was via these inhibitory pathways.Laboring uterus response to dissimilar tocolytics differs from that of non-laboring uterus. In order to find a treatment for preterm labor, future studies should focus on the laboring uterus and also determine the structure activity relationship of the different tocolytics. This systematic review was registered to the PROSPERO with code number CRD42015027551.
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