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A great number of drugs have been used to inhibit preterm labor but none has been completely effective. This study has compared. The efficacy of Indomethacin and Mg-Sulfate for delaying delivery in preterm labor. In this randomized controlled trial study 120 pregnant women with intact membrane and preterm labor, cervical dilatation at least 2 cm were studied and if they had premature rupture of membranes, gestational age less than 24 or more than 32 weeks, complete cervical dilatation, severe hemorrhage, chorioamnionitis and triple or higher order gestation excluded from study. Subjects are randomly managed with Indomethacin 25 mg every 6 hours for 4 doses or Mg-Sulfate initially 4 gr/IV followed by 2 gr/h IU infusion until uterine activity diminished or decrease. The success of management was considered as either reduce or stopping the uterine contractions, and no increase in cervical dilatation or effacement. Statistical analysis were performed with Chi-square and T-test. The 2 groups understudy had the same inducer maternal matched maternal age, gestational age, parity, dilatation and effacement at initiation of study, frequency of uterine contractions. Delivery was delayed 24 hr in 66.6% and 48 hr in 58.3% by Mg-Sulfate, also delayed 24 hr in 40% and 48hr in 35% by Indomethacin (P<0.0001). No complications were reported in each group. Mg-Sulfate is more effective than Indomethacin in delaying preterm labor.

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Background and objective: To determine the effects of duration of second stage of labor on the newborn’s Apgar score in primigravida women admitted in Fatemeh Zahra Hospital. Materials and methods: Case control study on the 120 primigravide women (40 women with a duration second stage more than 2 hours and 80 women with a duration second stage less than 2 hours). The criteria such as pregnancy history, quality of prenatal care and socioeconomical status were the same for the both groups. Patients with preterm labor, cesarean section, multiple pregnancy, malpresentation, malformation and receipt sedation of narcotic less than one hours to baby’s birth were excluded. From this study statistically analysis had done by Chi-square and Z-test and person’s coefficient correlation. Results: Statistically significant relationship was observed between the age of the mothers and the duration second stage of labor, so that, the mothers with more than 30 years of age had prolonged duration in second stage of labor (P<0.05). More than half of the sample population had used oxytocin for augmentation of labor, which this difference was significant (P<0.05). Conclusion: The different studies showed that the duration of second stage of labor was significantly associated with fetal lactate and low Apgar score less than 7 at birth, but didn’t have any role in five-minute low Apgar scores and neonate morbidity.

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Background & Objective: In most cases, labor is accompanied with pain. Thus, decreasing labor pain is viewed as an important duty of midwives. In this regard, decreasing the duration of labor can be of value. Customarily midwives use drugs to shorten the duration of labor, but the effectiveness of some of the drugs has not been studied systematically. Among such widely used drugs are Atropine, Hyoscine and Promethazine. Materials & Methods: In this interventional research, the effects of these drugs on labor duration were studied. 160 multiparous women in active phase of labor were selected. 120 of the above women had been administered only one of the above-mentioned drugs and no drug had been administered to the remaining 40. According to the type of drug administered, the women formed three groups, with the women with no drugs administered making the 4th groups. Results: The 4 groups did not have any statistically significant difference with regard to variables such as age, occupation, education, infant sex, gestational age, infant birth weight, parity, fetal head position, and cervical dilatation at the beginning of our observation. The main result was that, the mean rate of cervical effacement (P<0.05) and descent of fetal head was not significantly different in the 4 groups. But the mean rate of cervical dilatation (P<0.05) was significantly different in the 4 groups. In women who had been given these drugs, the mean rate of cervical dilatation was lower than the women who had not been given any drugs. The mean duration of the first stage of labor was significantly different in 4 groups (P<0.05). With regard to the mean duration of the first stage of labor, it was also longer in women who had been given these drugs. The mean rate of 2nd stage of labor and 3rd stage of labor was not significantly different in the 4 groups. Conclusion: The use of these drugs can reduce the rate of labor progress and increase the risk of complications, it may also be a waste of prescribed drugs.

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Background & Objective: Preterm infants have less iron storage compared with the term one. Due to rapid growth they need more iron during infancy. This study was designed to evaluate the effect of early iron supplementation on hematologic indices and incidence of iron deficiency anemia in preterm infants. Materials & Methods: This experimental study was done on 20-days-old preterm breast-feed infants referred to the Gorgan-North of Iran primary health care services for vaccination, without any underline disease or growth retardation during 2005. They were divided to two groups (n=15 in each) and a questionnaire was completed for each case. Iron drop (2mg/kg) was given in the interventional group. Iron deficiency anemia was assesed in all sample T-student test and chi-square were used to analyze the independent variables and comparing the hematologic indices, after entering in SPSS-13 software and testing the normal distribution with komologrof-smearnoff test. Relative risk index (RR) was used to compare the two groups. Results: The relative risk of iron deficiency anemia in the interventional group was 0.4 folds [RR=0.4,CI %95 for RR=(0.091,1.749)]. No significant difference was seen between the two groups. Conclusion: The finding of this study showed that iron drop supplementation for preterm infant prevent the iron defeciency anemia, although this observation was not significant.

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Background and Objective: Maternal position during the second stage of labor can be considered to be an intervention in the natural course of labor. This study aimed to establish the effect of sitting versus lithotomic position on duration of second stage of labor, preneal truma and neonatal outcome.

Materials and Methods: This clinical trial study was done on 110 term nuliparuse women with normal conducte of labor in second stage, which divided randomly in sitting position, (n=55) and lithotomic position (n=55) in teaching hospital in Yazd, Iran during 2005-06. Duration of second stage, Perinea trauma and first 5 minutes APGAR evaluated and compared in two groups. Data analyzed by SPSS-11.5 with T student and Chi square tests. P<0.05 was significant.

Results: Duration of second stage of labor was 34 and 42 minutes in sitting and lithotomic position respectively (P<0.05). Perinea damage was seen in 15 (27.3%) and 24 (43.6%) women of sitting and lithotomic position respectively (P<0.05). No significant difference existed between the groups in neonatal first 5 minutes APGAR.

Conclusion: This study showed that sitting position reduce second stage duration and perinea trauma versus lithotomic position.

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Background and Objective: Respiratory distress syndrome is the most important lung problem during the neonatal period. Although the benefits of antenatal corticosteroids in neonates with a gestational age of less than 34 weeks have been demonstrated, the benefit of this treatment in neonates with higher gestational age is dubious. This study investigated the effect of Betamethasone on respiratory distress syndrome among neonates with gestational age of 35-36 weeks. Materials and Methods: This double blind randomized controlled trial study was done on 200 pregnant women who were of high risk for preterm labor in 35-36 weeks of gestation in Sanandaj city-Iran during 2007. 200 pregnant women randomly divided into treatment and placebo groups were received intramuscularly Betamethasone (12 mg/kg/BW twice) and normal saline, respectively. Data including age of mother, sex, weight, respiratory distress syndrome and newborns admission in hospital were recorded for each subject. Data was analyzed by using two-tailed T, Mann-Whitney, chi-square and Fisher exact tests. Results: There were no difference among two groups about age of mother, sex and weight of newborns. There were 8 (8%) and 20 (20%) newborns with respiratory distress syndrome in case and controls, respectively (P<0.01). Admission in hospital was 16% in Betamethasone group vs 28% in normal saline group (P<0.04). Conclusion: The study demonstrated that exposure to antenatal Betamethasone with 12mg/kg/BW twice between 35 and 36 weeks of gestation is associated with a significant reduction in the rate of respiratory distress syndrome.

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Background and Objective: Anesthetic agents effect on pregnancy in operating room personnel is a challenge in anesthesiology. This study was carried out to determined pregnancy complications among hospital operating room personals in Fars province – Iran.

Materials and Methods: In this case-control study, 122 women working in operating rooms of governmental Fars province hospitals during their pregnancies with different jobs considered as case group. 122 women working in internal and pediatric wards considered as control group. The history of pregnancy complications including infertility, abortion, preterm labor, fetal death, neonatal death and low birth weight obtained using questionnaire. Data were analyzed using SPSS-15 software and Chi-Square test.

Results: The incidence of abortion was 19.8% and 16% in case and control group respectively, this difference was not statistically significant. Infertility was significantly higher (8.2% versus 2.5%) in case group than control group (P<0.05). No significant differences in incidence of preterm labor, fetal death, neonatal death and low birth weight were seen between two groups.

Conclusion: This study showed that the incidence of pregnancy complications is similar between women working in operating room and those working in other hospital wards but the prevalence of infertility is higher in operating room personnel than those of other wards.

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Background and Objective: Overweight, obesity and ethnicity are effective factors on pregnancy complications. This study was conducted to determine the relationship between third tri-mester body mass index (BMI) with maternal and neonatal complications. Methods: This descriptive analytic study was conducted on 551 pregnant women in third tri-mester with Fars, Sistani and Turkman ethnicities in Sayad Shirazi teaching hospital in Gorgan, north of Iran during 2012. BMI calculated at the time of labor admission and the subjects categorized into three groups of normal / underweight, overweight and obese. Results: The mean of maternal age among Fars, Sistani and Turkman ethnic groups were 26.5±5.5, 24.6±5.3 and 26.2±5.2 years, respectively. The mean of gestational age among Fars, Sistani and Turkman ethnic groups were 38.4±2.3, 38.6±2.3 and 37.4±3.2 weeks, respectively. A significant relationship was found between BMI and cesarean section and labor dystocia in Fars and Sistani ethnic groups, respectively (P<0.05), while no relationship was found between BMI and neonatal complications. Conclusion: Overweight and obesity in Fars ethnicity are at risk of cesarean section and those with Sistani ethnicity are at risk of labor dystocia.

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Background and Objective: Respiratory failure is one of the most important respiratory problems in premature infants. Several studies have shown the efficacy of corticosteroids in gestational age less than 34 weeks. This study was done to determine the effect of prenatal betamethasone injection during 34 to 36 weeks of pregnancy on the prevention of newborn respiratory failure. Methods: This clinical trial study was conducted on 140 women with risk of preterm labor at 34 to 36 weeks of gestational age. Women in interventional group were received betamethasone 12 mg IM (2 doses, 12 hours apart). Women in control group were received the same volume of normal saline. Sex and birth weight, respiratory distress syndrome, requiring hospitalization in neonatal intensive care units and require respiratory support were recorded for each newborn. Results: No significant difference was seen in sex and weight of newborns between two groups. The precent of newborns with respiratory distress syndrome in the intervention and control groups was 12.5% and 22%, respectively. This difference was not significant. No significant difference was seen in the need to respiratory support, hospitalized in the NICU between intervention and control groups. Conclusion: Adminestration of betamethasone in 36-34 weeks of pregnancy has no effect on the prevention of respiratory failure in preterm infants.