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Introduction: The purpose of this study was to evaluting of salivary estriollevel in hospitalized women with diagnosis of preterm labor.
Materials and Methods: This was an analytic observationat investigation. During this study, salivary estriol specimens were obtained from 43 women at 24 to 34 weeks 6 days gestational age with symptoms of preterm lab or .We compared maternal salivary estriollevels between case group with preterm labor.
Results: This study showed that the mean of salivary estriollevels in 31, 32, 33, 34 weeks in case group were higher than control group. Reciever-operator curve showed that exceeding a 0.1875 ng/ml salivary estriollevel was associated with occurrence of preterm delivery.
Conclusion: This study showed a wide range of salivary estriollevels in different pregnants and this distinction became more extent with lengthening gestation. Detection of increased estriollevel may be clinically helpful in defining at risk woman for preterm birth.

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Introduction: Nearly, 6% of recently diagnosed cancer in the United States was upon to lymphoproliferate and leukemia and 9% of fatality in cancerous people was upon to these two illnesses. Using some simple, cheap and in-hand tests and special consideration to clinical inspections in suspected subjects provide a faster diagnostic and suitable treatment. It may ultimately promote the quality of life and decline the fatality among patients.
Materials and methods: This was a cross-sectional investigation which carried out during a 1.5 years in the form of forward direction. Forty-two lymphoproliferate (28 lymphoblast and 14 Hotchkin) and 21 acute lymphoblastic leukemia (10 acute lymphoblast leukemia and 11 miloid acute leukemia) subjects were evaluated. ESR, LDH and ALP levels were measured in all patients. In clinical examinations, oversizing of lymph nodes, spleen and liver were exactly considered.
Results: According to our results the best tests to rule in and rule out acute leukemia from lymphoprolifeatives were ESR and LDH, respectively. Additionally, The most sensitive and specific evaluations to rule out these two diseases were LDH and oversizing of liver inspection. It was also determined that LDH is the best screening test to rule out leukemia from lymphoproliferate.
Conclusion: Using of simple examinations such as ALP, LDH, ESR and more consideration to oversized spleen, liver and lymph nodes in each suspected patients, we could easily differentiate lymphoproliferate and acute leukemia from each other.

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Introduction: Considering the importance of diagnosing fetal distress and knowing diagnostic methods with minimum cost and time and high diagnostic value, this study was performed to evaluate the vibroacoustic stimulation test ( VAST) value in predicting fetal distress in women in active phase of labor, reffering to Motazedi hospital, Kermanshah, 2004.
Materials and Methods: This clinical trial study was carried out on women in active phase of labor (dilatation >3-4), full term, single fetus, cephalic presentation, without previous diseases and also abnormal fetus. At first FHR was monitored for 15 minutes, then vibroacoustic stimulation was done for 3 seconds using an artificial larynx of Seimens Servox with high - pitch intensity equal to 105 dB. Results were recorded as non reactive and reactive FHR ( twice 15 beats acceleration for 15 seconds). Other variables such as type of delivery, 1 and 5 minutes Apgar, meconium passing and nuch cord were documented. Data was analyzed by descriptive statistics and diagnostic value test.
Results: Age of women was 25.2 ±5.8, number of pregnancy 1.94 ± 1.33 and 51.8% of them had one pregnancy. FHR before VAST was 61.1% reactive and 26.3% suspicious and after VAST 60.8% reactive and 5.3% suspicious. In VAST method sensitivity, specificity and diagnostic value were 88.3%, 70% and 75.5% respectively and in nonVAST method 68.3%, 66.5%, 23.6%.
Conclusion: This study showed that VAST can assist to reduce suspicious cases of FHR.The prognostic value of VAST in predicting fetal distress was high. It is recommended to carry out further researches about duration and intensity of sound and using periodic FHR

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Introduction: Diagnosing parturients in risk of cesarean section early in the beginning of active phase of labor, is very important. This may let take necessary action to accelernate labor (delivery) and prevent maternal mortality and morbidity due to late cesarean section. Materials and Methods: During a period of 8 months from July 2004 to March 2005, 216 primiparous women, with term pregnancy and cephalic single fetus, referred to Imam Reza hospital in (during) active phase of labor, were studied. Changes of cervical dilatation and descent of the conceptus were observed. Parturients were devided to two groups, vaginal delivery and cesurean section. Protraction or arrest disorders were the indications of cesarean deliveries. Findings were analysed through using T-Test, unilateral variance and Chi square test. Results: The more changes in cervical dilatation in the first 2 hours of active phase of labor, the less possibility of cesarean delivery (p<0.001). Also the more rate of the conceptus descent in the first 2 hours of active phase of labor, the less rate of cesarean section (p<0.001). There was no significant statistical relationship between condition of membranes at the onset of active labor and method of delivery, however there was a significant relationship between oxytocin augmentation and method of delivery (p<0.001). Conclusion: In primiparous women with term pregnancy, vaginal delivery would be fairly predictable by observing changes of cervical dilatation and conceptus descent during the first 2 hours of active phase of labor.

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Introduction: Prolonged labor is an important problem during labor which can have undesirable effects on both maternal and fetal health. Shortening the duration of labor has always been one of the aims of obstetricians. Hence, the purpose of this research was to investigate the effect of massage on the duration of labor in women attending to Bentolhoda Maternity Unit in the city of Bojnord, Northern Khorasan, Iran in 2005. Materials and Methods: In this clinical tial study, 62 primiparous women with normal pregnancy were participated. The indications of normal pregnancy included a gestational age of 37-42 weeks, single tone, and vertex presentation. Sampling was done by purposive method. Women were randomly allocated in two groups. The experimental group (n=32) received a 30-minute directional, reasonably firm and rhythmic effleurage massage in the back in each of the three phases of labor. The control group (n=30), did not receive any form of massage and received a routine 30-minutes nursing care in each of the three phases. Measurements were then made for strength, interval and frequency of contractions and the duration of each phase. Data were analyzed using student t, Chi-square and Mann-Whitney tests. Results: Findings showed a significant decrease in the duration of labor after massage sessions. The mean duration of labor for the massage group was 5.75 hourse and for the routine nursing care group 9.15 houres (p=0.001). Conclusion: According to the above results, there was a significant decrease in duration of the first phase of labor in pregnant women receiving massage sessions. Therefore, this method can be used to decrease the period of hospitalization.

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Introduction: Labor refers to the chain of physiologic events that allows a fetus to undertake its journey from the uterus to the outside world. Friedman (1954) describes a sigmoid pattern for labor. This study is carried out to identify the trend of labor progression in multiparous women. Materials and Methods: The present cohort study was conducted on 336 multiparous women. In order to assess labor stages, dilatation per unit of time was evaluated in each participant. Participants were divided into four groups: non intervention, induced, sedated, and both intervention groups. The related parameters were evaluated in all groups. Data was analyzed using one way analysis of variance, one sample t-test and mixed model regression models in reverse method for drawing the curve. Results: In all groups, with the increasing expansion of cervix the rate of cervix dilatation was increased. A significant relationship was observed between expansion speed rate in active phase of the first stage and the third stage, with induction of labor (p<0.05). But there was no relationship between the second stage and induction. The mean time of active phase and the second stage in this study was significantly higher than women of Freidman study (3.56 hours in contrast to 2.2 hours and 25 minute in contrast to 18 minute, respectively)(p<0.001). Also in the present study the deceleration phase was not seen. Conclusion: Now the pattern of labor progression differs from Freidman's curve in 1950 and has not the sigmoid shape, and the most important factor affecting latent phase is the dilatation of cervix at the time of admission. So determining a standard curve, without bias, is very difficult, and statistical methods should be used to decrease the effect of confounding factors of participants.

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Background: Labor pain, which is a natural, unique and multi- factorial pain, is considereds a major part of women's anxiety at reproductive ages. There are two pharmacological and non-pharmacological approaches for reducing this pain. Since the pharmacological approach involves side effects, lots of attention has recently been given to the non-pharmacological methods. One of these methods, is use inc birth ball the, which includes sitting and rocking on the birth ball. The purpose of this study was to evaluate the effects of using birth ball on labor pain, the duration of active phase and contractions of physiologic labor. Materials and Methods: In this randomized control-clinical trial, sixty primiparous women (18-35 year old) were selected and randomly assighed into birth ball and control groups. The severity of pain was measured through Visual Analogue Scale (VAS) and the pain score, interval between contractions and duration of active phase were compared between the two groups. Results: The average pain score in the birth ball group was significantly lower than the control group (p<0.05). In terms of interval between the contractions, duration of active phase and uterine contractions, there were no significant differences between the two groups. Conclusion: Although use of birth ball did not have any effects on the duration of active phase, uterine contractions and interval between uterine contractions, this complementary therapy reduced the severity of pain during the active phase of delivery. Therefore, this safe method is suggested to be used during normal vaginal delivery and physiologic labor. Also, conducting a study, which examines the effects of using a combination of complementary methods, is recommended

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Background: Mother and newborn's health is one of the important indexes in health services of every country and one of its main assessment indexes is the number of normal deliveries in each country. Identifying the effective factors in labor helps the right selection of patients the process of delivery. The main goal of this study was to assess the association between fetal sex and unsuccessful labor process which result in cesarean section. Materials and Methods: This observational cross-sectional study was conducted on 1537 pregnant women admitted for delivery to Taleghani Hospital of Arak during 6 months. Data were catch through a check list consisting of obstetric history, physical examination, labor process, and lab tests coupled with interview and observation. The results were analyzed through Chi2, chance ration analysis, and t-test. Results: Of the 1537 pregnant women, 74% had normal delivery and 26% underwent cesarean section. Of all infants, 35.1% of those delivered by normal vaginal delivery and 13.4% of those delivered by cesarean section were male sex while 38.9% of the infants in the normal delivery group and 12.6% of those in the cesarean group were female. These results did not show any association between fetal sex and type of delivery. Overall, 36.5% of the deliveries done through cesarean section were due to dystosia (18.1% male and 18.4% female) (P=0.934). Also,14.3% of the newborns delivered through cesarean sction due to fetal distress were male and 10.8% of them were female (P=0.162) while 10.5% of newborns delivered through cesarean section due to meconium were male and 8.5% of them were male (P=0.359). Conclusion: It appears there is no association between fetal sex and labor disorders which result in cesarean section.

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Background: The UN report on the 41% increase of cesarean labor and its risks in Iran in recent years on the one hand and its association with cognitive and psychological factors on the other motivated us to identify the involving variables so as to control unnecessary cesarean sections. The aim of this study was to investigate the role of fear of pain and related psychological variables (pain catastrophizing, catastrophic cognition, childbirth attitude, depression-anxiety-stress, and experience of pre-menstruation (PMS) in prediction of cesarean labor. Materials and Methods: In this cross-sectional study, 300 pregnant women from Atieh private and Shahid Akbar Abadi public Hospitals (150 participants from each) were selected and matched by variables, such as age, level of education, month of pregnancy, previous experience of deliveries, tendency to cesarean, type of hospital, and having PMS. To collect data, a battery of questionnaires, including fear of pain, pain catastrophising, catastrophic cognition, childbirth attitude, and depression-anxiety-stress (DASS) were used. The results were analyzed through correlation coefficient and logistic regression. Results: Education, previous experience of deliveries, month of pregnancy were not significant but such variables as the tendency to cesarean, type of hospital, and age were significant (P<0.05). Such variables as pain catastrophizing, catastrophic cognition, and childbirth attitude were significant but other variables, including fear of pain , depression-anxiety-stress, experience of PMS were not significant (P>0.05). Conclusion: Such variables as the experience of cesarean, type of hospital, and age as well as pain catastrophizing, childbirth attitude, and catastrophic cognition are significant variable in prediction of cesarean labor in pregnant women.

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Background: Brucellosis is a zoonotic disease which is endemic in Iran. Infection with brucella species during pregnancy can have negative impacts on the outcome of pregnancy however, there is no consensus on its leading to abortion or other severe complications. The aim of the present study is to determine the role of brucellosis in pregnancy and to characterize the risk factors, clinical presentations, and immunology of brucellosis based on the existing reports. Materials and Methods: In this review article, we studied papers on Pubmed, Elsevier, Cohrane, SID, Ovid, ISC, and IranMedex through such keywords as brucellosis, abortion, intra-uterine fatal diseases, and preterm labor. Results: Among the original research papers, 51 were found to be related to the title of this study and dealt with the outcome of brucellosis on pregnant women and had discussed the complications of pregnant patients suffering from brucellosis. Conclusion: According to the investigations made in this study, brucellosis in pregnancy can manifest as normal delivery, increased incidence of spontaneous abortion, intra-uterine fatal diseases, and premature delivery. Therefore, in endemic areas, especially those with inhabitants of low socioeconomic class, educating girls and women of childbearing age about brucellosis and its dangers and risk factors and isolating pregnant women may help prevent the disease and its complications in pregnancy. Moreover, further immunological investigation on the role of immunological reactions following brucellosis infection in pregnant women is required.