The Islamic Republic of Iran has witnessed a sharp increase in the number of caesarean sections in the past two decades. This study shows the trend of caesarean sections in the country, focusing on the probable causes of the increase during the past 30 years. The caesarean section rate was 35% in 2000 and increased to 48% in 2009. The study shows that there is a very wide range of prevalence of caesarean section rates in the country. This would indicate that most caesarean sections in our country are not medically indicated, although perhaps in some areas there are not enough caesarean sections. There is a need for research on health outcomes for mothers and infants associated with caesarean delivery without a medical or obstetrical indication. A more detailed examination is needed of mother, insurer, hospital and provider attitudes toward elective caesareans.

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Induction of labor is conducted in special fetal or maternal conditions. Labor is induced in about 20% of women. The aim of this study was realizing the relationship between some factors including cervical ripening and also response to induction so we could predict the induction outcome better. Material and methods: The present prospective study was based on 101 pregnancy cases admitted to the labor ward in Urmia from March 2010 until December 2010. Maternal age ranged from 17 to 41 years and the gestational age between 37 to 42 weeks according to an ultrasound or reliable last menstrual period, as criteria of study inclusion. After admission, patients had a vaginal speculum for Preterm Premature Rupture of Membranes (PPROM), Abdominal ultrasonography for biometry and Amniotic Fluid Index (AFI), transperineal ultrasonography for measuring fetal head distance to maternal perineum, and vaginal ultrasonography for measuring cervical length and posterior angle of fetal head with cervix were undergone. Bishop score was assigned to another person. Labor was induced by administering either intravaginal misoprostol (25 microgram every six hours for a Bishop score lower than 7) or intravenous oxytocin (low dose regimen for a Bishop score equal to or more than 7). Results: Misoprostol was used for 75 patients and 26 patients had induction of labor with low dose oxytocin. Eighty one patients had Normal Vaginal Delivery (NVD) while 20 were delivered via Cesarean Section. For cervical ripening, Bishop Score (p<0.001), cervical length (p=0.04) and parity (p=0.06) were predicting factors. The cervical posterior angle p=0.02 had a predicting role in natural delivery. Conclusion: The cervical posterior angle was a predicting factor for natural delivery. Although cervical length, Body Mass Index (BMI), and parity were not predicting factors for natural delivery; these factors were good predictors for cervical ripening.

Background Polycystic Ovary Syndrome (PCOS) is associated with high levels of phsychological implications and detriments to Quality of Life (QoL). The aim of this study was to assess Health- Related Quality of Life (HRQoL), depression, and anxiety in Iranian women with different PCOS phenotypes. Methods The present observational, cross-sectional study was carried out on 239 PCOS women who were classified on the basis of Rotterdam criteria into four categories: A (n = 77), B (n = 38), C (n = 68), and D (n = 56). They asked to fill out three questionnaires, namely, HRQoL, SF-12, and HADS. Results No significant differences were observed between the four PCOS phenotypes for anxiety, depression and QoL, as well as HRQoL domains related to infertiliy, weight and emotional problems (P > 0.05). Phenotypes A and B had worse HRQoL related to hirsutism (13.98 ± 5.22, 14.13 ± 6.23, P < 0.001). In addition, no significant differences were observed between them for HRQoL domains. While the score of acne in phenotype D (19.60 ± 5.12, P = 0.003) and menstrual score in phenotype C were significantly higher comparing to the other PCOS groups (16.82 ± 3.87, P < 0.001). Conclusion Presenting similar psychological profiles in all phenotypes unveils the importance of pychological well-being screening, even in milder reproductive phenotypes.

Introduction Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale. Materials and methods The present cross-sectional study was carried out on 192 women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12. Results In the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P < 0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P < 0.05). Conclusion The results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women’s QoL and sexual function should be considered according to the relevant PCOS phenotypes.

The pregnant women at higher risk of preterm labor, referred to the perinatal clinic of Kosar University Hospital in Urmia district of Iran, were enrolled into a parallel randomized clinical trial. In the investigational arm of the clinical trial, a double cervical cerclage procedure was performed addition to McDonald cerclage. In the control group however, only McDonald cerclage was performed. Extreme preterm labor (GA < 33 weeks) was the primary endpoint of this clinical trial. Age, gestational age at cerclage time, and gravidity were not found to be statistically different between the groups. Means of gestational age were 37.4 and 36.2 weeks, respectively, for the investigational and control groups. The gestational age was 1.2 weeks longer for double cerclage group but the difference was not found to be statistically significant. Preterm birth before 33 weeks of gestation was not experienced by any of the patients who received double cerclage, but five women in control group developed such an extreme preterm labor (P < 0.05). The absolute risk reduction in using double cerclage over traditional method was 18 percent (95% confidence interval, 4%–32%). Double cerclage appeared to have higher efficacy than traditional cerclage in preventing preterm labor <33 weeks of gestation.

Background: Polycystic ovary syndrome (PCOS) is associated with high levels of phsychological implications and detriments to quality of life (QoL). The aim of this study was to assess the quality of life (QoL), health related quality of life (HRQoL), depression, and anxiety in Iranian women with different PCOS phenotypes.Methods: The observational, cross-sectional study was carried out on 239 PCOS women PCOS which had been classified on the basis of Rotterdam criteria into four categories. Then they were classified into four groups according to the Rotterdam criteria: A (n=77), B (n=38), C (n=68), and D (n=56).Results: No significant differences were observed between the four PCOS phenotypes for anxiety, depression and QoL, likewise, HRQoL domains related to infertiliy, weight and emotional problems (P>0.05). Phenotypes A and B had worse HRQoL related to hirsutism (13.98±5.22, 14.13±6.23, P<0.001), also no significant differences were observed between them for HRQoL’s domains. While the score of acne in phenotype D (19.60±5.12, P=0.003) and menstrual score in phenotype C were significantly higher compare with the other PCOS groups (16.82±3.87, P<0.001). Conclusion: Presenting similar psychological profile in all phenotypes unveils the importance of pychological well-being screening, even in milder reproductive phenotypes.

Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. The present study aimed to compare the women with different PCOS phenotypes with the healty group in terms of sexual function, depression, anxiety and quality of life scale.Materials and Methods: The present cross-sectional study was carried out on 192 infertile women with PCOS (classified on the basis of Rotterdam criteria into four categories) and 50 healthy controls. All participants were asked to fill out the valid and reliable questionnaires of FSFI (Female Sexual Function Index), HADS (Hospital Depression and Anxiety Scale) and SF-12.Results: In the HADS questionnaire, phenotype B achieved the highest mean score in anxiety and depression domains, whereas, phenotype B had the lowest mean score in the FSFI and SF-12 quassionnaires. Furthermore, there was a significant difference between the women with PCOS phenotypes and the control grroup in arousal, lubrication, pain, and mean total score of FSFI (P<0.05). In regression logistic analysis, age, infertility and depression were predictors of sexual dysfunction (P<0.05).Conclusion: The results indicated significant differences in terms of sexual dysfunction, depression, anxiety and quality of life in the women suffering from different phenotypes of PCOS compared with the healthy group. These results provide evidence that care and recommendations for improving women’s QoL and sexual function should be considered according to the relevant PCOS phenotypes.