Aims Labor is a painful process. Managing and controlling labor pain is an essential aspect of midwifery services and is the main goal of childbirth care. One of the methods used in traditional medicine to relieve labor pain is aromatherapy. This systematic review and metaanalysis study was an update conducted with the aim of critically evaluating and summarizing all available evidence obtained from randomized clinical trials on the effect of aromatherapy with lavender on labor pain relief. Information and Methods In this systematic review, searching a number of foreign databases, including MEDLINE/PubMed, Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus, from the start date of these databases to December 2017 was independently conducted by two researchers, using symbols, i.e. Lavender* OR Lavandula* OR silexan AND labor OR labour OR birth OR childbirth. Comprehensive Metaanalysis (CMA) software version 2 was used for statistical analysis. Findings Based on the search strategy, 244 primary studies were found. Finally, 5 studies including 541 participants were examined in this systematic review. Three studies were subjected to meta-analysis. In general, the quality of clinical trials was moderate and combinatory. Aromatherapy with lavender reduced labor pain in the active phase. The mean difference of labor pain in the aromatherapy groups with lavender and control groups was 1.05 (0.552-1.548; p=0.000036). Conclusion Using aromatherapy with lavender among pregnant women reduces the labor pain. The availability of information obtained from this study can be useful for gynecologists, midwives, and nurses working in labor and delivery units.

Background Preterm birth (PTB) remains a significant problem in obstetric care. Progesterone supplements are believed to reduce the rate of preterm labor, but formulation, type of administration, and dosage varies in different studies. This study was performed to compare oral Dydrogesterone with intramuscular 17α-hydroxyprogesterone caproate (17α-OHPC) administration in prevention of PTB. Methods In this randomized clinical trial, we studied 150 women with singleton pregnancy in 28Th-34Th Gestational week, who had received tocolytic treatment for preterm labor. Participants were divided to receive 30 mg oral Dydrogesterone daily, 250 mg intramuscular 17α-OHPC weekly, or no intervention (control group). All treatments were continued until 37Th Week or delivery, whichever occurred earlier. Obstetric outcomes, including latency period, gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, and neonatal mortality were recorded. All patients were monitored biweekly until delivery. Results Baseline gestational age was not significantly different between groups. Latency period was significantly longer in the progesterone group compared with Dydrogesterone and control groups (41.06 ± 17.29 vs. 29.44 ± 15.6 and 22.20 ± 4.51 days, respectively; P < 0.001). The progesterone group showed significantly better results compared with the other two groups, in terms of gestational age at delivery, birth weight, and Apgar score (P < 0.001). None of the participants showed severe complications, stillbirth, or gestational diabetes. Conclusion Progesterone caproate can strongly prolong the latency period and improve neonatal outcomes and therefore, is superior to oral Dydrogesterone in the prevention of PTB.

Introduction: Normal physiologic childbirth program was implemented in mother-friendly hospitals of Iran after 2008. The aim of present study is to assess the effect of normal physiologic childbirth program in a mother-friendly hospital on duration of active phase and second stage of labor. Methods: This study was a clinical trial that was conducted at the Sina and Ommolbanin mother-friendly hospitals in Ahvaz, Mashhad, Iran, in 2016. The intervention group of 77 women was offered the childbirth preparation classes during pregnancy and normal physiologic childbirth program during labor and the control group of 77 women received routine care. Results: The results showed that after controlling the confounding factors, the active phase and second stage of labor were significantly shorter in the intervention group (p<0.001). Conclusion: Complete implementation of normal physiologic childbirth program can reduce the duration of labor.Keywords: natural childbirth, prenatal education, non-pharmacologic approaches, first stage of labor, labor duration, second stage of labor Makvandi et al. / Effect of normal physiologic childbirth program in mother-friendly hospitals on duration of labor 2 / 6

Background: Preterm birth (PTB) remains a significant problem in obstetric care. Progesterone supplements are believed to reduce the rate of preterm labor, but formulation, type of administration, and dosage varies in different studies. This study was performed to compare oral Dydrogesterone with intramuscular 17α-hydroxyprogesterone caproate (17α-OHPC) administration in prevention of PTB.Methods :In this randomized clinical trial, we studied 150 women with singleton pregnancy in 28Th-34Th Gestational week, who had received tocolytic treatment for preterm labor. Participants were divided to receive 30mg oral Dydrogesterone daily, 250mg intramuscular 17α-OHPC weekly, or no intervention (control group). All treatments were continued until 37Th Week or delivery, whichever occurred earlier. Obstetric outcomes, including latency period, gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, and neonatal mortality were recorded. All patients were monitored biweekly until delivery.Results: Baseline gestational age was not significantly different between groups. Latency period was significantly longer in the progesterone group compared with Dydrogesterone and control groups (41.06±17.29 vs. 29.44±15.6 and 22.20±4.51 days, respectively; P<0.001). The progesterone group showed significantly better results compared with the other two groups, in terms of gestational age at delivery, birth weight, and Apgar score (P<0.001). None of the participants showed severe complications, stillbirth, or gestational diabetes.Conclusion: Progesterone caproate can strongly prolong the latency period and improve neonatal outcomes and therefore, is superior to oral Dydrogesterone in the prevention of PTB.