Background. Entonox (N2O2) which is an inhalational gas for relieving labor pain is commonly used intermittently; however some women are interested in continuous breathing in face mask. So we decided to compare the complications induced by two methods to find out whether it is safe to permit the mothers to use Entonox continuously or not. Patients and Methods. This randomized clinical trial was performed in Mobini Hospital, Sabzevar, Iran. 50 parturients used Entonox intermittently and 50 cases used it continuously during labor. Then obstetrical outcomes were analyzed in two groups by spss 17 software, t-test, and Chi2 while P < 0.05 was considered significant. Results. This study showed the mean duration of second stage of labor had no significant difference (P = 0.3). Perineal laceration was less in continuous group significantly (P = 0.04). Assisted vaginal birth was not different significantly (P = 0.4). Uterine atony had no significant difference in two groups (P = 0.2). Maternal collaboration in pushing and satisfaction were higher in continuous group significantly (P = 0.03), (P < 0.0001). Apgar score of neonates at first and fifth minute was acceptable and not different significantly in two groups (P = 0.3). Conclusions. Our study demonstrated continuous method is also safe. So, it seems reasonable to set mothers free to choose the desired method of Entonox usage.

Our study proved the functionality of metoclopramide in preventing ileus. As this drug is safe, tolerable, harmless, inexpensive and available, and also no definite method has been developed to prevent ileus after cesarean; yet, metoclopramide could be considered as a suitable option. Certainly with regard to some limitations in our study, further comprehensive studies are still required to ensure validity of the obtained results.

Aim: This study was conducted to evaluate the ability of the effacement curve to predict fetal descent by comparing it to dilatation in order to improve the accuracy of the current partogram. Method: We conducted an observational study of women who were admitted for vaginal delivery at Mobini Hospital, Sabzevar, Iran in 2015. During labor, dilatation and effacement were plotted in different graphs and then their association with fetal descent was separately evaluated and compared. This assessment was performed in two groups: primipara and multipara. Results: From 1750 individuals, 503 primiparous and 512 multiparous women were eligible for the study. An adjusted generalized estimating equations multivariable model showed both dilatation and effacement had a significant relationship with fetal descent either in primipara or multipara. In primipara, the prediction value of effacement equalled dilatation (β,eff 0.29, P < 0.001; β,dil 0.30, P < 0.001). In multipara, the prediction value of effacement was obviously higher than dilatation (β,eff 0.45, P < 0.001; β,dil 0.27, P < 0.001). The strength of effacement to predict labor in multipara was clearly greater than in primipara (β,eff 0.45 and β,eff 0.29, respectively). The strength of dilatation to predict labor in multipara was comparable to primipara (β,dil 0.27 and β,dil: 0.30, respectively). Conclusions: Regarding the acceptable predictive value of effacement, we believe considering effacement, dilatation and station curves altogether can improve the power of the existing partogram for the assessment of labor progression and detection of failure to progress.

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Introduction: Recognition of labor pain is a primary concern of physicians, midwives and their clients in controlling labor pain and preventing the resulting suffering. The purpose of this study was to assess the relationship between self-esteem and anxiety with severity of pain and suffering of labor in women. Method: This cross-sectional study was conducted on 365 mothers who experienced delivery at Shahidan Mobini hospital in Sabzevar in 2014. The data were collected using Rosenberg Self-esteem questionnaire and Spielberger State-Trait Anxiety scales, visual analogue scale (VAS) for pain, and experience and perception of suffering. Data were analyzed using t-test, Pearson correlation coefficient and chi-square test considering level of significance equal to 0.05. Results: The mean age was 26.4± 4.7 years old. In this study, 119 (44.9%) samples were nulliparous, 20 (7.5%) were employed and 196 (74%) were urban citizens. There was no significant difference between the pain of labor score in terms of self-esteem levels (p=0.84) and the level of covert anxiety (p=0.15) and overt anxiety (p=0.06). However, there was a significant differences between the suffering of labor scores in terms of selfesteem levels (p<0.001),the covert anxiety levels (p<0.001) and the overt anxiety levels (p<0.05). Conclusion: Considering pregnant women with higher self- esteem and lower anxiety score had a lower score on labor suffering in this study, it seems health care providers can help reduce pregnant women’s suffering of labor through strengthening the well-being and health of pregnant women and supporting them during pregnancy and labor.