Background Vitamin D has an established role in female reproduction. There is also evidence for an association between vitamin D levels and menstrual problems such as premenstrual syndrome (PMS) and dysmenorrhea. Curcumin, is a bioactive polyphenol constituent of turmeric, that can potentially interact with vitamin D receptors and its molecular targets. This study evaluated the effects of curcumin on vitamin D levels in young women with PMS and dysmenorrhea. Methods In this randomized, triple-blind, placebo-controlled trial, women with PMS and dysmenorrhea were divided randomly into experimental and control groups to receive one capsule (500 mg of curcuminoid+ 5 mg piperine, or placebo) daily, from approximately 7 days before until 3 days after menstruation for three consecutive menstrual cycles. Serum vitamin D levels, renal function, and liver enzymes were also measured before and after intervention. Results A total of 76 subjects (38 in each group) were recruited into the trial. Curcumin significantly increased the median (IQR) serum levels of vitamin D [from 12.8 ng/ml (7.0–24.6) to 16.2 ng/ml (6.4–28.8); P = 0.045], compared with placebo [from 18.6 ng/ml (2.2–26.8) to 21.3 ng/ml (5.2–27.1); P = 0.17]. Serum levels of aspartate aminotransferase and direct bilirubin were reduced by the end of trial in the curcumin group (p < 0.05), but did not change significantly in the control group (p > 0.05). Finally, no significant differences in levels of fasting blood glucose were detected between curcumin and placebo groups. Conclusion Curcumin supplementation in women with PMS and dysmenorrhea led to a significant improvement of vitamin D, liver function enzyme test, but did not affect blood glucose. Trial registration The trial was registered on Iranian Registry of Clinical Trials registry (Trial ID: IRCT20191112045424N1 on 23 January 2020; available at https://www.irct.ir).

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Background: Since maternal near miss (MNM) could act as a surrogate of maternal death, the implementation of MNM audit at hospital level can provide an opportunity to study maternal morbidity at a large scale. Objectives: The current study aimed at investigating severe maternal outcomes (SMO; i.e. MNM + maternal death [MD]) in a referral hospital. Methods: A prospective, facility-based, cross sectional study was conducted from 22 June to 22 December 2017. The current study was performed in a tertiary referral teaching hospital in Zahedan, Iran. The study population included all pregnant females with a gestational age of 22 weeks giving birth in this hospital or referred to this center for delivery, as well as females within 42 days of pregnancy termination. The World Health Organization maternal near-miss criteria were used to identify MNM and analyze the data. Logistic regression was used to predict SMO risk factors. Results: Overall, 3527 deliveries and 3480 live births were reported in the hospital under investigation. Severe maternal outcomes were observed in 68 cases. The rate of MNM was 13.79 per 1000 live births; furthermore, the ratio of MNM to mortality was 12:1. Binary analysis showed that hemoglobin level, place of residence, parity, history of cesarean section (CS), insurance coverage, and type of delivery were the significant decisive factors in SMO. Moreover, severe hemorrhage and hypertensive disorders were the common causes of SMO. Conclusions: According to the collected data, MNM indicators were high in the under study hospital. Therefore, it seems necessary to adopt context-based interventions at hospital level to find and manage mothers prone to SMO during pregnancy and childbirth.

Background: Insufficient evidence exists regarding the causes of adverse birth outcomes among women with previous cesarean sections (C-Section).Objectives: This study aimed to explore women"s perspectives on childbirth care services leading to maternal near-miss (MNM) events. Methods: Following a narrative design, 12 women with a previous C-section who had an episode of MNM during childbirth or postpartum period referring to a tertiary referral hospital in Zahedan city, Iran, were chosen using purposive sampling. Face-to-face interviews were used to collect data. Data were analyzed using the six-phase guide to thematic narrative analysis approach. Results: Two themes related to childbirth care services leading to maternal near-miss events were extracted:(1) "Ineffective communication" (Ignoring the patient's words, Insensitive listener, and Non-critical thinking listener) and ( 2) "Inappropriate care" (implementation of unnecessary or inappropriate care and early discharge). Conclusion: An audit system is necessary to provide objective information on the domains related to care provision and help timely feedback to healthcare providers to improve the quality of care.