Background: Women’s experience and satisfaction with childbirth care are increasingly being addressed by health care providers, managers, and policymakers. Due to need for a validated special scale for assessing satisfaction of women with preterm birth, we aimed to translate and adapt the first specific tool, Preterm Birth Experiences and Satisfaction Scale (P-BESS), into Persian language and evaluate its psychometric properties. Methods: A methodological and cross-sectional study was conducted in two tertiary levels of maternal hospitals in Tabriz. The Iranian version of the scale was developed from the original English version using forward-backward translation. After confirmation of its face and content validity, the scale was completed by 201 women who had given birth prematurely. Results: Exploratory factor analysis revealed three factors (staff professionalism and empathy, confidence in Staff, information and explanations) with eigenvalues greater than 1, explaining a total variance of 55.4%. Confirmatory factory analysis showed that the 17-item, three factor model fitted the data well: the root mean square error of approximation 0.060. There were moderate correlations between the total and sub-scales of Iranian P-BESS and overall satisfaction (r = 0.45 to 0.66), as well as need for improvement (r = -0.46 to -0.61), which confirm convergent validity. Internal consistency and test–retest reliability of the scale and its sub-scales were satisfactory (α = 0.852 to 0.922, intraclass correlation coefficient; 0.83 to 0.92). Conclusion: The Iranian version of P-BESS is a valid and reliable scale which can be used by policy makers, managers, health care providers and researchers.

Threatened preterm labour is defined as regular uterine contractions in the absence of cervical change or ruptured membranes that is occurred after the gestation of viability and before 37 completed weeks of gestation (Hezelgrave & Shennan, 2017). It is the most common cause of hospitalization during pregnancy (Bacak et al., 2005). There are limited studies on incidence of threatened preterm labour. In a prospective cohort study in the United States, the incidence of first-time hospitalization for threatened preterm labour was 9% and of whom 38% resulted in preterm birth in the first episode (McPheeters et al., 2005).

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This systematic review was conducted to compare the effectiveness of hyaluronic acid and estrogen on symptoms of atrophic vaginitis (primary outcomes) and corresponding side effects (secondary outcome). We reviewed all parallel clinical trials, systematically, to compare the effectiveness of hyaluronic acid and estrogen on atrophic vaginitis. We searched Pubmed, Embase, Web of Sciences, Cochrane library, Scopus, Google Scholar, Magiran, Scientific Information Database (Iran) and Iranian Registry of Clinical Trials, from inception to July 2018 and the reference lists of retrieved articles. Two reviewers used the Cochrane collaboration tool to assess the risk of bias independently. Five parallel controlled trials with 372 participants were included in the present systematic review. One trial reported estrogen superiority to hyaluronic acid in improving the symptoms of atrophic vaginitis. Three trials failed to show a significant statistical difference between the intervention groups. Only a trial with a high risk of bias in random allocation and blinding indicated that hyaluronic acid was more effective than estrogen in improving the symptoms of atrophic vaginitis. Hyaluronic acid is an effective drug with few side effects for the treatment of atrophic vaginitis symptoms; however, better designed trials are required to show the statistical superiority of hyaluronic acid to vaginal estrogen.

In this prospective cohort study, we aimed to investigate external validity of the Allouche’s nomogram to predict preterm birth in symptomatic women in Iran. We employed six variables of cervical length, uterine contractions, rupture of membranes, vaginal bleeding, gestational age, and multiple pregnancy to draw the nomograms. These variables were examined in the first day of women’s hospitalization and participants followed up until giving birth. The concordance index of area under the curve (AUC) was used for validation of the nomograms. Of the participants 10% gave birth within 48 hours and 29% before 34 weeks. The nomogram had sufficient accuracy in predicting birth within 48 hours (AUC 0.89 [95% CI 0.82–0.96]) and birth before 34 weeks (AUC 0.89 [95% CI 0.84–0.94]). The optimal risk threshold for nomogram predicting birth within 48 hours was 0.16. Use of these two nomograms, can improve the health of women and their neonates.