Relationship between Delivery Type and Menstrual Disorders: A Case-Control Study.
BACKGROUND
High incidence of menstrual disorders at late ages of fertility ac-counts for 20% of clinical visits and 25% of gynecological surgeries. This study was conducted to identify the relationship between delivery type and menstrual disorders in women referring to hospitals affiliated to Medical Universities in Tehran in 2008.


METHODS
In this case-control study, which was conducted from April to August, 2008 in Tehran, 160 women aged 36 to 44 years, 8o women with and 80 without menstrual disorder as case and control groups were enrolled respectively. Data collection tool was a questionnaire (included questions regarding demographic and obstetrical characteristics). Higham pictorial chart (scores more than 80 denoted menorrhagia), a verbal multidimensional scoring scale (from 0 for painless to 3 for severe pain), and Holmes-Rahe scale for assessing stress were used.


RESULTS
About 93.1% of the cases and 65% of the controls had experienced dysmenorrhea at the begging of the study (P=0.009). In other words, 65% of women with dysmenorrhea had a history of C-section. Women with menstrual disorders had more caesarian sections (53.7%) than those without the disorders (27.5%) (P<0.001) with an odds ratio estimate of 3.06 [95% CI: 1.58, 5.91]. There were significant differences in the number of pads/tampons used (P=0.009) and amount of uterine bleeding based on Higham chart (P=0.009) among case and control group.


CONCLUSIONS
Caesarian may be considered as a risk factor for menstrual disor-ders particularly at late ages of fertility. Therefore, pregnant women should be consulted by health providers regarding advantages versus disadvantages of caesarian before selective C-section.
Department of Midwifery and Reproductive Health, School of Nursing and Midwife, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Fatemeh
F
Nahidi
Leila
L
Bagheri
Sharareh
S
Jannesari
Hamid
H
Alavi Majd