الفهرس 
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Abstract
This chapter provided an overview on the study and its significant findings and present recommendations based on the current study findings. While menstrual cramps, labor and pregnancy are all related to the reproductive system, several key facts distinguish these three phases of a woman’s life. Pain in obstetrics arises from numerous sources and reasons as labor pain, caesarean section, episiotomy, postpartum and dysmenorrhea (Mojka, 2013). The study aimed to assess the relationship between the intensity of labor pain and the history of menstrual pain. A descriptive correlational design was used; it was conducted at the central hospital of Berket El-Sabae at Berket El-Sabae district and ELKASR teaching hospital at Shibin Elkom hospital at Menofiya governorate. It included (150) pregnant women who meet the inclusion criteria. Three tools were used to collect the required data. The first tool is structured interviewed questionnaire, which directed and written in a simple, clear Arabic language. It included three parts, the first part; include socio-demographic characteristics such as, name, age, educational level. The second part, referred to menstrual history which included age of menarche, regularity of the cycle, length and duration of the cycle, characteristic of the menstrual pain (type, time, duration, consistency), severity of the menstrual pain, ways of coping with it. The third part, described pregnancy history which included, the age of marriage, parity, week of gestation, expected date of the delivery, history of abortion, the problem and outcome of the previous delivery if present, minor discomfort during the present pregnancy, the knowledge the studied sample have to cope with labor pain. The second tool was the partogram that provides a graphical illustration of the progress of the labor and is considered by the World Health Organization (WHO) as a valuable tool for managing intrapartum women. The partograms is a graphical representation of all the changes that occur in labor, including cervical dilatation, fetal heart rate, maternal pulse, blood pressure, and temperature; it also showed a numerical record of features such as urine output and the volume and type of intravenous infusions (including oxytocin drips). It helped identify any deviations from normal in any of these variables. The third tool was pain intensity scale to assess the degree of the menstrual and labor pain. It includes the numerical rating scale, which was developed by Mccaffery 1993. The user has the option to verbally rate their scale from zero to 10 or to place a mark on a line indicating their level of pain. Zero indicates the absence of = No Pain, 1-3 = Mild Pain (nagging, annoying, interfering little with ADLs), 4–6 = Moderate Pain (interferes significantly with ADLs), 7-10 = Severe Pain (disabling; unable to perform ADLs) while 10 represents the most intense pain possible. The Numerical Rating Pain Scale allows the healthcare provider to rate pain as mild, moderate or severe, which can indicate a potential disability level. Operational design: Review of the current and past national and international literature related to this research area was done to be oriented with the relevant researches and websites. The review was helpful in developing the data collection tools used.
A pilot study was done to test the tools for data collection; the purpose of the study was explained to each woman before starting. The study has shown statistically significant correlation between the intensity of labor pain and the history of menstrual pain. The study concluded that, the majority of women described that labor pain was more intense than menstrual pain. Women expressed that they deal with menstrual pain ,more than labor pain .more than half (53,3%) of cases used hot drinks to relieve menstrual pain and described it as very effective method, nearly one quarter (24%)of cases used the analgesic to decrease menstrual pain and only in severe cases. Two fifth (42%) of cases used walking to alleviate labor pain and expressed it was having moderate effect. The degree of labor pain wasnot paralleling to the degree of menstrual pain. Menstrual pain was affected by age of menarche, age and menorrhgia. dysmenorrhea affected daily living activities of adolescent and primipara more than multipara . The highest percents (64.7%), (98%) illustrated that labor pain was similar to menstrual pain in description and site. The highest percent (64.7%) of cases illustrated that methods used to relief labor pain were different from methods used to decrease menstrual pain .more than half (53, 3%)of cases described that, monthly menstrual pain did not affect tolerance of labor pain. Moreover, the study findings concluded negative correlation between the intensity of labor pain and the history of menstrual pain. The study recommended providing, health teaching in the third trimester to those women who had history of menstrual pain about coping strategies with labor pain to decrease the chances of using anaesthesia during the normal labor. Designing an illustrated booklets containing health teaching to the adolescent girls to increase their awareness about coping strategies with menstrual pain to decrease the effect of pain on daily living activities .Moreover further researches should be conducted in other obstetric departments in different hospitals to explore other factors affecting both labor and menstrual pain.