Obstetrics and Gynecology
Nahla W. Shady; Amed A. Taha; Hany F. Sallam
Volume 8, Issue 6 , November and December 2023, , Pages 579-586
Abstract
Background & Objective: To determine the safety and adequacy of intravenous (IV) carbetocin compared to IV tranexamic acid (TA) plus sublingual misoprostol in reducing hemorrhage during and following cesarean delivery (CD) in women with at least one risk factor for postpartum hemorrhage.Materials ...
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Background & Objective: To determine the safety and adequacy of intravenous (IV) carbetocin compared to IV tranexamic acid (TA) plus sublingual misoprostol in reducing hemorrhage during and following cesarean delivery (CD) in women with at least one risk factor for postpartum hemorrhage.Materials & Methods: This clinical study was randomized. We randomly assigned 400 term pregnant women who were candidates for elective CD to receive either a 100 μg intravenous infusion of carbetocin or 1gm. IV TA along with 400 μg of sublingual misoprostol after delivery. Comparing the quantity of blood loss at and six hours following a CD was the primary result. We also disclosed the necessity for any extra medications and any adverse drug reactions.Results: When compared to the misoprostol plus tranexamic acid group, the carbetocin group's total mean blood loss was considerably higher (829.7 293.3 mL vs. 609.33 211.5 mL; P = 0.0001). Following the administration of carbetocin and misoprostol with TA, respectively, 9.5% and 26.5% of patients required further uterotonics treatment (P = 0.0001). When compared to the carbetocin group, the misoprostol group's side effects, such as a bad taste in the mouth and fever, were much greater (P = 0.0001).Conclusion: When it comes to minimizing overall blood loss during and after CD, IV tranexamic acid combined with sublingual misoprostol is superior to IV carbetocin.
General Gynecology and Pelvic Floor
Nahla W. Shady; Hassan A. Farouk; Hany F. Sallam
Volume 7, Issue 5 , July and August 2022, , Pages 391-398
Abstract
Background & Objective: To see if 900 mg of vaginal isonicotinic acid hydrazide (INH) given 12 hours before insertion of a T380A copper intrauterine device (IUD) was more effective than placebo in increasing insertion ease and reducing insertion discomfort in nulliparous ...
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Background & Objective: To see if 900 mg of vaginal isonicotinic acid hydrazide (INH) given 12 hours before insertion of a T380A copper intrauterine device (IUD) was more effective than placebo in increasing insertion ease and reducing insertion discomfort in nulliparous ladies.Materials & Methods: A double-blind, randomized controlled study recruited nulliparous women who wanted to use the Copper IUD for contraception. Women who were WHO-eligible for IUD implantation were recruited and randomly assigned (1:1) to vaginal INH 900 mg or placebo (n=100 in each group), 12 hours before the IUD was placed. The primary endpoint was the ease of insertion for the providers. The number of unsuccessful IUD insertions was also recorded.Results: The groups had similar baseline characteristics. The ease of insertion score in the INH group was lower than in the placebo group (3 (2-5).5 vs. 6 (3-8); P=0.01), indicating that physicians in the INH group had an easier time inserting the device. The INH group had a reduced mean pain score during the procedure (3.97 ± 0.991 vs. 6.42 ± 0.66; P=0.001). In the INH group, two incidences of failed IUD insertion occurred (2%) compared to four cases in the control group (4 percent). 0.594 is the p-value. Conclusion: Self-administered INH 900 mg vaginally 12 hours before a copper T380A IUD insertion successfully reduced discomfort during insertion and improved women's satisfaction and ease of insertion as measured by physicians in nulliparous teenagers and young ladies.
