Obstetrics and Gynecology
Khadijeh Elmizadeh; Marziyeh khezri; Hamideh Pakniat; vahideh pandamuz; nezal Azh; Simindokht Molaverdikhani
Articles in Press, Accepted Manuscript, Available Online from 02 October 2023
Abstract
Background: Cooling the uterus during cesarean section has emerged as one of the non-pharmacological management for blood loss during cesarean section. The aim of this study was to evaluate the effect of uterine cooling during the cesarean section on decreasing postpartum hemorrhage.
Methods: In this ...
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Background: Cooling the uterus during cesarean section has emerged as one of the non-pharmacological management for blood loss during cesarean section. The aim of this study was to evaluate the effect of uterine cooling during the cesarean section on decreasing postpartum hemorrhage.
Methods: In this single-blinded randomized clinical trial, a sample of 300 women with a singleton pregnancy, at 37 to 40 weeks gestation, who were scheduled for cesarean section was divided into two groups of 150 participants. In the intervention group after placental delivery, the uterus was covered with cold saline-soaked surgical sponges at 0-4°C at the time of hysterotomy repair, and the control group received standard cesarean section. The volume of blood loss, the hemoglobin level before surgery and 24 h after surgery, the need for additional oxytocic therapy, and the incidence of adverse effects were recorded.
Results: The bleeding volume and hemoglobin concentration reduction were significantly lower in the intervention group than in the control group (260.86± 150.25 Vs 214.35± 83.51, P<0.0001 and 1.24±0.75 Vs 1.54±0.92, P = 0.007 respectively). There were no statistically significant differences between the two groups in the frequency of need for additional uterotonic drugs. (18% vs. 21.33%, P = 0.475.)
Conclusion: The use of uterine cooling during cesarean section reduced the volume of blood loss and the rate of decline in hemoglobin concentration.
Obstetrics and Gynecology
Mina EL Hiyani; Sakhr Ahizoune; Asmaa Mdaghri Alaoui; Othmane Benlenda; Amal Thimou Izgua
Volume 8, Issue 6 , November and December 2023, , Pages 587-598
Abstract
Background & Objective: The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and ...
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Background & Objective: The safety of women during childbirth and personnel working in maternity care amidst the COVID-19 pandemic is a priority for the health system. Hence, good risk management practices need to be implemented to reduce the spread of infection between healthcare workers and pregnant women who have contracted COVID-19. Therefore, this study aimed to establish a risk map for managing dyspneic parturients suffering from COVID-19-related pneumopathy during delivery.Materials & Methods: This study focuses on examining potential risks beforehand in the context of the management of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery, executed using the method FMECA (Failure Mode, Effects and Criticality Analysis); this was conducted from September to December 2021 in the maternity service of the Hospital Center ElJadida, Morocco.Results: The risk analysis of a dyspneic parturient suffering from COVID-19-related pneumopathy during delivery revealed thirteen failure modes. Proposed are corrective measures aimed at addressing the failure modes of criticality class C3 whose vital risks are linked to the care of the dyspneic parturient suffering from COVID-19-related pneumopathy at the level of the reanimation service and the level of the neonatal intensive care unit.Conclusion: Employing risk mapping is a fundamental instrument for the ongoing enhancement of quality to maximize the safety of the parturient care process by changing the organizational culture from a reactive to a preventive approach.
Obstetrics and Gynecology
Fereshteh Fakour; Roya Kaboodmehri; Amirhossein Hajizadeh Fallah; Maryam Dourandeesh; Fatemeh Gholamalipour; Seyedeh Maryam Attari; Forozan Milani; Zahra Pourhabibi
Volume 8, Issue 3 , May and June 2023, , Pages 217-222
Abstract
Background & Objective: Most pain relief methods are associated with some side effects and limitations. Magnesium sulfate, due to its osmotic properties and absorption of cervical water (moisture) can shorten labor duration and decrease labor pain via improving effacement and cervical edema. ...
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Background & Objective: Most pain relief methods are associated with some side effects and limitations. Magnesium sulfate, due to its osmotic properties and absorption of cervical water (moisture) can shorten labor duration and decrease labor pain via improving effacement and cervical edema. The aim of our study was to evaluate the effect of intravaginal magnesium sulfate on pain severity and duration of the first and second stages of labor.Materials & Methods: In this double-blind randomized clinical trial study, 70 nulliparous women were allocated into two groups after the beginning of the active phase of labor. In group 1, 10 ccs of magnesium sulfate 50% was poured on the whole cervix during the vaginal examination. In group 2, a placebo (sterile water) in a similar way and amount was used. Then the two groups were compared in variables of demographic, obstetrics, clinical, pain severity, duration of the first and second stages of labor, and maternal and neonatal outcomes.Results: In different dilatations, pain severity in group 1 was significantly lower (P=0.0001). The duration of the first and second stages of labor was shorter in group 1 (P =0.0001). The two groups were similar in neonatal outcomes, drug side effects, and treatment satisfaction (P >0.05).Conclusion: Intravaginal magnesium sulfate improves the condition of the cervix, reduces the duration and the severity of labor pain, and has no medical or neonatal side effects.
Obstetrics and Gynecology
maryam dehghan; tajosadat alameh; Zahra Allameh; zahra Seyed-Hoseini
Volume 8, Issue 2 , March and April 2023, , Pages 113-119
Abstract
Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly ...
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Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter or misoprostol modes. Cervical ripening in Foley catheter group was done with transcervical Foley catheter 18, and in misoprostol group with 25 μg single dose vaginal misoprostol (The maximum allowed dose for patients was 6 doses.). Bishop score, Apgar score, active phase duration, stage 2 duration and insertion to delivery interval were the main outcomes.Results: The mean time of ripening and the active phase in vaginal misoprostol group was significantly shorter than in Foley catheter group (2.32 versus 5.11 hours respectively, P-value = 0.0001). After intervention, Bishop score in vaginal misoprostol group was significantly more than Foley catheter group (8.70 versus 6.68 respectively, P-value = 0.0001). Insertion to delivery interval in vaginal misoprostol group was 9.54 hours and in Foley catheter group was 12.88 hours (P-value = 0.0001). The hospitalization time in Foley catheter group was significantly more than vaginal misoprostol group (P-value = 0.0001). The other outcomes were similar between groups.Conclusion: By the decreasing in the total time from insertion to birth, vaginal misoprostol was more effective than Foley catheter, as a cervical ripening method in our study.
Hojjat Pourfathi; Haleh Farzin
Volume 3, Issue 3 , September and October 2018, , Pages 93-97
Abstract
Aims: Postpartum depression is a common event after delivery. Among some possible causes, pain is an important contributing factor which can play role in increasing psychiatric disease. The aim of the present study was to assess the effect of neuraxial analgesia methods on reducing incidence of postpartum ...
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Aims: Postpartum depression is a common event after delivery. Among some possible causes, pain is an important contributing factor which can play role in increasing psychiatric disease. The aim of the present study was to assess the effect of neuraxial analgesia methods on reducing incidence of postpartum depression.
Materials & Methods: 280 pregnant women (140 cases, 140 controls) without depression history who referred for vaginal delivery in the maternity ward of Taleghani teaching hospital, from February 2016 until February 2017 were participated in this randomized clinical trial. Samples were selected by random sampling method. Depression risk was assessed by Edinburgh Postnatal Depression Scale (EPDS) and the pain was measured by Visual Analogue Scale (VAS). Data were analyzed by SPSS 22 using Mann-whitney test and independent t-test for comparing of quantitative mean values. The association between qualitative variables was assessed by Chi square and exact Fisher tests.
Findings: Postpartum depression occurred in the painless delivery group and natural delivery group. There was statistically significant difference between them (p=0.04). It means that depression rate in painless delivery group was lower than natural delivery group. High Edinburg score was associated with high risk of depression.
Conclusion: Postpartum depression in women with painless delivery is lower comparison to women with natural delivery.
