scholarly journals A Randomized, Open-labelled, Interventional Study to Evaluate the Incidence of Infection with or Without Use of Prophylactic Antibiotics in Patients of Episiotomy in a Normal Vaginal Delivery

2017 ◽  
Vol 68 (4) ◽  
pp. 294-299 ◽  
Author(s):  
Amrita N. Tandon ◽  
Asha R. Dalal
Author(s):  
Nirav J. Garala ◽  
Sabnam S. Nambiar

Background: Postpartum  infectious  complications  following  normal  vaginal delivery  remains  a  cause  of   major  concern for  the  health  care professionals  due  to  higher  morbidity  and  mortality  and  prolonged hospital  stays  and  increased  healthcare  costs which makes us consider prophylactic use of antibiotics after normal vaginal delivery. On the other hand unjudicious use of antibiotics has led to widespread antibiotic resistance. Therefore this study was carried out to validate the use of prophylactic antibiotics in these patients and their role in prevention of puerperial pyrexia, wound infections and prolonged hospital stay.Methods: This Randomised clinical trial was conducted at KCHC-Kerala Co-operative Hospital Complex, Pariyaram, Kannur District, Kerala from 1st March 2012 to 30th April 2013. Eligible women were randomly assigned to group which does not receive prophylactic antibiotics (Group A) and group receiving prophylactic antibiotics (Group B). Patients in both the groups were examined every day till the patient was discharged from the hospital and observed for signs and symptoms of infected episiotomy wound, puerperial pyrexia and duration of hospital stay was noted.Results: Mean age in years was 25.6 for Group A and 26.2 for Group B. Mean gestational age in both the groups was 37.6 weeks. Mean duration of labour was 6.62 and 6.22 hours for Group A and B respectively. 6 subjects in Group A and 5 subjects in Group B had puerperial pyrexia. 3 Subjects in Group A and 2 subjects in Group B had wound infection. The mean duration of hospital stay for Group A was 4.18 with SD of 1.0 while mean hospital stay for Group B was 4.01 with SD of 1.1.Conclusions: By comparing subjects in both the groups with respect to puerperial pyrexia, wound infection and duration of hospital stay there was no statistical difference in any of the above criteria in both groups. Hence, in view of the risk of allergic reactions, toxicity and the selection of resistant strains the prophylactic administration of antibiotics does not seem to be justified in patients with episiotomy following vaginal delivery as per this study.


1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15


2016 ◽  
Vol 4 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Manijeh Pirdil ◽  
Leila Pirdel

Background: Maternal childbirth expectations play an important role in determining a woman’s response to her childbirth experience. Women need to be helped to develop realistic and positive expectations and identify the factors that influence these expectations.Objective: The aim of this study was to compare woman’s expectations and experiences of childbirth.Methods: This descriptive-comparative study was carried out in Tabriz Alzahra Hospital from 2006 to 2007. For this purpose, a total of 600 primiparas and multiparas women who were candidates for vaginal delivery, were randomly selected and interviewed. The data were collected by questionnaire.Results: Comparison of the means of mothers expectation and experience of labor and birth between the two groups demonstrated a statistically significant difference (p<0.05). The findings indicated a number of differences exist between primiparas and multiparas women in relation to expectations and experiences of birth when compare two groups. The majority of women had negative expectations and experiences of childbirth.Conclusion: The evaluation and understanding of birth expectations and experiences as positive and negative is priority of maternity system. Antenatal educators need to ensure that pregnant women are appropriately prepared for what might actually happen to limit this expectation-experience gap. Health-care providers should improve the quality of antenatal care which can change negative childbirth expectations and experiences of womenJournal of Kathmandu Medical College, Vol. 4(1) 2015, 16-25


2017 ◽  
Vol 32 (2) ◽  
pp. 244
Author(s):  
Yong-Sun Noh ◽  
Sung-Ho Her ◽  
Jong Bum Kwon ◽  
Chan Joon Kim ◽  
Tae-Seok Kim

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1885
Author(s):  
Guglielmo Stabile ◽  
Francesco Cracco ◽  
Davide De Santo ◽  
Giulia Zinicola ◽  
Federico Romano ◽  
...  

Objective: To identify the possible causes of spontaneous bladder rupture after normal vaginal delivery and to propose a diagnostic and therapeutic algorithm. Material and Methods: MEDLINE (PubMed), Web of Science and Scopus databases were searched up to August 2020. Manuscripts considered were published from 1990 and only English articles were included. The research strategy adopted included the following terms: (bladder rupture) AND (spontaneous) AND (delivery). 103 studies were identified. Duplicates were found through an independent manual screening. Subsequently, two authors independently screened the full text of articles and excluded those not pertinent to the topic. Discrepancies were resolved by consensus. Finally, thirteen studies were included. Results: PRISMA guidelines were followed. For each study, fetal weight, catheterization during labor, parity, maternal age, occurrence time, previous abdominal or pelvic surgery, symptoms complained of, diagnostic methods, and treatment were considered. Median age was 26.0 (range 20–34 years); median presentation time was 3.0 days after delivery (range 1–20 days); and median newborn weight was 3227.0 g (range 2685–3600 g). Catheterization during labor was reported only in four of the thirteen cases (30.8%) identified. The symptoms most frequently complained of were abdominal pain and distension, fever, oliguria, haematuria and vomiting. Instrumental diagnosis was performed using X-rays in five cases and computerized tomography in six cases. Ultrasound was chosen in five cases as a first diagnostic tool. In two cases, cystography was performed. Treatment was always laparotomic repair of the visceral defect. Conclusion: Abdominal pain, increased creatinine and other signs of kidney failure on blood tests should lead to suspicion of this complication. Cystourethrography is regarded as a procedure of choice, but a first ultrasound approach is recommended. The main factor for the therapeutic choice is the intraperitoneal or extraperitoneal rupture of the bladder. Classical management for intraperitoneal rupture of the bladder is surgical repair and urinary rest.


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