The Role of Delivery Route on Colostrum Melatonin and Serum Il-6 Levels: a Prospective Controlled Study

2021 ◽  
Vol 225 (06) ◽  
pp. 506-512
Author(s):  
Canan Çalışkan ◽  
Samettin Çelik ◽  
Safak Hatirnaz ◽  
Handan Çelik ◽  
Bahattin Avcı ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Maternal Serum ◽  
Controlled Study ◽  
Before And After ◽  
Abdominal Route ◽  
Group 3 ◽  
Group 2 ◽  
Prospective Controlled Study

Abstract Introduction the aim of this study was to determine whether maternal serum IL-6 and postnatal melatonin levels change with the mode of delivery. Materials and Methods a prospective controlled study was performed on pregnant women (17–43 years) over 37 weeks of pregnancy. Patients were divided into three groups according to the route of delivery: Group 1) 30 women delivering by vaginal route; Group 2) 30 delivering by iterative cesarean section (CS); Group 3) delivering by emergency CS. Maternal serum IL-6 levels were measured before and after delivery, and maternal colostrum melatonin levels after delivery, and the results between the 3 groups compared. Results pre-delivery and post-delivery maternal serum IL-6 levels were significantly higher in patients who delivered vaginally than in patients who delivered by the abdominal route (p<0.01). Maternal colostrum melatonin levels of patients after delivery were significantly higher in patients who delivered vaginally (32.88±7.16 ng/L) than in patients who delivered by elective and emergent cesarean deliveries (24.86±2.40 ng/L and 23.73±4.03 ng/L, respectively) (p<0.01). Conclusion These data support, should there ever be a further need, the benefit of vaginal delivery over cesarean section, in which cytokine and melatonin levels are reduced compared to vaginal delivery.

scholarly journals A Study of Relationship Between Maternal Vitamin D Status and Mode of Delivery in a Tertiary Care Military Hospital

2020 ◽  
Author(s):  
Gurpreet Kaur Dhillon ◽  
Suneeta Singh ◽  
Harpreet Singh Dhillon ◽  
Shibu Sasidharan
Keyword(s):  
Vitamin D ◽  
Cesarean Section ◽  
Vaginal Delivery ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Serum Vitamin ◽  
Maternal Serum ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
The Relationship

Abstract Background: Vitamin D deficiency has been shown to be related to multiple adverse pregnancy related outcomes. An observational study was undertaken to study the relationship between maternal serum vitamin D levels during peripartum period and outcome in the form of mode of delivery.Methods: This study was done in a tertiary care centre on 569 patients to study the relationship between maternal serum vitamin D levels and mode of delivery categorized into vaginal delivery (VD), (including assisted delivery) and Lower Segment Cesarean Section (LSCS). The primary objective of this project was to assess the vitamin D levels in maternal serum and to study its relationship, if any, with mode of delivery. Results: A total of 569 samples of maternal and neonatal serum were analyzed for serum 25(OH)D levels. 464 (81.54%) mothers had Vitamin D sufficient (VDS) levels ≥30ng/ml and 105 (18.45%) had vitamin D deficient (VDD) levels <30ng/ml. Out of total 569 newborns; LSCS and spontaneous Vaginal Delivery were 152 (26.71%) and 417 (73.28%) respectively. The incidence of LSCS was 19.61% in the vitamin D sufficient group as compared to 58.09% in the vitamin D deficient group (p<0.0005). The mean cord blood 25(OH) D levels of the neonates born by vaginal delivery was 14.05ng/ml (SD 3.86, range 8.2-27) whereas those born by LSCS was 12.11 ng/ml (SD 3.18, range 7.9-22), which was significantly lower (p<0.00000042).Conclusion: The rates of Cesarean section deliveries was 2.96 times higher in mothers who had deficient Vitamin D levels. Also the levels of mean cord blood vitamin D was higher in vaginally delivered newborns.

Spontaneous Human Myometrial Contractility in the Third Trimester of Pregnancy in Relation to Past Mode of Delivery

2019 ◽  
Author(s):  
Gillian A. Ryan ◽  
Sarah M. Nicholson ◽  
Denis J. Crankshaw ◽  
John J. Morrison
Keyword(s):  
Vaginal Delivery ◽  
Contractile Activity ◽  
Mode Of Delivery ◽  
Maximum Amplitude ◽  
Human Myometrium ◽  
Success Rates ◽  
Uterine Contractions ◽  
Group 3 ◽  
Group 2

Abstract Objective It is well established that women with a previous vaginal delivery have higher success rates in relation to vaginal birth after cesarean than those without. The aim of this study was to examine the effect of past mode of delivery on contractile parameters of human myometrium in vitro. Study Design Myometrial strips were excised from 64 women at cesarean delivery (CD) and recordings of spontaneous contractile activity analyzed and compared across three clinical groups: (1) women with no previous delivery (Group 1); (2) women with CD only (Group 2); and (3) women with a history of vaginal delivery and CD (Group 3). Results Myometrial samples from women in Group 3, women who had a previous vaginal delivery, had a significantly greater maximum amplitude of contractions (p < 0.05), a greater force (mean contractile force) of contractions (p < 0.01), and a faster rate of rise (p < 0.01) and relaxation of contractions (p < 0.05) than those in Groups 1 and 2. Conclusion Many of the functional parameters of human uterine contractions are altered, or enhanced, in the women who have had a previous vaginal delivery, when compared with those without. This may partly explain the clinical differences observed in labor.

scholarly journals Adiponectin levels in maternal serum and umbilical cord blood at birth by mode of delivery: relationship to anthropometric measurements and fetal sex

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Seyedeh Razieh Fazeli Daryasari ◽  
Najmeh Tehranian ◽  
Anoshirvan Kazemnejad ◽  
Fatemeh Razavinia ◽  
Fatemeh Tork Tatari ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Cord Blood ◽  
Cesarean Delivery ◽  
Vaginal Delivery ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Mode Of Delivery ◽  
Maternal Serum ◽  
Anthropometric Measurements ◽  
Fetal Sex

Abstract Background The rate of cesarean section is increasing worldwide. Adiponectin is a hormone related to anti-inflammatory and anti-atherogenic effects; and it′s concentrations may change in response to inflammatory situations including surgical intervention. The aim of the current study was to investigate serum adiponectin levels in maternal and umbilical cord blood according to different modes of delivery and their relationship with anthropometric measurements and fetal sex. Methods The study population initially comprised 90 healthy pregnant women referred to the teaching hospital. Eventually, 40 participants in the vaginal delivery group and 35 subjects in the cesarean delivery group were recruited in to the study. Umbilical cord blood and maternal serum samples were analyzed according to the standard protocol from the manufacturer. The collected data were analyzed using SPSS-16 software. P-value < 0.05 was considered as the significance level for all tests. Results Our results indicated a significant association between maternal adiponectin and the mode of delivery, with adiponectin levels significantly higher in vaginal delivery compared to cesarean section (P < 0.001). However, no difference was found in umbilical cord blood adiponectin between the two groups (P = 0.51). A significant positive correlation was found between maternal serum adiponectin in the first day after birth and umbilical cord blood adiponectin in the vaginal delivery group (P = 0.007). Nevertheless, this correlation was not statistically significant in the cesarean delivery group (P = 0.62). There was also no significant correlation between fetal sex and anthropometric measurements with maternal adiponectin (P = 0.44) and umbilical cord blood adiponectin (P = 0.86). Conclusions The result of the current study revealed that maternal adiponectin concentration was significantly higher in vaginal delivery compared to cesarean section, which might be due to the increased levels of maternal adiponectin release during labor.

Influence of Sonographic Fetal Weight Estimation Inaccuracies in Macrosomia on Perinatal Outcome

2020 ◽  
Author(s):  
Jutta Pretscher ◽  
Sven Kehl ◽  
Patrick Stelzl ◽  
Florian Matthias Stumpfe ◽  
Andreas Mayr ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Mode Of Delivery ◽  
Fetal Weight ◽  
Weight Estimation ◽  
True Negative ◽  
Fetal Weight Estimation ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Objective To evaluate the influence of inaccurate sonographic fetal weight estimation in macrosomia on the mode of delivery and neonatal outcome (NO). Methods In 14 633 pregnancies between 2002 and 2016, this retrospective study evaluated the association between sonographic fetal weight estimation, true birth weight (BW), mode of delivery (primary cesarean section [pCS], secondary cesarean section, vaginal delivery, and operative vaginal delivery rates) and NO parameters (5-min Apgar < 7, pH < 7.1, neonatal intensive care unit [NICU] admission, shoulder dystocia). Singleton pregnancies > 37 + 0 weeks with ultrasound-estimated fetal weight (EFW) within 7 days before delivery were included. The study population was divided into four groups: Group 1 (false-negative): EFW < 4000 g/BW ≥ 4000 g; Group 2 (true-positive): EFW ≥ 4000 g/BW ≥ 4000 g; Group 3 (false-positive): EFW ≥ 4000 g/BW < 4000 g; and Group 4 (true-negative): EFW < 4000 g/BW < 4000 g. Results As expected, the highest secondary cesarean section (sCS) rate was found in Group 2 (true-positive) (30.62 %), compared with only 17.68 % in Group 4 (true-negative). The sCS rate in the false-positive Group 3 was significantly higher (28.48 %) in comparison with the false-negative Group 1 (21.22 %; OR 1.48; 95 % CI, 1.16 to 1.89; P = 0.002). In comparison with the true-negative Group 4, univariate analyses showed significantly higher rates for sCS in all other groups: odds ratio (OR) 2.06 for Group 2 (95 % CI, 1.74 to 2.42; P < 0.001), 1.85 for Group 3 (95 % CI, 1.54 to 2.22, P < 0.001), and 1.25 for Group 1 (95 % CI, 1.05 to 1.49; P < 0.01). No significant differences were found for NO between Groups 1 and 3 for the parameters 5-min Apgar < 7 (P = 0.75), pH < 7.1 (P = 0.28), or NICU admission (P = 0.54). However, there was a significantly higher chance for shoulder dystocia in Group 1 compared with Group 3 (OR 4.58; 95 % CI, 1.34 to 24.30; P = 0.008). Conclusion Sonographic EFW inaccuracies in fetal macrosomia appear to have a greater impact on the mode of delivery than birth weight itself. Underestimation of fetal weight may be associated with a higher probability of shoulder dystocia.

scholarly journals The Effect of Broccoli Sprout Extract on Seasonal Grass Pollen-Induced Allergic Rhinitis

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1337
Author(s):  
Joseph Yusin ◽  
Vivian Wang ◽  
Susanne M. Henning ◽  
Jieping Yang ◽  
Chi-Hong Tseng ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Spray ◽  
Placebo Tablet ◽  
Group 4 ◽  
Cytokine Levels ◽  
Before And After ◽  
Group 3 ◽  
Nasal Steroid ◽  
Group 2 ◽  
Broccoli Sprout

Patients exposed to pollutants are more likely to suffer from allergic rhinitis and may benefit from antioxidant treatment. Our study determined if patients diagnosed with grass-induced allergic rhinitis could benefit from broccoli sprout extract (BSE) supplementation. In total, 47 patients were confirmed with grass-induced allergic rhinitis and randomized to one of four groups: group 1 (nasal steroid spray + BSE), group 2 (nasal steroid spray + placebo tablet), group 3 (saline nasal spray + BSE) and group 4 (saline nasal spray + placebo tablet). Peak Nasal Inspiratory Flow (PNIF), Total Nasal Symptoms Scores (TNSS) and nasal mucus cytokine levels were analyzed in samples collected before and after the 3-week intervention. Comparing before and after the intervention, PNIF improved significantly when comparing Groups 1 and 2, vs. placebo, at various time points (p ≤ 0.05 at 5, 15, 60 and 240 min) following nasal challenge, while TNSS was only statistically significant at 5 (p = 0.03), 15 (p = 0.057) and 30 (p = 0.05) minutes. There were no statistically significant differences in various cytokine markers before and after the intervention. Combining nasal corticosteroid with BSE led to the most significant improvement in objective measures.

scholarly journals Pre-stenting for Retrograde Intrarenal Surgery: Need and Duration: a Prospective Randomized Clinical Study

2020 ◽  
Vol 3 (2) ◽  
pp. 361-365
Author(s):  
Prakash Chhettri ◽  
Anil Shrestha ◽  
Robin Bahadur Basnet ◽  
Parash Mani Shrestha
Keyword(s):  
Controlled Study ◽  
Retrograde Intrarenal Surgery ◽  
Ureteral Access Sheath ◽  
Access Sheath ◽  
Randomized Clinical Study ◽  
Institutional Review ◽  
Group 3 ◽  
Group 2 ◽  
Wall Injury ◽  
Group 1

Introduction: To evaluate if retrograde intrarenal surgery with ureteral access sheath requires prestenting. In case pre-stenting becomes an option, how long does it need to be stented.  Materials and Methods: After obtaining approval from Institutional Review Board and informed consent, a prospective randomized controlled study was conducted in the Department of Urology, Bir Hospital for 18 months. All the patients enrolled for retrograde intrarenal surgery were grouped into 3 groups: Group 1 – without pre-stenting, Group 2 – one week of pre-stenting, and Group 3 – two weeks of pre-stenting. Success was defi ned as an ability to accommodate a 10/12 F ureteral access sheath during retrograde intrarenal surgery. Ureteral access sheath induced ureteric wall injury was also taken into consideration.Results: Among 179 cases, 152 cases were included in the study. In 36 patients out of 53 (67.92%) in group 1, 10/12 F ureteral access sheath was negotiable without pre-stenting, marking the frequency of distensible ureters. In 44 patients out of 47 (93.66%) from group 2 and all 52 patients (100%) from group 3, ureteral access sheath placement was successful after one and two weeks of pre-stenting respectively. Ureteric wall injury of grade1 and 2, was found in 9 patients (5.9%).Conclusions: The majority of ureters (67.92%) are distensible, not requiring pre-stenting before retrograde intrarenal surgery. One and two weeks of pre-stenting carries a success rate of 93.66% and 100% respectively.

scholarly journals Anandamide Exerts a Differential Effect on Human Placenta Before and After the Onset of Labor

2021 ◽  
Vol 12 ◽  
Author(s):  
Paula Accialini ◽  
Cyntia Abán ◽  
Tomás Etcheverry ◽  
Mercedes Negri Malbrán ◽  
Gustavo Leguizamón ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Endocannabinoid System ◽  
Cesarean Sections ◽  
Vaginal Deliveries ◽  
Before And After ◽  
Elective Cesarean ◽  
Main Components ◽  
Relevant Finding

The onset of labor involves the action of multiple factors and recent reports have postulated the endocannabinoid system as a new regulator of this process. Our objective was to study the role of anandamide, one of the main endocannabinoids, on the regulation of placental molecules that contribute to the onset of labor at term. Placental samples were obtained from patients with laboring vaginal deliveries and from non-laboring elective cesarean sections. Vaginal delivery placentas produced higher prostaglandins levels than cesarean section samples. Besides, no differences were observed in NOS basal activity between groups. Incubation of vaginal delivery placentas with anandamide increased prostaglandins concentration and decreased NOS activity. Antagonism of type-1cannabinoid receptor (CB1) did not alter the effect observed on NOS activity. Conversely, incubation of cesarean section placentas with anandamide reduced prostaglandins levels and enhanced NOS activity, the latter involving the participation of CB1. Furthermore, we observed a differential expression of the main components of the endocannabinoid system between placental samples, being the change in CB1 localization the most relevant finding. Our results suggest that anandamide acts as a modulator of the signals that regulate labor, exerting differential actions depending on CB1 localization in laboring or non-laboring term placentas.

scholarly journals A randomized, controlled study to compare the effects of intravenous labetalol and esmolol on haemodynamic changes during laryngoscopy and intubation

2017 ◽  
Vol 5 (9) ◽  
pp. 4003
Author(s):  
Atit Kumar ◽  
Prashant Kumar Mishra ◽  
Saurabh Shukla
Keyword(s):  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Cardiovascular Stress ◽  
Significant Difference ◽  
Haemodynamic Changes ◽  
Β Blocker ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Direct laryngoscopy and endotracheal intubation frequently induce cardiovascular stress response characterised by hypertension and tachycardia due to reflex sympathetic stimulation. Considering the clinical significance of these changes stress attenuation is needed to blunt these responses. β- blockers are used to reduce the unwanted hemodynamic responses. Esmolol is ultra-short acting cardio selective β blocker. Labetalol is useful in not only attenuating the response to laryngoscopy and intubation but also in preventing perioperative cardiovascular events. Present study compared the efficacy of esmolol and labetalol for attenuation of sympathomimetic response to laryngoscopy and intubation.Methods: It was a prospective, randomized, controlled study carried out in 75 adult patients with ASA 1 and ASA 2 posted for elective surgeries. Patients were allocated randomly into Group-1 (esmolol) and Group-2 (labetalol) and Group-3 (placebo) of 25 patients each. Inj. esmolol (1mg/kg) or Inj. labetalol (0.4 mg/kg) or placebo (0.9NS) dissolved up to 5 ml in distilled water was injected intravenously 5 minutes prior to intubation. All patients premeditated with Inj. glycopyrrolate (4µg/kg). Patient were then induced with Inj. propofol (2mg/kg), Inj. scoline (2mg/kg) given followed by laryngoscopy and intubation. Haemodynamic readings were noted at T0 (baseline before injecting the drug), T1 (1 minute after injecting the drug), T2 (after intubation), T3 (2 minutes after intubation), T4 (4 minutes after intubation), T5 (6 minutes after intubation), T6 (8 minutes after injection), T7 (10 minutes after injection).Results: Gr-1, Gr-2 and Gr-3, when compared with each other for systolic BP, diastolic BP, mean BP, and HR, showed a statistically significant difference at different intervals.Conclusions: Both the drugs are found to be effective in attenuation of hemodynamic reflex without any side effects. Further studies are recommended to substantiate the findings in present study.

EVALUATION OF EFFICACY OF SILODOSIN VERSUS SILODOSIN WITH DEFLAZACORT IN EXPULSION OF LOWER URETERIC CALCULI

2021 ◽  
pp. 30-33
Author(s):  
Dev Yadav ◽  
P.N Agarwal ◽  
Sham Lal Singla ◽  
Kanwar Singh Goel ◽  
R. Talukdar ◽  
...  
Keyword(s):  
Plain Radiograph ◽  
Pharmacological Therapy ◽  
Urinary Stones ◽  
Controlled Study ◽  
Expulsion Rate ◽  
Ureteric Calculi ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objectives: To compare the efcacy of silodosin versus silodosin with deazacort in expulsion of lower end ureteric calculi, in terms of episodes of pain,stone expulsion rate,stone expulsion time ,analgesic requirements and side effects Introduction: Ureteric calculi represent 20% of urinary stones. Ureteroscopy and Shock wave lithotripsy proven the method of treatments for lower ureteric stones; however, they are expensive and not risk free. Aconservative approach is becoming more popular as a result of advances in pharmacological therapy which reduces the symptoms and helps in stone expulsion. We performed a randomized controlled prospective study to evaluate the efcacy of Deazacort in combination with alpha blocker silodosin in medical management of symptomatic lower Ureteric stones of ≤8 mm size. Material and methods: A prospective randomised controlled study was conducted on 60 patients, age ≥ 18 , who had unilateral lower ureteric stone of ≤ 8 mm. Patients were divided into three groups. Group 1 received silodosin 8 mg for 14 days,Group 2 received silodosin 8 mg plus deazacort 30mg daily for 14 days and Group 3 (control) received diclofenac potassium (75 mg ) when required. The patients were followed-up by ultrasonography ,plain radiograph KUB and computed tomography (in some cases). Results: There was a higher stone expulsion rate of 95% in Group 2 as compared to Group 1(85%) and Group 3(35%) . Group 2 showed a signicant advantage for stone expulsion time ,decreased pain episodes and analgesic use. Two patients, one in group 1 and group 2, reported retrograde ejaculation. Conclusion: The results showed that silodosin with deazacort , increases the stone expulsion rate, decrease the stone expulsion time, decreases the mean number of pain episodes and decreases the mean analgesic dosage requirement. But larger study is required to establish its efcacy for expulsion rate which will be statistically signicant.

Relationship between painless delivery and postpartum depression: The Japan Environment and Children’s Study (JECS)

2021 ◽  
Author(s):  
Nobuhiro Suzumori ◽  
Takeshi Ebara ◽  
Hazuki Tamada ◽  
Taro Matsuki ◽  
Hirotaka Sato ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Cesarean Section ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
First Trimester ◽  
Regression Analyses ◽  
One Year ◽  
Spinal Epidural ◽  
Paracervical Block

Abstract Background Postpartum depression is one of the most commonly experienced psychological disorders for women after childbirth, usually occurring within one year. This study aimed to clarify whether women with painless delivery, including epidural analgesia, spinal-epidural analgesia, and paracervical block, had a decreased risk of postpartum depression after giving birth in Japan. Methods The Japan Environment and Children’s Study (JECS) was a prospective cohort study that enrolled registered fetal records (n = 104,065) in 15 regions nationwide in Japan. Binomial logistic regression analyses were performed to calculate the adjusted odd ratios (aORs) for the association between mode of delivery with or without analgesia and postpartum depression at one-, six- and twelve-months after childbirth. Results At six months after childbirth, painless vaginal delivery was associated with a higher risk of postpartum depression (aOR: 1.218, 95% confidence interval: 1.067–1.391), compared with vaginal delivery without analgesia or cesarean section. Nevertheless, the risk disappeared one year after delivery. Among the pregnant women who requested painless delivery, 5.1% had a positive Kessler-6 scale (K6) score for depression before the first trimester (p < 0.0001), which was significantly higher than the proportions in the vaginal delivery without analgesia (3.5%) and cesarean delivery (3.5%) groups. Conclusions Our data suggested that the risk of postpartum depression at six months after childbirth tended to be increased after painless vaginal delivery, compared with vaginal delivery without analgesia or cesarean section. Requests for painless delivery continue to be relatively uncommon in Japan, and women who make such requests might be more likely to experience postpartum depressive symptoms because of underlying personality characteristics, including a tendency to worry.

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