A randomized controlled study of acupuncture for pain relief during first trimester surgical termination of pregnancy performed under local analgesia

2021 ◽  
pp. 096452842110575
Author(s):  
Dorothy Yuet Tao Ng ◽  
Alexandra Lo ◽  
Emily Wing Sze So ◽  
Grace Ching Yin Wong ◽  
Raymond Hang Wun Li ◽  
...  
Keyword(s):  
Pain Relief ◽  
First Trimester ◽  
Termination Of Pregnancy ◽  
Controlled Study ◽  
Control Group ◽  
Local Analgesia ◽  
First Trimester Pregnancy ◽  
Nulliparous Women ◽  
Group Data ◽  
Oral Diazepam

Background: Acupuncture reduces pain levels in many painful conditions. This study compared pain levels during surgical termination of first trimester pregnancy by suction evacuation (SE) under local analgesia with and without the use of acupuncture. Methods: In all, 60 nulliparous women undergoing SE before 10 weeks of gestation were randomly assigned into one of the following three groups in a 1:1:1 ratio according to a computer-generated randomization list. In the control group, women received oral diazepam 5 mg and intramuscular (i.m.) injection of pethidine 30 and 15 min, respectively, prior to SE. In the acupuncture group, women received acupuncture 10 min before SE until the end of SE while oral diazepam 5 mg and i.m. injection of normal saline were given. In the combined group, women received acupuncture in addition to the drugs in the control group. Data from 52 participants were analysed. Pain scores during and after SE, post-operative side-effects and satisfaction levels were compared. Results: The three groups had similar baseline characteristics. The median pain levels during SE differed significantly between the control, acupuncture, and combined groups (80, 50 and 66 mm, respectively, p = 0.03). Pain levels during SE in the acupuncture and combined groups were significantly lower than that of the control group. However, the anxiety scores did not differ between the three groups after SE (p = 0.86). Conclusion: Acupuncture can provide additional benefit in terms of pain relief in women undergoing first trimester termination of pregnancy by SE under local analgesia.

scholarly journals LB20. Valacyclovir to Prevent Vertical Transmission of Cytomegalovirus After Maternal Primary Infection During Pregnancy

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S1002-S1002 ◽  
Author(s):  
Keren Shahar-Nissan ◽  
Joseph Pardo ◽  
Orit Peled ◽  
Irit Krause ◽  
Efraim Bilavsky ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Vertical Transmission ◽  
Primary Infection ◽  
Antiviral Drug ◽  
First Trimester ◽  
Controlled Study ◽  
Therapeutic Drug ◽  
Control Group ◽  
Cmv Infection ◽  
In Pregnancy

Abstract Background Cytomegalovirus (CMV) is the most common cause of congenital infection in humans. The highest risk of fetal injury follows a maternal primary infection early in pregnancy. Despite the potential for severe fetal injury, to date there are no proven means to prevent viral transmission. Valacyclovir is an antiviral drug proven effective in decreasing the risk for CMV infection among transplant recipients. Valacyclovir is safe for use in pregnancy, and concentrates in the amniotic fluid without accumulating. A dose of 8 g/day creates therapeutic drug levels in the amniotic fluid and fetal blood. Methods This is a randomized, double-blind, placebo-controlled study comprising pregnant women with serologic evidence of primary CMV infection during the periconceptional period and first trimester. After informed consent, patients were randomly assigned to a treatment group (8 g/day of Valacyclovir) or control group (placebo). Treatment was initiated at the time of serological detection, and continued until amniocentesis. The primary endpoint was the rate of vertical transmission of CMV—determined by amniotic fluid CMV PCR. Secondary endpoints included evidence of symptomatic congenital CMV infection—in utero or postnatally. Results One hundred women were recruited, 90 were included in the data analysis; 45 patients received Valacyclovir and 45 placebo. There were 2 twin pregnancies, and therefore 92 amniocentesis Amongst the Valacyclovir group, 5 (11.1%) amniocentesis were positive for CMV, compared with 14 (29.8%) in the placebo group (P GLMM = 0.03), corresponding with an odds ratio of 0.29 (95% CI: 0.09–0.90) for vertical CMV transmission. Amongst patients infected during the first trimester, a positive amniocentesis for CMV was significantly (P = 0.02) less likely in the Valacyclovir arm (2/19) compared with placebo (11/23). No significant differences (P = 0.91) in CMV-positive amniocentesis were observed between study arms amongst patients infected periconceptionally. Conclusion Valacyclovir at a dose of 8 g/day is effective in reducing the rate of fetal CMV infection following early maternal primary infection during pregnancy. The drug reduces the rate of fetal infection by 71%. Disclosures All authors: No reported disclosures.

scholarly journals Comparison of Medical Abortion with Manual Vacuum Aspiration in Termination of Pregnancy up to Nine Weeks

2020 ◽  
Vol 18 (1) ◽  
pp. 116-119
Author(s):  
Kanti Prabha Giri ◽  
Ganesh Dangal
Keyword(s):  
Vaginal Bleeding ◽  
Medical Abortion ◽  
First Trimester ◽  
Termination Of Pregnancy ◽  
Chi Square ◽  
Vacuum Aspiration ◽  
First Trimester Pregnancy ◽  
Manual Vacuum Aspiration ◽  
Comprehensive Abortion Care

Background: Nepal government has legalized abortion and approved both medical abortion and manual vacuum aspiration for first trimester pregnancy. However, there is inadequate evidence in our setup to comment on the acceptability and complications of medical abortion and manual vacuum aspiration for termination of pregnancy up to nine weeks of gestation. The objective of this study is to compare the reasons for termination of pregnancy, effectiveness and complications between medical abortion and manual vacuum aspiration in termination of pregnancy up to nine weeks.Methods: A comparative study was conducted among women requesting termination of pregnancy up to nine weeks of gestation in Comprehensive Abortion Care unit of Paropakar Maternity and Women’s Hospital. Women were kept in medical abortion and manual vacuum aspiration groups after they chose the method. They were advised for follow up in two weeks. Reasons for termination, effectiveness and complications of medical abortion and manual vacuum aspiration were compared using Chi square test.Results: In a total of 160 women, the most common reason for termination of pregnancy was completion of the family. In manual vacuum aspiration group 43 (58.9%) women had minimal per vaginal bleeding while 30 (40.54%) women in medical abortion group had per vaginal bleeding for 6-10 days (p <0.001). Rate of complete abortion in medical abortion group was 85.14% (n=63) and in manual vacuum aspiration group was 93.15% (n=68). Conclusions: The complications following medical abortion were higher than manual vacuum aspiration in termination of pregnancy up to nine weeks. Rate of completeness of abortion following manual vacuum aspiration is superior over medical abortion.Keywords: Manual vacuum aspiration; Medical abortion; Termination of pregnancy

scholarly journals The Retrospective Analysis on the Influence of Taking Mifepristone and Misoprostol During First-trimester Pregnancy and Its Following Impact on Tissue Residual After Induced Abortion

2021 ◽  
Author(s):  
Hai Xia xie ◽  
Xiao Li Liu ◽  
Jun Jie Sun ◽  
Jian Rong Huang
Keyword(s):  
Gestational Age ◽  
Uterine Cavity ◽  
Test Group ◽  
First Trimester ◽  
Induced Abortion ◽  
Control Group ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Women And Children ◽  
Residual Tissue

Abstract Objective: To explore the application of mifepristone in the stream of Residual tissue after abortion . Methods: A retrospective study of 1067 women who selected induced abortion in first-trimester pregnancy(gestational age ≤ 70 days) between January 1st，2018 and May 31st，2019 in Chongqing Health Center For Women and Children . Inclusion criteria: the first pregnancy patients, aged 18-30 years, gestational age ≤ 70 days. Test group (mifepristone + misoprostol) 467 cases. Control group(misoprostol) 600 cases. Analyzing the incidence of residual tissue after induced abortion. Evaluating the preventive effect of preoperative oral mifepristone on abortion incompleteness. Results: a total of 9 in test group occur residual tissue in uterine cavity，the incidence is 1.93%. In the controlled group, the number of residual tissue is 25,the incidence is 4.16%(P<0.05)，there was statistic difference between two groups. The uterine residue diameter in the test group(1.1±0.31cm) was lower than that in the control group(1.24±0.64cm)，but there was no statistical difference between the two groups of residue diameter (P>0.05)Conclusion: Oral mifepristone before operation can significantly reduce the incidence of tissue residual after induced abortion.

scholarly journals Yolk sac–embryo distance in correlation with soluble form of vascular endothelial growth factor levels in pregnancy with potentially reserved evolutivity

2018 ◽  
Vol 20 (4) ◽  
pp. 487
Author(s):  
Carmen Elena Bucuri ◽  
Razvan Ciortea ◽  
Doru Diculescu ◽  
Andrei Malutan ◽  
Radu Mocan-Hognogi ◽  
...  
Keyword(s):  
Growth Factor ◽  
First Trimester ◽  
Yolk Sac ◽  
Soluble Form ◽  
Control Group ◽  
Case Group ◽  
Crown Rump Length ◽  
Low Level ◽  
First Trimester Pregnancy ◽  
Endothelial Growth Factor

Aims: Embryonic demise is a frequent complication of the first trimester pregnancy. The purpose of this study was to evaluate the correlation between a serum biomarker, the soluble form of the vasculo-endothelial growth factor (sFlt-1) and the distance between the yolk sac (YS) and embryo (DYSE), determined by ultrasonography.Material and methods: The study was a prospective case-control study that included 2 groups of patients – the control group with 81 first-trimester pregnancies in evolution and the case group with 89 first-trimester pregnancies with a potentially reserved evolutivity.Results: A correlation between the serum level of sFlt-1 and DYSE in embryos with crown-rump length (CRL) greater than 5 mm was identified, showing that a DYSE ≤3 mm correlates with a low level of sFlt-1 (p<0.05) and a DYSE> 4 mm correlates with an increased level of sFlt-1 (p<0.05).Conclusions: A low level of sFlt-1 associated with a distance between the embryo and yolk sac of small dimensions, respectively <3 mm, correlates with an increased rate of non-viable embryos. This correlation between an ultrasound and a serum parameter is of great value and brings important information about the viability of firsttrimester pregnancies.

Gemeprost for second-trimester termination of pregnancy

1989 ◽  
Vol 27 (26) ◽  
pp. 103-103
Keyword(s):  
First Trimester ◽  
Termination Of Pregnancy ◽  
Prostaglandin E ◽  
Second Trimester ◽  
Vacuum Aspiration ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Vaginal Pessary ◽  
Medical Termination ◽  
Endogenous Prostaglandins

During labour endogenous prostaglandins are involved in the process of softening the cervix. Gemeprost, an analogue of prostaglandin E1, is used as a vaginal pessary (Cervagem - May & Baker) to soften and dilate the cervix before vacuum aspiration of first-trimester pregnancy.1 It can now also be used for medical termination of pregnancy in the mid-trimester.

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