The effect of the use of oxytocin on blood loss during different postpartum periods

2015 ◽  
Vol 43 (4) ◽  
Author(s):  
Ulaş Fidan ◽  
Uğur Keskin ◽  
Mustafa Ulubay ◽  
Rıza Efendi Karaca ◽  
Fahri Burçin Fıratlıgil ◽  
...  
Keyword(s):  
Blood Loss ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Postpartum Hemorrhage ◽  
Biochemical Parameters ◽  
Developed Countries ◽  
Maternal Deaths ◽  
Before And After ◽  
Group 2 ◽  
Group 1

AbstractPostpartum hemorrhage is the most important reason for maternal mortality. In developed countries, the reason of 13% of maternal deaths is postpartum hemorrhage while this percentage reaches more than 30% in other countries. In this study, the effect of oxytocin use in different times at the 3In the study, 89 pregnant women to whom oxytocin was administered after placenta separation were studied in Group 1, 89 pregnant women were included in Group 2, and oxytocin was administered after delivery of the shoulder. The levels of hemoglobin and hematocrit before and after delivery were quantified.The biochemical parameters were examined, there was no significant statistical differences in the levels of hemoglobin and hemotocrit before delivery between the two groups. When compared to Group 1, Δ-hemoglobin (P=>0.001), Δ-hematocrit (P=>0.001), the change between the prepartum and postpartum hemoglobin percentage (P<=0.001), and change between the prepartum and postpartum hemotocrit percentage (P<=0.001) were statistically lower in Group 2.It was determined that the use of oxytocin after shoulder delivery has more effects on decreasing the amount of postpartum hemorrhage.

Effect of Sustained Uterine Compression versus Uterine Massage on Blood Loss after Vaginal Delivery: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Labib M. Ghulmiyyah ◽  
Alaa El-Husheimi ◽  
Ihab M. Usta ◽  
Cristina Colon-Aponte ◽  
Ghina Ghazeeri ◽  
...  
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Primary Outcome ◽  
Dropout Rate ◽  
Significant Difference ◽  
Uterine Massage ◽  
Secondary Outcomes ◽  
Group 2 ◽  
Group 1

Objective This study aimed to compare the effectiveness of sustained uterine compression versus uterine massage in reducing blood loos after a vaginal delivery. Study Design This was a prospective randomized trial conducted at the American University of Beirut Medical Center (AUBMC) between October 2015 and October 2017. Inclusion criteria were women with a singleton pregnancy at ≥36 weeks of gestation, with less than three previous deliveries, who were candidates for vaginal delivery. Participants were randomized into two groups, a sustained uterine compression group (group 1) and a uterine massage group (group 2). Incidence of postpartum hemorrhage (blood loss of ≥500 mL) was the primary outcome. We assumed that the incidence of postpartum hemorrhage at our institution is similar to previously published studies. A total of 545 women were required in each arm to detect a reduction from 9.6 to 4.8% in the primary outcome (50% reduction) with a one-sided α of 0.05 and a power of 80%. Factoring in a 10% dropout rate. Secondary outcomes were admission to intensive care unit (ICU), postpartum complications, drop in hemoglobin, duration of hospital stay, maternal pain, use of uterotonics, or of surgical procedure for postpartum hemorrhage. Results A total of 550 pregnant women were recruited, 273 in group 1 and 277 in group 2. There was no statistically significant difference in baseline characteristics between the two groups. Type of anesthesia, rate of episiotomy, lacerations, and mean birth weight were also equal between the groups. Incidence of the primary outcome was not different between the two groups (group 1: 15.5%, group 2: 15.4%; p = 0.98). There was no statistically significant difference in any of the secondary outcomes between the two groups, including drop in hemoglobin (p = 0.79). Conclusion There was no difference in blood loss between sustained uterine compression and uterine massage after vaginal delivery. Key Points

scholarly journals Efficacy of prophylactic tranexamic acid administration in prevention of postpartum hemorrhage in placenta previa cesarean section: an interventional study

2021 ◽  
Vol 11 (1) ◽  
pp. 153
Author(s):  
Monika Rathore ◽  
Anjali Gupta ◽  
Nidhi Kumari
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Intravenous Infusion ◽  
Very Low Birth Weight ◽  
Placenta Previa ◽  
Skin Incision ◽  
Group 2 ◽  
Group 1

Background: Postpartum hemorrhage accounts for the major part of the mortality as well as morbidity like severe anemia, need for blood transfusion, hospital stay and infection. Aim and objectives of the study were to determine the efficacy and safety of prophylactic tranexamic acid and intravenous tranexamic acid in preventing postpartum hemorrhage in women undergoing caesarean section for placenta previa.Methods: Seventy women with placenta previa over 1 year, randomized into 2 groups: group 1 (n=35): Women who received 10 IU oxytocin intravenous infusion after placental delivery and group 2 (n=35): Women who received 1 gm (10 ml) tranexamic acid IV before skin incision plus 10 IU oxytocin intravenous infusion after placental delivery.Results: The mean age was similar in 2 groups i.e., 26.34±4.78 years in group 1 and 27.31±5.62 years in group 2. Most women in the present study presented with type IV placenta previa i.e., 34.3% in group 1 and 48.6% in group 2. Mean pre-operative hemoglobin was 9.57±1.54 g/dl in group 1 and 9.59±1.35 g/dl in group 2. Intra-operative mean blood loss was 729.31±172.45 ml in intravenous oxytocin group and 464.86±28.00 ml in intravenous tranexamic acid group. A total of 74.3% women in group 1 and 20% women in group 2 developed postpartum hemorrhage. Mean post-operative hemoglobin was 8.04±1.34 g/dl in group 1 and 8.85±1.26 g/dl in group 2. In group 1, 5.7% neonates were born with very low birth weight and while none in group 2. 51.4% neonates in group 1 and 45.7% in group 2 had low birth weight.Conclusions: It is concluded that tranexamic acid used prophylactically intravenously before skin incision in patients undergoing cesarean section for placenta previa significantly reduces intra-operative blood loss. 

Uterine Compression Suture Versus Cesarean Hysterectomy in Management of Intractable Postpartum Hemorrhage

2020 ◽  
Vol 103 (10) ◽  
pp. 1075-1082
Keyword(s):  
Pregnant Women ◽  
Surgical Management ◽  
Postpartum Hemorrhage ◽  
Suture Technique ◽  
Cesarean Hysterectomy ◽  
Operative Outcomes ◽  
Uterine Compression Suture ◽  
Compression Suture ◽  
Group 2 ◽  
Group 1

Background: Postpartum hemorrhage (PPH) is the third leading cause of maternal death. Uterine atony is the most common cause, and surgical management is the last method for PPH. Objective: To assess operative outcomes after uterine compression suture (B-Lynch suture technique) versus cesarean hysterectomy. Materials and Methods: The comparison retrospective research evaluated the operative outcomes of the pregnant women managed by the B-Lynch suture technique (group 1) versus cesarean hysterectomy (group 2). Unique data form, designed to collect all patients involved in the present study, were reviewed and analyzed. The population study was pregnant women divided into two groups. Thirty-five patients were assigned to group 1 and thirty-five patients were assigned to group 2. The independent t-test was used to compare means of categorical variables between the two groups, with p<0.05 indicating statistical significance. Results: Twenty-three thousand two hundred fifty-eight pregnant women delivered during the study period, which was 18 years 6 months. PPH occurred in 563 patients (2.42%), in both vaginal and cesarean deliveries. Intractable PPH occurred in 177 patients (0.76%) during cesarean section. Clinical data risk factors were age, complications while receiving blood transfusion, injury to the urinary bladder, and death. Several outcomes in group 1 were better than in group 2, such as the interval of operation, blood loss, fever after surgery, and saving of life. However, three patients in the trial of B-Lynch suture were changed to hysterectomy due to curative management. Conclusion: The uterine compression suture (the B-Lynch technique) should be used promptly to manage acute PPH due to uterine atony. Additionally, a cesarean hysterectomy might be used for surgical management in the latter method, depending on the severity of the patient, the etiology of PPH, and the obstetrician’s skills and experience. Keywords: Postpartum hemorrhage, Uterine compression suture, Cesarean hysterectomy

scholarly journals Penyuluhan Perdarahan Masa Nifas Pada Kader Di Posyandu Desa Kairatu

2021 ◽  
Vol 2 (4) ◽  
pp. 228-231
Author(s):  
Windatani Mayasari ◽  
Marwia Samal
Keyword(s):  
Developing Countries ◽  
Blood Loss ◽  
Maternal Mortality ◽  
Post Partum ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Developed Countries ◽  
World Health ◽  
Total Blood ◽  
Maternal Deaths

World Health Organization (WHO) data shows that 99% of maternal deaths due to childbirth or birth problems occur in developing countries. When compared with the ratio of maternal mortality in nine developed countries and 51 Commonwealth countries, the ratio of maternal mortality in developing countries is the highest with 450 maternal deaths per 100 thousand live births. Post-partum bleeding is diagnosed when the amount of bleeding is considered to be more than normal. Clinical signs and symptoms of blood loss include weakness, sweating, and tachycardia which usually occur after the loss of 15-25% of total blood volume loss. Hemodynamic reduction only occurs in blood loss of 35% and 45%.Keywords: Posyandu Cadres, Puerperal Bleeding

scholarly journals Active management of third stage of labour: a comparative study of intra-umbilical oxytocin versus intramuscular oxytocin

2017 ◽  
Vol 6 (8) ◽  
pp. 3434
Author(s):  
Neerja Gupta ◽  
Manjushree Athokpam
Keyword(s):  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Developed Countries ◽  
Active Management ◽  
Singleton Pregnancy ◽  
Third Stage ◽  
Maternal Morbidity And Mortality ◽  
Group 2 ◽  
Volume Difference ◽  
Group 1

Background: Postpartum haemorrhage is a single major and leading cause of maternal morbidity and mortality, not only in the developing countries but also in developed countries. Every 4 minutes one woman dies from pregnancy or child birth related complications. The present study is to compare oxytocin used via intra-umbilical or intramuscular route in the active management of third stage of labour with respect to duration and amount of bleeding.Methods: Four hundred pregnant women at term of a singleton pregnancy with spontaneous onset of labour were included in the study and were randomly divided into 2 groups of 200 women each. Group 1, intra-umbilical oxytocin 10U diluted in 10ml of saline, and Group 2, intramuscular oxytocin 10U were given after the delivery of baby.Results: The outcome criteria with respect to third stage of labour were: duration of the 3rd stage of labour, blood loss by volume, difference in haemoglobin. A significant reduction in duration of third stage (p = 0.001) and blood loss in third stage (p =0.0001) in intra-umbilical oxytocin group was found when compared with intramuscular oxytocin use.Conclusions: Intra-umbilical oxytocin is better alternative to intramuscular oxytocin in active management of third stage of labour.

Comparison of 24-Hour Electrocardiogram Parameters in Patients with Graves Disease Before and After Anti-Thyroid Therapy

2020 ◽  
Vol 20 ◽  
Author(s):  
Gamze Akkuş ◽  
Yeliz Sökmen ◽  
Mehmet Yılmaz ◽  
Özkan Bekler ◽  
Oğuz Akkuş
Keyword(s):  
Treatment Group ◽  
Medical Treatment ◽  
Surgical Therapy ◽  
Graves Disease ◽  
Before And After ◽  
Euthyroid Status ◽  
Ectopic Beats ◽  
Group 2 ◽  
Electrocardiographic Parameters ◽  
Group 1

Background: We aimed prospectively investigate the laboratory and electrocardiographic parameters (hearth rate, QRS, QT, QTc, Tpe, Tpe/QTc, arrhythmia prevalance) in patients with graves disease before and after antithyroid therapy. Methods: 71 patients (48 female, 23 male), age between 18-50 (mean±SD: 36.48±12.20 ) with GD were included into the study. Patients treated with antithyroid therapy (thionamids and/or surgical therapy) to maintain euthyroid status. Patients were examined in terms of electrocardiographic parameters before and after the treatment. Results: Mean TSH, free thyroxin (fT4) and tri-iodothyrionine (fT3) levels of all patients were 0.005±0.21, 3.27± 1.81, 11.42±7.44, respectively. While 9 patients (group 2) underwent surgical therapy, had suspicious of malignant nodule or large goiter and unresponsiveness to medical treatment; the other patients (n=62, group 1) were treated with medical therapy. Patients with surgical therapy had more increased serum fT4 (p=0.045), anti-thyroglobulin value (p=0.018) and more severe graves orbitopathy (n=0.051) before treatment when compared to medical therapy group. Baseline Tpe duration and baseline Tpe/QTc ratio and frequency of supraventricular ectopic beats were found to be significantly higher in group 2 when compared to group 1 (p=0.00, p=0.005). Otherwise baseline mean heart rate, QRS duration, QTc values of both groups were similar. Although the patients became their euthyroid status, group 2 patients had still suffered from more sustained supraventricular ectopics beats than group 1. Conclusion: Distinct from medical treatment group, surgical treatment group with euthyroidism at least 3 months had still suffered from an arrhythmia (Tpe, Tpe/QTc, supraventricular and ventricular ectopic beats).

scholarly journals Maternal mortality during the COVID-19 pandemic in Mexico: a preliminary analysis during the first year

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Mendez-Dominguez ◽  
Karen Santos-Zaldívar ◽  
Salvador Gomez-Carro ◽  
Sudip Datta-Banik ◽  
Genny Carrillo
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Maternal Mortality ◽  
Respiratory Distress ◽  
Pregnant Women ◽  
Distress Syndrome ◽  
Maternal Mortality Ratio ◽  
Maternal Deaths ◽  
Immune Impairment ◽  
Mortality Ratio

Abstract Background In Mexico, the COVID-19 pandemic led to preventative measures such as confinement and social interaction limitations that paradoxically may have aggravated healthcare access disparities for pregnant women and accentuated health system weaknesses addressing high-risk patients’ pregnancies. Our objective is to estimate the maternal mortality ratio in 1 year and analyze the clinical course of pregnant women hospitalized due to acute respiratory distress syndrome and COVID-19. Methods A retrospective surveillance study of the national maternal mortality was performed from February 2020–February 2021 in Mexico related to COVID-19 cases in pregnant women, including their outcomes. Comparisons were made between patients who died and those who survived to identify prognostic factors and underlying health conditions distribution. Results Maternal Mortality Ratio increased by 56.8% in the studied period, confirmed COVID-19 was the cause of 22.93% of cases. Additionally, unconfirmed cases represented 4.5% of all maternal deaths. Among hospitalized pregnant women with Acute Respiratory Distress Syndrome consistent with COVID-19, smoking and cardiovascular diseases were more common among patients who faced a fatal outcome. They were also more common in the age group of < 19 or > 38. In addition, pneumonia was associated with asthma and immune impairment, while diabetes and increased BMI increased the odds for death (Odds Ratio 2.30 and 1.70, respectively). Conclusions Maternal Mortality Ratio in Mexico increased over 60% in 1 year during the pandemic; COVID-19 was linked to 25.4% of maternal deaths in the studied period. Lethality among pregnant women with a diagnosis of COVID-19 was 2.8%, and while asthma and immune impairment increased propensity for developing pneumonia, obesity and diabetes increased the odds for in-hospital death. Measures are needed to improve access to coordinated well-organized healthcare to reduce maternal deaths related to COVID-19 and pandemic collateral effects.

scholarly journals Semen testis expressed protein 101 and spermatid-specific thioredoxin reductase 3 levels may be biomarkers in infertile male

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatma Zehra Erbayram ◽  
Esma Menevse ◽  
Duygu Dursunoglu
Keyword(s):  
Male Infertility ◽  
Biochemical Parameters ◽  
Sperm Concentration ◽  
Thioredoxin Reductase ◽  
Clinical Approach ◽  
Elisa Method ◽  
Infertile Male ◽  
Protein Levels ◽  
Group 2 ◽  
Group 1

Abstract Objectives We aimed to determine the differences between normozoospermic and oligozoospermic individuals according to levels of spermatid-specific thioredoxin reductase 3 (SPTRXR3/STRX3/TXNDC8/TXNRD3) and testis expressed protein 101 (TEX-101), and to evaluate the correlations between spermiogram data and biochemical parameters. Methods The study was carried out at the Andrology Laboratory of Medicine Faculty of Selcuk University. Two groups were designed: Group 1: Normozoospermia (n=40, sperm concentration ≥ 15 million/mL), Group 2: Oligozoospermia; (n=40, sperm concentration < 15 million/mL). Seminal plasma SPTRXR3 and TEX-101 levels were analyzed with ELISA method. Spermiogram analysis was evaluated according to WHO 2010 Kruger criteria. Results TEX-101 protein levels were significantly different in normozoospermia (2.12 ± 0.08 ng/mL) compared to oligozoospermia (1.55 ± 0.04 ng/mL). SPTRXR3 levels (6.98 ± 0.46 ng/mL) were higher in oligozoospermia than normozoospermia (3.07 ± 0.35 ng/mL). Both TEX-101 and SPTRXR3 levels were correlated statistically with most of the spermiogram parameters. Conclusions High SPTRXR3 and low TEX-101 levels may be a biomarker in evaluation of male infertility. The relations between spermiogram parameters indicates that results present a new clinical approach in biology of oligozoospermic male.

scholarly journals Antiphospholipid antibodies, genetic thrombophilia and fetal growth retardation

2022 ◽  
Vol 15 (6) ◽  
pp. 695-704
Author(s):  
E. A. Orudzhova
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Antiphospholipid Antibodies ◽  
Controlled Trial ◽  
Factor V Leiden ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Group 2 ◽  
Group 1

Aim: to study the role of antiphospholipid antibodies (AРA) and genetic thrombophilia as a potential cause of the development or a component in the pathogenesis of early and late fetal growth retardation (FGR).Materials and Methods. There was conducted a prospective randomized controlled trial with 118 women enrolled. The main group consisted of 83 patients, whose pregnancy was complicated by FGR degrees II and III, stratified into two groups: group 1 – 36 pregnant women with early FGR, group 2 – 47 pregnant women with late FGR. Women were subdivided into subgroups according to the FGR severity. The control group consisted of 35 pregnant women with a physiological course of pregnancy. АРА were determined according to the Sydney antiphospholipid syndrome criteria by enzyme immunoassay (ELISA): against cardiolipin, β2 -glycoprotein 1, annexin V, prothrombin, etc. (IgG/IgM isotypes); lupus anticoagulant – by the three-stage method with Russell's viper venom; antithrombin III and protein C levels – by chromogenic method; prothrombin gene polymorphisms G20210A and factor V Leiden – by polymerase chain reaction; homocysteine level – by ELISA.Results. AРA circulation (medium and high titers), genetic thrombophilic defects and/or hyperhomocysteinemia were detected in 40 (48.2 %) patients with FGR, which was significantly higher than that in the control group (p < 0.05): in group 1 (41.7 % of women) AРA (30.6 %) and AРA with genetic thrombophilia or hyperhomocysteinemia (11.1 %) were revealed; in group 2 (51.1 % of women) AРA (21.3 %), AРA with hyperhomocysteinemia (4.3 %), genetic thrombophilia (25.5 %), and due to hyperhomocysteinemia (2.1 %) were found. No differences in prevalence of thrombophilia rate in patients were observed related to FGR severity, but a correlation between the FGR severity and AРA titers was found.Conclusion. Testing for the presence of AРA, genetic thrombophilia and hyperhomocysteinemia should be recommended for patients with FGR (including those with FGR in medical history), especially in the case of its early onset. It is recommended to determine the full AРA spectrum.

scholarly journals The role of uterine artery Doppler index and nuchal translucency measurement in predicting perinatal problems and the gestational age in patients diagnosed with hyperemesis gravidarum

2020 ◽  
Vol 2 (3) ◽  
pp. 19-22
Author(s):  
Dilek Kartal ◽  
Azra Arıcı Yurtkul ◽  
Ayşe Rabia Şenkaya
Keyword(s):  
Pregnant Women ◽  
Uterine Artery ◽  
Hyperemesis Gravidarum ◽  
Systemic Disease ◽  
Nuchal Translucency ◽  
Control Group ◽  
Uterine Artery Doppler ◽  
Tertiary Center ◽  
Group 2 ◽  
Group 1

Objective: We aimed to investigate the effectiveness of uterine artery Doppler index and nuchal translucency (NT) measurement in determining perinatal problems in patients diagnosed with hyperemesis gravidarum (HEG). Material and methods: We included 80 pregnant women between the ages of 19–40 years with a singleton, noncomplicated pregnancy, no systemic disease, and no structural and chromosomal disorders in the fetus, who were admitted to our hospital which is a tertiary center with a large patient population in the region, between October 2015 and October 2016 in this study. Further, two group were formed as 40 pregnant women with the diagnosis of HEG (group 1) and 40 pregnant women for control group (group 2). Age, body mass index (BMI), educational status,pregnancy history (live birth, miscarriages), smoking, alcohol consumption, substance use, last menstrual period, serum pregnancy-associated plasma protein A (PAPP-A), free beta-human chorionic gonadotropin, (free ß-hCG), thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) levels, nuchal translucency (NT), and uterine artery Doppler measurement values were recorded. The data between two groups were compared. Results: The education level of the group 1 was found higher (p = 0.001). The frequency of smoking in group 1 (n = 18; 45%) was found significantly higher than group 2 (n = 3; 7.5%) (p = 0.001). In group 1, uterine artery Doppler pulsatility index (PI) and resistance index (RI) values were found higher than group 2 (p = 0.026 and 0.024, respectively). Conclusion: The uterine artery Doppler PI, RI values measured at 20–24 weeks in patients with HEG were statistically significantly higher than those without HEG.

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