scholarly journals Impact of Face-to-Face Educational Outreach Plus Printed Materials on Preoperative Anxiety level in Iranian Parturient Undergoing Elective Cesarean Section Delivery

Author(s):  
Alireza Saliminia ◽  
Omid Azimaraghi ◽  
Zahra Ebadi ◽  
Fahimeh Azizinik ◽  
Ali Movafegh

Background: Anxiety, in demanding situations such as the perioperative period, can exacerbate underlying diseases and lead to a variety of perioperative complications. Educating patients not only improves the level of knowledge but can also help patients coping skills. The aim of the present study is to determine the effect of face-to-face plus printed educational materials on the anxiety level of Iranian pregnant women undergoing elective cesarean section delivery in the perioperative period. Methods: STAI questionnaire was distributed to 50 pregnant women undergoing cesarean section on the day before operation, then the intervention group was educated face to face for one session followed by the pamphlet. After training, the STAI questionnaire was again distributed to the intervention group on the same day. For evaluating the level of anxiety, we also used the Visual Analog Scale (VAS). The presence of nausea/vomiting after surgery and the type of anesthesia technique were recorded. Results: Basic characteristics of the parturient regarding age, education level and the baseline level of anxiety were similar. In the intervention group, the average anxiety level with STAI(S) questionnaire was 48.1 before the education and 45.2 after face to face outreach (P = 0.019). The average anxiety level with VAS score was 5.6 before the education and 4.8 after the outreach in the interventional group (P = 0.018). STAI(S) and VAS scores in the control group were 43.3 and 5.1 respectively which increased to 44.2 and 5.7 in the second survey. The correlation coefficient between score in the STAI questionnaire and VAS was 0.479. Conclusion: A single period of face to face education followed by handing out a pamphlet before an operation reduces the anxiety of mothers before cesarean section delivery.

2018 ◽  
Vol 1 (2) ◽  
pp. 70-74
Author(s):  
Rohini Sigdel ◽  
Maya Lama ◽  
Sanish Gurung ◽  
Bishal Gurung ◽  
Anil Prasad Neupane ◽  
...  

Background: Several methods have been used to prevent post spinal hypotension including preloading, co-loading, use of vasopressors, placement of pelvic wedge, lumbar wedge and tilting of operating table in parturients undergoing cesarean section. We conducted a randomized controlled study to determine the hemodynamic effects of a standard pelvic wedge placed below the right hip immediately after the spinal block till the delivery of baby. Methods: One hundred consenting women undergoing elective cesarean section under spinal anesthesia were randomly allocated to wedge group (N=50) and control group (N=50). A standard wedge was placed under the right pelvis soon after spinal anesthesia till the delivery of baby in wedge group whereas the control group remained supine. Hemodynamic parameters including blood pressure, heart rate, vasopressor consumption, other side effects like nausea, vomiting and neonatal outcome were also recorded. Results: The incidence of hypotension and bradycardia was similar between groups (Wedge group 60% vs Control group 75.51%, p=0.125) before the birth of baby. The use of vasopressors (p=0.212), incidence of nausea (p=0.346) and Apgar score at 1 and 5 minutes (p=0.629, p=0.442) were also not statistically significant. None of the patients had vomiting. Conclusion: In our study, the use of right pelvic wedge immediately after spinal anesthesia was not effective in preventing post spinal hypotension in elective cesarean section.


Author(s):  
Pravin Shah ◽  
Ajay Agrawal ◽  
Shailaja Chhetri ◽  
Pappu Rijal ◽  
Nisha K. Bhatta

Background: Postpartum hemorrhage is a common and occasionally life-threatening complication of labor. Cesarean section is associated with more blood loss in compared to vaginal delivery. Despite, there is a trend for increasing cesarean section rates in both developed and developing countries thereby increasing the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of intravenous Tranexamic acid on blood loss during and after elective cesarean section.Methods: This was a prospective, randomized controlled study with 160 eligible pregnant women of 37 or more period of gestation. They were all planned for elective cesarean section and were randomized into two groups either to receive 10ml (1gm) of Tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation.Results: The mean estimated blood loss was significantly lower in women treated with Tranexamic acid compared with women in the placebo group (392.13 ml±10.06 vs 498.69 ml±15.87, respectively; p<0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the Tranexamic acid group than in the control group (0.31±0.18 vs 0.79±0.23, respectively; p<0.001).Conclusions: Pre-operative use of Tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where postpartum hemorrhage is a major threat to the life of the mothers, it seems to be a promising option.


2002 ◽  
Vol 97 (2) ◽  
pp. 320-324 ◽  
Author(s):  
Michael S. Avidan ◽  
Philippa Groves ◽  
Margaret Blott ◽  
Jan Welch ◽  
Theresa Leung ◽  
...  

Background Elective cesarean section decreases the likelihood of vertical human immunodeficiency virus (HIV) transmission from mother to infant. This study aimed to determine whether cesarean section done with spinal anesthesia on HIV-1-infected pregnant women taking antiretroviral therapy is associated with intraoperative hemodynamic instability, postoperative complications, or changes in immune function or HIV-1 viral load. Methods A case-controlled study was conducted over a 3-year period in a London academic hospital. Forty-four women infected with HIV-1 and a control group of 45 HIV-negative women undergoing cesarean sections were included. The main outcome measures included intraoperative blood pressure, heart rate, blood loss, and ephedrine requirements, and postoperative infective complications, blood transfusion, changes in blood HIV-1 viral load and lymphocyte subsets, and time to hospital discharge. Results There were no differences in hemodynamic stability and postoperative complications between the HIV-infected group and the controls. There was an acute postoperative increase in the CD4T lymphocyte count (P = 0.01), but the CD4T:CD8T ratio and viral load did not change. Conclusions Elective cesarean section under spinal anesthesia for women infected with HIV-1 taking antiretroviral therapy was not associated with intraoperative or postoperative complications.


2019 ◽  
Vol 09 (02) ◽  
pp. 199-208
Author(s):  
Afaf Abdul-Jabar Al Sulamy ◽  
Shadia A. Yousuf ◽  
Hala Ahmed Thabet

Author(s):  
Nurlaela Kurnia Rahayu ◽  
Pepi Hapitria ◽  
Rani Widiyanti

As the pregnancy gets older, the attention and thoughts of pregnant women begin to focus on something that is considered as a climax, so that the anxiety experienced will intensify just before the childbirth. Excessive anxiety and sleep disorders during pregnancy can cause mental disorders in pregnant women and inhibit fetal growth. To determine the effect of prenatal gentle yoga and hypnotherapy on anxiety level and sleep quality in the third trimester pregnant women. This is a quasi-experimental study with a pre-post test with a control group. The sample was 32 respondents consisting of 16 respondents as an intervention group and 16 respondents as a control group taken by purposive sampling. The analysis used was the Paired T-test. There is a difference in the average of anxiety level in the third trimester pregnant women in the intervention and control groups with a p value 0,000; there is a difference in the average of sleep quality in the third trimester pregnant women in the intervention and control groups with a p value 0,000; and there is no difference in the average of anxiety level and sleep quality in the third trimester pregnant women in the intervention and control groups with a p value 0,64. Prenatal Gentle Yoga and Hypnotherapy have an effect in reducing the anxiety level and improving the sleep quality in the third trimester pregnant women.


Author(s):  
Therese K. Abboud ◽  
Michael J. Moore ◽  
Jerry Jacobs ◽  
Kazushige Murakawa ◽  
Manoutchehr Soraya ◽  
...  

The effects of epidural anesthesia using mepivacaine on maternal blood pressure, newborn Apgar scores, neonatal acid-base status, and the Early Neonatal Neurobehavioral Scale (ENNS) were studied in 21 pregnant women undergoing cesarean section. Maternal and neonatal blood levels of mepivacaine were also determined. Neonatal outcome was compared with a control group of 14 neonates of healthy mothers who received 3% 2-chloroprocaine for elective cesarean section. All patients had satisfactory anesthesia for cesarean section with an onset of 19 ± 1.8 minutes (mean ± SEM) and duration of 95 ± 11.9 minutes. Hypotension developed in two patients, and they were treated with intravenous ephedrine. All neonates had Apgar scores of 8 or more at 1 and 5 minutes and normal blood gases and acid-base status. None of the variables of the ENNS differed significantly between the mepivacaine and the chloroprocaine control group with the exception of truncal tone, which was significantly higher in the mepivacaine group ( p < 0.05). Mepivacaine was detected in all maternal and fetal samples, and the umbilical venous to maternal venous ratio was 0.57 ± 0.17 (mean ± SEM).


2021 ◽  
Vol 15 (7) ◽  
pp. 2039-2043
Author(s):  
Runjati . ◽  
Sri Rahayu ◽  
Ida Ariyanti ◽  
Sri Wahyuni ◽  
Emy Suryani

Background: Antenatal education is considered standard care for pregnant women. Unfortunately, this class does not provide sufficient skills for women to cope with stress during pregnancy and delivery. In the other side, study literature claims that coping skill is truly essential for the mother to cope with and minimize the anxiety which leads to a serious risk for both mother and baby. Objective: This study aims to prove the impact of smart mother classes to improve coping skills ability and decrease anxiety levels among pregnant women. Methods: This study used a randomized pre-test post-test control group design in which the ages of pregnancies were 28-35 weeks in Semarang City Region. The mothers were randomly assigned to be members of an experiment group (n=50) and a control group (n=50). The experiment group was given smart mother classes that did perform antenatal classes and coping skills, while the control group was given standard classes, antenatal education only. The data analysis employed a dependent sample t-test and independent sample t-test. Results: There is a significant change over coping skill ability for the intervention group (p<.01), but not in the control group. Furthermore, there is also a significant change in the decrease in anxiety levels in the intervention group (p<.01). Conclusion: Smart mother classes are predominantly effective to reduce anxiety levels and enhance coping skill ability among pregnant women. Thus, pregnant women need to join smart mother classes during pregnancy. Keywords: smart mother classes; coping skill, anxiety level, antenatal classes


2020 ◽  
Author(s):  
Elina Holopainen ◽  
Svetlana Vakkilainen ◽  
Outi Mäkitie

Abstract Background Cartilage-hair hypoplasia (CHH) is a rare skeletal dysplasia characterized by disproportionate short stature, immunodeficiency, anemia and risk of malignancies. All these features can affect pregnancy and predispose to maternal and fetal complications. This study aimed to evaluate obstetric history and maternal and fetal outcomes in women with CHH. Methods Among 47 Finnish women with CHH, we identified 14 with pregnancy-related diagnoses in the National Hospital Discharge Registry and obtained detailed data on gynecologic and obstetric history with a questionnaire. Offspring birth length and weight were collected and compared with population-based normal values. Results There were altogether 42 pregnancies in 14 women (median height 124 cm, range 105–139). Twenty-six pregnancies (62%), including one twin pregnancy, led to a delivery. Miscarriages, induced abortions and ectopic pregnancies complicated 9, 5, and 2 pregnancies, respectively. Severe pregnancy-related complications were rare. All women with CHH delivered by cesarean section, mostly due to evident cephalo-pelvic disproportion, and in 25/26 cases at full-term. In the majority, the birth length (median 48 cm, range 45.5–50) and weight (3010 g, range 2100–3320) of the offspring in full-term singleton pregnancies was normal. Conclusions Despite CHH mothers’ significant short stature and other potential CHH-related effects on pregnancy outcome, most pregnancies lead to a term cesarean section delivery. Since fetal growth was generally unaffected, cephalo-pelvic disproportion was evident and elective cesarean section should be planned in term pregnancies.


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