scholarly journals Evaluation of the Adherence of Obstetricians to International Guidelines for Dispensing Misoprostol and Oxytocin in Saad Abu Ella Maternity Hospital: A Retrospective Study

2020 ◽  
Author(s):  
Mona Elbashir ◽  
Safaa Badi ◽  
Muhammad Abdulraheem ◽  
Bashir Yousef
Keyword(s):  
Postpartum Hemorrhage ◽  
Maternity Hospital ◽  
Labor Induction ◽  
Termination Of Pregnancy ◽  
Intrauterine Fetal Death ◽  
Normal Vaginal Delivery ◽  
Cesarean Sections ◽  
International Guidelines ◽  
Age Range ◽  
Incomplete Miscarriage

Background: Misoprostol and oxytocin are commonly prescribed drugs by obstetricians to induce labor and prevent postpartum hemorrhage. In Sudan, there is no national guideline for prescribing these drugs. Thus, the prescribers follow the international guidelines. Hence, our study aimed to evaluate the adherence of Sudanese obstetricians to the international guidelines for dispensing misoprostol and oxytocin. Methods: A retrospective descriptive hospital-based study was performed at Saad Abu Ella hospital through their medical files archived in 2018 using a checklist designed by the researcher. Collected data were analyzed and presented in frequency tables using the statistical package for social sciences (SPSS). Results: A total of 357 medical files were evaluated, about 50% of cases examined was in the 25–35 years age range, multigravida pregnant ladies were 62%. General indications of oxytocin and/or misoprostol were induction of labor (17%), postpartum hemorrhage prevention (PPH) after normal vaginal delivery (NVD) (30%) and cesarean sections (32%), evacuation of incomplete miscarriage (20%), and termination of pregnancy (1%). Compared to the guidelines, only 14% were given the recommended regimens for labor induction; 9.4% of women who had undergone NVD were given the recommended regimen to prevent PPH. While, 57% and 43% of the cases with incomplete miscarriage and termination of pregnancy were given the recommended regimens, respectively. Based on the correct indication, total adherence was estimated to be 17%. Conclusions: Higher percentages of cases with incomplete miscarriage and intrauterine fetal death were given the recommended regimens to manage them. While, lower percentages of the participants were given the recommended regimens for labor induction and to prevent PPH.  Key words: misoprostol, oxytocin, obstetricians, adherence, international guidelines

scholarly journals Termination of pregnancy services: a year in review in a tertiary maternity hospital

2021 ◽  
pp. bmjsrh-2021-201049
Author(s):  
Eimear O'Shaughnessy ◽  
Sara Leitao ◽  
Nóirín Russell ◽  
Keelin O'Donoghue
Keyword(s):  
Maternity Hospital ◽  
Termination Of Pregnancy

The analysis of abdominal delivery cases at labor activity anomalies

2017 ◽  
pp. 103-106
Author(s):  
Yu.P. Vdovichenko ◽  
◽  
N.P. Goncharuk ◽  
E.Yu. Gurzhenko ◽  
◽  
...  
Keyword(s):  
Objective Assessment ◽  
Maternity Hospital ◽  
Professional Activity ◽  
Cesarean Sections ◽  
Birth Canal ◽  
Professional Management ◽  
Natural Birth ◽  
Abdominal Route ◽  
History Of ◽  
Abdominal Delivery

The objective: analysis of the frequency of cesarean sections, their structure according to the indications from the mother; study of the dynamics of the frequency of cesarean sections in case of abnormalities of labor activity (ALA) as indications for operative delivery on the basis of Kyiv City Maternity Hospital No. 1 for 2001-2011. Patients and methods. During the study, the frequency of cesarean sections in general, the frequency of urgent cesarean sections, the structure of cesarean sections according to the indications from the mother's side, the frequency of cesarean sections in ALA were studied and analyzed, and the dynamics of the cesarean section rate in ARP as well as one of the main indications with Mother's side. The history of the delivery of labor was used, which culminated in the abdominal route. Results. An increase in the level of cesarean sections was noted. The number of urgent cesarean sections is gradually decreasing. There has been a significant reduction in the incidence of cesarean sections in anomalies of labor, which are not amenable to drug treatment. Conclusion. The professional management of births, adequate justified use of medicines, the use of modern medical means in practice, an objective assessment of the obstetrical situation, cardiotocoagraphic support, timely and adequate use of epidural analgesia positively influenced the increase in the number of deliveries through the natural birth canal, which is a priority in the professional activity of the obstetrician-gynecologist. Key words: caesarian section, anomalies of labor activity.

scholarly journals Puerperal infection from the perspective of humanized delivery care at a public maternity hospital

2007 ◽  
Vol 15 (4) ◽  
pp. 536-542 ◽  
Author(s):  
Elisângela Euripedes Resende Guimarães ◽  
Tânia Couto Machado Chianca ◽  
Adriana Cristina de Oliveira
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cesarean Delivery ◽  
Maternity Hospital ◽  
Delivery Care ◽  
Cesarean Sections ◽  
Normal Delivery ◽  
Puerperal Infection ◽  
Concurrent Study ◽  
Effective Conditions

This is an epidemiological, prospective and non-concurrent study of the cohort type about puerperal infection from the perspective of humanized delivery care, based on information from 5,178 records of patients who went through the experience of humanized delivery. The study aimed at describing the women who underwent humanized delivery, determining the incidence and time for manifestation of puerperal infections and investigating the association between the infection and the risk factors. An accumulated puerperal infection rate of 2.92% was found. The risk factors associated to puerperal infection in Cesarean delivery were the duration of labor and the number of digital examinations. No variable behaved as a risk factor for infection in normal delivery. Cesarean delivery was an important risk factor for puerperal infection. The results reinforce the need to develop alternative forms of delivery care that provides effective conditions for normal delivery, in order to reduce the number of Cesarean sections.

scholarly journals Gynecological outcomes of uterine niche after cesarean section: A descriptive study

2021 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
E. A. Abdelfattah ◽  
T. M. Abd-El Dayem ◽  
H. M. Galal ◽  
S. S. Taylon
Keyword(s):  
Cesarean Section ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Maternity Hospital ◽  
University Hospital ◽  
Cesarean Sections ◽  
Gynecological Examination ◽  
The Social ◽  
Space Data ◽  
Previous Cesarean

Objectives: Our aim was to study the prevalence of isthmocele in cases with previous cesarean section scar presented to El Shatby maternity university hospital and its association with gynecological complications. Material and Methods: After approval of the ethics committee of Alexandria faculty of medicine, a sample of 300 patients delivered by cesarean section since 6 months or more presented by one or more of the following symptoms: Abnormal uterine bleeding (AUB) dysmenorrhea, secondary infertility, and lower abdominal pain were selected from the gynecology clinic of El Shatby maternity university hospital. All patients were subjected to history taking, clinical, and gynecological examination. Post-menstrual 2D transvaginal ultrasonography was done. Where the niche or isthmocele was seen as triangular or dome- shaped echo-free space. Data were collected and entered to the computer using Statistical Package for the Social Science program for statistical analysis. Results: Niche was found in 44 cases. Most of them were symptomatic. Duration from the last (CS) was statistically significant. Symptoms were related to number of previous cesarean sections. Conclusion: The incidence of post-cesarean section niche in El Shatby Maternity hospital was 14.67%. Most common symptoms were AUB and dyspareunia.

Induction of Abortion in the Second Trimester by Misoprostol or Misoprostol with Letrozole

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ashraf Mohamed Farouk Kortam ◽  
Tarek Aly Raafat ◽  
Rehab Mohamed Abd El Rahman ◽  
Amir Hamdy Abd El Hady Mahfouz
Keyword(s):  
Maternity Hospital ◽  
Abortion Rate ◽  
Termination Of Pregnancy ◽  
Control Group ◽  
Second Trimester ◽  
Exclusion Criteria ◽  
Trimester Abortion ◽  
Second Trimester Abortion ◽  
Vaginal Misoprostol ◽  
Peripheral Conversion

Abstract Background Abortion is the termination of pregnancy by any means (surgical or medical) before the age of viability. The definition varies in duration of gestational age according to the countries and available facilities. Estrogen is important in the maintenance of pregnancy. Aromatase inhibitors such as letrozole, suppress the peripheral conversion of androgen to estrogen, the use of letrozole combined with vaginal misoprostol was more effective than misoprostol alone in termination of pregnancy. Objective Assessing the efficacy of addition of letrozole to Misoprostol in medically induced abortion in the second trimester of pregnancy in the Maternity hospital of Ain Shams University. Methods This clinical trial was conducted at Ain Shams University Maternity hospital in the period between December 2018 and May 2019. Patients that seem to be fulfilling the inclusion criteria were recruited, then informed written consent was taken from every patient before starting the examination That was followed by detailed history and examination of all patients to confirm fulfilling the inclusion and exclusion criteria. Results This study demonstrated that 10 mg letrozole for three days followed by 800 mcg of vaginal misoprostol is more effective than misoprostol alone for second trimester abortion. In the total of 72 women were recruited the complete abortion rate of the letrozole group was significantly higher than that of the control group (61,1% in the letrozole group compared with 33,3% in the control group). Conclusion s: The use of letrozole in addition to misoprostol was associated with a higher complete abortion rate, shorter induction to abortion interval and shorter curettage rates compared to a placebo followed by misoprostol in patients undergoing induction of abortion between 12 & 24 weeks gestation.

Titrated oral misoprostol solution versus vaginal misoprostol for labor induction in primi gravid ladies

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
I M Abdalfattah ◽  
W E Mohammed ◽  
A A El-gaml
Keyword(s):  
Safety Profile ◽  
Tap Water ◽  
Maternity Hospital ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Cervical Ripening ◽  
Controlled Clinical Trial ◽  
Solution Versus ◽  
Oral Misoprostol ◽  
Vaginal Misoprostol

Abstract Background It is now generally accepted that the uterine cervix plays an important role during pregnancy and labor and that it depends on an active ripening process within the cervix; which is necessary for successful labor induction. Aim of the Work to test the safety and efficacy of titrated oral misoprostol compared to vaginal misoprostol for labor induction in term gravid ladies. Patients and Methods This prospective, single-blinded randomized controlled clinical trial was conducted at Ain-Shams University Maternity Hospital during the period between August 2017 and August 2018. 120 pregnant women planned for induction of labor were recruited in the study according to the inclusion / exclusion criteria. Subjects included in the study were randomized into two groups: patients who received oral 200 ug misoprostol in 200 ml water titrated over 24 hours and placebo tablets vaginally which resemble vagiprost tablets (25 microgram misoprostol) and the second group contained pients who received vaginal misoprostol 25microg maximum four doses, and placebo solution of 200 ml of tap water. Results titrated oral misoprostol is as effective in promoting cervical ripening and inducing labor as intravaginal misoprostol, oral Misoprostol has a similar maternal and perinatal safety profile to vaginal misoprostol. Conclusion This new approach to oral misoprostol administration was successful in minimizing the risk of uterine hyper-stimulation, which has been a feature of misoprostol use for induction of labor, at the expense of a somewhat slower response. Oral Misoprostol has a similar maternal and perinatal safety profile compared to vaginal misoprostol.

Timing and Safety of Postpartum Enoxparin.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4110-4110
Author(s):  
Rachel A. Freedman ◽  
Jeffrey Zwicker ◽  
Kenneth Alan Bauer
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Postpartum Period ◽  
Retrospective Cohort ◽  
Low Molecular Weight Heparin ◽  
Control Group ◽  
Low Molecular Weight ◽  
Cesarean Sections ◽  
Vaginal Deliveries

Abstract The appropriate time to restart anticoagulation in the postpartum period is not known. Both the American College of Obstetrics and Gynecology as well as American College of Chest Physicians (ACCP) have issued guidelines regarding the use of anticoagulants during pregnancy but neither have generated recommendations regarding the timing of the first dose of low-molecular-weight heparin (LMWH) in the postpartum period. The incidence of postpartum hemorrhage was assessed in a retrospective cohort study of 95 women treated with enoxaparin and compared with 303 consecutive deliveries where anticoagulation was not administered. The rate of severe postpartum hemorrhage did not differ significantly for women treated with peripartum enoxaparin versus a control group of women undergoing vaginal delivery (3.6% versus 1.4%, P=0.72) or cesarean section (5.1% versus 3.4%, P=0.98). There were no severe postpartum hemorrhages following the re-initiation of enoxaparin postpartum. In 75% of vaginal deliveries and 49% of cesarean sections, enoxaparin was restarted within 24 hours. Two incisional hematomas were observed in the group of women who received enoxaparin within 24 hours following cesarean section. We conclude that severe postpartum hemorrhage is an infrequent complication following the administration of enoxaparin postpartum. In support of current clinical practice, enoxaparin can be safely administered 0 to 24 hours following vaginal delivery and 12 to 36 hours following cesarean section.

Feticide Does Not Modify Duration of Labor Induction in Cases of Medical Termination of Pregnancy

2008 ◽  
Vol 23 (3) ◽  
pp. 192-197 ◽  
Author(s):  
Luciana Vivas Silva ◽  
José Guilherme Cecatti ◽  
João Luiz Pinto e Silva ◽  
Eliana Amaral ◽  
Ricardo Barini
Keyword(s):  
Labor Induction ◽  
Termination Of Pregnancy ◽  
Medical Termination Of Pregnancy ◽  
Medical Termination

scholarly journals Immersion in Water During Active Labor Decreases Postpartum Hematocrit Fall Following Vaginal Delivery

2018 ◽  
pp. 1
Author(s):  
Gul Nihal Buyuk ◽  
Serkan Kahyaoglu ◽  
Ezgi Turgut ◽  
Omer Hamid Yumuşak ◽  
Caner Kose ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Study Groups ◽  
Normal Vaginal Delivery ◽  
Control Group ◽  
The Mean ◽  
Group 2 ◽  
Water Birth ◽  
Control Group Group ◽  
Group 1

<p><strong>OBJECTIVE:</strong> The objective of the study was to investigate the effect of immersion in water strategy during labor on postpartum bleeding by calculating the postpartum reduction rates of the hematocrit values of the patients.</p><p><strong>STUDY DESIGN:</strong> The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (group 1) and the control group (group 2) of 84 women undergoing normal vaginal delivery. Patients who have received additional medical and surgical interventions for alleviation of postpartum hemorrhage, patients who have undergone an episiotomy and/or perineal trauma were not included in the study. All data were taken from patients who have delivered with spontaneous vaginal delivery. Postpartum hematocrit fall rates of the groups have been compared and the effect of immersion in water on postpartum hemorrhage has been evaluated.</p><p><strong>RESULTS:</strong> The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (Group 1) and the control group (Group 2) of 84 women undergoing vaginal delivery at the hospital. The women in the two groups were matched with respect to age, parity, birth weight and gestational age. The mean age of the women was 29.8±4.8 and 30.5±4.9 respectively. The mean hematocrit difference in the first group was 2.08 ± 1.88 and in the second group was 3.81 ± 1.55. The mean percentage of hematocrit reduction in the first group was 5.71% and in the second group 10.23%.</p><p><strong>CONCLUSION:</strong> Our data showed that mean hematocrit level decreases among women following vaginal delivery more than women who give birth vaginally within immersion in water during labor. The percentage of hematocrit reduction in the water birth group was lower than in the control group. Water birth seems to facilitate uterine contractions more efficiently following vaginal delivery.</p>

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