Comparing the Experiences of Parturient Women With Remifentanil Analgesia and Elective Cesarean Section and Providing Improver Strategies: A Sequential Explanatory Mixed Method Study

2021 ◽  
Author(s):  
rana dousti ◽  
Sevil Hakimi ◽  
Hojjat Pourfathi ◽  
Roghayeh Nourizadeh ◽  
Niloufar sattarzadeh jahdi
Keyword(s):  
Cesarean Section ◽  
Mixed Method ◽  
Elective Cesarean Section ◽  
Mixed Method Study ◽  
Quality Of Data ◽  
Sequential Approach ◽  
Private Hospitals ◽  
Elective Cesarean ◽  
The City

Abstract Background Identifying methods that can effectively and safely improve the childbirth experience and are tailored to mothers' needs are of crucial importance. The current study aimed to compare experiences of parturient women with remifentanil analgesia and elective cesarean section and providing improver strategies for women living in the city of Tabriz, Iran.MethodsThis is a mixed-method study with an explanatory sequential approach. The first stage is quantitative and longitudinal. The study population is all parturient women who will give birth by elective C-section or vaginal painless delivery using remifentanil in private hospitals of the city of Tabriz in 2020-2021. All mothers are free to choose either method. Participants will be selected from all private hospitals using the convenience sampling technique proportioned to the number of eligible women in each hospital. Participants will be followed up to 30 days after delivery to complete the Edinburgh Postpartum Depression questionnaire. The second stage is a qualitative study aimed at exploring the perceptions of parturient women who had either elective C-section or painless delivery (using remifentanil), including factors related to labor experiences. Data will be collected by semi structured interviews with new mothers and important others (if needed).In the third stage, a mixed study will be performed to provide strategies for improving labor experiences. we will use an explanatory Sequential approach in order to increase the accuracy and quality of data and to use the findings to evaluate different methods of delivery.DiscussionBy comparing the experience of parturient women receiving Remifentanil analgesia and elective C-section, evidence-based improving strategies using a culturally sensitive approach can be provided. Presentation of the results obtained from this study using the mixed method may help in better understanding the issue. Also, the obtained results can be used to enhance the quality of midwifery care to be examined by health policymakers and planners.Trial registrationThis study is approved by the ethics committee of the Tabriz University of Medical Sciences (code: IR.TBZMED.REC.1399. 521). Besides, it's evaluated by relevant refers.

Intravertebral Anaesthesia For cesarean section

2019 ◽  
Author(s):  
Fangjun Wang ◽  
Dan Xie ◽  
Chun Hong Xu ◽  
Qin Ye
Keyword(s):  
Cesarean Section ◽  
Spinal Anaesthesia ◽  
Motor Block ◽  
Epidural Block ◽  
Elective Cesarean Section ◽  
Complete Regression ◽  
Caudal Block ◽  
Sensory Blockade ◽  
Elective Cesarean

Abstract BACKGROUND: Although epidural and spinal anaesthesia in patients undergoing cesarean section is the general choice recently, both of the two anesthesia methods still have imperfects. Caudal anesthesia has been considered more appropriate for gynecological surgery. However, there is a lack of experiments on the effects of epidural block combined with caudal block anaesthesia for cesarean section. METHODS: One hundred and fifty patients undergoing elective cesarean section were recruited to this clinical trial and randomized to receive epidural block, subarachnoid block, and epidural block combined with caudal block. The primary objective was to compare and evaluate the clinical efficacy of three groups. Secondary outcomes included side effects and the quality of intraoperative and postoperative comfort assessment. RESULTS: The times to cryanaesthesia at T10 and time to maximum motor block were shorter in group SAB. The maximal sensory blockade spinal segments of group SAB(15.18±0.90)and EAC (14.74±1.16)were much more than group EPB(10.74±1.77). Compared to group EPB(155.40±13.28) and EAC(160.70±12.58), the duration of complete regression of motor block was longer in group SAB(190.00±13.25). The intraoperative quality of anesthesia was judged by the gynecologist was excellent in group EAC and SAB(P=0.005), and by the parturients was only best in group EAC(P=0.001). The parturients felt more comfortable after surgery in group EPB and group EAC(P=0.007). CONCLUSIONS: Epidural block combined with caudal block anaesthesia can achieve the same anesthetic effect as spinal anaesthesia which is bettter than epidural anaesthesia for elective cesarean section, and have the highest level of intraoperative and postoperative comfort for parturient.

scholarly journals Type of Childbirth and its Association with the Maternal-Filial Interaction

2020 ◽  
Vol 42 (10) ◽  
pp. 597-606
Author(s):  
Crystiane Hereny dos Santos Neto ◽  
Fábio Sagula Oliveira ◽  
Graciele Fernanda Gomes ◽  
Edward Araujo Júnior ◽  
Mary Uchiyama Nakamura ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Sao Paulo ◽  
Elective Cesarean Section ◽  
São Paulo ◽  
Visual Contact ◽  
Cross Sectional ◽  
Elective Cesarean ◽  
Observation Protocol

Abstract Objective The purpose of the present study was to evaluate the quality of mother-child bonding in three different contexts related to the labor, that is, vaginal delivery, elective cesarean section, and intrapartum cesarean section. Methods This was an observational, cross-sectional clinical study conducted in two cities within the state of São Paulo, Brazil. The study sample consisted of 81 babies born without any major complications during pregnancy and labor, aged 3 to 4 months, and their respective mothers, aged between 20 and 35 years old, primiparous, living in the cities of Palmital and Ourinhos, state of São Paulo, Brazil. The evaluation of the quality of the maternal-filial interaction was performed through video-image analysis, using the Mother-baby Interaction Observation Protocol from 0 to 6 months (POIMB 0–6, in the Portuguese acronym). Results Mothers who had vaginal delivery had higher amount of visual contact or attempted visual contact (p = 0.034), better response to the social behavior of the child (p = 0.001) and greater sensitivity (p = 0.007) than the others. Their children also showed more interaction with them, as they looked more frequently at the mother's face (p ≤ 0.008) and responded more frequently to the mother's communicative stimulus (p < 0.001). Conclusion Considering the occurrence of vaginal delivery, it is concluded that the interaction between the mother-child dyad is quantitatively larger and qualitatively better when compared with intrapartum or elective cesarean section.

Acute Dystonia after a Single Dose of Intravenous Metoclopramide during Elective Cesarean Section: A Case Report.

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Danielle Levin
Keyword(s):  
Single Dose ◽  
Case Report ◽  
Cesarean Section ◽  
Epidural Anesthesia ◽  
Elective Cesarean Section ◽  
Single Administration ◽  
Dystonic Reaction ◽  
Elective Cesarean ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

We would like to present the first report of severe acute dystonic reaction after a single administration of metoclopramide during cesarean section under combined spinal-epidural anesthesia.  During elective cesarean section, a 30-year-old female vomited four times and was treated with 10mg intravenous metoclopramide and 8mg intravenous ondansetron.  Nausea subsided with the antiemetic treatment, but two minutes later, patient had rapid eye blinking, uncontrollable head movement, and became unresponsive.  Bolus of 50mg intravenous diphenhydramine resolved the acute dystonic symptoms within seconds.  Patient was again oriented times three, with no recollection of symptoms, and remained symptom free for the rest of admission. 

scholarly journals Women’s empowerment and elective cesarean section for a single pregnancy: a population-based and multivariate study in Vietnam

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Myriam de Loenzien ◽  
Quoc Nhu Hung Mac ◽  
Alexandre Dumont
Keyword(s):  
Cesarean Section ◽  
Partner Violence ◽  
Negative Impact ◽  
Mode Of Delivery ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Elective Cesarean Section ◽  
Multiparous Women ◽  
Elective Cesarean ◽  
Primiparous Women

Abstract Background Women’s empowerment, and maternal and neonatal health are important targets of the Sustainable Development Goals. Our objective is to examine the relationship between women’s empowerment and elective cesarean section (ECS), focusing on Vietnam, a country where the use of CS has increased rapidly in recent decades, which raises public health concerns. Methods We hypothesized that in the context of the developing biomedicalization of childbirth, women’s empowerment increases the use of ECS due to a woman’s enhanced ability to decide her mode of delivery. By using microdata from the 2013–2014 Multiple Indicator Clusters Survey, we conducted a multivariate analysis of the correlates of ECS. We studied a representative sample of 1343 institutional single birth deliveries. Due to higher ECS rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women. Results Among the indicators of women’s external resources, which include a higher level of education, having worked during the previous 12 months, and having one’s own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. Among primiparous women, no resource indicator was significantly linked to ECS. However, considering women’s empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of ECS. Among multiparous women, disapproval of intimate partner violence (IPV) was associated with a doubled likelihood of undergoing ECS (odds ratio = 2.415), and living in an urban area also doubled the likelihood of ECS. The positive association with living in the richest household quintile was no longer significant when attitude towards IPV was included in the model. In both groups, being aged 35 or older increased the likelihood of undergoing ECS, and this impact was stronger in primiparous women. Conclusions These results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. The results advocate for the integration of women's empowerment into policies aimed at reducing ECS rates.

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