Comparison of Efficacy of Refrigerated Oxytocin with Oxytocin Kept at Room Temperature for the Prevention of Post-Partum Haemorrhage in Vaginal Deliveries in a Tertiary Care Setting

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Pandey U
Keyword(s):  
Blood Loss ◽  
Low Income ◽  
Room Temperature ◽  
Postpartum Haemorrhage ◽  
Past History ◽  
Post Partum ◽  
Cold Chain ◽  
Vaginal Deliveries ◽  
History Of ◽  
The Mean

Introduction: Postpartum haemorrhage is one of the leading causes of maternal death worldwide and it accounts for nearly one-quarter of all maternal deaths and almost half of all postpartum deaths in low-income countries. Primary postpartum haemorrhage (PPH) is the most common form of major obstetric haemorrhage. Materials and Methods: The study protocol was comprised of Consent, Measurement of Pre-delivery Hemoglobin, Administration of the Intervention, Measurement of postpartum blood loss and Measurement of Post-delivery (24-48 hours) Hemoglobin. Blood loss was measured using a calibrated drape. The drape was placed beneath the parturient buttocks and secured around her abdomen with ties. Blood loss was monitored for a minimum of one hour and was continued in the second hour in case of persistent bleeding. The drape with the collected blood was weighed on a scale. The weight of the drape and the container in which it is placed was deducted from the total recorded weight in order to obtain the weight of the blood collected in the drape. Blood loss weight in grams was converted to milliliters by dividing the figure in grams by 1.06 (blood density in grams per milliliter). Results: The cross tabulations were used to study the demographic, obstetrical and medical factors in women with obstetrical haemorrhage. Table 1 shows the selected sociodemographic characteristics of the study population. The mean age of cases and controls are 26.333.559 and 26.853.873 respectively. On comparison, they are statistically insignificant. (p=0.324). The educational, occupational and socioeconomic status was comparable between cases and controls (p >0.05). Table 2 shows Antenatal, intra-partum and post-partum data in cases and controls. Discussion & Conclusion: It is a study done in North India comparing the Oxytocin kept at room temperature with failure of maintenance of cold chain during transport and storage and the refrigerated Oxytocin. It is the common understanding and general training that Oxytocin must be stored in the refrigerator, failing which its efficacy reduces i.e. it, will not be effective in controlling PPH. During the study we compared the mean blood loss and change in hemoglobin levels in cases and control and despite the fact that major risk factor for PPH for example past history of PPH, past history of D&C, prolonged third stage labour duration, manual removal of placenta were comparable in both cases and controls, still the mean blood loss and change in hemoglobin values was more in cases than controls. This could be attributed to usage of market oxytocin which had failed cold chain maintenance resulted in less effective oxytocin in prevention of PPH, Hence causing more blood loss and drop in hemoglobin values. This shows the need of room temperature stable uterotonic drug in LMIC’s like ours. Recently room temperature stable carbetocin shows the potential as an effective uterotonic drug for the prevention of PPH. However according to various studies carbetocin cannot be used for induction or augmentation of labour so it cannot replace oxytocin fully, rather it acts as a part of collective PPH reduction strategy.

scholarly journals Comparative Study of Rectal Misoprostol to Oxytocin Infusion in Preventing Postpartum Haemorrhage After Caesarean Section

2014 ◽  
Vol 8 (2) ◽  
pp. 34-37 ◽  
Author(s):  
AI Adanikin ◽  
E Orji ◽  
PO Adanikin ◽  
O Olaniyan
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Comparative Study ◽  
Postpartum Haemorrhage ◽  
Post Partum ◽  
Operative Blood Loss ◽  
Oxytocin Infusion ◽  
The Mean ◽  
Post Partum Haemorrhage ◽  
To Receive

Aims: This comparative study aimed to compare the efficacy of rectal misoprostol to oxytocin infusion in preventing primary postpartum haemorrhage after caesarean section. Methods: Fifty pregnant women with identifiable risk factors for post-partum haemorrhage who delivered baby by caesarean section were randomized to receive 600 μg rectal misoprostol and a placebo infusion intravenously or placebo rectally and a 20 iu oxytocin infusion. Post-operative blood loss four hours after surgery was estimated by application of pads of known weight. Results: The mean immediate four hours post-operative blood loss was not significantly different between the rectal misoprostol and oxytocin infusion group (100.08 ± 24.85 ml versus 108.20 ± 29.93 ml; p =0.144) and the change between the pre-operative and post-operative hematocrit was similar. Conclusions: Post-caesarean section rectal misoprostol has comparative efficacy to oxytocin infusion in preventing post-partum haemorrhage. It is recommended for use as alternative uterotonic in settings where there is low refrigeration capacity.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 34-37 DOI: http://dx.doi.org/10.3126/njog.v8i2.9767

scholarly journals A two-year retrospective study of infants with Erb-Duchenne's palsy at a tertiary centre in Rajasthan, India

2018 ◽  
Vol 7 (2) ◽  
pp. 700
Author(s):  
Rakesh Appasaheb Hasabe ◽  
Dnyaneshwar S. Diwane ◽  
Sushant S. Chandawar
Keyword(s):  
Brachial Plexus Injury ◽  
Single Mother ◽  
Shoulder Dystocia ◽  
Fetal Macrosomia ◽  
Live Births ◽  
Tertiary Centre ◽  
Vaginal Deliveries ◽  
History Of ◽  
The Mean ◽  
Care History

Background: Brachial plexus injury (BPI) has prevalence of between 0.5 and 4.4/1000 live births. It is commonly believed to be attributed to extensive lateral traction during difficult neck delivery. This paper aims to look at one aspect of birth injuries, Erb-Duchenne palsy, its incidence and contributing factors.Methods: All infants sustaining Erb-Duchenne palsy during birth were identified at Department of OBGY, NIMS Hospital, Jaipur. The notes of the infants and mothers were reviewed. Special attention was given to the known risk factors for birth trauma such as ethnicity, parity, antenatal care, history of diabetes etc.Results: During the two-year period 2013 to 2015, there were 6 infants diagnosed with Erb-Duchenne palsy, giving an incidence of 0.79 in 1000 live births. Out of six, four were primigravidae. All pregnancies were singleton, cephalic/vertex undergoing vaginal deliveries; none required forceps or ventouse deliveries. The mean infant birthweight was 4.378 kg with a median value of 4.48 kg (range 3.51-4.78). Four infants were classified as macrosomic i.e. birthweights greater than 4 kg, four infants had birthweights of 4 kg to 5 kg; none weighed over 5 kg. Three of the deliveries were documented as difficult shoulder delivery/shoulder dystocia. Five of the infants had APGAR scores that were less than seven.Conclusions: This study suggested that Erb-Duchenne palsy is strongly associated with fetal macrosomia and shoulder dystocia. Diabetes was not significant in causing macrosomia as only single mother was found diabetic. Fetal macrosomia contributed to shoulder dystocia in the majority of cases.

scholarly journals Epidemiology and associated factors of atopic dermatitis in Malagasy children

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
F. A. Sendrasoa ◽  
I. M. Ranaivo ◽  
N. H. Razanakoto ◽  
M. Andrianarison ◽  
O. Raharolahy ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Low Income ◽  
Rural Areas ◽  
Associated Factors ◽  
Age Of Onset ◽  
Descriptive Study ◽  
History Of ◽  
The Mean ◽  
Urban And Rural Areas ◽  
Duration Of Breastfeeding

Abstract Background Little is known about the epidemiology and associated factors of childhood AD in the markedly different, low-income, tropical environment like Madagascar. Methods We aim to assess the epidemiology and associated factors of AD in individuals fewer than 15 years of age in Antananarivo Madagascar. It was a retrospective and descriptive study over a period of 7 years (2010 to 2016) in children 6 months to 14 years in the Department of Dermatology, Joseph Raseta Befelatanana Antananarivo Madagascar. The diagnosis of AD was based on clinical data. Results The prevalence of AD was 5.6% in children aged 6 months to 14 years. The details of 151 cases of atopic dermatitis were analyzed. The mean age of patients was 4 years. There was a female preponderance (sex ratio: 0.7). A family history of AD was noted in 56 cases (37%). No association between breast-feeding and AD was found. The age of onset of AD was before the age of 3 months in 7.5% and between 6 months to 5 years in 70%. Children born in March (dry season) had the highest risk of AD. Consultations for AD increased during the winter (from July to October; p = 0.005). However, the prevalence of AD was similar in urban and rural areas. Conclusion Weather may have an impact on the prevalence of atopic dermatitis in Madagascar. No significant correlation was found between the duration of breastfeeding and AD, as well as urbanization.

scholarly journals Caesarean myomectomy - a safe procedure: A retrospective case controlled study

1970 ◽  
Vol 2 (2) ◽  
pp. 59-62 ◽  
Author(s):  
Alexander T Owolabi ◽  
Oluwafemi Kuti ◽  
Olabisi M Loto ◽  
Oluwafemiwa N Makinde ◽  
Adebanjo B Adeyemi
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Post Partum ◽  
Uterine Fibroids ◽  
Controlled Study ◽  
Control Group ◽  
High Dose ◽  
Safe Procedure ◽  
The Mean ◽  
Duration Of Operation

Objective(s): The aim of the study is to determine whether myomectomy at the time of caesarean section leads to increase incidence of intrapartum and postpartum complications. Methods: Fourteen women, with uterine fibroids in pregnancy who were treated by caesarean myomectomy between January 2001 and June 2007, were compared retrospectively with fourteen women, without uterine fibroids who had routine caesarean section during the same period. Myomectomy for all types of myoma was performed at caesarean section after the delivery of the baby. Haemorrhage was controlled with the use of Foleys catheter tourniquet and high dose oxytocin infusion. The cases and control were analysed for age of the patient, parity, pre and post-operative haematocrit levels, duration of operation, blood loss, blood transfusions, and incidence of postpartum fever. Results: Caesarean myomectomy resulted in the mean blood loss of 589 ml (range 300-1300 ml) compared with 518 ml (range 350-850 ml) in the control group (p=0.376). The mean duration of operation was longer in the cases of caesarean myomectomy (66.8 mins) than those of the controls (56.4 mins). There were no significant differences between the two groups in the incidence of intraoperative haemorrhage, the need for blood transfusion, post partum fever, and length of hospital stay. Conclusions: This study shows that myomectomy during caesarean section is a safe procedure in experienced hands and is not as dangerous as generations of obstetricians have been trained to believe. Further research is necessary to establish the cost effectiveness of the procedure. Key words: myomectomy, cesarean section, hemorrhage      doi:10.3126/njog.v2i2.1457 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 59 - 62

scholarly journals Authorship characteristics of retracted COVID-19 articles

2021 ◽  
Author(s):  
Rafaela Carolina da Silva ◽  
Hadiseh Heidari ◽  
Amanda Mendes da Silva
Keyword(s):  
Public Health ◽  
Past History ◽  
H Index ◽  
History Of ◽  
Research Findings ◽  
The Mean ◽  
Number Of Authors

Following the explosion of publications about COVID-19, some of these articles were retracted. These articles are potentially dangerous to public health as they can mislead about the nature of the virus. The growth and sensitive nature of retracted papers led to bibliometrics studies on them, although few, which focused more on the level of documents. This study, instead, examines the characteristics of the authors of these articles. 54 retracted COVID-19 articles that fit our study’s criteria were identified. The results revealed that 32% of these authors were MD, and about one-fifth of them had a past history of publishing retracted articles. The average number of authors per article was 6. Also, according to their profile in the Scopus, the mean number of documents, citations and their H-index were 61, 3159 and 12, respectively. Women also appeared in one-third of the articles as first and last authors. Continued research about retracted COVID-19 articles can continue to help prevent the further dissemination of questionable research findings.

scholarly journals Efficacy of tranexamic acid in preventing postpartum haemorrhage in vaginal delivery

2019 ◽  
Vol 8 (9) ◽  
pp. 3485
Author(s):  
G. Anantha Lakshmi Satyavathi ◽  
Chandrika K.
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Postpartum Haemorrhage ◽  
Acid Group ◽  
Active Management ◽  
Singleton Pregnancy ◽  
Total Blood ◽  
Postpartum Blood Loss ◽  
Third Stage ◽  
History Of

Background: Postpartum blood loss is difficult to evaluate especially in developing countries like India where most of the women are anaemic with poor reserve and these conditions are further aggravated by increased demand during pregnancy and blood loss during third stage of labour. The present study was planned to compare the efficacy of prophylactic 10 IU intramuscular oxytocin and 10 IU intramuscular oxytocin +1g Tranexamic acid in reducing blood loss in the third stage of labour.Methods: The present study was carried out on full term pregnancies primigravida/ multiparas with singleton pregnancy being delivered vaginally at GSL Hospital, Rajahmundry between 2016-2017 were included. For this comparative study, 200 women in labor were included after obtaining informed consent. A detailed obstetric history, history of previous medical illnesses, history of the treatment received earlier, cardiovascular and respiratory system and other systems including thyroid and breast were noted.Results: The average total blood loss in IIIrd stage of labour with IM oxytocin was 210 ml and with IM oxytocin + Tranexamic acid was130 ml, which was statistically significant (p<0.001). Oxytocin + Tranexamic acid group had less blood loss when compared to oxytocin group alone. Side effects like, nausea vomiting, headache were slightly more with oxytocin + Tranexamic acid group when compared to oxytocin group alone.Conclusions: In the active management of IIIrd stage of labour 10 IU intramuscular Oxytocin + one gram of tranexamic acid IV is a better combination in reducing the blood loss at delivery when compared to 10 IU intramuscular oxytocin alone.

scholarly journals P256 Reproductive health outcomes in women with PsA

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Kieran Murray ◽  
Louise Moore ◽  
Francis Young ◽  
Fionnuala McAulliffe ◽  
Douglas J Veale
Keyword(s):  
Disease Activity ◽  
Disease Control ◽  
Post Partum ◽  
National Average ◽  
Quality Data ◽  
European League Against Rheumatism ◽  
Vaginal Deliveries ◽  
Oral Steroids ◽  
The Mean ◽  
In Pregnancy

Abstract Background There is quality data showing rheumatoid arthritis (RA) improves in pregnancy and flares postpartum and that active disease is associated with adverse foetal outcomes. For psoriatic arthritis (PsA), the data is less clear, with previous studies giving contrasting results. We prospectively monitored disease control, maternal and foetal outcomes in women with PsA attending our multidisciplinary service. Methods Age, medications, disease control, maternal and foetal outcomes were reviewed and descripitive statistics applied. Results 14 patients were reviewed. 12 became pregnant. There were 20 pregnancies in total. Eight patients had 1 pregnancy. Two patients had 3 pregnancies, 1 patient was pregnant twice and 1 patient had 4 pregnancies and is currently pregnant. Two patients failed to become pregnant. There were 13 live births (one set of twins), 7 vaginal deliveries and 5 Caesarean sections. There were 6 intrauterine deaths (4 1st trimester, 2 2nd trimester). Two patients had postpartum complications (grade 4 vaginal tear and Caesarean wound infection). Mean foetal birth weight was 3.54kg (national average 3.49kg). 8 infants (55%) were breastfeeding at 6 weeks (national average 62%). 14 patients were on a DMARD (including oral steroids) in pregnancy. There were 8 pregnancies on a bDMARD alone, one on a bDMARD plus prednisolone. The bDMARDs used were certolizumab (five times), adalimumab (twice), infliximab (once) and etanercept (once). Two patients were on prednisolone alone. One patient on sulfasalazine plus prednisolone. One pregnancy on sulfasalazine plus hydroxychloroquine, 1 on sulfasalazine alone. Two patients were on NSAIDs. Disease activity was measured using DAS28-CRP 3 as this is validated for use in RA during pregnancy. Overall, the mean disease activity scores decreased during pregnancy and increased postpartum. After applying the European League Against Rheumatism-defined response criteria disease activity, almost half of the women had at least a moderate response during pregnancy and more than one-third had at least a moderate flare post partum, particularly at 6 weeks. The postpartum flare may be underestimated as medication use was remarkably increased after delivery. At 6 weeks, in five cases the bDMARD therapies had already been restarted. In two cases, the patients missed this appointment. One patient was started on methotrexate at their 6-week review. Conclusion Disease activity generally improved during pregnancy and flared postpartum. Miscarriage rates were higher than the general population (32% v 20%). Birth weights and breastfeeding rates at six weeks were similar. Disclosures K. Murray None. L. Moore None. F. Young None. F. McAulliffe None. D. Veale None.

scholarly journals Nutrition–fertility interaction in lactating women of low income groups

1981 ◽  
Vol 45 (3) ◽  
pp. 461-467 ◽  
Author(s):  
K. Prema ◽  
A. Nadamuni Naidu ◽  
S. Neelakumari ◽  
B. A. Ramalakshmi
Keyword(s):  
Body Weight ◽  
Low Income ◽  
Post Partum ◽  
Income Group ◽  
Nutritional Intervention ◽  
Lactating Women ◽  
Maternal Nutritional Status ◽  
Low Income Groups ◽  
Group Population ◽  
The Mean

1. Duration of lactational amenorrhoea and interpreganancy interval were related to maternal body-weight in an urban low-income group population of 2250 women.2. Breast-feeding practices were similar in all the women, none of whom had received any nutritional intervention.3. In the study group the mean duration of lactation, lactational amenorrhoea and interpregnancy interval (months) were 20.7, 11.2 and 24.2 respectively.4. Mean duration of lactation was significantly shorter in women whose body-weights were over 55 kg. Duration of lactational amenorrhoea increased with increasing duration of lactation (r 0.5164).5. The duration of lactational amenorrhoea showed a progressive fall with increasing body-weight (r − 0.8139) even when duration of lactation was kept constant.6. The mean duration of post-partum amenorrhoea in women who did not lactate remained unaltered irrespective of body-weight.7. The findings suggest that maternal nutritional status modifies return of menstruation only in lactating women.

scholarly journals Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial

2021 ◽  
Author(s):  
Sougata Kumar Burman ◽  
Ritwik Samanta ◽  
Kumari Kanak Lata ◽  
Jayeeta Mukherjee ◽  
Tapan Kumar Dey
Keyword(s):  
Randomised Controlled Trial ◽  
Adverse Effects ◽  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Controlled Trial ◽  
Effective Control ◽  
Control Group ◽  
Third Stage ◽  
The Mean ◽  
Randomised Controlled

Introduction: In India, the routine Active Management of Third- Stage of Labour (AMTSL) with conventional intramuscular oxytocin, at the rural, resource-constrained areas, is often compromised due to lack of trained healthcare personnel and proper maintenance of cold chain system, causing maternal mortality and morbidity from Postpartum Haemorrhage (PPH). In these scenarios, tablet misoprostol, can be efficacious and convenient alternative. Aim: To evaluate efficacy and safety of misoprostol administered per rectum with respect to intramuscular oxytocin for effective control of PPH in a Randomised Controlled Trial (RCT). Materials and Methods: In this RCT, conducted in Sambhunath Pandit Hospital, kolkata, West Bengal, India from September 2015 to August 2016, total 80 eligible pregnant mothers in normal labour with prior consent and fulfilled criteria, were allocated to two separated groups (n=40) by computer generated randomisation table. Control group received 10 IU injection oxytocin and case group received 600 μg misoprostol tablet per rectally within one minute of cord clamping and cutting. The primary outcome measures were mean third- stage and mean postpartum blood loss up to eight hours after delivery. Secondary outcome variables were Mean Arterial Pressure (MAP) after eight hours postdelivery, haemoglobin and haematocrit after 24 hours of delivery and reported side effects. Data was entered into a Microsoft excel spreadsheet and statistical analysis was done by Statistical Package for the Social Sciences (SPSS) version 20.0.1 and Graph Pad Prism version 5.0. Results: Total sample size was 80 equally divided into two groups, with a mean age of 23.20±3.1558 years and 23.7750±3.8927 years in case and control group respectively. The mean third-stage blood loss (332.4105±72.6632 mL versus {vs} 329.0088±59.4503 mL, p=0.8193) and mean total blood loss (426.5575±80.0215 mL vs 424.8783±61.5808 mL, p=0.9165) were statistically indifferent between misoprostol and oxytocin groups by two-sample t-tests. The mean for eight hours postpartum MAP (p=0.0894), 24 hours postpartum haemoglobin (p=0.4534) and haematocrit (p=0.1325) were statistically insignificant between the two groups by two- sample t-tests. Incidence of adverse effects like shivering, diarrhoea, compared by Pearson’s Chi-square test, were found to be more but non significant in misoprostol group. Conclusion: This study concludes that per-rectal misoprostol is equally effective as intramuscular oxytocin to control PPH without significant adverse effects.

scholarly journals Post-COVID-19 Syndrome: Nine Months after SARS-CoV-2 Infection in a Cohort of 354 Patients: Data from the First Wave of COVID-19 in Nord Franche-Comté Hospital, France

2021 ◽  
Vol 9 (8) ◽  
pp. 1719
Author(s):  
Souheil Zayet ◽  
Hajer Zahra ◽  
Pierre-Yves Royer ◽  
Can Tipirdamaz ◽  
Julien Mercier ◽  
...  
Keyword(s):  
Past History ◽  
Duration Of Symptoms ◽  
Persistent Symptoms ◽  
Significant Difference ◽  
High Prevalence ◽  
History Of ◽  
Group 3 ◽  
The Mean ◽  
Pain Symptoms ◽  
Smell Loss

(1) Background. Post-COVID-19 syndrome is defined as the persistence of symptoms after confirmed SARS-CoV-2 infection. (2) Methods. ANOSVID is an observational retrospective study in Nord Franche-Comté Hospital in France that included adult COVID-19 patients confirmed by RT-PCR from 1 March 2020 to 31 May 2020. The aim was to describe patients with post-COVID-19 syndrome with persistent symptoms (PS group) and to compare them with the patients without persistent symptoms (no-PS group). (3) Results. Of the 354 COVID-19 patients, 35.9% (n = 127) reported persistence of at least one symptom after a mean of 289.1 ± 24.5 days after symptom onset. Moreover, 115 patients reported a recurrence of symptoms after recovery, and only 12 patients reported continuous symptoms. The mean age of patients was 48.6 years (19–93) ± 19.4, and 81 patients (63.8%) were female. Patients in the PS group had a longer duration of symptoms of initial acute SARS-CoV-2 infection than patients in the no-PS group (respectively, 57.1 ± 82.1 days versus 29.7 ± 42.1 days, p < 0.001). A majority of patients (n = 104, 81.9%) reported three or more symptoms. The most prevalent persistent symptoms were loss of smell (74.0%, n = 94), fatigue (53.5%, n = 68), loss of taste (31.5%, n = 40), and dyspnea (30.7%, n = 39). These were followed by pain symptoms (26.8% (n = 34), 26.0% (n = 33), 24.4% (n = 31); headache, arthralgia, and myalgia, respectively). More than half of patients reporting persistent symptoms (58%, n = 73) were healthcare workers (HCWs). Among outpatients, this population was more present in the PS group than the no-PS group ((86.6%) n = 71/82 versus (72.2%) n = 109/151, p = 0.012). Post-COVID-19 syndrome was more frequent in patients with a past history of chronic rhinosinusitis (8.7% (n = 11%) versus 1.3% (n = 3), p < 0.001). No significant difference was found regarding clinical characteristics and outcome, laboratory, imaging findings, and treatment received in the two groups. (4) Conclusions. More than a third of our COVID-19 patients presented persistent symptoms after SARS-CoV-2 infection, particularly through loss of smell, loss of taste, fatigue, and dyspnea, with a high prevalence in HCWs among COVID-19 outpatients.

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