scholarly journals Effectiveness of combined use of rectal misoprostol and oxytocin for prevention of postpartum hemorrhage after cesarean section

2020 ◽  
Vol 11 (3) ◽  
pp. 3556-3562
Author(s):  
Nirmala Maniachari ◽  
Sathish Kumar Sure ◽  
Priyanka Jagadeesh ◽  
Lavanya Agamudi ◽  
Usha Brindhini

Post-Partum Hemorrhage (PPH) is defined as the loss of blood which is greater than 500ml after vaginal delivery or greater than 1000 ml after a cesarean section delivery. About 28% of the total maternal deaths were due to PPH particularly in developing countries. Oxytocin has been considered as the ‘gold standard’ drug in the treatment and prevention of PPH. Prophylactic use of prostaglandin analogue i.e., misoprostol in addition to oxytocin during cesarean section is expected to reduce the incidence of PPH. This study aims at comparing the efficacy of combined use of rectal misoprostol and oxytocin infusion with oxytocin in the prevention of PPH. A comparative observational study was conducted on 200 subjects which were divided into two equal groups by Simple Random Selection. One group was treated with Inj. Oxytocin 20U I.V infusion alone while the other group was treated with Tab. Misoprostol 600mcg, rectal route and Inj. Oxytocin 20U I.V infusion. Majority of the subjects were observed under the age group of 21-25years, under primigravidae. A significant decrease in the volume of mean blood loss (740.00 ± 164.00 ml: p = 0.045) and the mean drop of hemoglobin level(Hb) (0.88±0.74gm/dl; p = 0.0001) were observed in group treated with Tab. Misoprostol 600mcg and Inj. Oxytocin and was found to be statistically significant. Preoperative administration of misoprostol per rectal route and oxytocin infusion after the cesarean section have shown, a better control of bleeding and maintenance of hemoglobin level when compared to oxytocin infusion alone. Thus, instead of oxytocin monotherapy combined use of misoprostol and oxytocin would be more effective in prevention of PPH.

2020 ◽  
pp. 82-94 ◽  
Author(s):  
V. O. Belash ◽  
L. R. Urazgalieva ◽  
R. I. Fayzullina ◽  
L. G. Agasarov

Introduction. Degenerative-dystrophic changes in the spine are the most common chronic human diseases. Pronounced clinical manifestations of vertebrogenic diseases are observed during active labor activity and represent one of the most frequent causes of temporary disability. It is also known that any pain syndromes are accompanied by the development of psychovegetative disorders, which reduces the effectiveness of treatment. In recent years, there has been a reasonable increase in the interest of the medical community to the non-drug treatment methods. It is caused by the polypharmacotherapy side effects, an increased numbers of allergic reactions, problems with polypragmasia, and a low level of compliance. At the same time, the question of the possibility of various non-drug treatment methods combining is quite acute.The goal of research is to substantiate the clinical effectiveness of the combined application of osteopathic correction and reflexotherapy in the complex treatment of patients with dorsopathy at the cervical-thoracic level.Materials and methods. A prospective controlled randomized study was conducted on the basis of the medical clinics of LLC «Family Health» (Kazan) and ANO «Center for SEB assistance» (Kazan) from April 2018 to May 2019. The study involved 52 people with dorsopathy at the cervical-thoracic level, aged from 25 to 45 years. In accordance with the exclusion criteria, 7 people dropped out of the study. The remaining patients (45 people), depending on the used treatment method, were divided by a simple randomization method using a random number generator into three groups of 15 people. The first group (main group) received osteopathic correction and reflexotherapyon the background of standard drug therapy; the second and the third groups (control groups) received only osteopathic correction orreflexotherapy, respectively, on the background of standard drug therapy. The osteopathic examination was performed for all patients regardless of the group, before and after the course of therapy, with the formation of an osteopathic conclusion.Also there was the estimation of the degree of pain syndrome severity,the asthenia, and the degree of accumulated emotional and energy charge that does not get out in a person.Results. It was found in the course of the study that the inclusion of osteopathic correction and reflexotherapy in the complex therapy of patients with dorsopathy at the cervical-thoracic level is clinically more effective than the isolated use of these methods. Such complex therapy allows to achieve a more significant reduction in the severity of the pain syndrome by VAS (p<0,05), relief of internal emotional tension (p<0,05), and increase the effectiveness of correction of dominant somatic dysfunction. Based on the obtained data, it could be assumed that reflexotherapy potentiates the effects of osteopathic correction.Conclusion. Based on the study, it can be concluded that the combination of osteopathic correction and reflexotherapy in the treatment of patients with dorsopathy at the cervical-thoracic level increases the clinical effectiveness of the standard drug therapy. At the same time, it is worth noting the potentiating effect of the combined use of two non-medicinal methods. The question of combining of various non-drug treatment methods is quite acute today, so this study will be continued. 


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.


2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Rini Rahmayanti

In the world according to WHO 2014 there are (16%) SEKSIO SESARIA deliveries that exceed the recommended limits. Whereas in Indonesia according to the 2013 Riskesdas the method of cesarean section surgery was 9.8% of the total 49,603 births throughout 2010-2013. Based on the 2013 Riskesdas data in West Sumatra the rate of West Sumatra cesarean section delivery (14%) where the figure is almost close to the maximum WHO standard. One common complaint felt by post seksio sesaria mothers is surgical pain. The purpose of this study was to determine the analysis of the application of murottal therapy in post-secsio caesarea women on the indication of a history of heart disease to reduce postoperative pain in the obstetric room of RSUP Dr. M. Djamil Padang. Nursing implementation in accordance with the objectives and interventions that have been formulated. The implementation is carried out for 5 days, from 3-7 June 2018. Ny. A listens to the explanation, and demonstrates the explanation given, especially murottal Al-Qur'an therapy to reduce postoperative pain. From the results of observations and interviews that the author did, Ny.A understood what had been explained and demonstrated. It is hoped that this research will be useful for health workers to be able to apply murottal therapy as one of the complementary therapies in treating post-cesarean patients.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem F El-Shahawy ◽  
Sherif F El-Mekkawi ◽  
. Haitham F Mohmmed ◽  
Hend M Afifi

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000


2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.


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