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 Caesarean Myomectomy is No Longer a Dreaded Job: a Case Control Study in Multiple Specialized Centre

2013 ◽  
Vol 8 (1) ◽  
pp. 07-10
Author(s):  
Dilruba Zeba ◽  
Shila Rani Das ◽  
Nusrat Fatima ◽  
Nazrul Islam ◽  
Julhash Uddin ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Post Partum ◽  
Operation Time ◽  
Cost Effective ◽  
Control Group ◽  
Study Group ◽  
Safe Procedure ◽  
Severe Haemorrhage ◽  
A Prospective Study

Removal of uterine myoma during caesarean section (CS) is not commonly done due to fear of severe haemorrhage which may lead to hysterectomy. Contradicting the previous belief many studies have been showing that myomectomy during caesarean section is a safe procedure without significant increase of risk. The objective of this study is to analyze the safety and clinical outcome of caesarean myomectomy. This is a prospective study carried out in different hospitals of Faridpur district, Bangladesh from 01.01.10 up to 31.12.12. Total 16 (study group) patients had undergone caesarean myomectomy. Operation time, peroperative blood loss, post operative complications and length of hospital staying was compared with that of 32 women (control group) with caesarean section alone. The result shows that peroperative blood loss was average 350±100 ml in study group which is 50 ml more than control group. Operation time was 20 minutes more and length of hospital staying was 1 day more than control group. There was no post partum haemorrhage, no hysterectomy was done at the time of CS and there was no maternal or perinatal mortality. So, caesarean myomectomy is safe and convenient to patient and cost effective without increasing any extra risk. DOI: http://dx.doi.org/10.3329/fmcj.v8i1.16889 Faridpur Med. Coll. J. 2013;8(1): 07-10

scholarly journals Tranexamic acid in prevention of postpartum hemorrhage in elective cesarean section

2019 ◽  
Vol 8 (2) ◽  
pp. 372
Author(s):  
Pravin Shah ◽  
Ajay Agrawal ◽  
Shailaja Chhetri ◽  
Pappu Rijal ◽  
Nisha K. Bhatta
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Estimated Blood Loss ◽  
Elective Cesarean ◽  
The Mean

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.

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 The efficiency and efficacy of tranexamic acid in prevention of blood loss during or after caesarean delivery: a comparative study

2020 ◽  
Vol 9 (4) ◽  
pp. 1549
Author(s):  
Supriya Raina ◽  
V. Suguna ◽  
Padmaja Prabraju
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Normal Saline ◽  
Test Group ◽  
Normal Vaginal Delivery ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Significant Difference

Background: The practice of caesarean section is increasing day by day. Delivery by caesarean section can cause more complications than normal vaginal delivery and one of the most common complications is primary or secondary postpartum hemorrhage. The aim of present study was to study the efficacy and safety of tranexamic acid in reducing blood loss during and after caesarean section.Methods: This study was conducted at Deccan College of Medical Sciences, Hyderabad. It was a prospective randomized double blind placebo controlled study. This study includes 60 pregnant women divided in to two groups. Just before the induction of anesthesia 1 gm of tranexamic acid in 20 ml of normal saline was given over 10 minutes in test group and 20 ml of normal saline was infused in control group.Results: The demographic characters of patients in two groups were comparable. There was no statistically significant difference in the heart rates, respiratory rates and blood pressures in the two groups. There was statistically significant difference in the quantity of the blood loss from during the operation and 2 hours postpartum (p=0.003). Total mean blood loss in control group was 718.80±233.1 ml and in study group was 554.28±207.8 ml. The drop in hemoglobin after caesarean section in study group was not significant where as in control group was significant. There was no significant difference in the prothrombin time and partial thromboplastin time in the groups, pre and post operatively. In this study the use of tranexamic acid reduced the dose of other uterotonics like syntocin in study group.Conclusions: Tranexamic acid significantly reduced the amount of blood loss during the caesarean section and also reduced the use of other uterotonics. Thus, tranexamic acid can be used safely and effectively in subjects undergoing caesarean section.

scholarly journals Effectiveness of ligation of uterine vessels prior to uterine incision for major placenta previa on reducing maternal morbidity without increasing neonatal morbidity

2018 ◽  
Vol 7 (7) ◽  
pp. 2891
Author(s):  
Shantha V. K. ◽  
Priyadarshini M. ◽  
Priya Dharshini A. ◽  
Litty Mariyam Jacob
Keyword(s):  
Caesarean Section ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Maternal Morbidity ◽  
Placenta Previa ◽  
Control Group ◽  
Mild Depression ◽  
Uterine Incision ◽  
The Mean ◽  
Uterine Vessels

Background: Placenta previa causes massive obstetric haemorrhage and severe maternal morbidity. The objective is to analyse the effectiveness of uterine vessels (artery and vein) ligation before uterine incision in reducing blood loss and hysterectomy during caesarean section for major placenta previa without increasing morbidity in the newborn.Methods: A retrospective analysis of caesarean section for major placenta previa from 2002 to 2017 was done.  Uterine vessels ligation before uterine incision was done in 52 patients. In 19 patients unilateral and in 33 patients bilateral uterine vessels ligation was done before uterine incision. In control group, 12 patients with major placenta previa uterine vessels were ligated after the removal of the placenta. The blood loss, blood transfusion, maternal morbidity and NICU admission of the newborns were compared.Results: The mean blood loss was 1002 ml in unilateral, 793 ml in bilateral uterine vessels ligation group, compared to 2191 ml in the control group. The mean blood transfusion volume 0.89 units in unilateral 0.60 units in bilateral ligation group while 2.33 units in the control group. The difference in blood loss and blood transfusion were statistically significant. Out of 52 babies, only 6 babies were admitted in NICU for mild depression with stay less than 3 days.Conclusions: Uterine vessels ligation before uterine incision reduces blood loss and hysterectomy during caesarean section for placenta previa without increasing the morbidity in the newborns.

EVALUATION OF RESULTS OF SIMULTANEOUS MYOMECTOMY AND CESAREAN SECTION

2018 ◽  
Vol 8 (1) ◽  
pp. 45-51 ◽  
Author(s):  
A. G. Yaschuk ◽  
L. A. Dautova ◽  
A. A. Tyurina ◽  
A. G. Imelbaeva
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Blood Loss ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Uterine Fibroids ◽  
Control Group ◽  
Intraoperative Blood Loss ◽  
One Stage ◽  
Duration Of Hospitalization

Introduction. Myoma of the uterus is the most common neoplasm of the female reproductive system. The frequency of combination of uterine fibroids and pregnancy varies from 1.6% to 10.7%, often fibroids occur in pregnant women of late reproductive age. Traditionally, myomectomy during caesarean section was not recommended because of the risk of bleeding and postoperative complications. To assess the safety and feasibility of a one-stage myomectomy in a caesarean section, this study was conducted.Materials and methods. From 2010 to 2015, we examined 260 pregnant women with uterine myoma, who had a cesarean section with a single-stage myomectomy. The data obtained during the survey were compared with the data of 96 women from the control group. We study assessment of intraoperative blood loss, pre- and postoperative hemoglobin levels, duration of hospitalization.Results. Statistically significant differences in intraoperative blood loss, changes in hemoglobin levels and in the duration of hospitalization between the examined groups of women were not revealed. A prognostic model has been developed to assess risk factors for intraoperative blood loss of more than 1000 ml.Conclusion. The size, localization of myomatous nodes are not risk factors for high blood loss in abdominal delivery with a one-stage myomectomy. The factor of risk of hemorrhage is multiple uterine fibroids, whereas the size of myomatous nodes less than 5 cm can be regarded as a protective factor for blood loss. The study showed that a one-stage myomectomy with a caesarean section is safe and can be performed with the surgeon’s experience. 

scholarly journals The effect of short-term use of finasteride versus cyproterone acetate on perioperative blood loss with monopolar transurethral resection of prostate

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Shabieb A. Abdelbaki ◽  
Adel Al-Falah ◽  
Mohamed Alhefnawy ◽  
Ahmed Abozeid ◽  
Abdallah Fathi
Keyword(s):  
Blood Loss ◽  
Transurethral Resection ◽  
Cyproterone Acetate ◽  
Histopathological Examination ◽  
Microvascular Density ◽  
Controlled Study ◽  
Control Group ◽  
Transurethral Resection Of Prostate ◽  
Perioperative Bleeding ◽  
And Control

Abstract Background Perioperative bleeding is the most common complication related to transurethral resection of prostate; the aim of the study was to compare the effect of pre-operative use of finasteride versus cyproterone acetate (CPA) on blood loss with monopolar TURP. Methods This prospective randomized controlled study was conducted on (60) patients with BPH underwent monopolar TURP between July 2019 and July 2020. Patients were distributed into three equal groups; CPA group: 20 patients received cyproterone acetate 50 mg tab BID for two weeks before TURP, finasteride group: 20 patients received single daily dose of finasteride 5 mg for two weeks before TURP, control group: 20 patients received no treatment before TURP, all patients underwent monopolar TURP, and then histopathological examination of the resected tissues was done with assessment of the microvascular density of the prostate. Results Our study showed that there was significant decrease in intraoperative blood loss and operative time in CPA and finasteride groups in comparison with control group (p = 0.0012) (p < 0.0001), respectively, significant decrease in post-operative Hb and HCT value in finasteride and control groups in comparison with CPA group (p < 0.01), significant increase in specimen weight in CPA group compared to other groups (p < 0.01), and there was also significant decrease in microvascular density in CPA group in comparison with other groups (p < 0.01). Conclusion Cyproterone acetate is more effective than finasteride in decreasing perioperative bleeding with TURP by decreasing microvascular density of the prostate.

Enlargement of cerebrospinal fluid spaces in long-term benzodiazepine abusers

1987 ◽  
Vol 17 (4) ◽  
pp. 869-873 ◽  
Author(s):  
C. Schmauss ◽  
J.-C. Krieg
Keyword(s):  
Low Dose ◽  
Matched Control ◽  
Control Group ◽  
High Dose ◽  
Withdrawal Therapy ◽  
The Mean ◽  
Dose Dependent ◽  
Dose Dependent Effect ◽  
Age And Sex

SynopsisIn 17 benzodiazepine (BDZ) dependent in-patients a CT scan was performed before initiation of withdrawal therapy. The evaluation of the ventricular to brain ratio (VBR) by standardized and computerized measurements revealed significantly higher mean VBRs for both high-and low-dose BDZ-dependent patients compared to the mean VBR of an age- and sex-matched control group. In addition, the mean VBR of high-dose BDZ-dependent patients (N = 8) was significantly higher than the mean VBR of low-dose BDZ-dependent patients (N = 9). This difference could not be accounted for by the age of the patients or duration of BDZ-dependency and, therefore, suggests a dose-dependent effect of BDZs on the enlargement of internal CSF-spaces. On the other hand, higher values for the width of external CSF-spaces were found to be related to increasing age of the patients and duration of BDZ-dependency.

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.

Self-Managed Music-Guided Exercise Intervention Improved Upper and Lower Extremity Muscle Strength for ICU Survivors—A Pilot Randomized Controlled Study

2021 ◽  
pp. 109980042110502
Author(s):  
Zhan Liang ◽  
Hilary Yip ◽  
Kimberly Sena Moore ◽  
Tanira Ferreira ◽  
Ming Ji ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Lower Extremity ◽  
Active Control ◽  
Exercise Intervention ◽  
Controlled Study ◽  
Control Group ◽  
Active Control Group ◽  
Randomized Controlled ◽  
Left And Right ◽  
The Mean

Objective The objective of this study was to evaluate effects of a self-managed music-guided exercise intervention on muscle strength among intensive care unit (ICU) survivors. Methods We used a two-arm randomized-controlled trial. Following ICU discharge, eligible participants were assigned to one of two groups: music group ( n = 13) or active control group ( n = 13). The music group was taught to self-manage upper and lower extremity exercise movements by listening to an individualized music-guided playlist twice daily for 5 days. The active control group was provided an exercise brochure and advised to perform the same exercises at the same intervals. Dynamometers were used to measure muscle strength. T-tests and Weighted GEE models were used for testing the intervention effect between groups. Results Twenty-six subjects were enrolled. The mean age was 62.8 ( SD = 13.8), 53.8% were male, 65.4% were Caucasian, and the mean APACHE severity of illness score was 59 ( SD = 23.4). Reasons for ICU admission were mainly cardiac and medical. The music group showed significant improvements in handgrip, plantar flexion, leg extension, elbow flexion, and shoulder adduction strengths on left and right sides. Additionally, left and right leg extensor and left plantar flexor strengths showed significant post-differences, and small to moderately large effect sizes, between the music group and control group. Conclusion These findings suggest that a music-guided exercise intervention has the potential to improve muscle strength in ICU survivors and prevent further post-ICU deterioration in ICU survivors. Future trials should build upon these preliminary findings.

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