scholarly journals Consequences of Zuspan Protocol Applications in Eclampsia Pregnant Women and Seizures

2021 ◽  
Vol 5 (8) ◽  
pp. 01-03
Author(s):  
Bilge Aslan ◽  
Feray Aydın ◽  
Özlem Moraloğlu

Backgraund: Magnesium sulfate is the preferred anticonvulsant in the prevention and control of eclamptic convulsions. The Zuspan Regime is one of the most popular protocols used. However, due to toxicity concerns, several low-dose regimens have been implemented, given the low body mass index of Asian women. In our hospital, Zuspan Protocol is generally applied. Objective: We aimed to compare the results, effectiveness and reliability of 6-hour and 12-hour intravenous (i.v) MgSO4 infusions in the Zuspan Protocol in our hospital. Methods and Materials: A total of 700 cases of eclampsia were examined and these cases were treated with the Zuspan Protocol. The patients in the first group received 6 hours of treatment (n: 400), while the second group (n: 300) received the 12-hour treatment with magnesium sulfate. Recurrent convulsion rates, maternal and perinatal results of both regimens were evaluated and compared using unpaired t-test and chi-square test, respectively, for continuous and categorical variables. Result: We detected 700 eclamptic cases among 50.620 births in our hospital during the 7-year working period and this rate was found as 80.5 % of 700 women were in the 19-30 age group. Despite the fact that MgSO4 was infused in 700 eclamptic pregnant women, the rate of seizures was found to be total 3.57 %. Conclusion: The 12-hour intravenous Zuspan Protocol was found to be more effective and more preventive and safer than the eclamptic seizure compared to the 6-hour Zuspan Protocol.

2017 ◽  
Vol 24 (08) ◽  
pp. 1147-1151
Author(s):  
Raheela Rani Junejo ◽  
Rabail Rani Junejo ◽  
Raheel Sikandar ◽  
Shahla Baloch ◽  
Mehrunnisa Khaskheli

Objectives: To determine the frequency of macrosomia in obese primigravidwomen. Study Design: Case series study. Period: Six months. Setting: Department ofGynecology and Obstetrics Department Jamshoro. Patients and Methods: The inclusioncriteria of the study were primigravida women between age 18 to 35 years with singletonpregnancy and gestational duration of 37 to 42 weeks, and during labour with BMI 30 or >30kg/m2 and All booked women who were primigravid during antenatal visit try to come and BMIcalculated by weight in kg and height in meter square. The variables include post-delivery ifthe weight of baby is 4.5 kg is macrosomic and mode of the delivery. The data was analyzed inSPSS version 17, the frequency and percentage was calculated while the chi-square test wasapplied on categorical variables and the p-value ≤0.05 was considered as significant. Results:During six months study period total 203 pregnant obese ladies were observed for macrosomicbabies. Age group was analyzed which shows that in age group between 18-25 years were105(52.00%) women, in age group of 26-30 years were 62 (30.69%) women and age group of30 years and above were 35 (17.31%) women with mean age ± SD of ladies was 24.6 ±6.2years. Regarding modes of delivery shown 132 (65.02%) ladies had C-section and 71 (34.97%)ladies had vaginally delivery. Weight of the babies was assessed which shows 27 (13%) wereborn with less than 2.5 Kg, babies having weight between 2.6-3 Kg were 71 (35.3%) , babieswere having weight 3 kg to 4.5kg 38 (18.7%) and babies having more than 4.5kg which shows67 (33%). Neonatal complications observed were macrosomic babies 67 (33.1%). Frequencyof macrosomic babies was higher in women with BMI more than 3.5kg/m2 44(21.67%) andin women with BMI between 30 to 35kg/m2 25(12.31%). Conclusion: Obesity responsible forcomplications during pregnancy and delivery for both mother and babies. Fetal complicationsare macrosomia and these obese ladies should motivate for maintenance of weight.


2020 ◽  
Vol 10 (1) ◽  
pp. 12
Author(s):  
Nahid Shahbazian ◽  
Najmieh Saadati ◽  
Mina Mahdavi

Introduction: Fetal and neonatal complications are more common in premature than full term pregnancy. Treatment of preterm labor and postpone delivery increases neonatal survival and better quality of life and reduces health care costs for premature infants. This study aimed to compare the effects of Nifedipine and Magnesium sulfate in arresting preterm labor and to adverse the effects of these drugs. Materials and Methods: This randomized and clinical trial study was performed on 100 pregnant women who were hospitalized for preterm labor pain. The participants were pregnant women with the gestational age of 28 to 34 weeks and with a single pregnancy and symptoms of preterm were studied. They were randomly divided into two equal groups. After not suppressing the pain by fluid therapy, in the first group Magnesium sulfate infused injection (N=50) was performed, while in the second group, oral Nifedipine were given. The research uses SPSS software (version 20) statistical software issue 20 to analyze the result of tests with descriptive statistical methods including independent T test and chi square test. Results: Mean maternal age, gestational age, parity converted Magnesium sulfate and Nifedipine group had no significant difference in statistical analysis. Delivery was delayed more than 48 hours in 48% (24 person) of cases in the Magnesium sulfate group and in 72% (36 person) in Nifedipine group (p=0.03). A statistically significant difference in response to treatment was more in group of Nifedipine. Conclusion: The results showed that Nifedipine is more effective than Magnesium sulfate in postponing delivery (more than 48 hours), producing minimal side effect, having adequate price and applying an easy use method. Therefore, Nifedipine, as a tocolytic, can be a good substitute for Magnesium sulfate in preterm labor treatment.


Author(s):  
Wahyu Ida Muliana Wahyu Ida Muliana

ABSTRACT Hyperemesis Gravidarum marked excessive nausea and vomiting in pregnant women at a young age. WHO estimates that 536,000 women died from direct complications of pregnancy and childbirth. One complication of pregnancy is Hyperemesis Gravidarum. Hyperemesis Gravidarum in the world has been estimated to occur in 1-2% of pregnant. According to data from the Medical Record of Dr. Mohammad Hoesin Palembang Hospital, the incidence of Hyperemesis Gravidarum in 2011 there were 72 people of 661 pregnant women. The purpose of this reseach was to determine the relationship between maternal age and parity with Hyperemesis Gravidarum in Dr. Mohammad Hoesin Palembang Hospital 2011. The Design of this reseach used Cross Sectional by analytic approach survey. The population of this reseach are all of mother who gestational ≤ 16 weeks (four months) in the Installation of Obstetrics and Gynecology, Dr. Mohammad Hoesin Palembang Hospital in January to December of 2011 with the sample of 661 people which taken by systematic random sampling and the reseach was conducted from 17 April to 24 April 2012.  Each variable that was observed in tests using Chi-Square test with a (0.05).  The results of this study showed that 5.9% of mothers with hyperemesis gravidarum, 21.8% of mothers with high risk age, and 30.0% primigravida. Chi-Square test showed no significant relationship between age (p value = 0.000) and parity (p value = 0.000) with the incidence of hyperemesis gravidarum. Expected to the Hospital to be implemented properly instructed how to provide counseling to pregnant women about pregnancy and childbirth, as well as provide confidence that the nausea and vomiting is a symptom of physiology in pregnancy.   ABSTRAK Hiperemesis Gravidarum ditandai mual dan muntah yang berlebihan terjadi pada ibu hamil di usia muda. WHO memperkirakan 536.000 perempuan meninggal dunia akibat langsung dari komplikasi kehamilan dan persalinan. Salah satu komplikasi kehamilan adalah Hiperemesis Gravidarum. Insiden Hiperemesis Gravidarum di dunia telah diperkirakan terjadi pada 1-2% wanita hamil. Menurut data dari Medical Record Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang, angka kejadian Hiperemesis Gravidarum pada tahun 2011 terdapat 72 orang dari 661 ibu hamil. Tujuan penelitian ini adalah untuk mengetahui hubungan antara umur dan paritas ibu dengan kejadian Hiperemesis Gravidarum pada ibu di Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang tahun 2011. Desain Penelitian ini menggunakan survei analitik dengan pendekatan Cross Sectional. Populasi penelitian ini adalah dengan umur kehamilan ≤ 16 minggu (4 bulan) yang pernah dirawat inap di Instalasi Kebidanan dan Penyakit Kandungan Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang pada bulan Januari-Desember tahun 2011 dengan jumlah sample 661 orang yang diambil secara systematic Random Sampling (secara acak sistematis) dan penelitian ini dilakukan dari tanggal 17 April sampai dengan 24 April 2012. Masing-masing variabel yang diteliti di uji dengan menggunakan uji Chi-Square dengan a (0,05). Hasil penelitian ini menunjukkan bahwa 5,9% ibu mengalami hiperemesis gravidarum, 21,8% ibu dengan umur resiko tinggi, dan 30,0% ibu primigravida. Uji Chi-Square menunjukkan ada hubungan yang bermakna antara umur (p value = 0,000) dan paritas (p value = 0,000) dengan kejadian hiperemesis gravidarum. Diharapkan dapat menjadi masukan bagi pihak Rumah Sakit agar dilaksanakan penyuluhan dengan cara memberikan konseling terhadap ibu hamil tentang kehamilan dan persalinan, serta memberikan keyakinan bahwa mual muntah merupakan gejala fisiologi pada kehamilan.


2020 ◽  
Vol 2 (1) ◽  
pp. 53-59
Author(s):  
Josimara A. de Araújo Varela ◽  
Tatiana F.T. Palitot ◽  
Smyrna L.X. de Souza ◽  
Alidianne F.C. Cavalcanti ◽  
Alessandro L. Cavalcanti

Objective: This study aimed to analyze the presence of lesions in the skull and face and the associated factors in pedestrian victims of traffic accidents. Methods: A cross-sectional, descriptive-analytical study carried out through the analysis of medical records of pedestrian victims of traffic accidents in an emergency service in the city of Campina Grande, Brazil, during the year of 2016. Information was collected regarding gender, age group, day of the week, time of the accident, type of vehicle involved, presence of trauma to the skull and face, and outcomes. The Chi-square and Fisher's Exact tests were used, with a significance level of 5%. Results: A total of 1,884 medical records were evaluated, out of which 7.1% (n = 133) involved pedestrians. Men were the most frequent victims (68.4%), and victims of age 60 years old or over (30.5%) predominated. Almost one-third of the cases were recorded during the weekends (30.5%), and the most prevalent time was at night (52.7%). Regarding the type of vehicle involved, motorcycles predominated (47.4%). Head trauma was present in 37.6% of victims, while facial injuries corresponded to 8.2%. In 12% of cases, the victims died. The variables of gender, age group, occurrence on weekends, and trauma to the face showed a statistically significant association with the occurrence of traffic accidents (Chi-square test; p<0.05). Conclusion: Among pedestrian victims of traffic accidents, there is a predominance of men aged 65 years or over. Accidents are frequent at night, and motorcycles are the main vehicles involved. The presence of trauma to the skull and face regions is high.


2019 ◽  
Author(s):  
Leila Ahmadian ◽  
Reza Khajouei ◽  
Sudabeh Kamali ◽  
Moghaddameh Mirzaee ◽  
Arefeh Ameri

BACKGROUND Today, the Internet may be a promising tool for interventions for pregnant women. However, these kinds of tools are only helpful if users are ready to use them. OBJECTIVE The present study was conducted with the aim of readiness assessment of pregnant women to use the Internet to access health information about pregnancy and childbirth. METHODS This study was carried out on a sample of 384 pregnant women. Data were collected using a valid and reliable questionnaire. The first section of this questionnaire collected demographic characteristics of the participants. The second part of the questionnaire contains 27 questions covering the following components: infrastructure readiness (6 questions); affordability readiness (3 questions); and skill readiness (12 questions). Data were analyzed with SPSS 19.0 using descriptive statistics, Chi-square test, and T-test. RESULTS This study was carried out on a sample of 384 pregnant women. Data were collected using a valid and reliable questionnaire. The first section of this questionnaire collected demographic characteristics of the participants. The second part of the questionnaire contains 27 questions covering the following components: infrastructure readiness (6 questions); affordability readiness (3 questions); and skill readiness (12 questions). Data were analyzed with SPSS 19.0 using descriptive statistics, Chi-square test, and T-test. CONCLUSIONS The use of the Internet by pregnant women depends on factors such as infrastructure, affordability, and skills readiness. This study showed that speed and the quality of the Internet, hardware and software availability, affordability of the Internet, and access to the Internet training were factors in measuring E-health readiness assessment. CLINICALTRIAL Not applicable


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenling Hu ◽  
Huanqing Hu ◽  
Wei Zhao ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Koech Irene ◽  
Poli Philippe Amubuomombe ◽  
Richard Mogeni ◽  
Cheruiyot Andrew ◽  
Ann Mwangi ◽  
...  

Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S244-S244
Author(s):  
Bharath Pendyala ◽  
Prasanth Lingamaneni ◽  
Patricia DeMarais ◽  
Lakshmi Warrior ◽  
Gregory Huhn

Abstract Background Neurocysticercosis is a Neglected Tropical Disease and an important public health issue. Our goal was to collect and analyze data regarding clinically significant gender differences among our Neurocysticercosis patients. Methods A retrospective chart search with ICD 9/ ICD 10 diagnostic code for Neurocysticercosis and neuroimaging suggestive of Neurocysticercosis was performed for clinical encounters in the hospital or affiliated clinics between years 2013–2018. After a careful chart review, patients who were clinically diagnosed with Neurocysticercosis were included in the study. T-test was used to compare means of continuous variables and chi-square test to compare proportions of categorical variables. Results Among 90 total patients included, male (49.4%) and female (50.6%) distribution were nearly identical. The mean age in females was found to be higher than males (52.5 vs 42.0, P &lt; 0.0001). Almost an equal number of males and females presented with either seizures (63.6% vs 57.8%, P= 0.85), headaches (25.0% vs 28.9%, p= 0.85), or other symptoms (11.4% vs 13.3%, p= 0.85). Males had more generalized seizures compared to females (60% vs 38%, P= 0.37), although this result was not statistically significant. Females were more likely to present with &gt; 1 lesion (82.2% vs 56.8%, P= 0.01). Males were more likely to have cystic lesions (64.7% vs 27.9%, P &lt; 0.001) compared to females who had more calcified lesions on presentation (65.1% vs 20.6%, P &lt; 0.001). Male patients were more likely to have contrast enhancement or edema surrounding the lesions (61.4% vs 33.3%, P= 0.01) and were more likely to require treatment with Albendazole/Praziquantel (75.8% vs 31.7%, P &lt; 0.001). Conclusion Although previously reported data is limited, there is a suggestion that there are gender differences in host immune response and that inflammation surrounding parenchymal lesions is more intense in females. This study suggests that men either present early in the disease phase or have different immune responses than women and require anti-parasitic therapy more frequently. More research in this aspect is needed. Disclosures All Authors: No reported disclosures


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Opeolu Adeoye ◽  
Dawn Kleindorfer

Background: In 2013, the NIH Stroke Trials Network (StrokeNET) was established to maximize efficiencies in stroke clinical trials. Successful recruitment in future trials was required for participating sites. A high volume of cases treated is a surrogate for the potential to recruit. Among Medicare-eligible acute ischemic stroke (AIS) cases, we estimated the IV rt-PA and endovascular embolectomy treatment rates at StrokeNET Regional Coordinating Centers and their partner hospitals compared with non-StrokeNET hospitals in the United States (US). Methods: We used demographics and IV rt-PA and embolectomy rates in the 2013 Medicare Provider and Analysis Review (MEDPAR) dataset. ICD-9 codes 433.xx, 434.xx and 436 identified AIS cases. ICD-9 code 99.10 defined rt-PA treatment and ICD-9 code 39.74 defined embolectomy. Demographics and treatment rates at StrokeNET and non-StrokeNET sites were compared using t-test for proportions and Chi-square test for categorical variables as appropriate. Results: Of 386,157 AIS primary diagnosis discharges, 5.1% received IV rt-PA and 0.8% had embolectomy (Table). By June 6, 2014, StrokeNET comprised 247 acute care hospitals that discharged 48,946 (13%) out of 386,157 AIS cases. rt-PA (7.4% vs 4.8%) and embolectomy (1.9% vs 0.6%) treatment rates were higher at StrokeNET hospitals. In 2013, 36% of StrokeNET hospitals treated more than 20 AIS cases with rt-PA or embolectomy compared with 6% of non-StrokeNET hospitals (P<0.0001).Conclusions StrokeNET hospitals treat more AIS cases with acute reperfusion therapies. Thus, StrokeNET could successfully recruit in acute reperfusion clinical trials depending on study size, capture of eligible patients and the number of competing trials. We likely underestimated treatment rates due to not accounting for drip-and-ship and non-Medicare cases. To further enhance enrollments in large acute reperfusion phase 3 trials, partnership with high volume non-StrokeNET hospitals may be warranted.


2021 ◽  
Vol 45 (5) ◽  
pp. 312-316
Author(s):  
Mishra Neha Sanjeev ◽  
Harsimran Kaur ◽  
Sandeep Singh Mayall ◽  
Rishika ◽  
Ramakrishna Yeluri

Objective: To evaluate the effectiveness of placing a resorbable collagen barrier in impeding the extrusion of obturation material in primary molars undergoing resorption. Study design: All the 94 canals in 47 mandibular molars were allocated to 2 groups- Group ‘A’- 47 canals with collagen barrier (Test group) and Group ‘B’- 47 canals without collagen barrier (Control group) based on randomization protocol. Pulpectomy was performed and obturation of both test and control canals were radiographically assessed. Pearson’s chi – square test was applied to analyze the results. The significance level was predetermined at p &lt; 0.05. Results: Among the test group, 93.6% of the canals showed no extrusion while, 6.4% showed visible extrusion of the material outside the apex. In the control group, 83% showed no extrusion whereas 17% of the canals showed visible extrusion outside the apex. But no significant difference was noted (p&gt;0.05). Conclusion: The placement of resorbable collagen barrier in the apical third of the canal prevented the extrusion of obturating material beyond the apex in resorbing primary molars.


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