scholarly journals CLINICAL-ANAMNESTIC AND ECHOCARDIOGRAPHIC MARKERS OF NEONATAL SEPSIS AT DIFFERENT GESTATION AGE OF NEWBORN

2021 ◽  
Vol 127 (4) ◽  
pp. 107-115
Author(s):  
Natalia Kretsu ◽  
Olena Koloskova ◽  
Tetiana Bilous
Keyword(s):  
Premature Infants ◽  
Gestational Age ◽  
General Condition ◽  
Neonatal Sepsis ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Sepsis Group ◽  
Group I ◽  
Echocardiographic Parameters ◽  
Group Ii

neonatal sepsis remains one of the leading causes of morbidity and mortality in the neonatal age. The involvement of the myocardium in sepsis remains insufficiently studied, in particular in neonatology, where issues of myocardial dysfunction in neonatal generalized infection seem even more controversial, especially in neonatal sepsis at different gestational terms. Objective. To study specific clinical and anamnestic and echocardiographic parameters in infants depending on gestational age for optimization of the prognosis in neonatal sepsis. Material and research methods. To achieve this goal, we observed 57 newborns with a verified diagnosis of "Neonatal sepsis". Group I (23 patients – 40.3%) included newborns with a gestational age of 37-42 weeks, Group II – 34 premature infants (59.7%) with a gestation of up to 36 weeks. The latter group, depending on the gestational age, was divided into IIA subgroup, which was formed by 21 prematurely born patients with NS with a gestational age of 32-36 weeks, and the IIB subgroup – 13 newborns born before 32 weeks of gestation. Research results. The analysis showed that the severity of the impairment in the general condition of the examined newborns general condition was assessed as severe in 47.8% of newborns of group I, in 88.2% of cases in group II (PI: II <0.05), in 85.7% of representatives of subgroup IIA (PI: IIA <0.05) and in 92.3% of children of subgroup IIB (PI: IIB <0.001). It is shown that every third child (30.4%) of group I, 67.6% of newborns of group II (PI: II <0.05), half (52.4%) of the representatives of subgroup IIA (PII: IIA <0.01) and all seriously ill patients (92.3%) of subgroup IIB (PI: IIB, IIA: IIB <0.05) required cardiopulmonary resuscitation in the delivery room. Thus, in relation to full-term patients, the risk of this significant postnatal factor of emergency is likely to increase: for group II: OR - 4.77 (95% CI 2.63-8.68), RR - 2.17 (95% CI 1.57-3.0), AR = 0.37; and for premature babies with a gestational age of less than 32 weeks (IIB subgroup), respectively: OR – 27.44 (95% CI 11.73-64.19), RR – 7.55 (95% CI 5.58-10.21 ), AR – 0.65. The correlation analysis showed that in premature infants suffering from NS, the increase in the functional capacity of the left ventricular myocardium was associated with the female sex (for EF r = 0.94, P = 0.0001, for FS - r = 0, 94, P = 0.0001) and the number of days of inotropic support (for EF r = 0.68, P = 0.043, for FS - r = 0.71, P = 0.03). Conclusions. The analysis of echocardiographic parameters in the group of premature infants revealed a direct correlation between the ejection fraction and cardiovascular resuscitation immediately after birth (r = 0.64) and the duration of inotropic drugs (r = 0.68).

Pre-Clinical Evaluation of a Novel, Pneumatic, Ventricular Assist Device (Medos® HIA-VAD®) under Pathophysiological Conditions

1997 ◽  
Vol 20 (7) ◽  
pp. 389-396 ◽  
Author(s):  
F.R. Waldenberger ◽  
B. Meyns ◽  
H. Reul ◽  
R. Eilers ◽  
W. Flameng
Keyword(s):  
Coronary Artery ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Assisted Circulation ◽  
Wall Thickening ◽  
Base Line ◽  
Assist Device ◽  
Circumflex Artery ◽  
Group I ◽  
Group Ii

To evaluate a new cardiac assist system, the Medos® HIA-VAD®, we studied the effects of mechanical unloading on regional and global myocardial dysfunction. As a model for the regional temporary contractile dysfunction we chose an anesthetized, open chest preparation in sheep. We occluded the diagonal coronary artery for 15 minutes and reperfused for 90 minutes. Hemodynamic parameters and wall thickening were monitored. Unloading with the 60-ml Medos® HIA-VAD® was performed either during ischemia (group II) or during reperfusion (group III). The recovery of non-uniformity indicated by post-ejection wall thickening was significantly faster (p<0.05) in both groups if compared to the non-assisted group (group I) (all groups n=4). Recovery of systolic wall thickening in the postischemic region in group I was only 76±12%, while it was 103±11% and 92±11% in groups II and III, respectively (p<0.05). In a canine model of global left ventricular failure, we occluded the left anterior descending coronary artery for 20 min, and after 5 minutes of reperfusion, the circumflex artery for 45 min (group I, n=5). After 5 min of CX occlusion in group II we performed assisted circulation for 90 min with the 10-ml (n=5) and the 25-ml (n=5) Medos® HIA-VAD®. In group I, no dog survided, in group II, all survided 4 hours of reperfusion (n=10). Lactate at the end of the experiment was 1.1±0.9 mmol/L (10-ml) and 1.1±0.2 mmol/L (25-ml) (p>0.05 vs. base line). We conclude that the Medos® HIA-VAD® is a reliable assist device that enhances myocardial recovery and allows sufficient peripheral circulation in the case of cardiogenic shock.

scholarly journals Certain clinical and paraclinical markers of sepsis-induced myocardial dysfunction in newborn

2021 ◽  
pp. 41-48
Author(s):  
О.К. Koloskova ◽  
◽  
N.M. Kretsu ◽  
T.M. Bilous ◽  
◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Inflammatory Process ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Preterm Neonates ◽  
Screening Methods ◽  
Term Infants ◽  
Lactate Dehydrogenase Activity ◽  
Group I ◽  
Minute Apgar Score

The problem of neonatal sepsis continues to be one of the leading places in neonatal practice. The issues of early diagnostics of cardiovascular disorders in neonates with sepsis by means of up-to-date methods of examination remain relevant. They can be used as screening methods with the purpose to verify possible development of cardiovascular dysfunction. Purpose — to study the meaning of certain clinical and paraclinical markers of myocardial dysfunction in neonates with sepsis. Materials and methods. In order to realize the objective we have observed 69 neonates with signs of generalized infectious-inflammatory process. Group I (32 patients — 46,4%) included neonates with the term of gestation 37–42 weeks, group II included 37 preterm neonates (53,6%) with the term of gestation under 36 week inclusive. Results. It was found that in mothers who gave birth prematurely, compared to mothers of newborns of group I, premature rupture of membranes occurred more often, but 1.5 times less often — indications of infectious diseases of the genitourinary system of the pregnant woman. Generalized infectious-inflammatory process during the neonatal period of term infants is accompanied by electrocardiographic signs of left ventricular overload associated with female sex (r=0,30), delivery by cesarean section (r=0,27), and assessment of neonatal condition by a 5=minute Apgar score (r=-0,33). Conclusions. Increased values of lactate dehydrogenase activity in the blood serum of both term and preterm neonates are associated with left ventricular over-load in the term ones, and right ventricular overload in the preterm infants. Changes found in electrophysiological heart activity promote the necessity of a routine use of electrocardiography in neonates with signs of septic process. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: neonatal sepsis; myocardial dysfunction.

scholarly journals What should be the protein target for adjustable Human Milk fortification in premature infants?

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Bayram Ali Dorum ◽  
Hilal Ozkan ◽  
Salih Cagri Cakir ◽  
Nilgun Koksal ◽  
Gizem Ezgi Sen
Keyword(s):  
Birth Weight ◽  
Human Milk ◽  
Premature Infants ◽  
Gestational Age ◽  
Protein Supplementation ◽  
Physical Growth ◽  
Protein Target ◽  
Group I ◽  
The Mean ◽  
Group Ii

Objective: To assess the short- and long-term effects of the adjustable fortification (ADJ) regimen on growth parameters in premature infants and to evaluate the amount of protein supplements given to reach the targeted blood urea nitrogen (BUN) levels. Methods: In this retrospective study, preterm babies who were born at ≤32 weeks gestational age and fed with human milk, were evaluated in two groups. Infants in Group-I were fed only standard fortification (STD). Infants in Group-II were fed the ADJ regimen. The study was conducted between 2011 and 2016. Results: There were 123 infants in the STD group and 119 in the ADJ group. The mean gestational age of the patients in Group-I was 29.7±1.8 weeks, and mean birth weight was 1266.1±347.1 g. The mean gestational age of the patients in Group-II was 29.5±1.9 weeks, and the mean birth weight was 1217.5±345.5 g. The daily increase in weight and weekly increase in HC were significantly higher in the ADJ group infants. Weight and HC of infants in the ADJ group were significantly higher at 40 weeks. At one year corrected age, weight, length, and HC measurements of both groups were similar. In Group-II, 63% of patients required additional protein supplementation up to 1.6 g/day to achieve the target BUN levels. Conclusion: A higher protein intake through the ADJ regimen improves the physical growth rate of premature infants in the NICU and after discharge. However, sometimes, the targeted growth and BUN values ​​cannot be achieved despite the administration of protein at the recommended increased doses. Increasing protein supplementation up to 1.6 g/day is safe, feasible, and beneficial for these infants. How to cite this:Dorum BA, Ozkan H, Cakir SC, Koksal N, Sen GE. What should be the protein target for adjustable Human Milk fortification in premature infants? Pak J Med Sci. 2019;35(1):277-281. doi: https://doi.org/10.12669/pjms.35.1.337 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effects of Rest and Exercise on Cardiac Blood Volume Determinations

1997 ◽  
Vol 36 (08) ◽  
pp. 259-264
Author(s):  
N. Topuzović
Keyword(s):  
Radionuclide Ventriculography ◽  
Left Ventricular ◽  
Peak Exercise ◽  
Volume Determination ◽  
Group I ◽  
Lv Volumes ◽  
Group Ii ◽  
Lv Volume

Summary Aim: The purpose of this study was to investigate the changes in blood activity during rest, exercise and recovery, and to assess its influence on left ventricular (LV) volume determination using the count-based method requiring blood sampling. Methods: Forty-four patients underwent rest-stress radionuclide ventriculography; Tc-99m-human serum albumin was used in 13 patients (Group I), red blood cells was labeled using Tc-99m in 17 patients (Group II) in vivo, and in 14 patients (Group III) by modified in vivo/in vitro method. LV volumes were determined by a count-based method using corrected count rate in blood samples obtained during rest, peak exercise and after recovery. Results: In group I at stress, the blood activity decreased by 12.6 ± 5.4%, p <0.05, as compared to the rest level, and increased by 25.1 ± 6.4%, p <0.001, and 12.8 ± 4.5%, p <0.05, above the resting level in group II and III, respectively. This had profound effects on LV volume determinations if only one rest blood aliquot was used: during exercise, the LV volumes significantly decreased by 22.1 ± 9.6%, p <0.05, in group I, whereas in groups II and III it was significantly overestimated by 32.1 ± 10.3%, p <0.001, and 10.7 ± 6.4%, p <0.05, respectively. The changes in blood activity between stress and recovery were not significantly different for any of the groups. Conclusion: The use of only a single blood sample as volume aliquot at rest in rest-stress studies leads to erroneous estimation of cardiac volumes due to significant changes in blood radioactivity during exercise and recovery.

Abstract 12952: Global Longitudinal Strain is Simple, Effective & Sensitive Assessment of Cardiac Chamber Function in Patients With Acute-phase Myocarditis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shaun Khanna ◽  
Aditya Bhat ◽  
Henry H Chen ◽  
Kennith Gu ◽  
Gary Gan ◽  
...  
Keyword(s):  
Acute Phase ◽  
Longitudinal Strain ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Disease Process ◽  
Left Ventricular ◽  
Lv Function ◽  
Lv Mass ◽  
Echocardiographic Parameters ◽  
Cardiac Therapy

Introduction: Myocarditis is an inflammatory disease process with growing clinical relevance in the current COVID-19 pandemic. Acute-phase myocarditis is known to result in subclinical changes in left ventricular (LV) function despite normal LV ejection fraction (LVEF), as assessed by myocardial deformation indices. The presence of right ventricular (RV) and left atrial (LA) subclinical dysfunction however has not been well described in current literature. Hypothesis: Myocarditis patients have subclinical impairment of LV, RV and LA function as assessed by global longitudinal strain (GLS) on speckle tracking echocardiography. Methods: Consecutive patients with clinical diagnosis of myocarditis admitted to our institution during 2013-2018 were assessed (n=76). Patients who did not meet appropriate diagnostic criteria (n=14), had impaired LVEF or prior cardiac disease (n=8) or poor transthoracic echocardiogram images (n=14) were excluded from analysis. Clinical and echocardiographic parameters were compared to age- , gender- and risk factor- matched controls. GLS was performed by two independent observers using vendor independent software (TomTec Arena, Germany v4.6). Results: The final cohort consisted 40 patients with myocarditis (age 44.3±16.7, 60% male) and 40 matched controls (44.5±16.6, 60% male). No significant differences in baseline clinical characteristics were observed between groups. No differences in LVEF, indexed LV mass, RV fractional area change, indexed LA volume or TR pressure gradient (p>0.05 for all) were demonstrated between the two groups. Patients with myocarditis had a lower mean LV strain (GLS%: -16.4±2.9 vs -19.7±2.7, p=0.0001), a lower mean RV Free Wall Strain (FWS) (GLS%: -22.1±4.1 vs -26.2±6.9, p=0.03) and a lower mean LA reservoir strain (GLS%: 27.5±4.6 vs. 33.7±6.3, p<0.0001) when compared to controls. Conclusions: Our results demonstrate the presence of significant subclinical global myocardial dysfunction despite normal traditional echocardiographic indices, in patients with acute-phase myocarditis. Routine assessment of GLS may identify such patients for early targeted cardiac therapy.

scholarly journals Aminoglycoside trough levels in neonates

2010 ◽  
Vol 138 (1-2) ◽  
pp. 50-55 ◽  
Author(s):  
Biljana Pejovic ◽  
Milica Rankovic-Janevski ◽  
Niveska Bozinovic-Prekajski
Keyword(s):  
Gestational Age ◽  
Trough Level ◽  
Inverse Correlation ◽  
Risk Groups ◽  
Target Range ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
The Difference ◽  
Trough Levels

Introduction. Drug safety depends on trough levels. Objective. Objective of the study was to measure gentamicin and amikacin trough levels in neonates and to identify risk groups by gestational and postnatal age. Methods. Gentamicin and amikacin were applied according to the clinical practice guidelines. Trough levels (mg/l) were deter- mined using fluorescence polarization immunoassay methodology. Target trough levels were <2 mg/l for gentamicin, and <10 mg/l for amikacin. Patients were divided in 3 groups by gestational age: I ?32, II 33-36, and III ?37 gestational weeks and, by postnatal age, in 2 groups: ?7 and >7 days. Results. Out of 163 neonates, 111 were receiving gentamicin and 52 amikacin. Mean amikacin trough level was 7.8?4.8 mg/l and, in group I 10.5?4.9 mg/l, which was above the target range and significantly higher than in group II (LSD, p<0.05). In the amikacin group, 26 patients were 7 and less, and 26 more than 7 days old, without significant differences in trough levels between the groups. In the gentamicin group, 52.3% of neonates had trough values within the target range. Gentamicin trough level in group I was above the trough range, 3.7?1.8, 2.3?1.5 in group II and, 1.8?1.4 mg/l in group III. The difference in trough levels among the groups was highly significant (F=9.015, p<0.001, ?2=17. 576, p<0.001). Further analysis revealed that differences between groups I and II (LSD, p=0.002) and between I and III (LSD, p=0.000) were highly significant. Conclusion. Obtained gentamicin and amikacin trough levels are high. Inverse correlation has been confirmed between trough level and gestational age, with highly significant difference, and the risk group has been identified. There is obviously a need to change the dosing regimen in terms of those with extended intervals, particularly for neonates of the lowest gestational age, along with pharmacokinetic measurements.

Acoustic Reflex Testing in Neonatal Hearing Screening and Subsequent Audiological Evaluation

2018 ◽  
Vol 61 (7) ◽  
pp. 1784-1793
Author(s):  
Lilian Cássia Bórnia Jacob-Corteletti ◽  
Eliene Silva Araújo ◽  
Josilene Luciene Duarte ◽  
Fernanda Zucki ◽  
Kátia de Freitas Alvarenga
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Pure Tone ◽  
Broadband Noise ◽  
Acoustic Reflex ◽  
Group I ◽  
Group Ii ◽  
Gestational Age At Birth ◽  
Age At Birth

Purpose The aims of the study were to examine the acoustic reflex screening and threshold in healthy neonates and those at risk of hearing loss and to determine the effect of birth weight and gestational age on acoustic stapedial reflex (ASR). Method We assessed 18 healthy neonates (Group I) and 16 with at least 1 risk factor for hearing loss (Group II); all of them passed the transient evoked otoacoustic emission test that assessed neonatal hearing. The test battery included an acoustic reflex screening with activators of 0.5, 1, 2, and 4 kHz and broadband noise and an acoustic reflex threshold test with all of them, except for the broadband noise activator. Results In the evaluated neonates, the main risk factors were the gestational age at birth and a low birth weight; hence, these were further analyzed. The lower the gestational age at birth and birth weight, the less likely that an acoustic reflex would be elicited by pure-tone activators. This effect was significant at the frequencies of 0.5, 1, and 2 kHz for gestational age at birth and at the frequencies of 1 and 2 kHz for birth weight. When the broadband noise stimulus was used, a response was elicited in all neonates in both groups. When the pure-tone stimulus was used, the Group II showed the highest acoustic reflex thresholds and the highest percentage of cases with an absent ASR. The ASR threshold varied from 50 to 100 dB HL in both groups. Group II presented higher mean ASR thresholds than Group I, this difference being significant at frequencies of 1, 2, and 4 kHz. Conclusions Birth weight and gestational age at birth were related to the elicitation of the acoustic reflex. Neonates with these risk factors for hearing impairment were less likely to exhibit the acoustic reflex and had higher thresholds.

Abstract 4510: Pulmonary Hypertension before Transcatheter Aortic Valve Implantation Is Reversible and Lacks Prognostic Significance

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Abdullah M Al Ali ◽  
Brad Munt ◽  
Lukas Altwegg ◽  
Karin Humphries ◽  
Ronald Carere ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Group Iii ◽  
Transcatheter Aortic Valve ◽  
Group I ◽  
Group Ii ◽  
One Year ◽  
Valve Implantation

The prognostic significance of pulmonary hypertension (PH) and the potential for reversibility in the setting of aortic stenosis (AS) have been debated. We examined the clinical correlates and prognostic significance of PH in high risk elderly patients with symptomatic severe AS undergoing transcatheter aortic valve implantation (AVI). AVI was performed in 143 patients. Adequate echocardiographic estimation of baseline pulmonary artery systolic pressure was available in 115 (80%). Patients were divided into 3 groups according to baseline pulmonary artery pressure estimated by transthoracic echocardiogram: I: <30 mmHg, II: 30 –50 mmHg and III: >50 mmHg. Clinical and echocardiographic follow-up was obtained at 1, 6 and 12 months after AVI. Group I consisted of 17 patients (15%), group II 58 patients (50%) and group III 40 patients (35%). At baseline the three groups were similar in terms of age, functional status, presence of severe pulmonary disease, aortic valve area and mean gradient. Patients with severe PH (group III) were more likely to have left ventricular dysfunction (LVEF <50%) than patients with mild to moderate PH (groups I and II) (52% vs. 21%, p=0.002) and had more severe mitral regurgitation (grade ≥ 3 in 68% vs. 41%, p =0.0002). At one month, systolic pulmonary artery pressure fell significantly in group III (11.0 ± 14.3 mmHg, p=0.0008) and this reduction was maintained at 6 months. However, the changes in group I (increase of 7.1 ± 8.7 mmHg, p=0.07) and group II (decrease of 0.9 ± 9.3 mmHg, p=0.53) were not significant. Mortality at one year following AVI was 21%, but was not related to severity of PH. Using group III as a reference, hazard ratios were 0.83 (95% CI: 0.24 –2.9) for group I and 0.88 (95% CI: 0.4 –1.9) for group II. In elderly patients with severe AS treated with transcatheter AVI, severe PH is associated with more depressed left ventricular function and more severe mitral regurgitation. Severe PH is associated with a significant and greater fall in pulmonary pressure following AVI and does not influence one year survival.

Abstract 19826: Utility of Stroke Volume Index for Stratification of Patients With Low Gradient Severe Aortic Stenosis and Normal Left Ventricular Ejection Fraction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hong Shen ◽  
Brandon Stacey ◽  
Bob Applegate ◽  
David Zhao ◽  
Sujethra Vasu ◽  
...  
Keyword(s):  
Stroke Volume Index ◽  
Left Ventricular ◽  
Group Iv ◽  
Low Flow ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Cumulative Survival ◽  
Group I ◽  
Group Ii

Background: Decision of intervention for low gradient severe aortic stenosis (AS) with normal left ventricular ejection fraction (LVEF) is clinically challenging. The study was to determine the impact of stroke volume index (SVi) on prognosis in patients (pts) with AS. Methods: We examined 410 pts with moderate or severe AS and normal EF (≥50%). Pts were divided into four groups based on aortic valve area (AVA), mean pressure gradient (MPG) and SVi: Group I: low flow low gradient severe AS (AVA≤1.0cm 2 , MPG<40mmHg and SVi<35mL/m 2 , n=75); Group II: normal flow low gradient severe AS (AVA≤1.0cm 2 , MPG<40mmHg and SVi≥35mL/m 2 , n=97); Group III: severe AS with matched gradient-AVA (AVA≤1.0cm 2 and MPG≥40mmHg, n=88); Group IV: moderate AS (AVA>1.0cm 2 and MPG>20mmHg, <40 mmHg, n=150). Aortic valve gradients, AVA and SVi were assessed by echocardiography. Clinical charts were reviewed. Mean follow-up duration was 3.2±1.6 years. Results: Group I had higher prevalence of atrial fibrillation, more pronounced LV hypertrophy, lower SVi, smaller AVA, higher valvuloarterial impedance (Zva) (Table) and lower 3-year cumulative survival compared to Group II and Group IV (61% vs. 75% and 80%, p=0.004). Group II had a 3-year cumulative survival similar to moderate AS (75% vs. 80%, p>0.05). In pts with medical management, Group I and Group III had lower 3-year cumulative survival in comparison with Group II and Group IV (48% and 56% vs. 73% and 76%, p=0.001). Multivariate analysis showed SVi was a strong predictor of mortality in low gradient severe AS (HR 0.95, CI: 0.91-0.99, P=0.02). However, in gradient-AVA matched severe AS and moderate AS, SVi was not associated with mortality (p>0.05). Conclusions: Without AS intervention, low flow low gradient severe AS with normal EF carries poor prognosis similar to high gradient AS, but normal flow low gradient AS does not, suggesting that SVi may be used to identify the pts benefiting most from AS intervention in pts with low gradient AS.

B Lynch Suture and Intrauteribne Balloon Tamponade for Management of Severe Postpartum Hemorrhage: A Comparative Study

2021 ◽  
Vol 15 (9) ◽  
pp. 2948-2951
Author(s):  
Mehwish Syed ◽  
Afrah Aman ◽  
Saeeda Safi ◽  
Rabia Nawaz ◽  
Asia Habib ◽  
...  
Keyword(s):  
Success Rate ◽  
Gestational Age ◽  
Postpartum Hemorrhage ◽  
Randomized Control Trial ◽  
P Value ◽  
Bleeding Control ◽  
Balloon Tamponade ◽  
Group I ◽  
Randomized Control ◽  
Group Ii

Objective: The aim of this study is to compare the effectiveness of intrauterine balloon tamponade and B lynch suture for management of severe postpartum hemorrhage. Study Design: Randomized Control trial Place and Duration: The study was conducted at Gynae & Obs department of Qazi Hussain Ahmad Medical Complex, Nowshera KPK for six months duration from January to 2021 to June 2021. Methods: There were one hundred and twenty patients with ages 20-45 years were presented in this study. All women had severe postpartum hemorrhage were included in this study. Demographically detailed of enrolled cases age, body mass index, gestational age and parity were recorded after taking informed written consent. Patients were equally divided into 2-groups I and II. Group I had 60 patients and received Lynch suture while in group II 60 patients received intrauterine balloon tamponade. Post-operative success rate among both groups were assessed and compared in terms of bleeding control within 10-15 minutes. SPSS 24.0 version was used to analyze the complete data. Results: In group I mean age was 29.09±2.53 years with mean BMI 25.11±7.64 kg/m2 while in group II mean age was 29.02±3.62 years with mean BMI 24.87±6.32 kg/m2. Mean gestational age in group I was 37.87±3.29 weeks and in group II mean gestational age was 38.19±6.41 weeks. Mean parity in group I was 4.03±1.19 and in group II it was 4.01±0.87. Frequency of success rate in group I was significantly higher among 54 (90%) cases as compared to group II 39 (65%) with p value < 0.05. We found that patients of group I was significantly satisfied than that of patients who received intrauterine balloon tamponade. Conclusion: In this research we concluded that lynch suture for the management of severe postpartum hemorrhage among females had higher effectiveness in terms of bleeding control within 15 minutes and with higher satisfaction among patients as compared to those females who received intrauterine balloon tamponade. Keywords: Postpartum hemorrhage, Lynch Suture, intrauterine balloon tamponade, Success Rate

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