scholarly journals Different Doses of Intraumbilical Oxytocin on the Third Stage of Labor

Author(s):  
Nurul Islamy ◽  
Nuswil Bernolian ◽  
Firmansyah BasiR ◽  
Theodorus Theodorus

  Objective: To compare the dose of oxytocin injected intraumbilicalltowards the duration of the third stage, blood loss volume, hemoglobinand hematocrit.   Methods: This study is a prospective randomised study with acontrol. The control group was given an intramuscular injection of10 IU oxytocin. The intervention of the three groups intraumbilicaloxytocin treatment dose of 10 IU, 20 IU and 30 IU diluted in 50 ml ofnormal saline solution and administered intraumbilically. Thesample selection by purposive sampling and the distribution groupbased on systematic random sampling (10 samples each). Data weretaken from the period April 2016-January 2017 with the inclusionand exclusion criteria. Data were analysed using Chi-square, T-test,ANOVA and Post hoc tests.   Results: Characteristics study for variables of age, occupation,parity, education, episiotomy and neonates weight showed homogeneouscharacteristics. The mean duration of the third stage forall groups was between 366.7  159.0 seconds and 440.1  244.99seconds. While the average number of postpartum haemorrhage forall group 61.894  226.3ml and 309.5  110.26 ml. There were nodifferences in the dose of oxytocin on the duration of the thirdstage (p> 0.05) and the amount of bleeding (p> 0.005). There was adifference of haemoglobin between intervention group of oxytocindose of 10 IU and 30 IU intraumbilical (p = 0.031). There was nodifference between the mean hematocrit levels between the groups(p> 0.005).   Conclusion: There were no differences in the dose of oxytocinintraumbilical towards the duration of the third stage, the amountof bleeding and hematocrit levels. The decrease of haemoglobingreater in 30 IU intraumbilical significantly. Keywords: duration of the third stage, haemoglobin and hematocrit,oxytocin intraumbilical, the amount of bleeding

Author(s):  
Fatemeh Zahra KARIMI ◽  
Hamid HEIDARIAN MIRI ◽  
Maryam SALEHIAN ◽  
Talat KHADIVZADEH ◽  
Mohaddese BAKHSHI

Background: One of the causes of postpartum hemorrhage is prolongation of third stage of labor. Mother-infant skin to skin contact (SSC) immediately after delivery is one of the non-pharmacological interventions to reduce this stage. Studies which assessed the effect of mother-infant SSC after delivery on duration of the third stage of labor reported controversial results on this issue. Therefore, this study investigated the effect of mother-infant SSC immediately after birth on the duration of third stage of labor Methods: In this systematic review and meta-analysis, the databases of PubMed, Scopus, Cochrane, SID, Magiran IranDoc and Google Scholar were searched from 2000 to 2018, using the keywords related to the objectives of this review to access randomized control trials published in Persian or English. The quality of papers was examined using Cochran's Risk of bias tool. Data was analyzed using Stata software. We used I2 index and Chi-square test to investigate heterogeneity and Egger’s and Begg’s tests to assess publications bias. Random effects model was used to combine the data. Results: Six studies were entered into the meta-analysis. The third stage of labor in SSC group was shorter than that of control group with a mean difference of -1.33 and 95% CI (-2.31 to -0.36) and this difference was statistically significant (P=0.007). Conclusion: Mother-infant SSC decreases the duration of third stage of labor. Therefore, the current study provides some evidences to use this non-pharmacological method in order to accelerate the third stage of labor and ultimately prevent postpartum hemorrhage.  


2021 ◽  
Vol 17 ◽  
Author(s):  
Seyedeh Zahra Masoumi ◽  
Khodayar Oshvandi ◽  
Masoumeh Rostami-Moez ◽  
Arezoo Shayan ◽  
Farideh Kazemi

Background: Infertility can cause low marital satisfaction. Marital satisfaction has an important effect on infertile couples’ health. Objective: This study aimed to assess the effect of relationship enrichment training on improving the marital satisfaction of infertile couples. Methods: This randomized clinical trial was conducted on 50 infertile couples in the infertility center of Fatemieh Hospital in Hamadan, Iran in 2018. Participants were matched for demographic characteristics and randomly assigned to intervention and control groups (each group had 25 couples). Informed consent was obtained from all participants. The Enrich Marital Satisfaction questionnaire and demographic information were used to collect data before the study and two months after the intervention. Two trained midwifery students taught only the intervention group the relationship enrichment topics in seven sessions (each session = 90 minutes). The data were analyzed by SPSS Statistics version 21 using analysis of covariance, independent t-test, chi-square, and Mann–Whitney. The significance level was set at p ≤ 0.05. Results: There was no significant difference in demographic and obstetric information between the two groups (p >0.05). The mean of marital satisfaction in the intervention group significantly increased among women and men from 151.00 ±28.61 to 154.88 ±22.62 and from 152.56 ±27.33 to 159.24 ±22.14, respectively, (p <0.001). Conversely, the mean of marital satisfaction decreased among women and men from 158.13 ±13.86 to 146.25 ±19.53 and from 164.25 ±17.00 to 153.17 ±27.50 in the control group (p=0.02). Conclusion: Relationship enrichment training can be effective in promoting the marital satisfaction of infertile couples. Registration number: The National Center for Strategic Research in medical education, No. 960185.


Author(s):  
K. Sharmila

Postpartum haemorrhage (PPH) has been more common over the last three decades, accounting for 11% of all pregnancy-related deaths in the United States. In the third stage of labour, risk classification and active management are crucial preventative techniques. To avoid negative effects, a multidisciplinary approach to PPH patient care is required. To treat uterine atony, uterotonic medicines like oxytocin are used in combination with manipulative procedures like uterine massage and balloon tamponade. The amount of blood loss, duration of the third stage, need for MRP, incidence of PPH, need for repeated oxytocics, and its side effects were measured in Group I 100 women who were administered injection oxytocin 10 IU injection methergin 0.2 mg IV within one minute of the baby's delivery. The mean blood loss at vaginal delivery in Group I was 100-150 ml and in group I P value 0.027, which was statistically significant .In  Group II was 160-200 ml with P value 0.036, which was statistically significant. The mean duration of third stag labour in Group 1 was 124.6 min and Group 2 was 144.8 min intravenous methergin is a better uterotonic when compared to intramuscular oxytocin to reduce the amount of blood loss at delivery and prevent complications like atonic PPH.


2021 ◽  
Vol 9 (4) ◽  
Author(s):  
Arsalan Latifi ◽  
Farshid Saeedinezhad ◽  
Asadollah Keikhaei ◽  
Ghasem Miri Aliabad

Background: It is important to address the problems of parents of children with cancer to reduce the negative consequences, especially in mothers as primary caregivers. Objectives: The present study aimed to determine the effect of cognitive-emotional intervention on the psychological distress of mothers of children with cancer in the chemotherapy ward. Methods: This randomized clinical trial was conducted on 100 mothers of children with cancer who presented to the chemotherapy ward of the hospitals affiliated to Zahedan University of Medical Sciences in 2018. The eligible mothers were chosen conveniently and then randomly assigned to intervention and control groups. Mothers in the intervention group received five sessions of cognitive-emotional intervention, two sessions per week. Each session took about 60 to 90 minutes on average per group. Before and sixteen weeks after the end of the intervention, data were collected using the Kessler Psychological Distress scale (K-10). The data were analyzed using SPSS 21 utilizing statistical tests, including independent and paired t-tests, Chi-square, and covariance analysis. Results: Although there was no difference in the mean score of psychological distress before the intervention (P = 0.5), but the results showed that the mean score of psychological distress of mothers of children with cancer after cognitive-emotional intervention was significantly lower in the intervention group (6.16 ± 3.40) than the control group (16.84 ± 6.67) (P = 0.001). Conclusions: Cognitive-emotional intervention had a significant positive effect on reducing psychological distress in mothers of children with cancer. Such interventions are recommended for parents, especially mothers in the chemotherapy ward.


2020 ◽  
Vol 10 (2) ◽  
pp. 119-129
Author(s):  
Halimah Wenny Yulina Astuti ◽  
Murti Agustin ◽  
Sri Padma Sari ◽  
Diyan Yuli Wijayanti ◽  
Widodo Sarjana ◽  
...  

Background: Hope has an essential role in the recovery journey for people with schizophrenia. Current studies showed that people with schizophrenia reported having low hope. There is growing evidence that mindfulness has favorable effects on mental health in populations with chronic illness, including people with schizophrenia. However, the studies evaluating effects of mindfulness on hope and recovery for people with schizophrenia are limited.Purpose: This study aimed to examine the effects of mindfulness on hope and recovery among people with schizophrenia.Methods: This quasi-experimental study was carried out on 54 patients with schizophrenia based on purposive sampling in a psychiatric hospital in Indonesia. The respondents were divided into two groups with 27 patients each in the intervention and the control group. The intervention group received 2-session mindfulness, while the control group received standard care. The data were collected using the demographic questionnaire, the Schizophrenia Hope Scale (SHS-9), and Recovery Assessment Scale (RAS), and analyzed using the Chi-Square and Mann-Whitney tests. Results: After mindfulness therapy, the intervention group showed a higher mean score of hope than the control group (14.30±2.50 and 9.04±2.15, respectively) as well as in the mean of recovery (86.78±4.00 and 73.56±6.04, respectively). There were significant differences in hope and recovery levels between the two groups with p-value <0.001.Conclusion: This study showed that mindfulness is an effective strategy to stimulate hope and recovery among people with schizophrenia. Nurses can apply mindfulness as one of the nursing interventions for helping the recovery process among this population. 


2020 ◽  
pp. 175114372097262
Author(s):  
Tahereh Najafi Ghezeljeh ◽  
Fatemeh Rahnamaei ◽  
Soghra Omrani ◽  
Shima Haghani

Background Nursing care for patients with delirium is very complex and stressful and is associated with considerable care strain for nurses. Delirium recognition is the first step to the prevention and management of delirium and reduction of strain of care. Education is one of the strategies for improving nurses’ delirium recognition ability. Objectives This study aimed to evaluate the effects of interactive E-learning on delirium recognition ability and delirium-related strain of care among critical care nurses. Methods This quasi-experimental study was conducted in 2019 using a two-group pretest-posttest design. Participants were 98 critical care nurses recruited through a census from two hospitals in Iran. They were non-randomly allocated to an intervention and a control group. Study intervention was an interactive E-learning program with four parts on delirium, its prevention, its treatment, and its diagnostic and screening procedures. The program was uploaded on a website and its link was provided to participants in the intervention group. Before and two months after the intervention, data were collected using the Strain of Care for Delirium Index and five case vignettes. For data analysis, the Chi-square, Fisher’s exact, independent-sample t, and paired-sample t tests were performed usingthe SPSS software (v. 16.0). Findings Groups did not significantly differ from each other regarding the pretest mean scores of delirium recognition ability and strain of care. After the intervention, the mean score of delirium recognition ability in the intervention group was significantly greater and the mean score of strain of care was significantly lower than the control group (P < 0.05). Conclusion Interactive E-learning is effective in significantly improving critical care nurses’ delirium recognition ability and reducing their strain of care. As nurses’ heavy workload and limited free time are among the main barriers to their participation in face-to-face educational programs, interactive E-learning can be used for in-service education.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kaori Takahata ◽  
Shigeko Horiuchi ◽  
Yuriko Tadokoro ◽  
Erika Sawano ◽  
Kazuyuki Shinohara

Abstract Background Breast stimulation is performed to self-induce labor. However, there are apparently no reports on hormonal evaluation during stimulation for consecutive days in relation to induction effect. We evaluated the salivary oxytocin level following 3 consecutive days of own breast stimulation for 1 h each day compared with no breast stimulation. Methods We used a quasi-experimental design. The participants were low-risk primiparas between 38 and 39 gestational weeks. Eight saliva samples per participant were collected at preintervention and 30, 60, and 75 min postintervention on the first and third days. The primary outcome was change in the salivary oxytocin level on the third day after 3 consecutive days of breast stimulation for 1 h each day compared with no breast stimulation. The secondary outcomes were the rate of spontaneous labor onset and negative events including uterine hyperstimulation and abnormal fetal heart rate. Results Between February and September 2016, 42 women were enrolled into the intervention group (n = 22) or control group (n = 20). As there were differences in the basal oxytocin levels between the 2 groups, to estimate the change in the oxytocin level from baseline, we used a linear mixed model with a first-order autoregressive (AR1) covariance structure. The dependent variable was change in the oxytocin level from baseline. The independent variables were gestational weeks on the first day of intervention, age, education, rs53576 and rs2254298, group, time point, and interaction of group and time. After Bonferroni correction, the estimated change in the mean oxytocin level at 30 min on the third day was significantly higher in the intervention group (M = 20.2 pg/mL, SE = 26.2) than in the control group (M = − 44.4 pg/mL, SE = 27.3; p = 0.018). There was no significant difference in the rate of spontaneous labor onset. Although there were no adverse events during delivery, uterine tachysystole occurred in 1 case during the intervention. Conclusions The estimated change in the mean oxytocin level was significantly higher 30 min after breast stimulation on the third day. Thus, consecutive breast stimulation increased the salivary oxytocin level. Repeated stimulations likely increase the oxytocin level. Trial registration UMIN000020797 (University Hospital Medical Information Network; Prospective trial registered: January 29, 2016).


2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Zeinab Farmani ◽  
Marzieh Kargar ◽  
Zahra Khademian ◽  
Shahram Paydar ◽  
Najaf Zare

Abstract Objective This study aimed to determine the effect of awareness of subtle control after training on the hand hygiene compliance among nurses in intensive care units (ICUs). The study was conducted in two ICUs of a trauma center in Shiraz, Iran on 48 nurses. The nurses of one ICU were randomly allocated to the intervention and the nurses of the other ICU were allocated to the control group. All nurses were trained on hand hygiene. Then a fake closed camera television (CCTV) was visibly installed in the intervention group’s ICU, while the nurses were aware of it. The degree of compliance with hand hygiene was observed in both groups before and after the intervention. Data were gathered using a checklist based on the World Health Organization hand hygiene protocol and analyzed using SPSS 16 and the Chi square, Wilcoxon, Mann–Whitney U, and Independent T-tests, were performed. Results The mean percentage of hand hygiene compliance in the intervention group after the intervention was significantly higher than before the intervention (p < 0.001). Additionally, the changes in the mean percentage of the intervention group was significantly higher than that for the control group (p = 0.001). The findings showed that a fake CCTV after training, installed in ICUs, can improve hand hygiene compliance.


Author(s):  
Harshita Naidu ◽  
Sujatha B. S. ◽  
Muralidhar V. Pai

Background: Postpartum hemorrhage is the most common preventable cause of maternal mortality in developing countries. The present study aimed to examine the impact of cervical traction technique in reducing the amount of postpartum blood loss and rate of PPH.Methods: This was a case-control, pilot study conducted in a tertiary hospital between June 2017 to June 2018. A total of 200 singletons, low-risk pregnant females, undergoing normal vaginal delivery, were enrolled in this study. Subjects showing a high risk for PPH were excluded. Patients were randomized as case group (n=100) and control group (n=100). The case group received sustained traction for 90 seconds to anterior and posterior lip of the cervix with active management of the third stage of labor, whereas the control group received routine active management of the third stage of labor. All subjects were followed up for 6 hours post-delivery. The amount of blood loss, hematocrit and hemoglobin post-delivery were compared between both groups.Results: The mean blood loss (ml), decrease in hemoglobin (g/L) and decrease in hematocrit post-delivery in cases were significantly low compared to controls (207±37.6 versus 340±49, P<0.01), (0.78±0.2 versus 1.4±0.3, P=0.03) and (1.7±0.2 versus 3.5±0.2, P<0.01). PPH occurred in 7 of 200 (3.5%) patients. The difference in the number of PPH was not significant (5/100; 5% versus 2/100; 2% P=0.2). There were no complications reported due to cervical traction.Conclusions: Cervical traction is a simple and safe maneuver to reduce the amount of postpartum blood loss. Larger RCT is recommended to investigate the reduction in PPH rate.


2020 ◽  
Vol 14 (2) ◽  
pp. 145
Author(s):  
Devi Pratiktowati ◽  
Dewi Marhaeni Diah Herawati ◽  
Ginna Megawati ◽  
Deni Kurniadi Sunjaya

A high prevalence chronic energy deficiency (CED) in pregnant women exist in Indonesia, which approximately 16.2%. The government had made various efforts to eliminate CED in pregnant women. Therefore, our study aimed to analyze the efficacy of eel cookies on improving nutritional status of pregnant women with CED risk. An experiment with a pre-post design of 36 pregnant women with risk of CED in Ciletuh, Sukabumi was carried out for 30 days. Pregnant women in intervention group were given eel cookies, while control group were given cookies without eel. At the beginning and end of the study, MUAC were measured and food intake was assessed through a 24 hour recall. The research data was analysed using t-test, Mann-Whitney test and chi square. Significant difference in body weight between intervention and control groups was not found (p > 0.05). The mean bodyweight in intervention group after intervention (48.5) was higher than in control group (48.3). The Mean bodyweight and MUAC in the two groups before and after intervention also did not show a significant difference  (p> 0.05). The risk of CED in pregnant women who received eel cookies were lower compared to the control group. Consumption of eel cookies can reduce CED risk in pregnant women by 35%, while cookies without eel only reduce the risk by 29.4%. Eel cookies had higher efficacy compared to cookies without eel on reducing CED risk in pregnant women.


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