scholarly journals A Patient-Controlled Intravenous Analgesia With Tramadol Ameliorates Postpartum Depression in High-Risk Woman After Cesarean Section: A Randomized Controlled Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhuoxi Wu ◽  
Peng Zhao ◽  
Jing Peng ◽  
Liang Fang ◽  
Jinping Ding ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
High Risk ◽  
Postpartum Depression ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Depression Scale ◽  
Clinical Trial Registration ◽  
High Risk Women ◽  
Randomized Controlled ◽  
Intravenous Analgesia

Background: Postpartum depression (PPD) is a severe psychiatric disorder. Its risk is associated with the cesarean section (CS). Currently, there are few early intervention strategies for these women with PPD who underwent CS.Methods: This was a parallel-group randomized controlled trial of singleton pregnant women who underwent elective CS in a tertiary referral hospital in China from October, 2017 to September, 2019. After operation, patients received randomly tramadol patient-controlled intravenous analgesia (PCIA; 4 mg/ml; TRA group), hydromorphone PCIA (0.04 mg/ml; HYD group), or ropivacaine patient-controlled epidural analgesia (PCEA; 1.5 mg/ml; ROP group) for 48 h in a 1:1:1 ratio. Total blinding during hospitalization was not feasible due to differences between the PCEA and PCIA treatments. All investigators who performed the follow-up were blinded to the group assignment.Outcomes: A total of 1,230 patients were enrolled for eligibility. Intention-to-treat analysis showed reduced incidence of PPD in the TRA group (n = 27 [6.6%]) than that in the HYD (10.2%, OR 1.62, 95% CI 0.98~2.68; p = 0.059) and ROP groups (10.5%, OR 1.66, 95% CI 1.01~2.75; p = 0.046) at 4 weeks post-operation, however, the difference was not statistically significant (Bonferroni corrected p = 0.118, p = 0.098, respectively). Subgroup analysis in high-risk women (preoperative Edinburgh Postpartum Depression Scale [EPDS] ≥10) showed a significantly lower incidence of PPD in the TRA group (16.5%) than in the HYD (32.6%) and ROP groups (30.9%) (Bonferroni corrected p = 0.022 and p = 0.038, respectively). The per-protocol analysis yielded similar results. Reported adverse events (AEs) were mostly mild. None of the women or infant discontinued treatment due to AEs.Conclusions: Tramadol PCIA after CS in high-risk women can help to reduce the risk of PPD at 4 weeks after elective CS.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03309163?term=ETPPD&draw=2&rank=1; ClinicalTrials.gov (NCT03309163).

Satisfaction with Team Midwifery Care for Low- and High-Risk Women: A Randomized Controlled Trial

Birth ◽  
2003 ◽  
Vol 30 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Mary Anne Biró ◽  
Ulla Waldenström ◽  
Stephanie Brown ◽  
Jan H. Pannifex
Keyword(s):  
Randomized Controlled Trial ◽  
High Risk ◽  
Controlled Trial ◽  
Midwifery Care ◽  
High Risk Women ◽  
Randomized Controlled

Telephone Genetic Counseling for High-Risk Women Undergoing BRCA1 and BRCA2 Testing: Rationale and Development of a Randomized Controlled Trial

2008 ◽  
Vol 12 (1) ◽  
pp. 37-52 ◽  
Author(s):  
Beth N. Peshkin ◽  
Tiffani A. DeMarco ◽  
Kristi D. Graves ◽  
Karen Brown ◽  
Rachel H. Nusbaum ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Genetic Counseling ◽  
High Risk ◽  
Controlled Trial ◽  
Brca1 And Brca2 ◽  
High Risk Women ◽  
Randomized Controlled ◽  
Brca1 And Brca2 Testing

Telephone Genetic Counseling for High-Risk Women UndergoingBRCA1andBRCA2Testing: Rationale and Development of a Randomized Controlled Trial

2008 ◽  
Vol 0 (0) ◽  
pp. 080327164308306 ◽  
Author(s):  
Beth N. Peshkin ◽  
Tiffani A. DeMarco ◽  
Kristi D. Graves ◽  
Karen Brown ◽  
Rachel H. Nusbaum ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Genetic Counseling ◽  
High Risk ◽  
Controlled Trial ◽  
High Risk Women ◽  
Randomized Controlled

scholarly journals S-Ketamine As An Adjuvant in Patient-controlled Intravenous Analgesia for Prevention of Postpartum Depression: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Yaqian Han ◽  
Pule Li ◽  
Mengrong Miao ◽  
Yuan Tao ◽  
Kang Xia ◽  
...  
Keyword(s):  
Postpartum Depression ◽  
Adverse Events ◽  
Cesarean Section ◽  
Primary Outcome ◽  
Controlled Trial ◽  
Depression Scale ◽  
Control Group ◽  
Ramsay Sedation Scale ◽  
Intravenous Analgesia ◽  
Vas Scores

Abstract (1) Background: Postpartum depression (PPD) is a common complication after cesarean section. Recent studies have shown that intravenous S-ketamine during surgery could be effective in preventing PPD. However, no evidence shows S-ketamine used in patient-controlled intravenous analgesia (PCIA) could reduce the incidence of PPD. Our aim was to explore the effect of S-ketamine as an adjuvant in patient-controlled intravenous analgesia (PCIA) for prevention of postpartum depression. (2) Methods: In a single center, 375 parturients scheduled to undergo cesarean section were recruited and randomly assigned to two groups: Control group (C group) or S-ketamine group (S group). Parturients in both groups received PCIA, the formula of Group C: sufentanil 2 μg/kg + tropisetron 10 mg, S group was the same as C group except 0.5mg/kg S-ketamine. The primary outcome was the incidence of PPD measured by the Edinburgh Postnatal Depression Scale (EPDS) after surgery. The secondary outcomes were EPDS scores, Visual analogue scale (VAS) scores, and Ramsay Sedation Scale (RSS) scores, and incidence of related adverse events. (3) Results: A total of 275 puerpera were finally included and randomly assigned to two groups. The incidence of depression at postoperative 3, 14, 28days in C group and S group were 17.6%vs8.2%, P<0.05;24.2%vs9.8%, P<0.05, and 19.0%vs 17.2%, P=0.76, respectively). As for EPDS scores, C group and S group at 3,14, and 28 days after cesarean were 7.65±3.14vs6.00±2.47, p<0.05,7.62±3.14vs6.38±2.67, p<0.05, and 7.35±3.17vs6.90±2.78, p=0.15, respectively. Adverse events such as headache and nausea were 3.3% vs 4.1%, p=0.755; 5.9%vs8.2%, p=0.481. (4) Conclusions: 0.01mg/kg/h S-ketamine as an adjuvant in patient-controlled intravenous analgesia can significantly reduce the incidence of postpartum depression within 14 days and relieve postoperative pain within 48h after cesarean section, without increasing the incidence of adverse reactions.Trial registration: ChiCTR, ChiCTR2100050263，retrospectively registered. Registered 24/08/2021.

scholarly journals The Effect of Midwife-led Psycho-Education on Parental Stress, Postpartum Depression and Parental Competency in High Risk Pregnancy Women: A Randomized Controlled Trial

2021 ◽  
Vol 10 (2) ◽  
pp. 70-76
Author(s):  
Leila Chaharrahifard ◽  
Alireza Jashni Motlagh ◽  
Mahnaz Akbari-Kamrani ◽  
Mina Ataee ◽  
Sara Esmaelzadeh –Saeieh
Keyword(s):  
Randomized Controlled Trial ◽  
High Risk ◽  
Postpartum Depression ◽  
Parental Stress ◽  
Controlled Trial ◽  
Intervention Group ◽  
High Risk Pregnancy ◽  
Randomized Controlled ◽  
Nulliparous Women ◽  
Risk Pregnancy

Abstract Introduction: Women with high-risk pregnancy are at increased risk of depression and anxiety during pregnancy, as well as a less favorable parent-infant interaction. This study aimed to investigate the effect of midwife-led psycho-education intervention on parental stress, competency, and postpartum depression in nulliparous women hospitalized with high-risk pregnancy. Methods: This randomized controlled trial was carried out on 66 nulliparous women admitted to the high-risk pregnancy ward of Kamali Hospital, Karaj, Iran. Using convenient sampling method, the mothers were randomly assigned to control and intervention groups. In addition to routine care, the intervention group received four sessions of midwife-led psycho-education intervention in two group sessions in pregnancy and two individual sessions immediately after delivery. The parental stress, parental competency, and postpartum depression questionnaires were used for data collection before, after, and one month after the intervention. Data were analyzed using SPSS software ver. 13.0. Repeated-measures ANOVA test was used for comparing the mean scores of parenting stress, parental competency, and depression between and within both study groups before, after, and one month after delivery. Results: While postpartum depression and parental stress decreased in intervention group, parental competency increased. Conclusion: Our findings indicated that midwife-led psycho-education was effective on parental stress, competency, and postpartum depression in high-risk pregnancy mothers. Accordingly, prenatal distress in high-risk pregnancies should be assessed routinely.

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