scholarly journals Epidural Analgesia and Back Pain after Labor

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 354 ◽  
Author(s):  
Malevic ◽  
Jatuzis ◽  
Paliulyte
Keyword(s):  
Back Pain ◽  
Statistical Analysis ◽  
Epidural Analgesia ◽  
Post Partum ◽  
Labor Pain ◽  
Intravenous Anesthesia ◽  
Intravenous Drugs ◽  
Anesthesia Group ◽  
Increased Risk ◽  
The Impact

Background and Objectives: The aim of this survey was to assess the impact of epidural analgesia on post-partum back pain in post-partum women. Materials and Methods: The questionnaire was completed by post-partum women during the first days after delivery. Six months later, the women were surveyed again. The response rate was 70.66%, a total of 212 cases were included in the statistical analysis. The statistical analysis of the data was conducted using SPSS® Results. Seventy-nine (37.26%) women received epidural analgesia, 87 (41.04%) intravenous drugs, and 46 (21.7%) women gave birth without anesthesia. The prevalence of post-partum back pain was observed in 24 (30.38%) women of the epidural analgesia group, in 24 (27.58%) subjects of the intravenous anesthesia group, and in 14 (30.43%) women attributed to the group of subjects without anesthesia. The correlation between post-partum back pain and the type of anesthesia was not statistically significant (p = 0.907). Six months later, the prevalence of back pain was found in 31.65% of women belonging to the epidural analgesia group, in 28.74% of women with intravenous anesthesia, and in 23.91% of women without anesthesia. The correlation between complaints of back pain six months after delivery and the type of anesthesia applied was not statistically significant (p = 0.654). Conclusions. The labor pain relief technique did not trigger the increased risk of back pain in the early post-partum period and six months after delivery.

scholarly journals Evaluating probiotics for the prevention of ventilator-associated pneumonia: a randomised placebo-controlled multicentre trial protocol and statistical analysis plan for PROSPECT

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e025228 ◽  
Author(s):  
Jennie Johnstone ◽  
Diane Heels-Ansdell ◽  
Lehana Thabane ◽  
Maureen Meade ◽  
John Marshall ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Statistical Analysis Plan ◽  
Hospital Length Of Stay ◽  
Sensitivity Analyses ◽  
Ventilator Associated Pneumonia ◽  
Increased Risk ◽  
The Impact

IntroductionVentilator-associated pneumonia (VAP) is the most common healthcare-associated infection in critically ill patients. Prior studies suggest that probiotics may reduce VAP and other infections in critically ill patients; however, most previous randomised trials were small, single centre studies. The Probiotics: Prevention of Severe Pneumonia and Endotracheal Colonization Trial (PROSPECT) aims to determine the impact of the probioticLactobacillus rhamnosusGG on VAP and other clinically important outcomes in critically ill adults.MethodsPROSPECT is a multicentre, concealed, randomised, stratified, blinded, controlled trial in patients ≥18 years old, anticipated to be mechanically ventilated ≥72 hours, in intensive care units (ICUs) in Canada, the USA and Saudi Arabia. Patients receive either 1×1010 colony forming units ofL. rhamnosusGG twice daily or an identical appearing placebo. Those at increased risk of probiotic infection are excluded. The primary outcome is VAP. Secondary outcomes are other ICU-acquired infections includingClostridioides difficileinfection, diarrhoea (including antibiotic-associated diarrhoea), antimicrobial use, ICU and hospital length of stay and mortality. The planned sample size of 2650 patients is based on an estimated 15% VAP rate and will provide 80% power to detect a 25% relative risk reduction.Ethics and disseminationThis protocol and statistical analysis plan outlines the methodology, primary and secondary analyses, sensitivity analyses and subgroup analyses. PROSPECT is approved by Health Canada (#9427-M1133-45C), the research ethics boards of all participating hospitals and Public Health Ontario. Results will be disseminated via academic channels (peer reviewed journal publications, professional healthcare fora including international conferences) and conventional and social media. The results of PROSPECT will inform practice guidelines worldwide.Trialregistration numberNCT02462590; Pre-results.

scholarly journals Effect of Antenatal Exercises, Including Yoga, on the Course of Labor, Delivery and Pregnancy: A Retrospective Study

2020 ◽  
Vol 17 (15) ◽  
pp. 5274
Author(s):  
Yogyata Wadhwa ◽  
Ahmad H. Alghadir ◽  
Zaheen A. Iqbal
Keyword(s):  
Back Pain ◽  
Retrospective Study ◽  
Weight Gain ◽  
Newborn Infant ◽  
Perceived Exertion ◽  
Post Partum ◽  
Labor Pain ◽  
Maternal Weight Gain ◽  
Maternal Weight ◽  
Supervised Exercise

Background: Delivering a child is a very stressful experience for women. Pregnancy and labor entail complex events that are unique to each individual female. The management of labor pain is often done using analgesics and anesthesia, which have been shown to have some side effects. More comprehensive data are needed to provide clinically significant evidence for clinicians to confidently prescribe exercises to patients. This study was done to evaluate the effect of antenatal exercises, including yoga, on the course of labor, delivery, and pregnancy outcomes. Methods: A retrospective study was conducted among 200 primiparous subjects (aged 20–40). A questionnaire was provided to the subjects to obtain their demographic and obstetrical information 6 weeks after delivery, and their hospital records were also assessed for further details. Based on the nature and details obtained for the antenatal exercises, subjects were divided into two groups: control and exercise. Outcome measures included the need for labor induction, self-perceived pain and perceived exertion during labor, duration and nature of the delivery, newborn infant weight, maternal weight gain, history of back pain, and post-partum recovery. The total maternal weight gain (in kilograms) was calculated from weight at 6 weeks after delivery minus the weight at 12–14 weeks of gestation. Back pain during pregnancy and self-perceived labor pain were measured using a visual analog scale (VAS). The overall perceived exertion during labor was measured using an adapted Borg scale for perceived effort. Results: The subjects who followed regular antenatal exercises, including yoga, had significantly lower rates of cesarean section, lower weight gain, higher newborn infant weight, lower pain and overall discomfort during labor, lower back pain throughout pregnancy, and earlier post-partum recovery compared to those who did no specific exercises or only walked during pregnancy. Conclusions: This retrospective study showed that regular antenatal exercises, including yoga, result in better outcomes related to the course of labor, delivery, and pregnancy. These results notably indicated that pregnant women should be active throughout pregnancy and follow a supervised exercise program that includes yoga unless contraindicated. We require further large-scale prospective studies and quasi-experimental trials to confirm the observed findings.

scholarly journals The Influence Of Nutrition Counseling On The Knowledge And Intake Of Macro Nutrient Wus Kek In Region Work Puskesmas Sawah Lebar Bengkulu

2019 ◽  
Vol 10 (1) ◽  
pp. 35-45
Author(s):  
Meili Dwi Ananda ◽  
Jumiyati Jumiyati ◽  
Emy Yuliantini
Keyword(s):  
Statistical Analysis ◽  
Health Center ◽  
Post Partum ◽  
Wilcoxon Test ◽  
Nutrition Counseling ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Increased Risk ◽  
Low Birth Weight Babies ◽  
The City

Women of Childbearing Age (WUS) are a population that are of particular interest inthe prevention of nutritional problems, especially in addressing their Lack of Chronic Energy (KEK). KEK in WUS is very likely to result in a difficult childbirth and post partum hemorrhage as well as an increased risk death of the mother and of low birth weight babies. Data WUS SEZ in Indonesia in 2010 (30,9%) increased in 2013 (46,4%). Sixteen provinces with the prevalence of the risk of SEZ above the national province, namely the Bengkulu Province (15%). The purpose of this study is to determine the effect of nutrition counseling on the knowledge and intake of macro nutrient on WUS SEZ in the working area of Health Center of Sawah Lebar the Width of the City of Bengkulu the Year 2018. The results of this study there was significant influence of nutritional counseling (p = 0.000) on the intake of macro nutrient (p = 0.000). On WUS KEK in the working area of Health Center of Sawah Lebar the width of the city of bengkulu the year 2018.The Design of this Research is Pre Experimental Design with design One Group Pretest-Posttest. Nutrition counseling on WUS KEK performed 3 times during 3 weeks. The number of samples as many as 23 people. Statistical analysis using dependent t-test and wilcoxon test

Neuraxial analgesia is not associated with an increased risk of post-partum relapses in MS

2018 ◽  
Vol 25 (4) ◽  
pp. 591-600 ◽  
Author(s):  
Caroline Lavie ◽  
Fabien Rollot ◽  
Françoise Durand-Dubief ◽  
Romain Marignier ◽  
Iuliana Ionescu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Odds Ratio ◽  
Post Partum ◽  
Neuraxial Analgesia ◽  
Increased Risk ◽  
Obstetrical Analgesia ◽  
The Impact ◽  
Risk Of Relapse

Background: Obstetrical analgesia remains a matter of controversy because of the fear of neurotoxicity of local anesthetics on demyelinated fibers or their potential relationship with subsequent relapses. Objective: To assess the impact of neuraxial analgesia on the risk of relapse during the first 3 months post-partum, with a focus on women who experienced relapses during pregnancy. Methods: We analyzed data of women followed-up prospectively during their pregnancies and at least 3 months post-partum, collected in the Pregnancy in Multiple Sclerosis (PRIMS) and Prevention of Post-Partum Relapses with Progestin and Estradiol in Multiple Sclerosis (POPARTMUS) studies between 1992–1995 and 2005–2012, respectively. The association of neuraxial analgesia with the occurrence of a post-partum relapse was estimated by logistic regression analysis. Results: A total of 389 women were included, 215 from PRIMS and 174 from POPARTMUS. In total, 156 women (40%) had neuraxial analgesia. Overall, 24% experienced a relapse during pregnancy and 25% in the 3 months post-partum. Women with a pregnancy relapse were more likely to have a post-partum relapse (odds ratio (OR) = 1.83, p = 0.02), independently of the use of neuraxial analgesia. There was no association between neuraxial analgesia and post-partum relapse (OR = 1.08, p = 0.78). Conclusion: Neuraxial analgesia was not associated with an increased risk of post-partum relapses, whatever multiple sclerosis (MS) activity during pregnancy.

STATE OF SYSTEMIC HEMODYNAMICS FOR CHILDREN WITH CONGENITAL SURGICAL PATHOLOGY IN DIFFERENT COMBINED ANESTHESIA TYPES

2021 ◽  
pp. 27-30
Author(s):  
O. O. Vlasov
Keyword(s):  
Blood Pressure ◽  
Congenital Malformations ◽  
Surgical Correction ◽  
Systemic Hemodynamics ◽  
Intravenous Anesthesia ◽  
Abdominal Tumors ◽  
Intravenous Drugs ◽  
Different Types ◽  
Combined Anesthesia ◽  
The Impact

General anesthesia for a surgical correction of congenital malformations in children is accompanied, in particular, by the disorders of systemic hemodynamics. In order to assess the impact of different types of combined anesthesia on the state of systemic hemodynamics in surgical correction of congenital malformations, a retrospective study of the treatment of 150 newborns and infants was conducted. These were children with various congenital malformations, but the most common were intestinal obstruction and abdominal tumors. Three groups of patients were formed depending on the type of combined anesthesia during surgical correction of abnormalities: I − inhalation (sevorane) + regional anesthesia; II − inhalation (sevorane) + intravenous anesthesia (fentanyl); III − total intravenous anesthesia with two drugs: analgesic (fentanyl) and drug sleep on the background of intravenous injection of hypnotics (20 % sodium oxybutyrate). There were preformed the surgeries: thoracic, urological, abdominal. The study was retrospectively evaluated in five stages. The analysis of systemic hemodynamics showed a tendency to reduce diastolic blood pressure in children treated with anesthesia with two intravenous drugs (hypnotic and fentanyl), during all observation stages and a significant decrease in this index at the most painful and traumatic period. At the time of induction of anesthesia in children there was a decrease in heart rate. According to the research results, it is concluded that when using the pre−hypnotics as part of combined anesthesia in children with congenital malformations during surgery there is a risk of complications from central hemodynamics in the form of vasodilation, which leads to a drop in blood pressure and increases compensatively the heart contractions. Key words: infants, congenital malformations, anesthesia, hemodynamics.

The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section

2017 ◽  
Vol 19 (4) ◽  
pp. 393-398 ◽  
Author(s):  
Antonio Herrera-Gómez ◽  
Elvira De Luna-Bertos ◽  
Javier Ramos-Torrecillas ◽  
Francisco Manuel Ocaña-Peinado ◽  
Olga García-Martínez ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
Cesarean Delivery ◽  
Maternal Age ◽  
Well Being ◽  
Labor Pain ◽  
Cesarean Deliveries ◽  
Increased Risk ◽  
Newborn Weight ◽  
Fetal Position

Introduction: Epidural analgesia (EA) is the most widespread pharmacologic method of labor pain relief. There remains disagreement, however, regarding its adverse effects. The objective of this study was to determine the effect of EA administration on the risk of cesarean delivery and its causes (e.g., stalled labor, risk of loss of fetal well-being, among others) and the degree to which this effect may be modulated by mother-, newborn-, and labor-related variables. Method: A retrospective cohort observational study was conducted including all deliveries in a Spanish public hospital between March 2010 and March 2013 ( N = 2,450; EA = 562, non-EA = 1,888). Results: Risk of a cesarean section was significantly increased by EA administration (odds ratio [ OR] = 2.673; p < .0001). The percentage of cesarean deliveries due to the risk of loss of fetal well-being was significantly higher in the EA (47.8%) versus non-EA group (27.5%; OR = 1.739; p = 0.0012,). The EA-associated risk of cesarean section was not significantly modified as a function of maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration alone. However, these variables in combination may increase the risk. We present multivariate models for each group that account for these variables, allowing for estimation of the risk of a cesarean delivery if EA is administered. Conclusion: EA is associated with an increased risk of cesarean delivery. Other variables in combination (maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration) may increase this risk.

scholarly journals IMPACT OF DIASTASIS RECTI ABDOMINIS AND LOW BACK PAIN ON QUALITY OF LIFE IN POST-PARTUM FEMALE

2021 ◽  
Vol 10 (4) ◽  
pp. 3244-3248
Author(s):  
Shruti Desphande
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Lower Back Pain ◽  
Post Partum ◽  
Low Back ◽  
Lower Back ◽  
Diastasis Recti ◽  
The Impact

The literature defines DRA as a gap of more than two fingerbreadths between two rectal abdominal muscle bellies, either above or below the umbilicus. Separation is referred to as DRA. Female diastasis recti is more common in postpartum women. Lower back pain is the most common cause of daily activity limitation in postpartum females. Post-partum women express concerns about their mobility, pain, and normal activities, all of which have an impact on an individual's quality of life. The study aimed to check the Impact of diastasis recti and low back pain on quality of life in post-partum females. This research will be conducted at the Physiotherapy OPD at Ravi Nair Physiotherapy College and the AVBRH in Sawangi (Meghe), Wardha. Post-partum females will be evaluated for diastasis recti. The effect of diastasis recti and low back pain on postpartum females' quality of life. The current study significantly showed that the correlation between diastasis recti and quality of life with satisfaction is -0.473r, and the correlation between diastasis recti and importance is -0.452r, and the correlation between low back pain and quality of life is 0.025r.So the present study shows that an increase in inter rectal distance and low back pain will affect the quality of life in postpartum females. From the present study, we can conclude that an increase in rectal distance and lower back pain have an impact on the quality of life of postpartum females.

Risk Assessments of Epidural Analgesia During Labor and Delivery

2017 ◽  
Vol 27 (7) ◽  
pp. 841-852
Author(s):  
Antonio Herrera-Gómez ◽  
Elvira De Luna-Bertos ◽  
Javier Ramos-Torrecillas ◽  
Francisco M. Ocaña-Peinado ◽  
Concepción Ruiz ◽  
...  
Keyword(s):  
Health Care ◽  
Epidural Analgesia ◽  
Retrospective Cohort ◽  
Well Being ◽  
Labor Pain ◽  
Risk Assessments ◽  
Perineal Laceration ◽  
Increased Risk ◽  
Spanish Hospital ◽  
Mother And Child

Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies. However, women with EA were not and increased risk for perineal laceration or the condition of the membranes at the delivery or with the type of placental expulsion. Thus, the administration of EA should be assessed in each case by the health care professional.

scholarly journals Protocol for a prospective, hospital-based registry of pregnant women with SARS-CoV-2 infection in India: PregCovid Registry study

2021 ◽  
Author(s):  
Rahul Gajbhiye ◽  
Niraj N Mahajan ◽  
Rakesh Waghmare ◽  
Suchitra Vishwambhar Surve ◽  
Prashant Howal ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Post Partum ◽  
Laboratory Data ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Medical Case ◽  
Institutional Ethics ◽  
Increased Risk ◽  
The Impact ◽  
Mother To Child

Introduction: Pregnant women are at increased risk of contracting coronavirus disease 2019 (COVID-19) due to several factors and therefore require special attention. However, consequences of the COVID-19 pandemic on pregnant women and their newborns remain uncharted. The aim of PregCovid registry is to document the impact of SARS-CoV-2 infection on pregnant, post-partum women and their new-borns. The aim of the registry is also to determine mother to child transmission of SARS-CoV-2 infection in India. Methods and analysis: PregCovid is a hospital based registry for capturing information of pregnant, post-partum women with COVID-19 and their new-borns in India. Medical case records of pregnant and post-partum women with laboratory confirmed diagnosis of COVID-19 will be captured in real time using an online electronic patient record (EPR) software. The frequency of each symptom will be calculated. The laboratory data will be analyzed for calculating the frequency of laboratory parameters consistently higher in women with COVID-19. The adverse pregnancy and neonatal outcomes will be analyzed and their frequency will be calculated. Response to treatment will be analyzed for frequency calculation (number of women treated with different treatment regimens). The mother to child transmission data will be analyzed from the RT-PCR and/ antibody data of neonatal and maternal samples tested wherever the information is available. The registry data will be crucial for developing strategies for reducing the adverse impact of COVID-19 on pregnant women and their new-born. Ethics and dissemination: The study is approved by the Institutional Ethics Committee of ICMR-National Institute for Research in Reproductive Health (#55/2020), BYL Nair Hospital, Mumbai, India (# 63/2020); and all the 18 participating study sites under Medical Education and Drugs Department of Government of Maharashtra. The Institutional Ethics Committees granted a waiver of consent as the data is collected from the medical case records. Trial registration number: CTRI/2020/05/025423

Impact of comorbidity on health outcome after a transport-related injury

2019 ◽  
Vol 26 (3) ◽  
pp. 254-261
Author(s):  
Stella Samoborec ◽  
Pamela Simpson ◽  
Behrooz Hassani-Mahmooei ◽  
Rasa Ruseckaite ◽  
Melita Giummarra ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Health Outcomes ◽  
Chronic Back Pain ◽  
Healthcare Utilisation ◽  
Summary Score ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Impact ◽  
Time Since Injury

IntroductionUnderstanding the impact of comorbidity on health outcomes is important given that comorbidities can affect survival, morbidity, service delivery costs and healthcare utilisation. However, little is known about the types of comorbidities affecting specific health outcomes after minor to moderate road trauma.MethodsThis study involved 1574 participants who claimed injury compensation following transport-related injury. Cross sectional data were collected. Health outcomes were assessed using the EQ-5D-3L specific domains and summary score. Twelve self-reported pre-existing chronic conditions were assessed using a multivariate logistic regression, adjusting for demographic and injury characteristics.ResultsOut of 1574 participants, only 17 (1%) participants reported no pre-existing comorbidities, 72% reported one, 13% reported two and 14% reported three or more comorbidities. Hypertension (15%), depression (14%) and anxiety (14%) were the most commonly reported comorbidities, followed by arthritis (13%), chronic pain (11%) and asthma (11%). Participants with a history of arthritis (adjusted odds ratio [AOR] 1.90, 95% CI 1.24 to 2.91); chronic back pain (AOR 1.59, 95% CI, 1.04 to 2.43); other chronic pain (AOR 2.73, 95% CI 1.42 to 4.24); depression (AOR 2.55, 95% CI 1.60 to 4.05) and anxiety (AOR 2.08, 95% CI 1.32 to 3.26) were at increased risk of poorer health outcomes, after controlling for age, gender, type of injury and time since injury.ConclusionThis study found that comorbidities such as arthritis, chronic back pain, other chronic pain, depression and anxiety significantly increase the odds of poorer health postinjury, regardless of the time since injury. Regular screening of comorbid conditions may help identify people likely to have poorer outcomes, thereby enabling the implementation of interventions to optimise health despite the presence of comorbidities.

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