An unanticipated cardiac arrest and unusual post-resuscitation psycho-behavioural phenomena/near death experience in a patient with pregnancy induced hypertension and twin pregnancy undergoing elective lower segment caesarean section

BACKGROUND Post caesarean section pain requires effective analgesia. Effective analgesia is integral to improvement of quality and patient care among lower segment caesarean section (LSCS) patients. Magnesium, an N-methyl-D-aspartate receptor antagonist along with calcium-channel blocker, has previously been investigated for its analgesic properties. But there is scanty previous literature available for intramuscular magnesium sulphate in the analgesic role in post caesarean mothers. The purpose of this study was to evaluate the effect of existing MgSO4 regimens (among severe pregnancy induced hypertension patients, excluding eclampsia) during early 1st 24 hours’ postoperative analgesic requirements in caesarean section patients comparing to only analgesic group. METHODS It is a retrospective observational study, conducted from January 2019 to June 2020. Patients were randomly selected, normal patients as control = 50 who got post-operative inj. diclofenac 75 mg IM twice a day and rescue analgesia inj. diclofenac 75 mg IM. Test sample comprised of 50 randomly selected severe pregnancy induced hypertension (PIH) patients who got prophylactic inj. magnesium sulphate by Pritchard regimen for 24 hrs. post delivery with 4 gm 20 % inj. magnesium sulphate intravenous with 10 gm 50 % intramuscular in both buttocks as loading dose followed by 5 gm 50 % inj. magnesium sulphate intramuscular 4th hourly for 24 hrs. along with inj. diclofenac 75 mg IM twice a day. Visual analogue scale for pain was noted among both the groups, and were compared for the effect of analgesics in the study groups. RESULTS There was a decrease in analgesic consumption and immediate post-operative pain in the group receiving MgSO4 with analgesic (inj. diclofenac 75 mg), in comparison to control group of inj. diclofenac 75 mg. (P < 0.0001). CONCLUSIONS There was a decrease in analgesic consumption in the group receiving MgSO4 plus analgesic, in comparison to control group (analgesic group). Pain severity assessment 2, 6, 12 and 24 hours post operatively showed that there was a statistically significant decrease in pain scores between the study and the control groups (P < 0.0001). It established the role of magnesium sulphate as an adjuvant analgesic along with diclofenac or other traditionally used pain medications among the post caesarean mothers in early post-operative period. KEYWORDS Analgesia, Pregnancy, Post-Operative Analgesia, Magnesium Sulphate, Lower Segment Caesarean Section (LSCS), Pain Relief, Obstetrics

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Intraoperative Phenylephrine Infusion to Reduce Postoperative Shivering in Lower Segment Caesarean Section

Case Medical Research ◽

10.31525/ct1-nct04133961 ◽

2019 ◽

Author(s):

Keyword(s):

Caesarean Section ◽

Lower Segment ◽

Lower Segment Caesarean Section ◽

Phenylephrine Infusion

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Wound infiltration of local anaesthetic after lower segment Caesarean section

Anaesthesia ◽

10.1111/j.1365-2044.1991.tb09558.x ◽

1991 ◽

Vol 46 (5) ◽

pp. 404-407 ◽

Cited By ~ 41

Author(s):

T. N. Trotter ◽

P. Hayes-Gregson ◽

S. Robinson ◽

L. Cole ◽

S. Coley ◽

...

Keyword(s):

Caesarean Section ◽

Local Anaesthetic ◽

Lower Segment ◽

Wound Infiltration ◽

Lower Segment Caesarean Section

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Study of Vaginal Delivery in Patients with One Previous Lower Segment Caesarean Section

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/j.1479-828x.1986.tb01578.x ◽

1986 ◽

Vol 26 (4) ◽

pp. 245-248 ◽

Cited By ~ 6

Author(s):

T. Kishor C. Singh ◽

S. D. Barman ◽

A. N. Gupta

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Lower Segment ◽

Lower Segment Caesarean Section

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MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

10.36106/ijsr/3731386 ◽

2021 ◽

pp. 48-50

Author(s):

Neha Agarwal ◽

Samta Bali Rathore ◽

Shivani Baberwal-

Keyword(s):

Caesarean Section ◽

Perinatal Asphyxia ◽

Tertiary Care ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Care Hospital ◽

Pregnancy Induced Hypertension ◽

Meconium Aspiration ◽

Induced Hypertension

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.

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