Comparison between Forceps, Single Blade Forceps and Manual Extraction of Fetal Head in Elective Caesarean Section: A Randomized Control Trial—Forceps Delivery in Cesarean Section

Objective: To compare the frequency of caesarean section due to fetal distress with Isosorbide mononitrate versus PGE2 for the induction of labour in primigravida at term. Methods: It was Randomized Control Trial conducted in Unit I, Department of Obstetrics & Gynaecology, Lahore General Hospital, Lahore from 11th April 2015 to 10th October 2015. 230 primigravida were randomized into two groups i.e. Prostaglandin E2 and Isosorbide mononitrate for induction of labour. The difference in the frequency of caesarean section due to fetal distress with Prostaglandin E2 and Isosorbide mononitrate for induction of labour in the primigravidas at term was calculated as outcome. Results: The mean age of 27.62 ± 3.909 ranging from 21 to 34 years. The frequency of cesarean section was 12.2%in Prostaglandin E2 group while 0% in Isosorbide mononitrate. There was no effect of gestational age, age of mother and number of doses on outcome. Conclusion: There is no difference in frequency of cesarean section in primigravida groups induced by either Isosorbide mononitrate versus prostaglandin E2. Wherever applicable and feasible we should opt for Isosorbide mononitrate for induction of labour. Keywords: Cesarean section, Prostaglandin E2, Isosorbide mononitrate, Dinoprostone, Induction of labour, Primigravida How to cite: Waheed R., Ashraf N., Sabeen N., U Allah I.M., Javed Q., Khalid A. Induction of Labour with Isosorbide Mononitrate Versus Prostaglandin E2 (PGE2) in Primigravidas (PGs) at term. Esculapio 2021;17(02):166-169

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A prospective, randomized, cross sectional study of manual versus vacuum extraction of mobile head in caesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184507 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4556

Author(s):

Bhagyashree A. ◽

Julie Thomas ◽

Shobha N. Gudi

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Vacuum Extraction ◽

Fetal Head ◽

Cross Sectional ◽

Foetal Head ◽

Uterine Incision ◽

Group I ◽

The Mean ◽

Manual Extraction

Background: Considering the high rate of caesarean section, and the difficulty during delivery of the floating foetal head even by the most experienced obstetrician, the use of vacuum has been described. The present study was undertaken with the hypothesis that, vacuum assisted foetal head delivery during caesarean section is safe and effective without increasing maternal and neonatal complications. The outcomes enumerated by the limited literature available need to be evaluated before it is used routinely.Methods: A prospective, randomized, comparative, cross sectional Hospital based study was conducted at St. Philomena’s Hospital, Bangalore. Every woman randomized for the study received either conventional method or ventouse extraction of fetal head at cesarean section. 200 women were enrolled into the study with 100 in each arm. The primary outcome measures were percentage of successful extractions and I-D interval. The secondary outcome measures were, uterine incision extension, estimated blood loss, Apgar scores, neonatal hyperbilirubinemia and neonatal scalp or head injury.Results: Successful extraction was done in 89 % and 98 % cases in manual and vacuum extraction cases. (p =0.0184). U-D interval in the manual extraction group was 66.59±4.64 seconds and in the Vacuum extraction group it was 56.06±3.46 seconds (P<0.001). The mean pre-delivery hemoglobin levels in group I was 11.6±0.73 compared to 11.36±0.49 gm% in group II. The mean post-delivery hemoglobin levels in group I was 10.29±0.79 compared to 10.21±0.53 gm% in group II (p <0.001). The uterine incision extensions were significantly higher in manual extraction group, 18 of the 100 women (18 %), whereas only 2 of the 100 women in vacuum group had uterine extensions (p=0.0002).Conclusions: Authors conclude that the routine use of ventouse is safe and effective for mobile fetal head extraction at cesarean section.

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Effect of Foot and Hand Massage In Post–Cesarean Section Pain Control: A Randomized Control Trial

Pain Management Nursing ◽

10.1016/j.pmn.2012.07.008 ◽

2014 ◽

Vol 15 (1) ◽

pp. 132-136 ◽

Cited By ~ 15

Author(s):

Zahra Abbaspoor ◽

Malihe Akbari ◽

Shanaz Najar

Keyword(s):

Cesarean Section ◽

Pain Control ◽

Randomized Control Trial ◽

Hand Massage ◽

Randomized Control

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Cesarean section incisional infiltration with lidocaine and Epinephrine versus Lidocaine alone in reducing postoperative pain. A randomized controlled double-blinded clinical trial

QJM ◽

10.1093/qjmed/hcab115.017 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Hazem F El-Shahawy ◽

Sherif F El-Mekkawi ◽

. Haitham F Mohmmed ◽

Hend M Afifi

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

General Anesthesia ◽

Local Anesthesia ◽

Breast Feeding ◽

Local Anesthetic ◽

Elective Caesarean Section ◽

Control Group ◽

Cesarean Section Delivery ◽

Anesthetic Effect

Abstract Background Cesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation Aim of the Work to assess the efficacy and safety adding ef Epinephrine to lidocaine 2% in dose-related manner 1:200.000 in prolongation of anesthetic effect of lidocaine as a local anesthetic to reduce post; caesarean section pain after general anesthesia. Patients and Methods A total number of 200 women planned for elective caesarean section at Shams University Maternity Hospital Was recruited, 2 groups were randomized with a study group included 100 women received lidocaine 2% and epinephrine in dose-related manner and a control group included 100 women received lidocaine 2% only. Results women who received lidocaine and epinephrine were more satisfied and hadsignificant more time after caesarean section free of pain in comparison to women who received lidocaine only by 120 minutes. Also. adding Of epinephrine helped in decrease in amount of analgesic consumption after caesarean section. Women who received lidocaine and epinephrine started breast feeding and mobilization earlier than women who received lidocaine only. Epinephrine prolonged the action of lidocaine as a local anesthetic, this prolongation of action of local anesthetic had a significant effect in early mobilization and breast feeding and decrease in cost of analgesics. Nobody in our candidate had a post-operative infection, past operative pyrexia, Allergic reactions tar general anesthesia or complications with local anesthesia. Conclusion Adding of epinephrine to local anesthetics (such as lidocaine 2% in dose-related manner 1:200.0000) prolonged anesthetic effect by more than double of its original anesthetic time, This prolongation on anesthetic effect of local anesthesia by epinephrine helps in eariy mobilization; early breast feeding and less hospital duration stays. No complications (local nor systemic) developed with local infiltration of post-caesarean section incision with lidocaine 2% even aficr adding epinephrine in dose-related manner 1:200.000

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Perbandingan Efektivitas Anestesi Spinal dengan Bupivacain 12,5 Mg dan Bupivacain 5 Mg yang ditambah Fentanyl 50 Mcg pada Seksio Sesarea

Jurnal Anestesi Obstetri Indonesia ◽

10.47507/obstetri.v4i1.55 ◽

2021 ◽

Vol 4 (1) ◽

pp. 11-7

Author(s):

Fritzky Indradata ◽

Heri Dwi Purnomo ◽

Muh. Husni Thamrin ◽

Sugeng Budi Santoso ◽

Ardana Tri Arianto ◽

...

Keyword(s):

Side Effects ◽

Cesarean Section ◽

Spinal Anesthesia ◽

Randomized Control Trial ◽

Hyperbaric Bupivacaine ◽

Chi Square ◽

Double Blind ◽

Duration Of Action ◽

Significant Difference ◽

Randomized Control

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.

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Anaesthetic Management of a Morbidly Obese Parturient for Elective Caesarean Section

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v10i2.14342 ◽

2016 ◽

Vol 10 (2) ◽

pp. 64-66

Author(s):

R Pradhan ◽

S Shrestha ◽

T Gurung ◽

AB Shrestha ◽

KR Sharma

Keyword(s):

Caesarean Section ◽

Cesarean Section ◽

Epidural Anaesthesia ◽

Gestational Hypertension ◽

Elective Caesarean Section ◽

Anaesthetic Management ◽

Elective Cesarean Section ◽

Morbidly Obese ◽

Elective Cesarean ◽

Spinal Epidural

Anaesthesia for an obese parturient poses a challenge to anaesthesiologists. Here we report a case of 27 years obese primigravidae at 40 weeks of gestation with gestational hypertension who underwent elective cesarean section under combined spinal epidural anaesthesia. Her intraoperative and postoperative periods were uneventful.

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