Effectiveness of Abdominal Effleurage versus Pharmacological Intervention on Labour Pain among Primi Parturients Admitted in Labour Room

Background: Anaemia in pregnancy is the leading medical disorder in developing countries like India. Women with severe anemia in labor is a challenging situation for the obstetrician with increased maternal and perinatal morbidity and mortality. It has multifactorial etiology, Main cause of anemia in obstetrics is iron deficiency. There are specific risks for the mother like preterm labour pain, IUGR baby, preeclampsia, antepartum haemorrhage, sepsis etc and the fetus such as prematurity, lowbirth weight, birth asphyxia etc. Aim and Objectives: To determine the socio-demographic variables and also the maternal and perinatal outcomes of pregnant women admitted to labour room with severe anemia (Hb <7gm%) late in pregnancy. Results: It was seen that out of 50 severely anemic women, 82% had Hb between 4-7 gm% and 18% had Hb < 4gm%. Severe anemia is seen in 82% unbooked patients and only in 18% booked patients. There was increased incidence of preterm delivery, PPH, preeclampsia, eclampsia, mortality in anemic group as compared to non anemic group. Among the adverse fetal outcomes, there was increased incidence of intrauterine deaths, intrauterine growth restriction, NICU admission, low birth weight among the anemic group as compared to non anemic group. Conclusions: Severely anemic women reporting in labor had significantly high maternal and perinatal morbidity and mortality. Even a minor blood loss is much devastating for such patients. Extrapolating our observations, it can be said that a close vigilance, anticipation of complications and appropriate care and interventions during labor and puerperium will help in improving outcomes in these severely anemic women. Awareness and education on early antenatal bookings, regular iron intake and continuous antenatal care should be the goal in tackling anemia in pregnancy. Key words: Anaemia, Iron deficiency, Intrauterine growth retardation, prematurity, maternal outcome, neonatal outcome.

Download Full-text

Effect of back massage on relieving pain during labour: a systemic review

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212194 ◽

2021 ◽

Vol 10 (6) ◽

pp. 2466

Author(s):

Suman Choudhary ◽

Prasuna Jelly ◽

Prakash Mahala ◽

Amali Mery

Keyword(s):

Labour Pain ◽

Systemic Review ◽

Pharmacological Intervention ◽

Electronic Database ◽

Physiological Factors ◽

Relieve Pain ◽

Health Journal ◽

Pharmacological Method ◽

Nursing Health ◽

Back Massage

Managing labour pain is a challenging concern for nurses who involved in care of mothers during labour and child birth. Massage is a primordial method that has been generally employed during labour, however, relatively little study has been assumed examining the effects of massage on women during labour. The study insistent pain allied with labour may negatively impact mother further transforming to foetus, frequently varying the childbirth course. The techniques of health care humanisation mention that women in labour should have the chance to relieve their pain with pharmacological and non-pharmacological methods. The systemic review examines literature on effectiveness of back massage to relieve labour pain from 2013 to 2019. The electronic database reviewed for the systemic review included PubMed, Medline, nursing health journal, Google scholar etc by including relevant key words. Ten studies were included in the systemic review. The available literature on non-pharmacological method provides evidence as a back massage is effective to reduce labour pain. The aim of the present review is to examine the effect of back massage as a method to relieve labour pain and give comfort to mother. The experience of labour pain is different in women and it is affected by several psychological and physiological factors and its intensity may vary significantly. During labour majority of women need pain relief. Strategies of pain management include pharmacological and non-pharmacological intervention. Evidence suggests that non pharmacological methods are helpful to reduce labour pain. We identified 10 reviews out of 110 for inclusion within this review. All studies on back massages show that it is effective to relieve pain during labour.

Download Full-text

Effect of Foot Reflexology on Reduction of Labour Pain Among Primigravida Mothers

International Journal of Therapeutic Massage & Bodywork Research Education & Practice ◽

10.3822/ijtmb.v14i1.386 ◽

2020 ◽

Vol 14 (1) ◽

pp. 21-29

Author(s):

Manju Mohan, RN, RM ◽

Linda Varghese, RN, RM

Keyword(s):

Patient Satisfaction ◽

Sampling Technique ◽

Labour Pain ◽

Control Group ◽

Data Contamination ◽

Time Control ◽

Quasi Experimental ◽

Labour Room ◽

Post Hoc ◽

High Degree

Background: Reflexology may help induce labour and reduce pain during childbirth. Fear of pain associated with childbirth leads to increase in the irregular use of cesarean method. Purpose: This study was performed to evaluate the effect of reflexology on relieving labour pain and assess the recipient’s opinion regarding foot reflexology. Setting: The study taken place in the labour room, Amrita Institute of Medical Sciences, Kerala, South India. Participants: 50 primigravida patients experiencing labour. Research Design: A quasi-experimental study design was used. Subjects were selected by convenience sampling technique with the first 25 patients allocated to the experimental group and the successive 25 primigravida mothers to a time-control group, to avoid data contamination. Intervention: Intervention consisted of foot reflexology applied by a trained therapist to five pressure points of both feet that correspond to the uterus. Total intervention time lasted 20 minutes. Control group rested quietly for 20 minutes to serve as a time control. Main Outcome Measure(s): Pain associated with labour was recorded on a visual analogue scale immediately prior to intervention, and at 20- and 40-minutes postintervention. Patient satisfaction with reflexology treatment was recorded. Results: Mean baseline pain score in foot reflexology group was significantly reduced across the study timeframe relative to control group (p < .001). Post hoc tests confirmed a reduction in labour pain at both the 20-min (p < .001, 95%CI 0.764–1.796) and 40-min (p < .001, 95%CI 0.643–1.677) time points. Eighty-one per cent of patients would recommend reflexology during labour. Conclusion: The findings showed that foot reflexology was effective in relief of labour pain, with a high degree of patient satisfaction in primigravida mothers.

Download Full-text

PRIMARY POSTPARTUM HAEMORRHAGE

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.02.2437 ◽

2010 ◽

Vol 17 (02) ◽

pp. 308-313

Author(s):

NUZHAT RASHEED ◽

MOEEN AKHTAR MALIK ◽

NOREEN NASIM

Keyword(s):

Post Partum ◽

Intervention Development ◽

Pregnant Patient ◽

Labour Pain ◽

College Hospital ◽

Medical College ◽

Misoprostol Group ◽

Skilled Personnel ◽

Group B ◽

Labour Room

Objective: To compare the effectiveness of Misoprostol with syntocinon in the prophylaxis of primary post partum haemorrhage during the management of 3rd stage of labour. Design: Experimental study. Setting: Department of Obstetrics & Gynaecology Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Patients and Methods: Pregnant patient with term pregnancy in labour were admitted in labour room. After confirmation that the patient is in labour, they were randomly divided in two groups A & B with 50 patients in each group. 600 ug oral Misoprostol was given to patients in group A and 10 units I/V Syntocinon were given to patients in group B at the time of delivery of anterior shoulder of the baby. Amount of blood loss was observed and all the information were recorded and entered in predesigned proforma. Results:Amongst the 100 pregnant patients the mean age was 28.86 + 2.94 and mean parity of patients was 3.94. 57% of patients were presented with labour pains only and 27% presented with both labour pain and leaking liquor. In 59 patients duration of labour was between 2-12 hours. Total 9 patients develop PPH in both groups, three patients from Misoprostol group and six patients from syntocinon group. PPH was mild to moderate and settled down with other uterotonic drugs none of the patient required surgical intervention. Development of minor side effect was relatively high in Misoprostol group i.e. 10% such as nausea, vomiting while 4% in syntocinon group. Shivering and mild pyrexia was 12% in Misoprostol group while 5% in syntocinon group. Conclusion: In this study effectiveness of both syntocinon & Misoprostol has been found comparable Misoprostol being slightly more effective than syntocinon in managing 3rd stage of labour also prophylacticaly and it also has fewer minor side effects with no serious danger to life. It does not need skilled personnel for its use.

Download Full-text

Pharmacology Issues Related to Dementia Syndrome of Depression in Elderly Residents of Long-Term Care Settings

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld25.2.61 ◽

2015 ◽

Vol 25 (2) ◽

pp. 61-69

Author(s):

Angel L. Ball ◽

Adina S. Gray

Keyword(s):

Depressive Symptoms ◽

The Elderly ◽

Environmental Communication ◽

Pharmacological Intervention ◽

Team Approach ◽

Discussion Paper ◽

Term Care ◽

Anticholinergic Medications ◽

Inappropriate Treatment ◽

Dementia Syndrome

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.

Download Full-text

ASSESSMENT OF SKILLED BIRTH ATTENDANTS REGARDING HELPING BABIES BREATH INTERVENTION TO IMPROVE NEWBORN CARE IN RURAL DISTRICT OF SINDH

Pakistan Journal of Public Health ◽

10.32413/pjph.v7i1.24 ◽

1970 ◽

Vol 7 (1) ◽

pp. 48-53

Author(s):

Sheh Mureed ◽

Muhammad Hassan Gandro ◽

Walid Hassan

Keyword(s):

Newborn Care ◽

Cross Sectional Study ◽

Vital Role ◽

Skilled Birth Attendants ◽

Cross Sectional ◽

Neonatal Deaths ◽

Birth Attendants ◽

Study Results ◽

Knowledge And Practice ◽

Labour Room

Background: Globally, 3.1 million newborn deaths occur every year out of these estimated 400,000 neonatal deaths occur in Pakistan. All neonatal deaths 99% take place in poorest region and countries of the world, usually within hours of birth; mostly the cause of neonatal deaths is hypoxia. To access knowledge and practice of SBAs regarding HBB and to access the availability of equipments required for HBB. Methods: Descriptive Cross-Sectional Study on SBAs as trained in HBB. All 46 SBAs trained on HBB working in Labour room eight rural Health centers, four Taluka, One district Head Quarter Health Facilities and thirteen Mlbcs of the district, were included in the sample for study. All 41 SBAs were trained on HBB participated in the study. Results: Mean age of 30 years. Out of total 41 participants 25 were working in B-EmoNC (61%), 3in C-EmoNC (7.3%) and 13 in mid wife laid birth Centre (MLBC) or birth station (31.7%). About 92.7% of participants said that main purpose of HBB training is to decrease the NMR by improving newborn care. Drying of newborn is 82.7%, hand washing is 95.12% and 85.3% of the study participants said that they gave 30-40 breaths per minutes. Cord clamp and pair of ties was accessible to 85% of participants versus 14.3% who reported it's not accessible. Almost one quarter (34.1%) participants have low knowledge and practice. Knowledge and training had significant effect on the overall practices of the skilled birth attendants for skilled birth deliveries and reduce the neonatal deaths (P <0.001). Conclusion: Tools play a vital role for the implication of the knowledge into practices and tools were available almost to every participant. Although few barriers also identified for the less application of the helping hand babies trainings in the community.

Download Full-text