ABSTRACT
Labor augmentation with intravenous oxytocin is a common method of midwifery in dealing with delivery dystocia and considering the dangers of using high dosage or wrong prescription, the Institute for safe medication has added intravenous administration of oxytocin to the list of high alert medications and recommended creating programs to minimize fetal and maternal injury by reducing the dosage of oxytocin. One method to reduce the dosage of oxytocin is propranolol administration. It has been observed that low dosage of propranolol during the active phase of labor can increase the uterine contractions and cause delivery and reduce the cesarean section significantly without causing maternal and no neonatal complications and cesarean rate. The comparison between the effects of oxytocin with propranolol and oxytocin with Placebo on the labor augmentation. A double-blind randomized clinical trial was performed on 118 nulliparas 38-41 weeks in active phase of labor and failure to progress. Exclusion criteria: Multi-parity with History of surgery on the uterus, malpresentation [non-cephalic], cephalopelvic disproportion[CPD], Fetal distress, macrosomia, polyhydroamnius, IUGR, HTN, Cardiac disease, lung disease, Patients with kidney or liver dysfunction, diabetes, patients prone to hypoglycemia, myasthenia Gravis and Wolf - Parkinson - White. The patients were divided randomly into two groups.The first group was given Oxytocin with propranolol and the second group oxytocin with placebo. Pregnancy outcomes including maternal complications including uterine atonic, complications during labor including hyperstimulation, fetal distress, meconium and placental abruption and neonatal complications including Apgar 1 and 5 minutes of birth, admission in NICU and birth weights in two groups were compared. Duration of the active phase of labor in propranolol group 325.74 +/- 71.57 was significantly less than that in the placebo group 406.04 +/- 80.32 [p<0.001]. Duration of the second stage of labor in propranolol group 23.03 +/- 8.31 was significantly less than that in the placebo group 33.83 +/- 12.33 [p<0.001]. Cesarean section in propranolol group 9 [15%] was significantly less than that in the placebo group 15 [25.9%] [p<0.001]. Failure to progress in propranolol group 2 [3.3%] was significantly less than that in the placebo group 5 [8.6%] [p<0.023]. Propranolol may shorten the duration of the active phase labor and the second stage of it and reduce the dosage of oxytocin and also Cesarean section rate
ABSTRACT
Introduction: contraception is a major component of preventive health care for women. Several methods are used for familly planning but tubal ligation [TL] is different from other contraceptives because often it isn't reversible.Recently,due to decrease in acceptability of TL in women,there are questions on saftey of this method
Objective: the purpose of this stuy was to investigate attitudes and knowledge about tubal ligation and possibility of Post Tubal Ligation Syndrome in women residing in Rasht
Materials and Methods: in this study, 403 women were collected with stratified randomized sampling. The data collection instrument consisted of a three-part questionnaire which included:[1] the demographics [2] knowledge level and [3] questions concerning the attitude. We applied the SPSS.9 statistical analysis software and Chi-square tests, pearsonian coefficient. P<0.05 was determined as statistical significance
Results: the research showed that 45/9% of women have poor knowledge and 21% have negative attitudes about tubectomy. There were significant correlations between the number of children, education level, and information source with level of knowledge [P<0.05]. Also, there were significant correlations between variations like education level, information source and contraception methods with level of attitude [P<0.05]. Our results showed that 82/1%,41/5% and 21/8% of women believed that Pelvic and Lumbar pain, Menstrual disorders and Ovarian cyst might occur after tubal ligation respectively
Conclusion: our research showed that many of women due to fear of tubal ligation complications [Post Tubal Ligation Syndrome] had a negative attitude. It seems that increasing the knowledge of women and more comprehensive studies are necessary for Post- Tubal Ligation syndrome about which there is no consensus yet
ABSTRACT
Introduction: one of the most important cause of mortality in parturients is early postpartum severe hemorrhage that accounts for 28% of maternal death
Objective: the aim of this study was to determine prevalence of postpartum hemorrhage in cesarean section and requirement of blood transfusion during 24 hours after operation
Materials and Methods: this was a cross sectional study that performed among patients who underwent cesarean section at Alzahra Hospital in Rasht in 2000. Selection of 1600 records out of 3200 records by systematic Randomization was the base of this study. Of these, 100 records were omitted because of poor information and the rest [1500 records] were considered with these variables: blood transfusion requirements, kind of anesthesia, amnionitis, kind of uterine incision and labor abnormalities. Test of chi-square has been used for making a comparison between two groups, namely those requiring blood transfusion and those who didn't need it
Results: our study showed that incidence of early postpartum hemorrhage in cesarean deliveries was 2.26 percent and it was similar to other studies and the risk factors associated with early postpartum hemorrhage were pre-eclampsia, labor abnormalities and general anesthesia
Conclusion: considering the results obtained, women with preeclampsia or labor abnormalities or receiving general anesthesia, were at higher risk of early severe hemorrhage after cesarean section. Thus, the hospital should be well- equipped in dealing with such high- risk patients
ABSTRACT
Introduction: placenta is essential for normal fetal development. Failure of the placenta can result in many fetal conditions. Placental development and function can be assessed by a number of methods, including measurement of placental weight
Objective: the aim of this study was to evaluate survey of placental weight and associated factors
Materials and Methods: in this study pregnant, women with singleton pregnancy and gestational age between 37-42 weeks delivered following complicated or no complicated pregnancies were included in a cross-sectional study. Also the patients were categorized into high placental weight [>750gr], normal placental weight [330-750gr] and low placental weight]<330gr]. The placental weight, birth weight, maternal age, gestational age, parity, preeclampsia, history of maternal diabetes, route of delivery, infants' gender and Apgar score were recorded and analyzed with chi2 test
Results: 1088 patients were included in this study. The mean maternal age was25.35+/-5.6 and gestational age at delivery was 274.51+/-9.56 days. The mean weight of birth and placental weight were 3214.28+/-529, 529.72+/-113 respectively. The prevalence rates of low and high placental weight were 2% and 2.8% respectively. There were statistically significant relationships between placental weight and birth weight, fetal distress, Apgar score, maternal diabetes, preeclampsia and kind of delivery. [P<0/05]
Conclusion: in this study, it was seen that placental weight can be related to some important variables that influence some maternal and neonatal outcomes. Therefore, attention to placenta and its growth during pregnancy, for example by sonography can guide us in providing neonatal health and even can be the base of preventive medicine. It appears that placental weight lower than 330gr can be a warning