The effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after surgery in cesarean section under spinal anesthesia

OBJECTIVE: Postoperative nausea and vomiting is one of the most common side effects after anesthesia in surgeries, such as cesarean section. This study aimed to investigate the effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after cesarean section.METHODS: This clinical trial was conducted on 180 patients aged 18–40 years who underwent cesarean section under spinal anesthesia. The first group received 10 mg of metoclopramide via intravenous injection (metoclopramide group), and the second group received 1 g of oral ginger (ginger group) half an hour before spinal anesthesia. The frequency and severity of nausea and vomiting during surgery and at 2, 6, 12, and 24 hours postoperatively were compared in both groups. To analyze the results, the t-test, chi-square test, and Mann-Whitney test were used.RESULTS: There was no significant difference in the frequency of nausea and vomiting between the 2 groups during operation, 2 hours and 6 hours after surgery (P=0.182, 0.444 and 0.563 respectively). The severity of nausea and vomiting was also similar in the 2 groups (P=0.487 and 0.652 respectively); however, the metoclopramide group had a lower systolic blood pressure (P<0.001; df=2.176; f=18.66) and mean arterial pressure (P<0.001; df=2.176; f=6.36) than the ginger group.CONCLUSION: The results revealed that ginger reduced nausea and vomiting to the same extent as metoclopramide in patients undergoing cesarean section.TRIAL REGISTRATION: Iranian Center for Clinical Trials Identifier: IRCT201611028611N3

value of qualitative detection of human chorionic gonadotropin in vaginal washing fluid for diagnosis of preterm premature rupture of membranes

This study was performed to determine the sensitivity and specificity of qualitative hCG testing of vaginal washings for diagnosis of preterm premature rupture of membranes [PPROM]. A total of 92 singleton pregnant women at 20 - 37 weeks of gestation were placed in two equal groups of documented rupture of membranes and intact membranes as control. Confirmatory tests included pooling of amniotic fluid in the vaginal vault with positive ferning test. Patients with vaginal bleeding and obvious fetal anomaly were excluded. After cleaning the vagina with a sterile tampon and irrigation with 5 ml sterile saline, fluids were collected from the posterior vaginal fornix. Samples were tested by a pregnancy test strip with sensitivity of 25 mIU/ml. Data were collected and analyzed using t-test, Mann-Whitney, Chisquared, Fisher's exact tests. The groups had similar demographic characteristics. The hCG test was positive in 38 [83%] of the ruptured membranes group and in 4 [8%] of the control group. Sensitivity, specificity, positive predictive value, and negative predictive value were shown to be 83%, 91%, 90%, and 84%, respectively. The qualitative determination of hCG in vaginal washings proved a simple, rapid, noninvasive, and reliable test in the diagnosis of PPROM.