ABSTRACT
Background@#Acupressure may stimulate oxytocin release from the pituitary gland, which in turn regulates uterine contractions to improve the progress of labor; hence, studies have shown that acupressure on the Spleen 6 (SP6) point may be a complementary strategy for augmenting labor and/or shortening the first stage of labor without causing adverse effects to the mother or the newborn.@*Objective@#To compare contractions produced by acupuncture technique from the contractions produced by conventional method using oxytocin in terms of: intensity, duration and interval of the uterine contractions and to determine if acupuncture technique at Sanyinjiao (spleen 6) and Hegu (Large Intestine 4) can be used as alternative method in establishing uterine contractions in Contraction Stress Test (CST) as a means of fetal surveillance.@* Methodology@#This is a Randomized Controlled Trial done in University of Santo Tomas Hospital. This included 54 term pregnant patients who met the inclusion criteria and were randomized into two groups: 27 patients in Acupuncture group and 27 patients in Oxytocin group (control group). All recruited patients were hooked to electronic fetal monitor to obtain baseline strips for 20 minutes. Acupuncture needles were applied bilaterally at Sanyinjiao (spleen 6) and Hegu (Large Intestine 4) for 20 minutes to the study subjects.@*Results@#Subjects who received acupuncture had greater intensity (p=0.551) and significant longer duration (p=0.001) of uterine contractions than the oxytocin group. However, there was significant shorter interval of uterine contractions after oxytocin treatment (p=0.013) than acupuncture. Furthermore, subjects who were in the acupuncture group obtained initial uterine contractions and achieved desirable uterine contractions faster than oxytocin.@*Conclusion@#Application of acupuncture in Spleen 6 (Sanyinjiao SP6) and Large Intestine 4 (Hegu LI4) can initiate and induce uterine contractions faster. Acupuncture technique when compared to the conventional method using oxytocin, produces stronger and longer contractions. Furthermore, there is shorter mean time to achieve initial and adequate contractions thru acupuncture technique. Contractions also disappear in a much shorter time in acupuncture technique than in oxytocin group hence ideal for outpatient setting.
Subject(s)
Pregnancy , Female , Uterine Contraction , Oxytocin , Acupuncture TherapyABSTRACT
Background@#A prolonged interval from prelabor rupture of membranes to delivery is associated with an increase in the incidence of maternal and neonatal morbidities and mortality. Various agents have been tested to improve the cervical Bishop score to expedite the delivery of the fetus and lessen the maternal and neonatal complications.@*Objective@#To compare two protocols for labor induction in pregnant women with prelabor rupture of membranes (PROM).@*Population@#Subjects were recruited from the University of Santo Tomas Hospital (Private Division and Clinical Division). Pregnant women with a live, term, singleton fetus, cephalic presentation, a reactive Non stress test, who presented with PROM and a Bishop score of ?5, with no previous Cesarean section, or other uterine surgery.@*Methodology@#This is a two-arm superiority, open label, randomized controlled trial. Pregnant women with a live, term, singleton fetus, cephalic presentation, a reactive Non stress test, who presented with PROM and a Bishop score of ?5, and with no previous Cesarean section or other uterine surgery were randomly assigned to receive either intravenous (IV) oxytocin infusion or intracervical dinoprostone 0.5 mg gel followed 6 hours later by IV oxytocin infusion.@*Results@#Vaginal delivery within 24 hours of labor induction increased significantly with intracervical dinoprostone gel followed by IV oxytocin infusion (87% versus 61%; RR: 1.43; 95% CI: 0.99 – 2.06; P<0.044). Comparable result was observed for nulliparous women included in the study population. The time interval from labor induction to active phase was significantly shorter in the dinoprostone-oxytocin group than in the oxytocin alone group (2.4 ± 2.1 versus 6.3 ± 1.4 hours; p<0.001). The time interval from labor induction to delivery was also significantly shorter in the dinoprostoneoxytocin group (6.3 ± 1.5 versus 10.4 ± 1.4 hours; p<0.000). Cesarean delivery rates were statistically similar in the dinoprostone-oxytocin and oxytocin alone groups (17% versus 40%; p=0.102). The neonatal outcomes were comparable in both groups, except for birth weight.@*Conclusion@#Intracervical dinoprostone 0.5 mg gel followed 6 hours later by an oxytocin infusion in term women presenting with PROM and an unfavorable cervix (Bishop Score of 5 or less) was associated with a higher rate of vaginal delivery within 24 hours, shorter time interval from labor induction to active phase of labor, and shorter time interval from labor induction to delivery, and no difference in maternal and neonatal complications was observed compared with oxytocin infusion alone.
Subject(s)
Dinoprostone , Oxytocin , Labor, ObstetricABSTRACT
We report a case of a twin pregnancy, wherein one twin presented with an abdominal cyst since 12 weeks' gestational age. Upon referral at 21 weeks' gestational age, three-dimensional ultrasound with Fly thru technology was used to aid in the identification of the etiology and nature of the mass. Once megacystis was confirmed, serial vesicocentesis and urine biochemistries were used to direct the management. This shows the potential of Fly thru technology in aiding the clinician in studying fetal congenital anomalies. This can help guide the diagnosis and provide earlier and timely management of such cases.