Evaluation of the effect of four maternal positions on the duration of the second stage in nulliparous women

For centuries, there has been controversy around whether being.upright [standing, sitting, birthing stools, chairs, squatting] or lying down [supine, left lateral, lithotomy] have advantages for women delivering their babies To assess the benefits and risks of the use of different positions during the second stage of labor. The primary outcome was the duration of the second stage. Secondary outcomes were incidence of operative delivery, incidence of perineal and vaginal tears, estimated blood loss during the third stage and Apgar score This prospective randomized study was carried out at the Department of Obstetrics and Gynecology of the Shatby Maternity University Teaching Hospital in Alexandria, Egypt between 1998 and 2002. The study was carried out on 2080 nulliparous women who reached the second stage of labor with alive, full term, singleton fetus presenting with cephalic vertex presentation and with estimated average fetal weight. Women with medical or obstetric risk factors were excluded. Five hundred and twenty cases were randomly allocated into one of 4 groups. Group I cases used squatting position and group II cases used sitting position. Standing and lithotomy positions were the positions taken by cases in groups III and IV respectively There was no significant difference between groups concerning gestational age, estimated fetal weight by ultrasonography, head station and uterine activity. The shortest mean duration of the second stage was observed among cases in group I [30 [6 minutes] while the longest duration was observed among cases in group IV [100 [25 minutes]. In group II the second stage lasted 60 [15 minutes while in group III the second stage lasted 40 [12 minutes. A statistically significant decrease for the use of medical analgesia [p=0.0001] and oxytocin [p=0.0001] [was observed in women using the upright birth position. A significantly lower rate of operative delivery was detected in women who delivered in an upright position [groups I, II, III] compared with women delivering in lithotomy position [group 1V] [p=0.0001]. The frequency of perineal tears, and vaginal and labial trauma did not differ between the four groups [p>0.05]. When analyzing maternal blood loss in the third stage, no significant differences between all groups were found [p>0.05]. No differences in APGAR score <7 at 1 and 5 minutes or cord pH <7.1 were observed [p>0.05] between groups Maternal position during the second stage of labor definitely affects the duration of the second stage. Upright posture [squatting, standing, and sitting] were associated with shorter duration of the second stage in comparison to lying down [lithotomy position]. Also upright posture was associated with lower incidence of operative delivery

Comparison between the effect of oral bromocriptine and bromocriptine injections on serum prolactin level in pathological hyperprolactinemia

The study included 20 females with hyperprolactinemia of different causes. They were subjected to careful history taking and physical examination. The basal serum prolactin and thyroid stimulating hormone [TSH] were assayed. Fundus examinations, plain X- ray skull and cat scan were done in some cases. Ten cases were given 7.5 mg oral bromocriptine daily for three months. The other ten cases were given long acting bromocriptine in repeated injections [LAR] in a dose of 50 mg monthly for three months. There were no significant differences in the efficacy of parlodel tablets and injections in suppressing serum prolactin. Also, no significant difference in the clinical efficacy was found except a more significant effect for the injections in galactorrhea. The number of cases with side effects was equal but its duration was shorter with the injections. Parlodel LAR injections can be repeatedly used without any side effects especially in patients who cannot tolerate the gastrointestinal side effects of the oral tablets and in galactorrhea cases

Plasma lipids and high density lipoproteins during oral administration of estriol succinate in post-menopausal females

The study aims to evaluate the effects of natural estrogen [estriol succinate] as a replacement cyclic therapy on plasma lipids and high density lipoproteins, in postmenopausal women. The results of this study showed that the effect of estriol succinate on plasma lipids conform to the pattern of other natural estrogens used in post-menopausal replacement therapy in that there was a tendency for total cholesterol and low density lipoprotein levels to fall. Serum high density lipoprotein and triglycerides levels, however, rose

Studies of the glomerular filtration rate, blood urea nitrogen and serum uric acid in hypertensive disorders during pregnancy

Twenty hypertensive pregnant women in the 3rd trimester were subjected to detailed history taking, clinical examination and laboratory investigation including complete urine analysis, glomerular filtration rate, serum uric acid and serum blood urea nitrogen

Study of the effect of treatment of pre-eclampsia on kidney function

Fifteen pregnant women with preeclampsia were treated by bed rest, sedatives and serpasil. Estimation of urine volume, albumin in urine, hematocrit, value, serum uric acid and creatinine, endogenous creatinine clearance and blood urea nitrogen was done before and after treatment

Establishment of normal baseline values of blood chemistry in Egyptian fertile women during the child bearing period

In this work the results of external and internal quality control of our laboratory were evaluated. The day to day quality control and external quality control results obtained were quite satisfactory. The working conditions in our laboratory were studied. Seven days storage in deep freeze had an insignificant effect on the results except for alkaline phosphatase. The precision, accuracy and linearity of the MT11 apparatus were checked. The normal range for ambulant healthy females for blood parameters was established. It proved to be within the limits of the international range

Culdoscopic sterilization of 262 cases

The results of surgical sterilization of 292 women using the culdoseope are presented. The operation is done under general analgesia with local anaesthesia. The operation is done in a short time, the technique is simple and hospitalization is only for one day. The efficacy of the method is very reliable and no major complications were encountered in the series presented. The operation is recommended as an ideal method of permanent contraception for couples who completed their families

Ectopic pregnency after lippes loop report of four cases

Four cases of tubal ectopic pregnancy is recorded. Review of literature and the mechanism is presented

Management of perforating lippes loop by colpotomy and culdoscopy. Report of four cases

Four cases of perforating Lippes loop were reported. The clinical picture was discussed. The cases were extracted by culdoscopy, one cases by posterior calpatomy, and the fourth was extracted by anterior colpotomy. Review of the literature concerning similar and other side effects are discussed

Evaluation of a new oral contraceptive [SH. 70850]

A new contraceptive drug containing rgesterel as the prgestatinal gent was tried in 50 women chosen at random for periods varying from 9-10 months. Side effects and endometrial changes were studied and the results discussed

Ophthalmologic studies under the effect of oral contraceptives

Eleven cases of short-term Anorlar 1 users [age 20-30 years] and 22 of the long-term pill users [up to four years] with an age ranging from 30 to 40 years were examined in the Ophthalmology department for ritual acuity, tension of the eye and fundus examination. All cases showed normal tension of the eye and no pathological findings were found in the fundus pictures of these pill users, even up to four years of intake. The defects in visual acuity was not related to the pill intake as they could be explained by the errors of refraction

Study of blood lipids under the effect of oral contraceptives

Serum cholesterol and beta lipoproteins were studied after the intake of Anovlar and Anovlar 1 tablets for short duration [six months] and long duration [2 to 10 years]. There was a significant increase in total serum cholesterol and in beta [atherogenic] lipoproteins, more marked in the long-term users. The state of hyperlipaemia induced by the combined pills can play a role in the pathogenesis of venous thrombosis, either by accelerating clotting or by inhibiting fibrinolysis

Study of liver function tests under the effect of oral contraceptives

A battary of liver function tests were done for a group of normal [30 cases]. Anovlar 1 tablets were given for 20 cases and the tests repeated and there was a significant increase in serum transaminases, zinc and thymol turbidity tests but no change was found in the serum alkaline phosphatase.. A group of long-term users [30 women] were also investigated for this liver functions and there wrre no significant changes in the values of these tests, this reversibility of the liver function could be explained by the phenomenon of "adaptation"

Study of the effect of oral contraceptives on blood coagulation factors

Blood coagulation factors, I, II, VII, VIII and X were assayed before and after the intake of Anovlar 1 tablets for six months and also after the long-term use of Anovlar and Anovlar 1 tables for 2 to 10 year. In both group there was a significant increase in Factors I, II, VII and X. Factors VIII [antihaemphilia globulin] showed no significant change in the studied groups

Electro-gardiographic studies under the effect of combined pills

Seven cases of short-term pill users and 13 of long-term users of combined oestrogen-progestogen combination were studied by ECG tracings. There was no pathological changes in the ECG for the studied cases even after ten years of intake of the pills. This excludes abnormalities in the vascular, myocardial and conduction system of the heart

Fibrinolytic activity under the effect of oral contraceptives

Twenty women were given Anovlar 1 tablets cyclically for six months, and the fibrinolytic activity of their plasma was studied by the euglobulin clot lysis time. Pre-intake study was done for 30 women, and for another group of long-term users of Anovlar and Anovlar 1 tablets for 2-10 years. There was a significant shortening in the euglobulin lysis time in the two groups of pill users. This enhanced fibrinolytic activity counter balances the increase in the blood coagulation and thus preventing the occurrence of intravascular thrombosis

New experience with uterine vacuum aspiration

Uterine evacuation by vacuum aspiration was carried out in Shatby Maternity Hospital for 1005 cases of therapeutic, inevitable, incomplete, septic and missed abortion and hydatidiform mole. The operation was performed without anaesthesia in most of the cases. Paracervical block was needed in those cases requiring cervival dilatation by means of "vibrodilator". Curettage was done after vacuum aspiration to delect incomplete evacuation "failure of method". The patients are discharged on the next day

Endometriol pattern with lippes loop

One hundred endometrial biopsies, from post partum patients with I.U.C.D were studied. The histological pattern coincided with the cycle date of the biopsy in 54.66% was earlier in 18.66%, and later in 26.CC%. According to these altered hormonal responses of the endometrium an explanation of the contraceptive effect is given. Abnormal pathological, findings of the endometrium were encountered in 15% of the cases