ABSTRACT
The incidence of ectopic pregnancy varies between 1.5-2% of all pregnancies. Bilateral tubal ectopic pregnancy is rare. It may occur in 1 per 200 000 pregnancies. This is a case report of 25 year-old woman who underwent intra uterine insemination [IUI], because of tubal factor infertility [unilateral]. On the 30th day after the IUI she complained from pelvic pain and vaginal bleeding. Pelvic ultrasound showed bilateral tubal ectopic pregnancy with fluid in Douglas Pouch and empty uterine cavity. Exploratory laparotomy, left salpingectomy, and right salpingostomy were performed on the same day of admission. The above case suggests that cases presenting with infertility and ectopic pregnancy should be followed very closely with beta -hCG and or Trans Vaginal Sonography [TVS] to exclude double ectopic. So, as in this case, early diagnosis is essential for prevention of maternal morbidity and mortality
ABSTRACT
Assisting parents in selection of appropriate method of delivery is one of targets of preparation classes of childbirth. Group training method gives mothers a chance to share their experiences and beliefs with each other and the midwife may provide them with high quality training by presenting them with correct information. The aim of this study is to investigate the effect group training on pregnant women's tendency about the method of delivery and pethidine consumption. In this interventional study, initially, after taking written consents, 85 participants attended group training. Moreover, 85 of the participants were provided with ordinary care in the control group. The classes were held for 1.5-2 h, every 2 weeks, with the participation of 10-15 mothers. Data were collected through demographic specifications, optional delivery method after training, and consequence of delivery questionnaires. Pain was measured by visual analog scale and statistical analysis was performed by X[2] test and t-test using SPSS for Windows 18.0. The results of the present study indicated that the presence of a significant difference in tendency for cesarean between the two groups after education [0.001]. Also, consumption pethidine during labor was significantly lower in the intervention group [0.001]. Group training was one of the appropriate methods for decreasing the number of tendency for cesarean operation and resulted in the reduction of natural labor pain and consumption of sedatives
ABSTRACT
Adding new supplements when performing spinal anesthesia can increase the duration of analgesia. The aim of the present study has been to compare intrathecal midazolam and tramadol with the conventional method for postoperative pain and shivering control after elective caesarean section. In this double-blind clinical trial, 210 ASA class I, II women, aged 20-35 years, candidate for elective caesarean section were randomly allocated to three groups. All patients received hyperbaric intrathecal lidocaine and additionally group I received 2 mg subarachnoid midazolam, group II received 25 mg subarachnoid tramadol and the control group received 5cc normal saline. Postoperative pain score, the painless duration and postoperative shivering were assessed in the three groups. The mean painless duration in tramadol, midazolam and the control group were 192.5 +/- 12.2, 111.3 +/- 16.6 and 86.1 +/- 9.9 minutes, respectively [p<0.001]. The mean painless duration in the midazolam group was significantly more than two other groups and this duration in the tramadol group was also more than the control one. The mean postoperative pain score, shivering occurrence and the frequency of requested painkiller in the first 24 hours, were also compared. In the midazolam group, they were all significantly less than the two other groups. In the meanwhile, these indexes in the tramadol group were less than the control one [p<0.001]. Adding intrathecal midazolam and tramadol to lidocaine 5% in elective caesarean section can increase the painless duration and lead to a reduction in postoperative shivering. Midazolam demonstrates a stronger effect