influence of the mode of anesthesia on the neonatal well being after the caesarian delivery

To evaluate the influence of the mode of anesthesia on the neonatal outcome after the caesarian delivery. All the patients who were going to have a caesarian section were enrolled to the trial and their demographic data along with the Apgar Score and need for the NICU [Neonatal intensive care unit] admission, was entered in a specially designed proforma. After the data collection [from 1[st March 2010 to 28[th] February 2011] the data was entered in SPSS version 19 and was analyzed statistically. There were 1308 caesarian deliveries out of which 59.6% [n=779] were delivered electively while 40.4% [n=529] had an emergency delivery. The rate of general anesthesia versus spinal anesthesia was the same i.e. 59.2% [n=199] and 59.7% [n=580] respectively in elective delivery group and 40.8% [n=137] and 40.3% [n=392] respectively in emergency delivery group and this difference was found statistically insignificant. The Apgar Score of the neonates delivered to patients having general anesthesia was significantly poor as compared to the spinal anesthesia group and the rate of NICU admission is also high in general anesthesia group i.e. 10% [n=34] as compared to 5.8% [n=56]; this difference was also statistically significant [p=0.018]. Spinal anesthesia is associated with better neonatal outcome as compared to general anesthesia in both emergency and elective C/Section group.

comparison of intravaginal misoprostol with prostaglandin E2 [dinoprostone] for induction of Labour at term

To compare the efficacy of Misoprostol and Dinoprostone used as labour inducing agents. The first 100 patients admitted in the labour ward of Shalamar Hospital Lahore for induction of labour between March 2003 and February 2004 and fulfilling the inclusion criteria were randomly allocated to the two drug trial groups and followed till outcome of the delivery. Parameters included induction to delivery interval, need for augmentation of labour, C-section rate, safety of drugs to mother and the neonate and the cost benefit rates. One case got dropped out on her personal choice and left the hospital. The remaining 99 were followed up. Among the vaginally induced Misoprostol group 56% women delivered vaginally within 12 hours, while in vaginally administered Dinoprostone group only 26% delivered within 12 hours. This difference was found statistically significant [p<0.05]. The rate of C-Section in the two groups was not found statistically different [p>0.05]. The most common side effect with Misoprostol was nausea while the patients in the other group experienced vomiting. Vaginally prescribed Misoprostol reduced the induction to delivery interval but did not effect the rate of C-Section. No increase in maternal or neonatal complications was observed. It was highly cost effective

effect of anaesthesia modus on amount of blood loss in cesarean sections

A cesarean section is the delivery of a baby through a incision in the mother's abdomen and the uterus. It is the most common major surgery that women undergo. In the UK about 1:4 pregnant women give birth by c/section every year. To compare the effect of spinal and general anaesthesia on the amount of blood loss during cesarean section. It is a cross - sectional study to be carried out at Shalamar Hospital. It was conducted in one year's time i.e. from 1st March 2010 to 28th February 2011. All the patients with low risk of bleeding were enrolled to the trial. The choice of anaesthesia was the patient's choice after counselling by the anaesthesiologist. The total number of patients enrolled to the trial were 1308 out of which 972 patients received spinal anaesthesia and 336 patients were given general anaesthesia. The Demographic data along with preoperative haemoglobin and haematocrite was recorded on the proforma designed for the purpose. The demographic data including age and gravidity was not statistically different in both the groups similarly the preoperative haemoglobin and haematocrite was also insignificantly different in both the groups. The mean amount of blood loss is 357 ml in the spinal group and 501 ml in the patients who received general anaesthesia, this difference is statistically significant. The postoperative haemoglobin and haematocrite is also significantly reduced in the patients who received general anaesthesia. The rate of transfusion is 14.6% [n = 49] in general anaesthesia group and 3.2% [n = 31] in the spinal anaesthesia group and this difference is also statistically significant. The study proves that spinal anaesthesia is a better choice of anesthesia as it reduces the amount of blood loss and requirement of the post-operative blood transfusion