ABSTRACT
Background: This study was aimed at evaluating effect of Gestational diabetes mellitus (GDM) and maternal characteristics on pregnancy outcomes. GDM has several risk factors including; advanced maternal age, ethnic background, obesity and family history of diabetes mellitus. These pregnancy complications are associated with fetal morbidity and mortality and may lead to macrosomia and shoulder dystocia. Others are stillbirth, miscarriages, preterm and small for gestational age babies.Methods: This was a retrospective case-control study which compared maternal characteristics and pregnancy outcome among pregnant women with and without GDM. Diagnosis of GDM was done in accordance with the American Diabetes Association (ADA) criteria. Weight and height were determined and Body mass index (BMI) calculated. Pregnancy outcome was determined at the end of pregnancy and information on maternal characteristics obtained using questionnaire and patient folders.Results: Those who developed GDM were significantly older (OR=1.772; 95% CI=1.432-2.192; P<0.0001) and had higher BMI (OR=1.637; 95% CI=1.004-1.289; P=0.044) than those who did not. A significant number of those who developed GDM also had stillbirths (OR= 5.188; 95% CI=1.093-24.613; p=0.038) and cesarean deliveries (OR=14.362; 95% CI=3.661-56.335; p= 0.001).Conclusions: Women who develop GDM are more likely to deliver stillborn or macrosmic babies and may require surgical intervention in order to have normal deliveries.
ABSTRACT
La historia de la Obstetricia ha estado indiscutiblemente ligada a una de las intervenciones quirúrgicas más antiguas que conoce la humanidad: la operación cesárea. La extracción del feto a través de las paredes abdominal y uterina, es practicada por el hombre desde la prehistoria. El objetivo del trabajo es presentar el desarrollo de esta cirugía obstétrica en la historia de la Medicina universal. Se revisaron 28 documentos contenidos en bibliotecas, portales digitales y textos. Se realizó la investigación de esta técnica quirúrgica a través de los años y se identificaron los momentos más importantes en su progreso, sus logros y reveses. Misterio, magia, sangre, leyenda y muerte definieron la historia de la cesárea desde su origen hasta la era moderna en que se lograron mejores resultados. La cesárea ha sido una de las cirugías de mayor permanencia en la historia de la Medicina, existiendo a lo largo de los siglos y controversial respecto a sus múltiples técnicas e indicaciones.
The history of obstetrics has been undeniably linked to one of the oldest surgical interventions known to humankind: cesarean section. Man practices the extraction of the fetus through the abdominal and uterine walls, since prehistory. The objective of this paper is to present the development of this obstetric surgery in the history of universal medicine. Twenty-eight documents contained in libraries, digital portals and texts were reviewed. The investigation of this surgical technique was carried out and the most important moments in its progress, its achievements and setbacks were identified. Mystery, magic, blood, legend and death defined the history of cesarean from its origin to the modern era in which better results were achieved. Cesarean section has been one of the most permanent surgeries in the history of medicine. Throughout centuries, it has been controversial with respect to its multiple techniques and indications.
ABSTRACT
Objective To observe the effect of subarachnoid block with 0.5% bupivacaine at different temperatures during cesarean section.Methods 100 cases of elective cesarean section were randomly divided into room temperature group and heating group,50 cases in each group.Room temperature group: bupivacaine hydrochloride injection and glucose injection equilibrated group in a constant temperature thermostatic bath of 24 degrees thermostatic bath heating for above 30 min.Heating group: bupivacaine hydrochloride injection and glucose injection heated in the constant temperature thermostatic bath of 37 degrees thermostatic bath heatingfor above 30 min.Anesthesia was injected into the subarachnoid space at different temperatures to observe the anesthetic effect.Results The anesthesia increased rapidly, and the analgesia and muscle relaxation effects were better in the heating group than room temperature group, but the heating group had hypotension rate was higher than the room temperature group (36.0% vs.16.0%).There was no obvious difference between the incidence of adverse reactions such as nausea and vomiting in both groups.Conclusion Different temperatures of bupivacaine can be used safely for section anesthesia.The anesthesia effect of the heateding bupivacaine is faster, the anesthesia level is higher, the anesthesic and muscle relaxant effect is better.Bupivacaine at room temperature has relatively small effect on hemodynamics.