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Childbirth is an experience in a woman' s life that holds the power to transform her forever. The objective of the study was to assess the effectiveness of Shiatsu massage upon rst stage Labour pain among the parturient mothers. In this pre-test, post-test experimental study, 60 parturient mothers were selected by simple random sampling technique among which 30 were assigned to the control group and 30 mothers to the experimental group. The labour pain level was assessed by the visual pain analogue scale, and foeto maternal parameters using modi- ed WHO partograph before and after intervention for both control and experimental group of parturient mothers. The experimental group was provided with Shiatsu massage on UB30 of the sacro-meridian region for 10 minutes for every two hours along with the routine care and the control group was treated only with the routine care during the labour process. The results showed a signi cant difference in after therapy pain score, at p'lt;0.001 between the control and experimental group. The foeto maternal parameters like foetal heart rate, uterine contraction and cervical dilatation was stable throughout the labour process. The Shiatsu massage was effective in reducing the level of labour pain perception. The management of labour pain is a primary responsibility of the nurse. Midwives can be empowered to provide Shiatsu massage as non-pharmacological pain management during childbirth.
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SUMMARY OBJECTIVE: The main aim of this study was to evaluate the impact of using interventions in low- and high-risk parturients on maternal and perinatal adverse outcomes during labor. METHODS: This is a prospective study. The analyzed variables were obtained through a questionnaire with puerperal women (between 1- and 48-h postpartum) and through medical record searches. The study population was divided into two groups as follows: Group I included parturients who underwent at least one type of obstetric intervention and Group II included parturients who did not undergo any type of obstetric intervention. RESULTS: Most parturients (75.3%) underwent at least one type of intervention, with oxytocin being the most prevalent intervention (49.5%), followed by misoprostol use (28.7%), elective cesarean section at the request of the patient (23.0%), amniotomy (21.2%), and episiotomy (21.0%). Regarding the adverse perinatal outcomes related to low-risk pregnancies, the prevalence of the second- or third-degree perineal tears (17.8% vs. 36.7%, p=0.001) was lower in Group I than in Group II. Moreover, in high-risk pregnancies, the prevalence of hospitalization in the neonatal intensive care unit (2.8% vs. 16.7%, p<0.001), adult intensive care unit admission (0.8% vs. 3.9%, p=0.004), and the need for oxygen therapy (26.8% vs. 40.4%, p<0.001) was lower in Group I than in Group II. CONCLUSIONS: In low-risk parturients, the interventions performed were associated with lower prevalence of second- or third-degree perineal tears. There was a lower prevalence of neonatal and adult intensive care unit admissions, the need for oxygen therapy, intracranial hemorrhage, and neonatal infection among high-risk parturients.
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Humans , Female , Child , Tooth, Deciduous , Bicuspid , Dentition, Mixed , Anodontia , MolarABSTRACT
Background: The attitude of the fetal head during labour significantly influences the progress and outcome of delivery and is mainly diagnosed by vaginal examination during labour. The aim of the study was to quantify the extent of deflexion of the fetal head by measuring the fetal occiput spine angle (OSA) through transabdominal ultrasonography in the first stage of labour and to determine whether the fetal OSA can predict the mode of delivery.Methods: We conducted a prospective observational study on 145 nulliparous uncomplicated singleton pregnant women without occiput-posterior position of the fetus during active labour. The OSA was measured as the angle between the two tangential lines to the occipital bone and the vertebral body of the first cervical spine, during active labour and monitored until delivery. Intra- and interobserver reproducibility of the OSA measurement and the correlation between the OSA and mode of delivery were also evaluated.Results: For the study population, the mean value of the OSA measured in the active phase of the first stage was 124.2±11.5⁰. The OSA measurement showed excellent intraobserver agreement (r = 0.82; 95% confidence interval [95% CI] 0.70-0.80) and fair-to-good interobserver agreement (r = 0.62; 95% CI 0.51-0.71). The mean OSA was significantly less for the group of patients who required conversion to cesarean section due to labour arrest (n=32) as compared to those who had vaginal delivery (n=113) (116.25±9.2⁰ versus 126.53±11.1⁰, P<0.01). An OSA of ≥121° was associated with vaginal delivery in 80.5% (91/113) of women, whereas 87.5% (28/32) of the women who delivered by cesarean section had an OSA <121⁰.Conclusions: Measurement of the OSA, by sonography is feasible, reproducible and an objective tool to assess the degree of fetal head deflexion during labour and to predict the mode of delivery.
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Objective To research the clinical application value of laparoscopic bile duct exploration and the first stage suture for choledocholithiasis. Methods The clinical data of 86 patients with choledocholithiasis were analyzed retrospectively from January 2015 to January 2017 in Affiliated Suzhou Hospital of Nanjing Medical University. According to the different methods of laparoscopic bile duct exploration, they were divided into one stage suture group (observation group, 46 cases) and T tube drainage group (control group, 40 cases). Results The recovery time of gastrointestinal function, hospitalization time and hospitalization expenses in observation group were significantly better than those in control group: (22.71 ± 10.92) h vs. (35.63 ± 11.12) h, (8.4 ± 2.6) d vs. (13.5 ± 2.3) d and (12.1 ± 3.2) thousand yuan vs. (13.5 ± 4.2) thousand yuan, and there were statistical differences (P＜0.05). Conclusions Compared with T tube drainage, the first stage suture after laparoscopic common bile duct exploration has shorter hospitalization time, lower treatment cost and faster recovery. It is a safe and feasible operation method, and is worthy of popularization and application.
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Objective To investigate the feasibility and efficacy of the first stage anastomosis using perineal ring-shaped flap in the treatment of anterior urethral defect after bladder-preserving urinary continence anterior urethral resection in female patients with early urethra carcinoma. Methods Tweenty-nine female patients with early urethra malignant tumor diagnosed in Changhai Hospital, Second Military Medical University from Jan. 2013 to Jan. 2016 were enrolled in this study. The average age of the patients was (61.4±14.4) years old, the clinical stages were type and the lesions were limited to half of the urethra. All patients underwent bladder-preserving urinary continence anterior urethral resection. After the resection of tumor, a free 30-40 mm long ring-shaped flap from the perineal vestibule was anastomosed inline to the end of the urethra. The clinical feasibility and safety of the operation were evaluated. Results The operation time was 0.45-1.50 h, with an average of (0.51±0.30) h. The postoperative urethral orifice shape of patients was close to the physiological shape with unobstructed urination, and the maximum urination rate was 12.8-33.0 mL/s, with an average of (19.3±8.7) mL/s. The success rate of one-stage operation was 100%, without any urethral stricture or urinary incontinence. All patients were followed up for 12-48 months with an average of (32.6±3.5) months. During follow-up, 1 case (1/6) with squamous cell carcinoma had a positive left inguinal lymph node metastasis in the first 2 years after surgery, and died of extensive lung metastasis 3 years after surgery; 1 case diagnosed with metastatic squamous cell carcinoma by postoperative pathological report developed regional swollen lymph nodes in the groin 13 months after surgery, and then ilioinguinal lymphadenectomy was perform to dissect the lymph nodes. No other recurrence was found during follow-up. Conclusion The first stage anastomosis surgury using perineal ring-shaped flap is safe and effective in the treatment of anterior urethral defect after bladder-preserving urinary continence anterior urethral resection in female patients with early urethra carcinoma.
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Objective To investigate the effect of diazepam injection on the degree of cervical dilatation, delivery outcome and negative emotion in the first stage of labor. Methods Retrospective study of 120 cases of maternal birth in our hospital as a study sample. Diazepam was used in the first stage of labor, and 60 cases of women with worse cervical dilatation and negative mood were selected as observation group, the other selected not to use any drug-assisted childbirth, only to take the basis of comfort and other interventions, the clinical symptoms and observation group were similar to 60 cases of maternal were classified as control group. The effects of the two groups intervention on maternal mood, delivery outcome and cervical dilatation were compared. Results The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores of the observation group were significantly lower than those of the control group at 1h, 12h and 24h after treatment, the difference was statistically significant (P<0.05). Observation group Bishop cervix related degree of cervical dilatation, cervical soft and hard, cervix position, cervical canal disappearance and fetal exposure were significantly higher than those of the control group, the difference was statistically significant (P<0.05). The rate of spontaneous delivery in the observation group (83.33%) was significantly higher than that the control group (56.67%), the difference was statistically significant (P<0.05). There were no statistical differences in the rate of adverse childbirth in the observation group (11.67%) and the control group (10.00%). Conclusion The use of diazepam injection in the first stage of labor can effectively improve the overall maturity of maternal cervix, relieve maternal depression, anxiety and other negative psychological, and drug safety is high, and there was no significant adverse effect on the outcome of their childbirth.
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AIM: To evaluate the use of 23G minimally invasive vitreous cutting system in the first stage of anterior segment reconstruction on severe ocular injury. METHODS: Fifteen patients with ocular injuries including the corneal and scleral rupture associated hyphema, vitreous hernia in anterior chamber, traumatic lens rupture, lens subluxation, applied 23G minimally invasive vitreous cutting system in the first stage of anterior segment reconstruction. RESULTS: The anterior ocular media of early postoperative became transparent quickly. No exudative lemma and no complications were found relate to puncture incisions after operations. CONCLUSION:23G minimally invasive vitreous cutting system can be used in the first stage of anterior segment reconstruction on sever ocular injury. It can reduce iatrogenic injury, operative complications and inflammatory response, also can shorten therapeutic time and create favorable conditions.
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Objective To discuss the effect on promoting the progress of the stage of labor and the natural delivery as the parturient adopts the different delivery position in the first and the second stage of labor. Methods One hundred and fifty-two cases of delivery primiparas of cephalic presentation whose pregnancy was from 37 to 41 weeks were enrolled and divided into two groups randomly. In the observation group (80 cases) ,the free positions of delivery like walking,squating,lateral position,half lying and others could be selected in the first stage of labor, the semi-reclining position was selected in the second stage of labor and the lithotomy position was adopted when the head was visible on vulvae gapping. The parturient in the control group (72 cases) selected the decubitus (alternation between prostration and lateral position) in the first stage of labor and the parturient selected routine lithotomy position of supine position in the second stage of labor. The progress of labor and the comfort of the parturient in the two groups were observed. Results In the observation group, time spent in the first stage and second stage were (361. 83 ± 58. 02) mins and (36. 39 ± 11. 97) mins, and (398.21 ±59. 72) mins in the total birth process, which were significantly shorter than those of (560.85 ± 131. 98)mins and (58.11 ± 15.44) mins, and (618. 96 ± 139. 61) mins, respectively (t = 12. 24,9. 74 and 12. 90, Ps <0. 01). There were 13 and 25 cases experienced tingle in two hours after delivery, and 2 and 10 cases in 12 hs after delivery, in the observation and control group, respectively. The comfort of parturient in the observation group was higher than that in the control group (x2 = 6. 90, P < 0.01; x2 = 5. 28, P < 0. 05)respectively. Conclusion The free position in the first stage of labor and the semi-reclining position in the second stage of labor can shorten the birth process effectively and relieve the discomfort after the delivery.
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Objective To evaluate the efficacy of laparoscopic first-stage Fowler-Stephens for high cryptorchidism. Methods Seven children with high cryptorchidism (10 testes) were enrolled in this study. After detecting the testicles under a laparoscope, we dissected the spermatic cord vessels. Then, the spermatic duct was separated, and the gubernaculum testis was retained. Afterwards, the first-stage orchidopexy was performed laparoscopically. Results Nine of the 10 testes were successfully placed into the scrotum by first-stage Fowler-Stephens. In one patient who had bilateral cryptorchidism, the left testis was placed into the scrotum at the second stage operation. The seven patients were followed up for 6-24 months (mean, 14 months). None of them had retraction or atrophy of the testis. Conclusions Laparoscopic first-stage Fowler-Stephens is effective for high cryptorchidism. The procedure is worth being widely used.
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Realizou-se um levantamento copro-parasitológico utilizando uma nova técnica para o diagnóstico de larvas de primeiro estágio de nematóides gastro-intestinais de bezerros no Município de Barra Mansa. Concluiu-se que larvas de Cooperia e Haemonchus são as mais prevalentes em bezerros e o número recuperado foi maior do que as outras espécies de nematóides. Haemonchus e Trychostrongylus foram as que tiveram maior frequência nas propriedades, enquanto que Bunostomum e Strongyloides obtiveram uma prevalência e frequência baixa em bezerros e propriedades, respectivamente.
A copro-parasitoligical survey were realized using the new technique for first stage gastro-intestinal nematodes larvae diagnostic in 110 calves, at Barra Mansa municipality. lt was concluded that Coopelia and Haemonchus larvae were lhe most prevalent and numerous in calves. Haemonchus and Trichostrongylus larvae were the most frequent in the farms while Bunostomum and Strongyloides were low prevalence and frequency in calves and farms, respectivelly.