RÉSUMÉ
Background: Epidural analgesia produces analgesia in labour without affecting nervous system, allows the mother to be well oriented, fully conscious and alert throughout labour. The aim of this study is to study the effect of epidural analgesia and intramuscular (IM) tramadol in different stages of labour and compare the effect of epidural analgesia with intramuscular tramadol on progress of labour and its outcome.Methods: Continuous monitoring of the haemodynamic parameters of the mother was done using multiparameter monitors. Foetal monitoring was done using continuous cardiotocography (CTG) monitor. Primigravida in spontaneous labour were randomly divided into two groups. Group I received epidural analgesia and group II received IM tramadol.Results: Duration of Ist stage of labour in group I was 167.0±47.2 min and in group II was 214.4±50.2 min. Mean duration of III stage of labour in the present group I was 7.9 min and 7.5 min in the group II. In the present study, total duration of labour is shortened by 47 min in group I compared to group II.Conclusions: Epidural analgesia during labour is a simple and effective method for painless and safe delivery. Analgesia produced by epidural route is significantly more effective than intramuscular tramadol. Epidural analgesia has favourable effect on the progress of labour. In developing nations where availability of facilities is the main limiting factor, intramuscular tramadol which is a safe and satisfactory drug for relief of labour pain, can be considered as a suitable alternative.
RÉSUMÉ
Background: Metabolic syndrome is a group of clinical, metabolic and biochemical abnormalities with negative impact on global health. The aim of the study was to determine the association between metabolic syndrome and pregnancy induced hypertension, and incidence and effects of metabolic syndrome in pregnant patients.Methods: Prospective observational study, performed in the Department of Obstetrics and Gynecology, Holy Family Hospital, New Delhi. Antenatal women before 20 weeks of gestation were enrolled in the study. Metabolic syndrome was diagnosed by utilizing the pregnancy adaptation of MeS criteria of NCEPATP III laboratory and clinical criteria. Cases were followed throughout pregnancy to observe their progression into hypertensive disorders of pregnancy i.e. gestational hypertension, pre-eclampsia and eclampsia.Results: Out of 100 cases with metabolic syndrome 37% developed PIH, 21 developed pre-eclampsia and 14 developed gestational hypertension, 2 patients developed eclampsia as compared to controls in which only 10% developed PIH among which only 3% developed pre-eclampsia.Conclusions: Our study demonstrates a higher rate of complicated pregnancy with higher incidence of PIH in association with metabolic syndrome compared to control group. Each component of metabolic syndrome increases the probability of PIH. The addition of components of metabolic syndrome exacerbates this probability, especially the combination of increased BMI, increased blood sugar levels and increased triglycerides.