Efficacy of acupressure on pain intensity during first stage of labor

Pain management may actually help to shorten labor and secure natural delivery. Safe and painless labor is a dream for the future rather than a reality today. This study aimed to explore the efficacy of acupressure on pain intensity during the first stage of labor. The study was conducted on 120 parturient attending in two hospitals in Tanta city, where 60 women were chosen from each setting. Four tools were used [1] a specially designed interview schedule was used to collect basic data such as general characteristics, medical history, women's experience of pain and their expectations about labor pain. [2] Physiological and behavioral responses to pain sheet: Physiological responses to pain including: vital signs, gastrointestinal tract responses and skin responses. Behavioral responses to pain were measured using a modified Chamber Price Pain Rating Scale which includes posture, gross motor activity, facial expression and verbalization. [3] A modified version of "Johansson Pain-o-meter" for measuring the intensity of sensory and affective components of pain. It is composed of 11 affective and 12 sensory pain word descriptors. [4] Visual Analogue Scale. The results revealed that the application of acupressure to women during the first stage of labor was related to their physiological responses to pain. In addition, it was showed that both those who received the acupressure and those who did not receive it had an increase in their blood pressure. Regarding pulse rate it was observed that three nursing intervention had led to a decrease in it among the laboring women within the experimental groups. As regards the respiratory rate, the present study showed that the application of acupressure was related to its increase. In addition, a decrease of nausea and vomiting was seen after the application of acupressure. Physiologically, the activity of the sympathetic nervous system is expected to increase in response to labor pain, resulting in pallor and diaphoresis. The study revealed a change in the behavioral response to labor pain after the application of acupressure. In addition, acupressure is sign significantly related to an increase in assuming a guarded position, and decrease in frowning and grimacing, groaning, moaning, crying out, decrease in quality and intensity of labor pain. The mean score of labor pain had been reduced after acupressure application

Vaginal reconstruction with bilateral pudendal-thigh flaps in vaginal atresia

Patients with vaginal atresia require vaginal reconstruction with sensate pliable tissue. Although many procedures using skin grafts, skin flaps and intestinal segments have been described, they all have disadvantages. In the present study, 8 patients with vaginal atresia underwent surgery using the pudendal-thigh flap based on the posterior labial artery. This technique has proved to be simple and reliable with satisfactory functional and cosmetic results

Neonatal outcome of meconium associated deliveries after amnioinfusion

The present randomized study was aimed at finding out the magnitude and the outcome of prophylactic intrapartum transcervical amnioinfusion [AI] in pregnancies complicated by moderate to thick meconium-stained liquor [MSL]. The labor and neonatal outcome of 23 women with MSL receiving AIs were compared to 27 matched-control group of patients whose labor was complicated by moderate to thick MSL not receiving AI, attending Obstetrics and Gynecology Department in Tanta University Hospital. The incidence of moderate to thick meconium below the vocal cords of the neonate was significantly lower in AI group [9%] compared with the control group [18.5%] [p<0.05]. The incidence of meconium aspiration syndrome [MAS] in Al group was 4.3% while that of the control group was 11%, the difference was statistically significant [p<0.05]. No statistical significant difference was found between Al and the control groups for the following: cesarean section [8.7% versus 14.8%], Apgar scores at one and 5 minutes, umbilical arterial and venous pH [p>0.05]. No complications related to AI were observed. Amnioinfusion, during labor complicated by meconium, is a simple and apparently safe procedure. AI appears to be an effective intrauterine intervention for the diminution of the frequency of moderate to thick meconium below the vocal cords, and the prevention of meconium aspiration, nevertheless, there is no statistically significant impact of this on Apgar scores or cord pH values

Predictive value of C-reactive protein in serum of maternal and cord blood in cases with premature rupture of membranes

This study was carried out on thirty five women of different gestational ages and their neonates 10 control and 25 study group with premature rupture of the membranes [PROM]. The aim of this study was to determine the significance of C-reactive protein as a predictor of infection in women with premature rupture of membranes. From the 25 studied patients, only 11 [44%] had significant chorioamnionitis on histopathology, while all of them had positive microbial culture at delivery. There were no maternal deaths or perinatal deaths attributable to sepsis. All patients were assessed daily for the development of chorioamnionitis. The temperature and total leukocytic count were significantly increased [P <0.05%] in the study group with chorioamnionitis at delivery compared with the control group. C- reactive protein [CRP] determination in both mother and their neonates were significantly increased [P < 0.001] compared with the control group and found most reliable with a high sensitivity and specificity in the study group