Exercise stress test through brisk walking: A complimentary way to assess fetal well-being in term pregnancy / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: To determine the effect of exercise stress test (EST) through brisk walking on the cardiotocogram tracings (CTGs) and the association of the tracings to neonatal outcomes. METHODOLOGY: This one-group pretest-post test experimental study involved 65 term pregnant women (mean age = 25.94 + 4.66 years) who underwent brisk walking exercise using a motorized treadmill for 30 minutes, following American College of Obstetricians and Gynecologists (ACOG) guidelines for exercise among pregnant women. Pre- and post- walk CTGs were assessed, with presence of post-walk decelerations taken to mean a positive EST. Sensitivity (positive EST in sick / meconium-stained / cord coil babies), specificity (negative EST in well babies), positive predictive value (PPV) (probability of sick / meconium-stained / cord coil babies given positive EST) and negative predictive value (NPV) (probability of well babies given negative EST) were computed. RESULTS: A significant difference in the proportion of subjects with pre- and post- walk decelerations was noted (p-value = 0.000) wherein 18 subjects (28.13%) without decelerations in the baseline CTG had decelerations in the post-walk CTG. These decelerations were significantly associated to having sick, meconium-stained, or cord coil babies (p-values CONCLUSION: Exercise stress testing is a complementary way of assessing fetal well-being due to manifestation of decelerations in the post-walk CTG which could have gone undetected if only the resting CTG was done. The EST had high sensitivity for detecting sick / meconium-stained / cord coil babies and has the advantage of reinforcing a reassuring fetal condition due to its high NPV for detecting well babies.

Comparison of the efficacy of guava leaves extract as hot steam and wash versus intake of oral antibiotic for postpartum wound healing after a normal spontaneous vaginal delivery with episiotomy / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: This single blind, randomized, controlled trial investigated the efficacy of the use of guava leaves as hot steam and wash for postpartum wound healing in women who underwent normal spontaneous delivery with episiotomy.METHODS: A total of 127 women aged 18 to 45, from 37 to 41 weeks AOG, served as subjects in this study. They were allocated to three treatments arms (guava group, antibiotic group and guava + antibiotic group) through block randomization. The guava group used a solution from boiled guava leaves as hot steam and wash tid for 7 days while the antibiotic group took amoxicillin 500 mg tid also for 7 days. The 3rd arm used both treatments. Outcomes included pain score (measured using Visual Analog Scale) and wound healing (measured using REEDA Scale) at 24 hours, 3 days and 7 days postpartum.RESULTS: Showed that mean pain scores and mean REEDA scores of the women in the three groups at 24 hours, 3 days and 7 days postpartum were not significantly different. Likewise, the risk of wound dehiscence was not significantly different for the three treatment arms. Therefore, this study revealed that guava leaves extract used as hot steam and wash is as effective as the standard oral antibiotic intake for postpartum wound care but no additional benefit is derived from combining guava leaves and oral antibiotic.CONCLUSION: Guava leaves used as hot steam and wash may be recommended for postpartum wound care after normal spontaneous  vaginal delivery with episiotomy.