The Effective of Keishibukuryogan on Uterine Subinvolution after Childbirth: NRCT / 日本東洋医学雑誌

The uterus starts shrinking after giving birth and returns to its size prior to pregnancy one month postpartum. However, absence of this natural shrinking is called uterine subinvolution. There are two types of subinvolution : organic and functional. Removal of the cause is the first option for organic subinvolution. Conversely, most cases of functional subinvolution require drug treatment. This study included patients with subinvolution caused by accumulation of lochia with a uterine cavity width of 15 mm or more during a 14-day postpartum checkup. These patients were categorized into the control, keishibukuryogan, and ergometrine maleate groups ; therapeutic intervention was performed. A comparative study was conducted to determine the presence of subinvolution during the 1-month medical screening. There was no difference in the rate of uterine cavity shrinkage between the ergometrine maleate group and the control group. However, the keishibukuryogan group had a significantly higher reduction rate than the ergometrine maleate group. Furthermore, the keishibukuryogan group showed a tendency of higher shrinking rate when compared with the control group (76.1 ± 17.1% vs 65.8 ± 25.4%, 68.3 ± 22.9%, p = 0.0101, p = 0.0709). Additionally, no difference in the reduction rate of the fundal height was noted among the groups. These results suggest that although keishibukuryogan has little effect on reducing the uterine size, however, it has the effect of lochia accumulated within the uterine cavity.

Effect of Mirtazapine Pre-treatment on Haloperidol, Ergometrine and Fluoxetine Induced Behaviours in Albino Rats.

Background: Central 5-HT and 5-HT serotonergic 2A 2Creceptors are mainly involved in the control ofnigrostriatal and mesolimbic dopaminergic neuronalactivity has been well proved and established. 5-HThas facilitatory effect on stimulated dopamine releaseby stimulating central 5-HT receptors and inhibitory 2Aeffect by stimulating 5-HT receptors. Aim and 2CObjectives: To evaluate 5-HT and 5-HT receptor 2A 2Cblocking activity of Mirtazapine (MIR) and the effectof mirtazapine pre-treatment on Ergometrine (ERG)induced behaviours, Fluoxetine (FLU) induced penileerections and Haloperidol (HAL) induced catalepsy inrats. Material and Methods: Each group wassubdivided into different subgroups consisting 6animals in each. Control group received DimethylSulfoxide (DMSO) and other groups received differentdoses of mirtazapine one hour before ERG/FLU/HAL.Values obtained from control group were comparedwith all remaining groups pre-treatment with differentdoses of MIR. Results: MIR (MIR) at 2.5, 5, 10 and 20mg/kg intraperitoneally (i.p) did not produce any per seeffects. Pre-treatment with 5, 10 and 20 mg/kg i.p. MIRsignificantly antagonised ERG induced behaviours. 5mg/kg i.p. MIR significantly antagonised whereas 10and 20 mg/kg i.p. MIR abolished FLU (10 mg/kg)induced penile erections in rats. MIR 5 and 20 mg/kgi.p. significantly antagonised HAL (1mg/kg) inducedcatalepsy at 1 hr testing time interval while 10 and 20mg/kg MIR significantly antagonised HAL (1 mg/kg)induced catalepsy at 2 hr testing time interval.Conclusion: Our results indicate that MIR at 5, 10 and20 mg/kg possesses 5-HT and 5-HT receptors 2A 2Cblocking activity. At 5, 10 and 20 mg/kg MIR, byblocking central 5-HT receptors predominantly, 2Ccauses release of dopamine from nigrostriataldopaminergic neurons and therefore antagonizes HALinduced catalepsy

Role of Oral Misoprostol 600 mcg versus Inj. Syntometrinein the Active Management of Third Stage of Labour

Postpartum haemorrhage is the leading cause of direct maternal death in developing countries. The incidence of PPH may vary from less than 5% to more than 10%. About 30% of maternal deaths in India occur due to massive haemorrhage. Normal blood loss in a vaginal delivery may exceed 500 ml and can range from 500 to 1000 ml. A decline in hematocrit is a more reliable estimation of blood loss. Active management had definitely reduced third stage blood loss. World Health Organisation (WHO) recommends Intra muscular oxytocin in the third stage of labour. Misoprostol PGE1 is a potent uterotonic agent. Ergometrine is also an effective oxytocic. This study has been conducted to compare the efficacy and safety of oral misoprostol 600 mcg with parenteral syntometrine in the active management of third stage of labour in 100 pregnant women of low risk pregnancies by objective assessment of the difference in pre-and post-delivery haemoglobin values. This study concludes that misoprostol has the potential of an effective, stable oral oxytocic with rapid onset of action. Though this study was limited to low risk patients, misoprostol has scope for use even in high risk patients of bronchial asthma, gestational hypertension, pre-eclampsia and Rhesus (Rh) negative groups where syntometrine is contraindicated. Thus, misoprostol may be used as an alternative to IM syntometrine in the active treatment of third stage of labour.