Current Issue : January - March Volume : 2019 Issue Number : 1 Articles : 7 Articles
Aims: To prevent fetal damage by excess oxytocin administration of manually\ncontrolled infusion, by automatic and safe increasing infusion setting with\nmonitoring uterine contraction and fetal heart rate. Methods: Starting infusion\nlevel was 2 milliU/ml, as oxytocin sensitivity of a pregnant uterus is unknown,\nto avoid hyper contraction and fetal bradycardia caused by unexpected\nexcess oxytocin sensitivity. The infusion automatically increased with\nautomatic monitoring of uterine contraction curve, then the increasing\nstopped when contraction reached to normal labor level, where the infusion\nlevel maintained, which continued until delivery, if there is no trouble. However,\nthe infusion continued until expiring all fluid in case of insensitive uterus,\nwhere the induction was performed in another day. The infusion stopped\nautomatically when contraction was too strong, or fetal heart rate is abnormal.\nThus, oxytocin sensitive case is protected from excess contraction and\nfetal asphyxia. Results: Normal vaginal delivery was achieved in 28/33 cases\n(85%), which was more than manually controlled infusion. No case was abnormal\nin successful oxytocin infusion. Conclusion: The automated technique\nwill be applied to oxytocin labor induction....
Here we reported a rare case of misdiagnosed ectopic pregnancy (EP) due to\nunintended ovulation during controlled ovarian stimulation (COS) in GnRH\nagonist cycle, resulting in no oocytes harvested and late hyper-stimulation\nsyndrome (OHSS). The patient was a 33-year old primary infertile woman\ndue to maleâ??s factors and underwent her second in vitro fertilization (IVF)\ncycle using GnRH agonist protocol, and no oocytes harvested on ovum\npicked-up (OPU) day. The start of gonadotropin usage was on day 8th of her\nperiod, and the P level increased rapidly and strangely high from day 8th after\ngonadotropin usage. The E2 level and follicles grew normally but finally no\noocytes harvested. She was diagnosed as late ovarian hyper-stimulation syndrome\n(OHSS) 7 days after OPU. 20 days after OPU, no menstruation come\nand a positive urine test of hCG were reported. And the patient was diagnosed\nas EP by laparoscopy. In conclusion, rapidly increased P level, no oocyte\nretrieval and late onset of OHSS should be very important clues to diagnose\nthis misdiagnosed EP....
Aim: To evaluate the effect of epidural analgesia during labour on neonatal-\nmaternal outcomes. Methods: A retrospective cohort study of nulliparous\nparturients who gave birth in Västernorrland County, Sweden, over a 2-year\nperiod between 2015 and 2016. Neonatal outcomes (Apgar score at 5 min and\numbilical cord arterial blood gases), maternal outcomes (perineal injury, total\nbleeding volume and maternal satisfaction with birth) and labour parameters\n(mode of delivery and the durations of labour and postpartum hospital stay)\nwere evaluated. Results: The study cohort consisted of 1449 women with singleton\npregnancies. Patients were divided into two groups according to\nwhether during labour they were administered epidural analgesia using bupivacaine\nand sufentanil (EDA group, n = 615) or not (non-EDA group, n =\n834). The rate of assisted vaginal delivery was significantly higher in the EDA\ngroup than in the non-EDA group (15.6% and 11.3%, respectively, p < 0.05),\nwhereas the rates of caesarean section were similar. The duration of the active\nphase of labour was significantly longer in the EDA group than in the\nnon-EDA group (489 ± 217 min versus 371 ± 210 min, respectively, p <\n0.001). The Apgar score at 5 min and umbilical cord blood pH were lower\nand the base deficit greater in the EDA group (p < 0.001, p < 0.001 and p <\n0.01, respectively). Bleeding volume was similar between the groups after adjusting\nfor gestational age. Women in the EDA group were more satisfied\nwith their labour experience, as measured by the visual analogue scale (p <\n0.05). Conclusion: The results of this study suggest that EDA affects delivery\nand neonatal-maternal outcomes negatively, but increases the motherâ??s satisfaction\nwith labour....
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A retrospective descriptive study is conducted at the San Juan de Dios Hospital,\nSan José, Costa Rica, during the period from February 2016 to March\n2017, with a total of 37 patients from which a combined screening during the\nfirst trimester of pregnancy was conducted, evaluating maternal age, biochemical\nand sonographic methods that together can predict the risk of fetal\nchromosomal alterations during pregnancy. The purpose of using combined\nscreening as a noninvasive method is to identify high risk gestations and to\nminimize the number of invasive procedures to detect the highest number of\ncases. Four patients with higher risk of aneuploidy during pregnancy were\nidentified through this screening....
Background: In recent years, there has been growing interest in the effect of\nmaternal exposure to physiological, environmental, and also psychological\nfactors during gestation on child development. Several independent studies\nlink maternal stress during pregnancy to emotional and behavioral problems\nin the child. Objectives: This study aimed to observe the effect of maternal\ncognitive activity on fetal brain blood flow to determine whether systematic\nmaternal mathematical activity during pregnancy might influence child brain\ndevelopment. Method: Thirty-five women in the 28th to 40th week of pregnancy\nengaged in mathematical activities. Fetal middle cerebral artery\n(MCA), pulsatility index (PI) and peak systolic velocity (PSV) were monitored\nbefore, during, and after the activity. Results: Brain activity and blood\nflow were shown to be intimately linked. We observed a significant decrease\nin fetal brain MCA resistance, as evidenced by decreased MCA PI, towards\nthe end of the mathematical activity. This may result in increased blood flow\nin the arteries supplying most brain regions and, possibly, increased brain activity.\nConclusions: A correlation between the motherâ??s engagement in mathematical\nactivities and fetal brain blood flow may lead to enhancement of\nthe fetusâ??s brain function and a cognitive advantage for the child....
Objective: To describe the epidemiological, clinical and therapeutic aspects\nof cases of vaginal bleeding in the nonpregnant patient received in emergency\nat Yalgado OUEDRAOGO University Hospital. Materials and Methods: It\nwas a retrospective and descriptive study that involved the clinical records of\n326 patients collected from January 01, 2009 to December 31, 2013. Results:\nThe average age of women was 47 years old with extremes at 12 and 82 years\nold. Women of childbearing age accounted for 61.6% and postmenopausal\nwomen 18.7%. 70.7% of women were pauciparous or nulliparous. Menorrhagia\nand pelvic pain were the main signs associated. This symptomatology required\nhospitalization in 85.2% of cases. The main aetiologies were uterine\nmyomas 49.69%, cervical cancer 23% and functional metrorrhagia 11.04%.\nProgestin was the most used drug in 67.1% of cases. Total abdominal hysterectomy\nand abdominal myomectomy were the most commonly used surgical\nmethods with 22.3%, 44.4% of cases. Eleven death cases were observed. Conclusion:\nGynecological metrorrhagia is more common in women of childbearing\nage than in menopausal women. The main causes are fibroma, cervical\ncancer and functional metrorrhagia....
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