scholarly journals An early contact with the baby: Benefit for the mother

2008 ◽  
Vol 61 (11-12) ◽  
pp. 576-579 ◽  
Author(s):  
Gordana Djordjevic ◽  
Bozidar Jovanovic ◽  
Momcilo Djordjevic

Introduction Numerous studies on the early contact between mother and the baby and the time they spend together-common stay stress the fact that these are invaluable for the mothers, infants, family and society in general. The objective of the research. The objective of the research was to establish whether mother benefits from the early contact with her baby and the importance of the time period they spend and share together. Materials and methods The study group consisted of 216 mothers that spend the time with their babies and had the early contact with the babies as well, and the control group consisted of 216 mothers that were detached from their babies. Puerpera were observed in the aspects of the uterus involution, post delivery hemogramme on the third day after the childbirth, sanitary napkin consumption and the hospitalization length. Results For the study group the following was significant: less of the bad uterus involution, less of the post delivery anemia measured in the hemoglobin values and in the number of erythrocytes, less of the sanitary napkin consumption and the shorter hospitalization length. Discussion The early contact and the time spent with their babies after the childbirth influence the less blood loss analyzed by post delivery hemogramme, better uterus involution, less of the sanitary napkin consumption analyzed in the first three days after the childbirth and the shorter hospitalization length. The positive component of the breastfeeding oxytocic reflex is probably responsible for these effects. Conclusion Puerpera benefit from the early contact and the time spent with their babies.

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.


2018 ◽  
Vol 08 (02) ◽  
pp. e142-e145
Author(s):  
Theresa Kuhn ◽  
Kristina Martimucci ◽  
Abdulla Al-Khan ◽  
Robyn Bilinski ◽  
Stacy Zamudio ◽  
...  

Objective To evaluate if prophylactic hypogastric artery ligation (HAL) decreases surgical blood loss and blood products transfused. Study Design This is a retrospective cohort study comparing patients with placenta percreta undergoing prophylactic HAL at the time of cesarean hysterectomy versus those who did not. Data were presented as means ± standard deviations, proportions, or medians with interquartile ranges. Demographic and clinical data were compared in the groups using Student's t-test for normally distributed data or the Mann–Whitney U test for nonnormally distributed data. Fisher's exact test was used for proportions and categorical variables. Data are reported as significant where p was <0.05. Results There were 26 patients included in the control group with no HAL and 11 patients included in the study group. Estimated blood loss for the study group was 1,000 mL versus 800 mL in the control. Units of PRCBs transfused were 4.5 units in the study group versus 2 units for the control group. None of these measures were found to be statistically significant. Conclusion Our data suggest there was no benefit in the use of prophylactic HAL in decreasing surgical blood loss or amount of blood products transfused in patients who had a cesarean hysterectomy performed for placenta percreta. Précis Prophylactic HAL does not decrease blood loss during surgery for placenta percreta.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chenchen Liu ◽  
Puying Wei ◽  
Jun Li

Abstract Objectives To observe and compare the difference in retinal thickness using optical coherence tomography (OCT) between patients with high myopia (HM) during the third trimester of pregnancy and age-matched HM non-pregnant women. Methods A case-control study. A total of 39 eyes from 39 HM women in the third trimester (study group) and 50 eyes of 50 age-matched non-pregnant women with HM (control group) were included. All subjects underwent SD-OCT examination. The built-in software was used to measure the retinal thickness in macular region. The data from two groups were compared using independent-samples t test. Results Among the 89 subjects in this study, the mean gestational age of the study group was 35.09 ± 2.44 weeks, and the average age was 32.24 ± 3.75 years. The average age of the control group was 34.04 ± 7.19 years old. Compared with the control group, the average thickness of parafoveal area, and the average thickness of parafoveal superior, inferior, temporal quadrants of the superficial retina and the average thickness of the foveal and parafoveal of the superficial retina were significantly decreased in the study group (P < 0.05). Compared with the control group, the average thickness of all quadrants of the retina in the parafoveal area except the nasal quadrant were significantly decreased in the study group (P < 0.05). Conclusions In this observational study, the retinal thickness of patients with high myopia during the third trimester of pregnancy was thinner than that of non-pregnant women with age-matched high myopia.


Author(s):  
Pratiksha Gupta ◽  
Suman Kumari

Background: The aim of this study is to evaluate the effects of omitting the step of bladder flap formation at lower-segment caesarean delivery.Methods: It is a RCT (randomised control trial), non-blinded study conducted in a tertiary care hospital. A total of 104 women who underwent caesarean delivery (elective or emergency) were prospectively randomized to one of the two groups. In the study group (n= 54), caesarean was performed without formation of a bladder flap. In the control group (n=50), caesarean was performed with the formation of a bladder flap before the uterine incision.Results: There were differences of median skin incision to delivery interval (5 versus 6.5 minutes, P <0.0001), median total operating time (35 versus 44.5 minutes, P 0.0002), and median blood loss (haemoglobin 0.5 versus 1g/dl, P 0.0001) in favor of the study group. Postoperative incidence of urinary tract infection was reduced in the study group (1% versus 9%, P <0.0006) and bowel function returned early in the study group (day 2 versus 3, P<0.0001).  Bladder flap formation step was successfully omitted in (11/18, 61.11%) of previous CS (caesarean section) patients in the study group and (7/12, 58.33%) in control group illustrating that unless required, BF (bladder flap) formation step can even be omitted in previous CS patients.Conclusions: Omission of the bladder flap provides short term advantages such as reduction of total operating time, incision-delivery interval, and reduced blood loss and that this technique can even be applied in previous caesarean section patients.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p &lt; 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p &lt; 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p &lt; 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hematocrite was significantly less in study group than control group (p &lt; 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.


2017 ◽  
Vol 11 (6) ◽  
pp. 898-902 ◽  
Author(s):  
Dong Ki Ahn ◽  
Won Shik Shin ◽  
Go We Kim ◽  
Ki Hyuk Koo

<sec><title>Study Design</title><p>Retrospective case-control study.</p></sec><sec><title>Purpose</title><p>To examine the hypothesis that the misuse of thrombin-containing local hemostatics (TCLH) increases the risk of postoperative spinal epidural hematoma (POSEH).</p></sec><sec><title>Overview of Literature</title><p>Many studies have focused on hypocoagulability as a risk factor for POSEH. However, there are no prior reports on the increased risk of POSEH in hypercoagulable states.</p></sec><sec><title>Methods</title><p>Posterior instrumented lumbar spine surgery cases over 2 consecutive years were divided into two groups: a study group (98 patients in whom TCLH was used) and a control group (176 patients in whom TCLH was not used). The excess TCLH matrix that was not associated with blood clot was not removed from the patients in the study group. The senior author decided whether to use TCLH or not. Suction drains were used in all patients. The demographics, coagulation-related factors, and intraoperative factors of the patients in the two groups were analyzed. The development of POSEH was compared between the two groups.</p></sec><sec><title>Results</title><p>The two groups were homogenous in demographics (age and sex), coagulation-related factors (platelet count, prothrombin time, activated partial thromboplastin time, and platelet function analysis), and surgical factors (total blood loss, operation time, blood loss/10 minutes, number of fusion segments, posterolateral fusion/posterior lumbar interbody fusion, and virgin or revision surgery). POSEH developed more frequently in the patients in the study group than in those in the control group (14/98 patients, 14.3% vs. 3/176 patients, 1.7%, respectively; <italic>p</italic>=0.001; odds ratio, 17.1).</p></sec><sec><title>Conclusions</title><p>TCLH causes blood clot not only at the edge of damaged vessels but also at the site of extravascular blood. Excess TCLH matrix not associated with blood clot at the epidural space can enhance POSEH development because early clotted hematomas do not drain through suction drains.</p></sec>


Author(s):  
Nagajyothi Gunturu ◽  
D. Shivani ◽  
P. Sravanthi

Background: The aim was to study the efficacy of tranexamic acid in reducing blood loss after childbirth in normal vaginal delivery and LSCS.Methods: 200 pregnant women divided into two groups group 1 and group 2, 100 women undergoing LSCS and 100 women undergoing vaginal delivery. Study group will be given 1 g iv tranexamic acid along with active management of third stage of labor and control subjects will be given only active management of third stage. Clinical observations and laboratory examinations, measurement of blood loss were measured.Results: Distribution with respect to indication of LSCS like fetal distress, cephalopelvic disproportion, abnormal presentation, previous LSCS, arrest of descent, failed induction and onset of labor were comparable between both the groups. Study group showed marked decrease in blood loss when compared to controls from time of placental delivery to 2 hours postpartum in women undergoing vaginal delivery and caesarean section. There was a significant fall in mean Hb level among the control group when compared with the study group. There was no significant difference in the vital signs of the subjects in both the groups. The incidence of adverse effect like nausea, vomiting and diarrhoea were not increased in the study group when compared to the control group. Also the incidence of thrombosis was not increased with tranexamic acid.Conclusions: Tranexamic acid significantly reduced the amount of blood loss after vaginal delivery and lower segment caesarean section. Its use was not associated with any adverse drug reactions like nausea, vomiting, diarrhoea or thrombosis. Tranexamic acid can be safely administered in pregnant women undergoing vaginal delivery and lower segment caesarean section. 


2021 ◽  
Author(s):  
Xuemin Wei ◽  
Yan Chen ◽  
Weiwei Cheng

Abstract Purpose To evaluate the efficacy and safety of prophylactic balloon occlusion of the infrarenal abdominal aorta among women with pernicious placenta previa and placenta accreta.Methods This retrospective study included 110 patients with pernicious placenta previa and placenta accreta. The control group consisted of 55 patients who underwent cesarean section alone, and the study group included 55 patients who underwent precesarean prophylactic balloon occlusion of the infrarenal abdominal aorta. In addition, both of the groups were further divided according to FIGO clinical grading standards. Prevention of hysterectomy was the primary outcome evaluated. The secondary outcomes included operative duration, estimated blood loss, blood transfusion, intensive care unit admission, total hospital stay (days), and puerperal morbidity, and these data were compared between the two groups. Additionally, the neonatal outcomes were compared.Results There were no significant differences in maternal and neonatal outcomes in the PAS 2 and PAS 3 groups (P > 0.05). However, in the PAS 4 and PAS 5 groups, the amount of bleeding in the study group was significantly less than that in the control group (3533.3 ± 2391.4 vs 4293.6 ± 1235.4, P < 0.05), and the total hysterectomy rate was also lower (7.8% vs 13.2%, P < 0.05).Conclusion Precesarean infrarenal abdominal aortic balloon occlusion is an effective and safe option for treating pernicious placenta previa and placenta accreta and can effectively reduce the risk of hysterectomy and intraoperative blood loss in women with PAS grade 4-5.


Author(s):  
Jaya Kashinathrao Bhongle ◽  
Rashmi Agarwal

Background: PPH is most common cause of maternal mortality accounting for 25-30% incidence and third stage of labour plays most crucial role in preventing postpartum haemorrhage.Methods: A prospective randomized control study in which 100 low risk pregnant women, admitted to labour ward with term gestation were evaluated. They were divided into 2 groups- control group (controlled cord traction) and study group (placental cord blood drainage), 50 pregnant women in each group. Duration of third stage and Amount of blood loss in third stage were evaluated and compared between the 2 groups.Results: Mean duration of third stage of labour in study group was 3.96±1.36 minutes and in control group was 6.00±2.12 minutes. The mean amount of blood loss in third stage of labour in study group was 99.80±56.47 ml in control group was 171.760±96.94 ml. Drop in haemoglobin level after delivery in control group was almost double than study group.Conclusions: Placental cord blood drainage in the management of third stage is non-invasive, easy, safe method which can be used in active management of third stage of labour as it has minimal interference in natural mechanism of placental separation. Placental cord blood drainage should be encouraged for management of third stage of labour universally to all pregnant women specifically in low resource setting areas.


2020 ◽  
Vol 18 (1) ◽  
pp. 22-25
Author(s):  
Kavita Sinha ◽  
Subhash Pandey ◽  
Dipendra Khadka

Introduction: The incidence of caesarean section is increasing day by day. One of the most common complications is primary or secondary postpartum haemorrhage. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion in varieties of surgery. Aims: To study the efficacy of tranexamic acid in reducing blood loss during and after the lower segment caesarean section. Methods: Arandomized, case controlled, prospective study was conducted on 100 women undergoing lower segment caesarean section carried out in the Department of Obstetrics and Gynaecology, Nepalgunj Medical College, Kohalpur from Sept 2019 to Feb 2020.Fifty of them were given tranexamic acid immediately before lower segment caesarean section and were compared with 50 others to whom tranexamic acid was not given. Blood loss was collected and measured during two different time interval. The first period was considered from placental delivery to end of lower segment caesarean section and second from the end of lower segment caesarean section to 2 hours postpartum period. Vital signs at time of delivery, at 1 hour and 2 hour postpartum and APGAR score at 1 min and 5 min were studied in both the groups. Results: Tranexamic acid significantly reduced the quantity of blood loss from the placental delivery to 2 hours post-partum: 360.9 ml in the study group, versus 443 ml in the control group (p=0.0008).It also significantly reduced the quantity of blood loss from the end of  lower segment caesarean section to 2 hours postpartum:71.5 ml in the study group versus 112.6 ml in the control group (p=0.0002).There was 18% less incidence of postpartum haemorrhage , who received tranexamic acid(p=0.02).There were no significant adverse drug reaction and difference in APGAR score in both the groups. No complications or side effects were reported in either group. Conclusion: Tranexamic acid is safe and effective in reducing blood loss among women undergoing lower segment caesarean section.


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