OBJECTIVE(S) : To assess, evaluate and compare the safety and efficacy of intramuscular PGF2 α 125 g and intravenous methergin 0.2 mg in the active management of third stage of labor.
METHODS(S) : Two hundred selected cases were divided in two groups of 100 each. In Group I PGF2α 125 g was given intramuscularly and in Group II 0.2 mg methergin was given intravenously at the time of delivery of the anterior shoulder of the fetus. The duration of the third stage, amount of blood loss, side effects, and complications if any were noted and analyzed.
RESULTS: The mean duration of the third stage of labor from the injection of the oxytocic to the expulsion of the placenta was significantly shorter in Group I (3.84 ±1.10 minutes) as compared to that in Group II (5.16±1.58 minutes) (P<0.0001). The mean blood loss was also significantly less in the study group (74.84±27.16 mL vs 93.6±32.69 mL ; P<0.0001). The only side effects were nausea and vomiting in two women in Group I.
CONCLUSION(S): Intramuscular PGF2 α 125 g is a better alternative to intravenous methergin 0.2 mg in the active management of third stage of labor.
active management of third stage of labor, PGF2 α, metherginOBJECTIVE(S) : To evaluate the lipid peroxidation and nonenzymatic antioxidant status in normal pregnancy.
METHOD(S) : The study comprised 25 healthy nonpregnant women as controls and 75 age matched women with normal pregnancy (25 in each trimester) as subjects. Estimation of lipid peroxidation was done by thiobarbituric reactive substance (TBARS) and nonenzymatic antioxidants were estimated by standard methods.
RESULTS : Statistically significant increase in levels of lipid peroxidation and marked decrease in levels of nonenzymatic antioxidants were observed in pregnant women as compared to levels in nonpregnant controls.
CONCLUSION(S) : Pregnant women are susceptible to oxidative damage.
lipid peroxidation, malondialdehyde, thiobarbituric acid, superoxidesOBJECTIVE(S) : To evaluate the effect of immediate postpartum curettage in eclmaptic women on resolution of clinical and laboratory indices, duration of stay in obstetric intensive care unit, and morbidity associated with eclampsia.
METHOD(S) : In this prospective study of 112 eclamptic women with singleton pregnancy, alternate women were allotted to study group and alternate to control group. Fifty-six formed the study group and underwent immediate postpartum curettage. They were compared with a similar number of control group who were not submitted to immediate postpartum curettage.
RESULTS : Significant improvement was noted in mean arterial blood pressure, urine output, renal function tests and platelet count in the study group compared to those in the control group. Average duration of 51.62 ± 5.14 hours hospital stay in the study group was significantly lower than 84.16 ± 3.28 hours is the control group ( P=0.002). Seven percent of women in the study group developed serious complications in the postpartum period in comparison to 28.6% in the control group.
CONCLUSION(S) : Immediate postpartum curettage is a safe and effective procedure which can accelerate recovery from eclampsia, averting the incidence and severity of complications.
eclampsia, curettage, postpartumOBJECTIVE(S) : To assess the efficacy and safety of intramuscular tramadol hydrochloride as an analgesic during labor compared to those of pentazocine.
METHOD(S): The study was conducted on 200 primigravidas and second gravidas in labor at term. They were alternately divided into two groups. The study group (n=100), received 100 mg of tramadol and the control group (n=100) received 30 mg of pentazocine intramuscularly at the onset of active labor. Maternal cardiovascular parameters, side effects, degree of analgesia and progress of labor were noted.
RESULTS : Pain relief was satisfactory in 37% vs 14% (P<0.002), moderate 38% vs 34% (P=0.63) and mild 16% vs 42% (P <0.006) in the tramadol and pentazocine groups respectively. Injection delivery interval was significantly shorter in the tramodol group, being only 3 hours 17 minutes ± 2 hours 5 minutes vs 4 hours 21 minutes ± 2 hours 6 minutes in the pentazocine group (P=0.002). Side effects were significantly less in the study group (18% vs 40%; (P=<0.001).
CONCLUSION(S) : Tramadol is an effective and safe labor analgesic, producing moderate to satisfactory analgesia. Besides it also significantly shortens the duration of labor (P<0.05).
tramadol, labor analgesiaOBJECTIVE(S) : To assess the alteration in visual reaction time, a reliable index of central nervous system processing, in pregnancy.
METHOD(S) : Sixteen nonpregnant women as controls and 37 age matched newly diagnosed healthy women in their first trimester of pregnant were included in the study. They were tested for simple visual reaction time (VRT) task in each trimester of pregnancy. Results were expressed as Mean ± SEM and statistically analyzed using students paired t test and single factor ANOVA.
RESULT(S) : The pregnant women in their first trimester had significantly longer simple VRT as compared to age matched controls. In the second and third trimesters VRT decreased as compared to the first trimester.
CONCLUSION(S) : A physiological stress like pregnancy tends to alter the VRT and thus inflicts an alteration in the central nervous system processing.
pregnancy, visual reaction timeOBJECTIVE(S) : To compare the safety, efficacy, cost and fetal outcome of misoprostol with that of combination of dinoprostone and oxytocin for induction of labor.
METHOD(S): All eligible women admitted for induction of labor during the period from December 2003 to May 2004 were included in the study (n=72). They were randomized to receive either misoprostol 25 µg intravaginally every 4 hours for a maximum of 8 doses (study group n=37) or dinoprostone 0.5 mg intracervically 6 hourly for a maximum of 3 doses followed by oxytocin if necessary (control group n=35).
RESULTS: Induction delivery interval was significantly shorter in the study group (10.20 ± 13.50 hours vs 14.27 ± 5.51 hours ;P<0.001). Cesarean section rate in the study group was lower than that in the control group but not significantly so (21.62% vs 37.14%; P>0.05) Failure to progress was the main indication for cesarean section in the control group. Fetal distress was more common in the study group than in the control group but not significantly so. Neonatal outcome was comparable in the two groups. The cost of therapy was significantly less in the study group. (Rs 9/- vs Rs 406.57/- per woman; P<0.001).
CONCLUSION(S): Misoprostol alone was more effective and highly inexpensive alternative to the combination of dinoprostone and oxytocin for labor induction.
labor induction, misoprostol, dinoprostone and oxytocinEpidurial analgesia has been accepted as the safest and most effective method of pain relief in labour. However, the potential effect of epidural analgesia on the progress and outcome of labour have been a subject of lasting controversy. Retrospective studies indicte that epidurals are associated with longer labours and/or increased incidences of operative deliveries. Similar results were obtained in nonrandomized prospective studies. But none of them could establish a casual relationship. Besides this, there has been no consensus regarding other undesired effect on the mother and the fetus. Critics of epidural analgesia state that epidural drugs can cross the placeenta and effect the baby. Hence adverse effects on the neonate are also a matter of concern.
OBJECTIVE(S) : To study the genital tuberculosis by identifying mycobacterial DNA with polymerase chain reaction (PCR) and with different laboratory methods available for its diagnosis.
METHOD(S) : Biopsy or curettage samples from 65 women clinically suspected to have genital tuberculosis were investigated with smear microscopy, histopathology, culture, and PCR for the mycobacterium.
RESULTS : Of the 65 clinically suspected patients investigated, only eight were acid fast bacilli (AFB) smear positive, 12 were culture positive, 17 were histology positive, and 28 were positive by PCR.
CONCLUSION(S) : A combination of PCR with the other available technics is the best method of achieving sufficient sensitivity and specificity for the diagnosis of female genital tuberculosis.
infertility, acid fast bacilli, female genital tuberculosis, polymerase chain reactionOBJECTIVE - To make some observations about malaria in pregnancy especially in relation to the parasite type, drug sensitivity and complications.
METHODS - The members of Medical Disorders in Pregnancy Committee of our Federation made these observation in different parts of India with an agreed proforma to have essential information by studying the records of a total of 215 pregnant women with malaria.
RESULTS - Plasmodium falciparum infection was observed in 61%. Sixtyfour percent of the women in the study were primigravidas and Seventynine percent responded to chloroquine. Pregnancy complications were high in terms of miscarriage (32.05), preterm labor (47.44%), IUGR (12.82%) and IUFD (7.7%). Maternal complications were high and 8.4% mothers died due to complications of malaria.
CONCLUSION - Malaria infection in pregnancy varies significanty according to
the region of the country. Maternal complications are high specially with P. falciparum infection.
