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 < 0.05). EST had 80% sensitivity, 75% specificity, 21.1% PPV and 97.8% NPV for detecting sick babies; 75% sensitivity, 77.2% specificity, 31.6% PPV and 95.7% NPV for detecting meconium-stained babies; and 75% sensitivity, 85.7% specificity, 63.2% PPV and 91.3% NPV for detecting nuchal cord.

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.

Human ; Female ; Adult ; Cardiotocography ; EXERCISE TEST ; Heart Rate, Fetal

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.

Human ; Female ; Adult ; Episiotomy ; Psidium ; Steam ; Amoxicillin ; Anti-bacterial Agents ; Pain Measurement ; Delivery, Obstetric ; Wound Healing ; Postpartum Period

Background: Gestational Diabetes Mellitus (GDM) is a common condition that complicates a substantial number of pregnancies. Currently, the first line management for patients with GDM is dietary modification and exercise. Recent evidence suggest that there may be a complimentary hypoglycemic effect of substances such as vinegar. Objectives: This study is a randomized, crossover trial, aiming to determine the effect of 2-week bedtime ingestion of apple cider vinegar (ACV) on the blood glucose concentration of gravidas diagnosed with GDM in a tertiary hospital. Specifically, it aims to describe the patients’ general profile, to determine the effect of ACV on the 75 grams OGTT levels of the subjects, to correlate the change in blood glucose levels with ingestion of the same amount of ACV with the patient’s BMI, and to determine the acceptability of ACV ingestion in pregnant patients. Methods: There were 32 patients included in the study. Upon diagnosis of GDM, subjects were randomized into two groups. Group A had a sequence of Medical Nutrition Therapy (MNT) for 2 weeks followed by MNT plus ingestion of 2 tablespoons of ACV diluted in a cup of water for another 2 weeks. Group B had the reverse sequence. A 75g OGTT was taken on Day 0, Day 14, and Day 28 of treatment, in which the values were compared. The data were analyzed using SPSS 16.0. Results Results showed that there is a marginally significant increase in the fasting blood sugar (FBS) and 2nd hour blood sugar at the moment when ACV was withdrawn. A greater reduction in the blood sugar level was noted in patients with higher BMI during the period when patients were given the ACV. The Likert scale response was also done showing that ACV is acceptable, affordable and well-tolerated among pregnant patients.
Diabetes, Gestational ; Pregnancy ; Hypoglycemic Agents