1.Acupuncture as an alternative technique in establishing uterine contractions in contraction stress test: A randomized controlled trial
Polla Lorenze K. Holgado ; Leah Socorro N. Rivera ; Paula Christi P. Tolentino-Orlina ; Corazon R. Arcangel
Philippine Journal of Obstetrics and Gynecology 2020;44(2):9-15
Background:
Acupressure may stimulate oxytocin release from the pituitary gland, which in turn regulates uterine contractions to improve the progress of labor; hence, studies have shown that acupressure on the Spleen 6 (SP6) point may be a complementary strategy for augmenting labor and/or shortening the first stage of labor without causing adverse effects to the mother or the newborn.
Objective:
To compare contractions produced by acupuncture technique from the contractions produced by conventional method using oxytocin in terms of: intensity, duration and interval of the uterine contractions and to determine if acupuncture technique at Sanyinjiao (spleen 6) and Hegu (Large Intestine 4) can be used as alternative method in establishing uterine contractions in Contraction Stress Test (CST) as a means of fetal surveillance.
Methodology:
This is a Randomized Controlled Trial done in University of Santo Tomas Hospital. This included 54 term pregnant patients who met the inclusion criteria and were randomized into two groups: 27 patients in Acupuncture group and 27 patients in Oxytocin group (control group). All recruited patients were hooked to electronic fetal monitor to obtain baseline strips for 20 minutes. Acupuncture needles were applied bilaterally at Sanyinjiao (spleen 6) and Hegu (Large Intestine 4) for 20 minutes to the study subjects.
Results:
Subjects who received acupuncture had greater intensity (p=0.551) and significant longer duration (p=0.001) of uterine contractions than the oxytocin group. However, there was significant shorter interval of uterine contractions after oxytocin treatment (p=0.013) than acupuncture. Furthermore, subjects who were in the acupuncture group obtained initial uterine contractions and achieved desirable uterine contractions faster than oxytocin.
Conclusion
Application of acupuncture in Spleen 6 (Sanyinjiao SP6) and Large Intestine 4 (Hegu LI4) can initiate and induce uterine contractions faster. Acupuncture technique when compared to the conventional method using oxytocin, produces stronger and longer contractions. Furthermore, there is shorter mean time to achieve initial and adequate contractions thru acupuncture technique. Contractions also disappear in a much shorter time in acupuncture technique than in oxytocin group hence ideal for outpatient setting.
Pregnancy
;
Female
;
Uterine Contraction
;
Oxytocin
;
Acupuncture Therapy
2.Development of portable uterine contraction pressure monitoring system.
Xiao WEI ; Xiaohong ZHANG ; Zhidong ZHAO ; Shuqiang SUN ; Jiayou DU
Chinese Journal of Medical Instrumentation 2014;38(6):413-426
For the high cost and mobility issues, a home uterine contraction pressure monitoring system based on Windows CE platform was developed. In this paper, the design of hardware circuit, micro-controller system and LabVIEW program based on Windows CE are discussed. The clinical validation experiment in hospital for this system was made and the experimental results show that this system complies with the trend that current medical equipment is becoming portable, homely and networked. Through real-time monitoring uterine contraction pressure, occurrence of premature birth and abortion can be prevented effectively.
Female
;
Humans
;
Monitoring, Physiologic
;
instrumentation
;
Pregnancy
;
Uterine Contraction
3.Efficacy of Epidural Anesthesia on Uterine Contraction.
Yoon Geun LEE ; Woon Yi BAEK ; Jung Gil HONG ; Jin Woong PARK ; Byng Kwon KIM
Korean Journal of Anesthesiology 1990;23(3):464-469
The aim of this investigation was to determine whether epidural analgesia has any effect on the uterine activity. Uterine activity was checked by an intermal tocometer and calculated in uterine activity units (UAU) which were expressed as Montevideo units. Twenty two gravidas who had the term pregnancy in labor without any obstertical complications were selected and epidural analgesia was performed in 17 of these patients. Plain lidocaine was used in 10 of them, lidocaine mixed with epinephrine (200,000:1) was used in another 7 gravidas and 5 gravidas were chosen as a control group. The results were as follows: The uterine actvity of the continuous epidural anesthesia group did not differ from that of the control group. The uterine activity changes were not statistically significant between the plain Iidocaine group and the epinephrine mixed group.
Analgesia, Epidural
;
Anesthesia, Epidural*
;
Epinephrine
;
Humans
;
Lidocaine
;
Pregnancy
;
Uterine Contraction*
4.A Case of Delayed Delivery of Second Twin.
Su Ho LEE ; Ji Soo LEE ; Su Ran CHOI ; Yong Soo SEO ; Soon Ha YANG ; Jong Hwa KIM
Korean Journal of Obstetrics and Gynecology 2004;47(5):966-969
With the introduction of assisted reproductive technologies, the incidence of multifetal pregnancies has significantly increased. In vaginal delivery for multifetal pregnancy, the delivery of the second fetus usually follows the first in few minutes. However in rare circumstances, the delivery is delayed for days due to disappearance of uterine contraction after delivery of the first fetus. Successful prolongation of the interdelivery time may improve the neonatal outcomes of the remaining fetus (es), particularly in the cases of extremely premature gestation. We present a case of a delayed delivery of second twin with an interval of 48 days.
Fetus
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Humans
;
Incidence
;
Pregnancy
;
Reproductive Techniques, Assisted
;
Uterine Contraction
5.An analytic method of wavelet energy value to evaluate the contraction intensity of uterus.
Journal of Biomedical Engineering 2012;29(1):80-83
The data of uterine contraction pressure is the information source for extracting uterine contractions status. Because there is a variety of interference existing in contraction pressure data, commonly used methods such as uterine contraction intensity integration method can not obtain decent evaluation results. We used the bior 2.4 biorthogonal wavelet to decompose and reconstruct the pressure data in order to obtain the best denoising effect. Combining with the denoised results, we proposed an algorithm of the wavelet energy value. Based on the algorithm, we calculated the curve of wavelet energy value. It was proved that using the curve of wavelet energy value can better identify contractions waveform and evaluation contractions intensity.
Algorithms
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Artifacts
;
Female
;
Humans
;
Pregnancy
;
Signal Processing, Computer-Assisted
;
Uterine Contraction
;
physiology
;
Uterine Monitoring
;
Wavelet Analysis
6.Control of Postpartum Bleeding by Rectal Misoprostols: A Report of 3 Cases.
Sang Eun LEE ; Seong Ook HWANG ; Seung Kwon KHO ; Sook CHO ; Mun Hwan LIM ; Woo Young LEE
Korean Journal of Obstetrics and Gynecology 1999;42(8):1857-1859
Postpartum hemorrhage is an important cause of maternal mortality and morbidity. Especially uterine atony is the most common cause of postpartum hemorrhage. Conventional method to control postpartum uterine atonic bleeding is based on the use of oxytocin and ergot preparations. Prostaglandin F2alpha analogue such as carboprost can be used to promote contraction when these agents fail to produce uterine contraction. Prostaglandin E1 analogue, misoprostol has uterotonic effect by oral or vaginal administration. They are used to induce labor and first or mid trimester abortion. In postpartum uterine atonic bleeding, misoprostols cannot be used via oral or vaginal route. Recently we have experienced that postpartum uterine atonic bleedings unresponsive to conventional methods were controlled by rectal misoprostols. So we report these cases with a brief review of literatures.
Administration, Intravaginal
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Alprostadil
;
Carboprost
;
Dinoprost
;
Hemorrhage*
;
Maternal Mortality
;
Misoprostol*
;
Oxytocin
;
Postpartum Hemorrhage
;
Postpartum Period*
;
Uterine Contraction
;
Uterine Inertia
7.The effects of etomidate on the contraction of pregnant rat uterine smooth muscle.
Chong Dal CHUNG ; Tae Hun AN ; Ki Tae JUNG ; Tae Heon LEE
Korean Journal of Anesthesiology 2009;57(1):84-87
BACKGROUND: It has been reported that etomidate has the relaxant effects on vascular, tracheal, and non-pregnant uterine smooth muscle in vitro. The purpose of this study was to investigate the relaxant effects of etomidate on the contraction of the pregnant rat uterine smooth muscle. METHODS: Uterine muscle tissues were obtained from pregnant rats (n = 15). The uterine segments were mounted in organ baths filled with Krebs solution. After oxytocin-induced contractile activity had been established, etomidate in incremental concentrations (10(-7) to 10(-3) M) was added cumulatively to the bath, each administered 20 min apart, and resultant changes in contractile activity were continuously recorded. EC5 (effective concentration of 5% reduction), EC25, EC50, EC75, and EC95 on active tension were calculated using a probit model. RESULTS: Etomidate (10(-7) to 10(-3) M) induced dose-dependent decreases in amplitude and frequency of uterine contraction. The EC50 of etomidate on active tension were 5.91 x 10(-5) M. CONCLUSIONS: These results demonstrate that etomidate had inhibitory effects on pregnant rat uterine muscle at supraclinical concentration (5.91 x 10(-5) M).
Animals
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Baths
;
Contracts
;
Etomidate
;
Female
;
Isotonic Solutions
;
Mice
;
Muscle, Smooth
;
Myometrium
;
Oxytocin
;
Rats
;
Uterine Contraction
8.Analysis of Affecting Factors for Cortisol Level in Cord Blood.
Hyun Jung LIM ; Chang Hun SONG ; Eun Young KIM ; Sang Kee PARK
Journal of the Korean Pediatric Society 2003;46(2):183-187
PURPOSE: Long-term stress to the fetus causes alterations in adrenal steroidogenesis. The purpose of this study was to analyze the association of cord blood cortisol with stress during delivery. METHODS: Cord blood samples were collected from 58 neonates at once to labor. Cortisol was measured by RIA method(DPC, USA). Cortisol level according to gestational age(<34, 34-37, >38 wks) and method of delivery(Cesarean section vs. vaginal delivery), Apgar score and uterine contraction, were compared to know stress during labor. RESULTS: Cortisol of cord blood had considerable differences between each group, according to gestational age(P<0.001). It was statistically higher in the cases of vaginal delivery than cessarian delivery(P<0.001). The concentration of cortisol was significantly higher according to duration of labor (P<0.05). There was a significant relationship between cortisol level and uterine contraction(P<0.05). The concentration of cortisol was significantly low when Apgar score at 1 min was low(P<0.05). CONCLUSION: Cord cortisol has close association with stress during labor. And so do with post birth prognosis of neonate.
Apgar Score
;
Fetal Blood*
;
Fetus
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Humans
;
Hydrocortisone*
;
Infant, Newborn
;
Parturition
;
Prognosis
;
Uterine Contraction
9.A selective hemostatic suturing technique for placental site bleeding: a case report.
Su Jeong PARK ; Seong Jin CHOI ; Sang Jun PARK ; Mahn Gyu CHO ; Hyo Eon KIM ; Kyoung Hee HAN ; In Bai CHUNG
Korean Journal of Obstetrics and Gynecology 2006;49(2):448-452
In postpartum hemorrhage, many clinicians should often consider hysterectomy after delivery. Many surgeons have suggested conservative surgical procedures such as uterine, ovarian and internal iliac artery ligation for preserving future childbearing potential. Recently, B-Lynch surgical technique and hemostatic multiple square suture technique were suggested to compress the entire uterine walls as another methods. The individual choice between these procedures depend on several factors including the general condition of patient and the experience of surgeon. Here, we introduce a case of the selective hemostatic suturing technique which was used to a patient with placenta previa at 20 weeks' gestation. The suturing technique could be used to a patient with massive bleeding from the placental separation site with normal uterine contraction during cesarean delivery.
Hemorrhage*
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Humans
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Hysterectomy
;
Iliac Artery
;
Ligation
;
Placenta Previa
;
Postpartum Hemorrhage
;
Pregnancy
;
Suture Techniques
;
Uterine Contraction
10.Development of an Analgesia Therapy System for Delivery Based on Bio-feedback Transcuataneous Electrical Nerve Stimulation.
Deng SONGBO ; Lu YAOSHENG ; Kun FANG ; Ruyi QIN ; Zhan LIN
Journal of Biomedical Engineering 2015;32(3):650-655
Transcuataneous electrical nerve stimulation (TENS) analgesia as a non-drug method has received people's more and more attention recently. Considering problems of existing products, such as unstable performance and unsatisfied effectiveness, we developed a new analgesia therapy system for delivery based on bio-feedback TENS in our laboratory. We proposed a new idea for stimulation signal design, that is, we modulated a middle frequency signal by a traditional low frequency TENS wave in the new system. We designed different prescription waves for pain relief during a uterine contraction or massage between contractions. In the end, a bio-feedback TENS method was proposed, in which the waveforms of stimulation signals were selected and their parameters were modified automatically based on feedback from uterine pressure, etc. It was proved through quality tests and clinical trials that the system had good performance and satisfied analgesia effectiveness.
Analgesia
;
methods
;
Biofeedback, Psychology
;
methods
;
Female
;
Humans
;
Pain Management
;
Transcutaneous Electric Nerve Stimulation
;
methods
;
Uterine Contraction