1.Randomized, Double-Blind, Placebo-Controlled Trial on the Efficacy of Hyaluronidase in Preventing Perineal Trauma in Nulliparous Women
Hayan KWON ; Hyun Soo PARK ; Jae Yoon SHIM ; Kyo Won LEE ; Suk Joo CHOI ; Gyu Yeon CHOI
Yonsei Medical Journal 2020;61(1):79-84
Edema
;
Episiotomy
;
Female
;
Humans
;
Hyaluronoglucosaminidase
;
Incidence
;
Lacerations
;
Parity
;
Wounds and Injuries
3.Height of elevated fetal buttock for prediction of successful external cephalic version
Jun Yi LEE ; Yeorae KIM ; In Sook SOHN ; You Jung HAN ; Jin Hoon CHUNG ; Moon Young KIM ; Min Hyoung KIM ; Hyun Mee RYU ; SungHong JOO ; Jung Yeol HAN
Obstetrics & Gynecology Science 2020;63(1):13-18
14 cm, and HOB >7.8 cm were 10.80 (95% confidence interval [CI], 1.57–74.94), 5.26 (95% CI, 1.06–26.19), and 10.50 (95% CI, 1.03–107.12), respectively. Areas under the curve (AUCs) for AFI, HOB, and parity were 0.66 (95% CI, 0.54–0.78), 0.74 (95% CI, 0.64–0.85), and 0.69 (95% CI, 0.62–0.76), respectively. HOB had the largest AUC, but there were no significant differences among the AUCs of other factors. The cut-off value of HOB was 6 cm.CONCLUSION: This study showed that the AUC of HOB was greater than that of parity and AFI, although it was not statistically significant. As HOB is a noninvasive and comprehensive marker to predict successful ECV, consideration of HOB would be helpful before conducting ECV. Further studies are needed.]]>
Amniotic Fluid
;
Area Under Curve
;
Breech Presentation
;
Buttocks
;
Female
;
Humans
;
Odds Ratio
;
Parity
;
Pregnancy
;
Pregnant Women
;
Prospective Studies
;
Pubic Symphysis
;
Ultrasonography
;
Version, Fetal
4.Cesarean section does not increase the prevalence of allergic disease within 3 years of age in the offsprings.
Hye In KIM ; SeonMi NAM ; Yejin PARK ; Yun Ji JUNG ; Ha Yan KIM ; Kyung Won KIM ; Myung Hyun SOHN ; Young Han KIM ; Joon Ho LEE ; Soo Jong HONG ; Ja Young KWON
Obstetrics & Gynecology Science 2019;62(1):11-18
OBJECTIVE: In this study, we evaluated the prevalence of allergic disease in offsprings delivered via the delivery modes of vaginal delivery vs. planned Cesarean section vs. Cesarean section with labor. METHODS: This study included 175 mother-neonate pairs from Severance Hospital who were enrolled in the Cohort for Childhood Origin of Asthma and allergic diseases study. Information regarding prenatal environmental factors, delivery, and diagnosis of allergic diseases was obtained from a questionnaire and medical record review. Patients with at least 3 years of follow-up data were included in this study. Results were adjusted for sex, birth weight, gestational age at birth, season of birth, neonatal intensive care unit admission, parity, breastfeeding, and maternal factors. RESULTS: A total of 175 offsprings were eligible for analysis. Among the subjects, 52.0% were delivered by vaginal delivery, 34.3% by planned Cesarean section, and 16.6% by Cesarean section with labor. Fifty-nine offsprings (33.7%) were diagnosed with allergic disease at a median age of 1 year (range 0.5–3 years). The prevalence of allergic disease was not associated with delivery mode after adjusting for confounding variables. Time period from membrane rupture to delivery, duration of the active phase, and the beginning of the pelvic division prior to Cesarean section were not associated with allergic disease development in offsprings. CONCLUSION: Cesarean section, irrespective of the occurrence of labor before surgery, did not increase the prevalence of allergic disease in infants up to 3 years of age.
Asthma
;
Birth Weight
;
Breast Feeding
;
Cesarean Section*
;
Cohort Studies
;
Confounding Factors (Epidemiology)
;
Diagnosis
;
Female
;
Follow-Up Studies
;
Gestational Age
;
Humans
;
Infant
;
Infant, Newborn
;
Intensive Care, Neonatal
;
Medical Records
;
Membranes
;
Parity
;
Parturition
;
Pregnancy
;
Prevalence*
;
Rupture
;
Seasons
5.Effect of transcutaneous electrical acupoint stimulation on recovery of gastrointestinal function after cesarean section.
Li MU ; Hui GAO ; Mai-Liang ZHAO ; Hong-Fen REN ; Hua-Shu MA
Chinese Acupuncture & Moxibustion 2019;39(3):259-262
OBJECTIVE:
To explore the effect on the recovery of gastrointestinal function after cesarean section treated with transcutaneous electrical acupoint stimulation at Zusanli (ST 36) on the basis of routine treatment.
METHODS:
A total of 110 primiparas after cesarean section were randomized into an observation group and a control group, 55 cases in each one. The conventional treatment was applied in the two groups, after operation, transcutaneous electrical acupoint stimulation at Zusanli (ST 36) was used immediately in the observation group, the skin electrode of disposable anti-magnetic buckle was attached to Zusanli (ST 36) and the corresponding part of the inner lower leg, with disperse-dense wave, 30 Hz/60 Hz and 15-20 mA. The treatment was given for 30 min every time, once every 8 h, until the end of the first bowel movement. The recovery of gastrointestinal function after cesarean section (the restoring time of borborygmus, the time of first anal exsufflation and the first defecation time), the time of secretion of foremilk, complications (abdominal distension, abdominal pain, nausea etc.), hospital stays after operation and the satisfaction of primiparas after bowel movement were compared between the two groups.
RESULTS:
The observation group was superior to the control group in the restoring time of borborygmus, the time of first anal exsufflation, the first defecation time and the time of secretion of foremilk (<0.01, <0.05). In the observation group, the incidence of postoperative complications such as abdominal pain, abdominal distension and nausea was 3.6% (2/55), which was lower than 16.4% (9/55) in the control group (<0.05). Compared with the control group, the observation group had shorter hospital stays (<0.01). The satisfaction of effect was 89.1% (49/55) in the observation group, which was superior to 72.7% (40/55) in the control group (<0.05).
CONCLUSION
Transcutaneous electrical acupoint stimulation at Zusanli (ST 36) can speed up the recovery of gastrointestinal function after cesarean section, reduce complications such as abdominal pain, abdominal distension, shorten hospital stays, promote patient nutrition intake and lactation, and improve comfort level and satisfaction of primiparas.
Acupuncture Points
;
Cesarean Section
;
Digestion
;
Female
;
Humans
;
Parity
;
Pregnancy
;
Transcutaneous Electric Nerve Stimulation
6.Effect of auricular-point pressure combined with personalized music therapy on perioperative stress response in primipara.
Wei LIU ; Qiu-Zhu CHEN ; Gui-Yan YANG ; Yu-Mei ZHAO
Chinese Acupuncture & Moxibustion 2019;39(8):827-831
OBJECTIVE:
To explore the effect of auricula-point pressure combined with personalized music therapy on perioperative stress response in primipara.
METHODS:
A total of 1000 primiparas who were elective for cesarean section were randomly divided into an observation group and a control group, 500 cases in each one. 1 h before surgery and 3 h, 6 h, 12 h and 24 h after surgery, individualized music relaxation intervention was given for 1 h in the two groups. On the basis of the treatment, auricular-point pressure was added at Pizhixia (AT), Shenmen (TF), Xin (CO), Zigong (uterus), Luanchao (ovary), Neishengzhiqi (TF) in the observation group. Each point was pressed for 1 min each time, repeated once every 15 min, the force is from light to heavy, and it is better to have a feeling of distension, sourness and radiation in the auricle. The scores of anxiety self-rating scale, visual analog scale (VAS), heart rate, systolic blood pressure, thyroid stimulating hormone, cortisol and blood glucose levels were observed in the two groups.
RESULTS:
A total of 973 primiparas completed the clinical study in the end, including 488 patients in the observation group and 485 patients in the control group. Compared to enrollment, the scores of anxiety self-rating scale before entering the operating room in the two groups were significantly improved (<0.05), and the observation group was superior to the control group (<0.05). Entering the operating room and tracheal extubation, the heart rate and systolic blood pressure of the primiparas in the observation group were more stable than those in the control group, and the differences were statistically significant (<0.05). Entering the operating room, 1 h into the surgery and 3 h after surgery, the thyroid stimulating hormone, cortisol and blood glucose levels of the primiparas in the observation group were significantly better than those in the control group (<0.05). The VAS scores in the observation group at 6 h, 12 h and 24 h after surgery were lower than those in the control group (<0.05).
CONCLUSION
Auricular-point pressure combined with personalized music therapy can reduce the perioperative stress response in primipara and promote the improvement of psychological, physiological and emotional.
Acupuncture Points
;
Acupuncture Therapy
;
Acupuncture, Ear
;
Cesarean Section
;
Female
;
Humans
;
Music
;
Music Therapy
;
Parity
;
Perioperative Care
;
Pregnancy
7.Effect of auricular acupuncture on postpartum rehabilitation of primipara with cesarean.
Gui-Yan YANG ; Qiu-Zhu CHEN ; Hui-Yu FU ; Chui-Hai CHEN
Chinese Acupuncture & Moxibustion 2019;39(7):717-720
OBJECTIVE:
To explore the postoperative effect of auricular acupuncture on primipara with cesarean in order to promote postpartum rehabilitation.
METHODS:
A total of 120 primiparas with cesarean were randomly divided into an observation group and a control group, 60 cases in each group. The routine treatment and care after surgery were given in the two groups. On the basis treatment, auricular acupuncture was applied at penqiang (TF), shenmen (TF), jiaogan (AH), pizhixia (AT), neishengzhiqi(TF), pi(CO), wei(CO) in the observation group, even-needling technique at all points. The needles were retained for 30 min, 3 times a day, the acupuncture was alternately every other day for 5 days continuously. The postpartum pain, anus exhaust time, incidence of postpartum hemorrhage, urinary retention and constipation, and postpartum average hospitalization day were recorded and compared between the two groups.
RESULTS:
Twenty-seven cases of postpartum uterine contraction pain (45.0%), 25 cases of wound pain (41.7%), 19 cases of breast distending pain (31.7%) and 11 cases of muscle soreness (18.3%) in the observation group, which was significantly lower than 38 cases (63.3%), 36 cases (60.0%), 30 cases (50.0%) and 21 cases (35.0%) respectively in the control group (<0.05). The anus exhaust time in the observation group was earlier than that in the control group (<0.05), and the average hospitalization time was shorter than that in the control group (<0.05). The incidence of postpartum hemorrhage, urinary retention and constipation in the observation group was lower than that in the control group (<0.05).
CONCLUSION
Auricular acupuncture can effectively relieve postpartum pain in primipara with cesarean, promote postpartum exhaust and shorten hospitalization days, and reduce the incidence of postpartum complications such as postpartum hemorrhage, urinary retention and constipation, it is conducive to postpartum rehabilitation.
Acupuncture Points
;
Acupuncture, Ear
;
Female
;
Humans
;
Parity
;
Postpartum Period
;
Pregnancy
8.Evaluation of isosorbide-5-mononitrate as a cervical ripening agent prior to induced abortion in contrast to misoprostol- a randomized controlled trial
Aloke Kumar DE ; Bhattacharyya Sanjoy KUMAR ; Aparna CHAKRABORTY ; Amrita SAMANTA
Obstetrics & Gynecology Science 2019;62(5):313-321
OBJECTIVE: To determine whether vaginal application of 40 mg isosorbide-5-mononitrate (ISMN) has a comparable cervical ripening efficacy to and lesser side effects than 400 µg misoprostol in women scheduled for the first trimester induced abortion using a manual vacuum aspirator (MVA). METHODS: We conducted a prospective randomized open- label study in 70 women at 6–12 weeks of pregnancy at the R G Kar Medical College and Hospital, Kolkata, India, over a period of two years from 2015 to 2017. Forty milligrams of ISMN and 400 µg misoprostol were vaginally applied for cervical priming. The primary outcome measure was the cervical response assessed by the passage of the appropriate and largest sized MVA cannula through the internal os without resistance, at the beginning of the procedure. RESULTS: The base line cervical dilatation was found to be significantly higher in the misoprostol group than in the ISMN group (7.65±1.38 vs. 6.9±1.26 mm; P=0.025, 95% confidence interval, −1.4046 to −0.953). However, when the women were sub-analyzed based on parity, there was no statistically significant difference in the same parameters among the multigravid women. The need for further cervical dilatation was significantly higher in the ISMN group when the primigravid women were compared, although the multigravid women responded favorably to ISMN. CONCLUSION: In the primigravid women, misoprostol appears to exert a higher efficacy as a cervical ripening agent in contrast to ISMN. However, ISMN can be used in multigravid women for the same purpose as in this group, misoprostol did not show any significant improvement in efficacy over ISMN.
Abortion, Induced
;
Catheters
;
Cervical Ripening
;
Female
;
Humans
;
India
;
Labor Stage, First
;
Misoprostol
;
Outcome Assessment (Health Care)
;
Parity
;
Pregnancy
;
Pregnancy Trimester, First
;
Prospective Studies
;
Vacuum
9.Obstetric outcome of induction of labor using prostaglandin gel in patients with previous one cesarean section
Vijayata SANGWAN ; Sunita SIWACH ; Pinki LAKRA ; Mukesh SANGWAN ; Sanjeet SINGH ; Rajiv MAHENDRU
Obstetrics & Gynecology Science 2019;62(6):397-403
OBJECTIVE: After globally acceptance of planned vaginal birth after cesarean section (VBAC), the mode of induction is still a matter of debate and requires further discussion. We aimed to study obstetric outcomes in post-cesarean patients undergoing induction of labor with prostaglandin gel compared with patients who developed spontaneous labor pains. METHODS: All patients at 34 weeks or more of gestation with previous one cesarean section eligible for trial of labor after cesarean section admitted in a labor room within one year were divided in 2 groups. Group one consisted of patients who experienced the spontaneous onset of labor pains and group 2 consisted of patients who underwent induction of labor with prostaglandin gel. They were analyzed for maternofetal outcomes. Descriptive statistics, independent sample t-test, and chi-square test were applied using SPSS 20 software for statistical analysis. RESULTS: Both groups were comparable in maternal age, parity, and fetal weight, but different in bishop score, mode of delivery, and neonatal outcome. Admisson bishop score was 6.61±2.51 in group 1 and 3.15±1.27 in group 2 (P<0.005). In the patients who experienced spontaneous labor, 86.82% had successful VBAC. In the patients with induced labor, 64.34% had successful VBAC with an average dose of gel of 1.65±0.75. Both groups had one case each of uterine rupture. The neonatal intensive care unit admission rate was 4.1% in group one and 10.4% in group 2. CONCLUSION: This study reflects that supervised labor induction with prostaglandin gel in previous one cesarean section patients is a safe and effective option.
Cesarean Section
;
Female
;
Fetal Weight
;
Humans
;
Infant, Newborn
;
Intensive Care, Neonatal
;
Labor Pain
;
Labor, Induced
;
Maternal Age
;
Parity
;
Pregnancy
;
Prostaglandins
;
Trial of Labor
;
Uterine Rupture
;
Vaginal Birth after Cesarean
10.Prenatal Secondhand Smoke Exposure: Correlation Between Nicotine in Umbilical Cord Blood and Neonatal Anthropometry
Mery RAMADANI ; Budi UTOMO ; Endang L ACHADI ; Hartono GUNARDI
Osong Public Health and Research Perspectives 2019;10(4):234-239
OBJECTIVES: Nicotine narrows uterine blood vessels reducing the flow of oxygen and nutrients to the developing fetus. This study examined the effects of fetal exposure to secondhand smoke on neonatal anthropometry. METHODS: This cross sectional study recruited 128 pregnant women in the third trimester of single pregnancies who had no chronic illness, were not active or ex-smokers, and who were willing to participate in the study. Pregnant women who were exposed to secondhand smoke had umbilical cord blood nicotine concentrations of ≥ 1 ng/mL. Neonatal anthropometry was assessed according to the newborn birth weight and length. The independent t-test was used to determine the neonatal difference in mean birth weight and length between the women who were exposed to secondhand smoke, and those who were not exposed. A multiple linear regression analysis was employed to assess the effect of secondhand smoke exposure on birth weight and birth length, controlling for potential confounding variables (weight gain during pregnancy, body mass index, parity, maternal age, and maternal hemoglobin). RESULTS: There were 35 women exposed to secondhand smoke (nicotine ≥ 1 ng/mL). Neonate birth weight and birth length were lower among mothers who were exposed to secondhand smoke. However, only neonate birth weight was significantly reduced by exposure to secondhand smoke (p = 0.005). The mean birth weight of these neonates was 2,916.5 g ± 327.3 g which was 205.6 g less than in unexposed fetuses. CONCLUSION: Exposure of mothers to secondhand smoke during pregnancy reduces fetal development and neonatal weight.
Anthropometry
;
Birth Weight
;
Blood Vessels
;
Body Mass Index
;
Chronic Disease
;
Confounding Factors (Epidemiology)
;
Female
;
Fetal Blood
;
Fetal Development
;
Fetus
;
Humans
;
Infant, Newborn
;
Linear Models
;
Maternal Age
;
Mothers
;
Nicotine
;
Oxygen
;
Parity
;
Parturition
;
Pregnancy
;
Pregnancy Trimester, Third
;
Pregnant Women
;
Tobacco Smoke Pollution
;
Umbilical Cord

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