RESUMO
OBJECTIVE: The purpose of this study was to relate the mode of delivery and outcomes in a cohort of cases of placenta previa that had the last transvaginal ultrasonographic scan <28 days before delivery. STUDY DESIGN: Cases in which the placental edge overlapped the internal cervical (n = 42) underwent cesarean section delivery. Labor was allowed in those with placental edge to internal os distance of 1-10 mm (group 1, 24 women) and those with a distance of 11-20 mm (group 2, 29 women). RESULTS: Rates of cesarean section delivery (75% vs 31%; odds ratio, 6.7; 95% confidence interval [CI], 2-22) and of bleeding before labor (29% vs 3%; odds ratio, 11.5; 95% CI, 1.6-76.7) were higher in group 1 than in group 2. Blood loss at delivery (662 +/- 466 mL vs 510 +/- 547 mL) and rate of severe postpartum hemorrhage (21% vs 10%; odds ratio, 2.3; 95% CI, 0.5-9.7) were similar in the 2 groups. CONCLUSION: More than two-thirds of women with a placental edge to cervical os distance of >10 mm deliver vaginally without increased risk of hemorrhage.
Assuntos
Cesárea/estatística & dados numéricos , Placenta Prévia/diagnóstico por imagem , Adulto , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Feminino , Humanos , Hemorragia Pós-Parto/epidemiologia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-NatalRESUMO
OBJECTIVES: The purpose of this pilot study was to evaluate the efficacy of acupuncture in relieving perineal pain after mediolateral episiotomy during childbirth. DESIGN AND SUBJECTS: Women with mediolateral episiotomy during delivery were enrolled in this study and were assigned to be treated or not with acupuncture. OUTCOMES MEASURES: Perineal pain relieving effect of acupuncture was evaluated considering oral analgesics request during post-partum period and was the main outcome of this trial. RESULTS: A total of 42 women were enrolled in this trial. Twenty-one (21) women were treated with "wrist-ankle" acupuncture, inserting one needle in their right ankle. A second group of 21 women was not treated with acupuncture. Women in the acupuncture group were significantly less likely to experience pain; only 8 of them (38.1%) asked for analgesics. All women in the second group assumed oral analgesics because of perineal pain (p < 0.01). CONCLUSIONS: Wrist-ankle acupuncture during the postpartum period is effective for perineal pain relief after mediolateral episiotomy.