الملخص
Labor is a painful process and one of the midwives duties is trying to reduce the intensity of labor pain, in which reduction of duration of clinical stages of labor has always been considered. The objective of this study was to evaluate the effect of hyoscine suppository on labor pain and process of labor. This double-blind clinical trial was down on 130 nulliparous pregnant women who referred to Ahvaz Sina hospital for parturition. A hyoscine suppository was given to case group and a placebo suppository was given to control group at beginning of active phase of labor, rectally. Then the labor pain mean, cervical dilatation and effacement progress, active phase and second stage duration and delivery type were recorded. The data were analyzed using T, Chi square and Fisher tests in 0.05 significant level in SPSS Version 15.0. were significant differences between mean of cervical dilatation and effacement 1 and 2 h after intervention in both groups [P<0.0001]. The active phase and second stage duration in case group were less than control group significantly [P=0.007]. Caesarean section rate in the case group was less than control group, but the difference was not significant [P=:0.07]. Labor pain intensity had not significant difference in both groups. There were no differences in fetal heart rate, maternal pulse rate and blood pressure and neonatal APGAR score between both groups. It seems that hyoscine suppository can be used to accelerate the process of labor and reduce duration of labor pain, effectively, but does not reduce labor pain
الموضوعات
Humans , Female , Labor Pain/drug therapy , Labor Stage, First/drug effects , Pregnant Women , Suppositories , Double-Blind Method , Fetal Heart/drug effects , Heart Rate, Fetal/drug effects , Apgar Score , Cesarean Section , Time Factorsالملخص
FUNDAMENTO: Os efeitos da anestesia local em odontologia com lidocaína e epinefrina, sobre parâmetros cardiovasculares de gestantes portadoras de valvopatias e seus conceptos, não estão esclarecidos. OBJETIVO: Avaliar e analisar parâmetros da cardiotocografia, de pressão arterial e eletrocardiográficos da gestante portadora de doença valvar reumática, quando submetida à anestesia local com 1,8 ml de lidocaína 2 por cento sem vasoconstritor e com epinefrina 1:100.000, durante procedimento odontológico restaurador. MÉTODOS: Realizamos monitorização ambulatorial da pressão arterial, eletrocardiografia ambulatorial materna e cardiotocografia de 31 portadoras de cardiopatia reumática, entre a 28ª e 37ª semana de gestação, divididas em dois grupos conforme presença ou não do vasoconstritor RESULTADOS: Demonstrou-se redução significativa dos valores de frequência cardíaca materna nos dois grupos, durante o procedimento, quando comparado aos demais períodos (p < 0,001). Houve ocorrência de arritmia cardíaca em 9 (29,0 por cento) pacientes, das quais 7 (41,8 por cento) pertencentes ao grupo de 17 gestantes que recebeu anestesia com adrenalina. A pressão arterial materna não apresentou diferença quando comparamos períodos ou grupos (p > 0,05). O mesmo ocorreu (p > 0,05) com número de contrações uterinas, nível e variabilidade da linha de base e número de acelerações da frequência cardíaca fetal. CONCLUSÃO: O uso de 1,8 ml de lidocaína 2 por cento associado à adrenalina mostrou-se seguro e eficaz em procedimento odontológico restaurador durante a gestação de mulheres com cardiopatia valvar reumática.
BACKGROUND: The effects of local dental anesthesia with lidocaine and epinephrine on cardiovascular parameters of pregnant women with heart valve diseases and their fetuses are not fully understood. OBJECTIVES: To assess and analyze cardiotocographic, blood pressure and electrocardiographic parameters of pregnant women with rheumatic heart valve disease undergoing local anesthesia with 1.8mL of lidocaine 2 percent with or without epinephrine 1:100,000 during restorative dental treatment. METHODS: Maternal ambulatory blood pressure and electrocardiographic monitoring as well as cardiotocography of 31 patients with rheumatic heart disease were performed between the 28th and 37th week of gestation. The patients were divided into two groups, those with or without vasoconstrictor. RESULTS: A significant reduction in maternal heart rate was shown in both groups during the procedure in comparison with the other periods (p<0.001). Cardiac arrhythmia was observed in nine (29.0 percent) patients, of which seven (41.8 percent) were from the group of 17 pregnant women who received anesthesia plus epinephrine. No difference in maternal blood pressure was observed when periods or groups were compared (p>0.05). The same occurred (p>0.05) with the number of uterine contractions, baseline level and variability, and number of accelerations of fetal heart rate. CONCLUSION: The use of 1.8mL of lidocaine 2 percent in combination with epinephrine was safe and efficient in restorative dental procedures during pregnancy in women with rheumatic heart valve disease.
FUNDAMENTO: Los efectos de la anestesia local en odontología con lidocaína y epinefrina, sobre los parámetros cardiovasculares de gestantes portadoras de valvulopatías y sus conceptos, no son claros. OBJETIVO: Evaluar y analizar parámetros de la cardiotocografía, de la presión arterial y electrocardiográficos de la gestante portadora de enfermedad valvular reumática, al someterse a anestesia local con 1,8 ml de lidocaína 2 por ciento sin vasoconstrictor y con epinefrina 1:100.000, durante procedimiento odontológico restaurador. MÉTODOS: Realizamos monitoreo ambulatorio de la presión arterial, electrocardiografía ambulatoria materna y cardiotocografía de 31 portadoras de cardiopatía reumática, entre la 28ª y la 37ª semana de gestación, divididas en dos grupos según la presencia o no del vasoconstrictor. RESULTADOS: Se observó reducción significativa de los valores de frecuencia cardíaca materna en los dos grupos, durante el procedimiento, al compararlo con los demás períodos (p < 0,001). Se registró ocurrencia de arritmia cardíaca en 9 (29,0 por ciento) pacientes, de las cuales 7 (41,8 por ciento) pertenecían al grupo de 17 gestantes que recibió anestesia con adrenalina. La presión arterial materna no presentó diferencia al comparar períodos o grupos (p > 0,05). Lo mismo ocurrió (p > 0,05) con el número de contracciones uterinas, nivel de variabilidad de la línea de base y número de aceleraciones de la frecuencia cardíaca fetal. CONCLUSIÓN: El uso de 1,8 ml de lidocaína 2 por ciento asociado a la adrenalina se mostró seguro y eficaz en procedimiento odontológico restaurador durante la gestación de mujeres con cardiopatía valvular reumática.
الموضوعات
Adolescent , Adult , Female , Humans , Pregnancy , Young Adult , Anesthesia, Dental/adverse effects , Anesthetics, Local/adverse effects , Epinephrine/adverse effects , Lidocaine/adverse effects , Pregnancy Complications/physiopathology , Rheumatic Heart Disease/physiopathology , Analysis of Variance , Anesthetics, Combined/administration & dosage , Anesthetics, Combined/adverse effects , Anesthetics, Local/administration & dosage , Arrhythmias, Cardiac/chemically induced , Blood Pressure/drug effects , Cardiotocography , Epinephrine/administration & dosage , Gestational Age , Heart Rate, Fetal/drug effects , Lidocaine/administration & dosage , Monitoring, Ambulatory/methods , Statistics, Nonparametric , Vasoconstrictor Agents/administration & dosage , Vasoconstrictor Agents/adverse effects , Young Adultالملخص
To investigate the effects of maternal steroid administration on umbilical and fetal middle cerebral artery flow velocity waveforms and fetal out-come. Sixty Pregnant Women with singleton healthy fetuses "without fetoplacental insufficiency" complaining from threatened preterm delivery at 30-36Wks were treated using steroid therapy. There was a significant decrease in umbilical artery and foetal middle cerebral artery pulsatility indices with decrease in UA/MCA P.I ratio at day 3, day 5 after treatment, with no changes at day 7 after steroid administration and also, no significant changes in foetal heart rate. Betamethasone therapy given to the mother to avoid complications of premature fetus e.g. R.D.S., there was transient significant effect on foetal middle cerebral artery and umbilical artery "decreased PI at day 3 and day 5" after steroid administration; The effects were disappeared or declined at day 7, with no significant changes in foetal heart rate during the courses of therapy
الموضوعات
Humans , Female , Ultrasonography, Doppler/methods , Umbilical Arteries , Middle Cerebral Artery , Fetus , Pregnancy Outcome , Heart Rate, Fetal/drug effectsالملخص
A influência do diazepam sobre os traçados cardiotocográficos foi estudada em 57 pacientes, com idade gestacional compreendida entre 30 e 42 semanas, separadas em dois grupos: normal (29 casos) e patológico (28 casos). A técnica empregada para a feitura dos exames compreendeu: a obtençäo dos registros gráficos de freqüência cardiofetal e a sinalaçäo simultânea da atividade uterina e dos movimentos fetais. Utilizou-se estímulo acústico em todas as pacientes. Inicialmente fez-se um registro cardiotocográfico e, logo em seguida, administrou-se o diazepam, pela via intramuscular, na dose única de 10mg. Com o intuito de observar a influência da droga, duas horas após realizou-se outro registro gráfico com as pacientes nas mesmas condiçöes técnicas. A ordem de interpretaçäo dos mesmos foi aleatória observando-se os grupos normal e patológico. Empregou-se o teste de Student e o qui-quadrado para a análise estatística. Concluiu-se que o diazepam na dose e via de administraçäo preconizadas näo alterou os traçados cardiotocográficos durante o teste da cardiotocografia basal