ABSTRACT
Background and Objectives: Postpartum Hemorrhage [PPH] is one of the major causes of maternal mortalities, and it needs to be management in a high quality center. The aim of this study was to evaluate the outcome of patients with postpartum hemorrhage who admitted to the obstetric ICU of Alzahra Hospital of the Tabriz University of Medical Sciences
Materials and Methods: In this retrospective study, one year records of all patients with PPH were studied their demographic data, details of their primary admission or referral, duration between onset of PPH and arrival, their condition at admission, resuscitative measures, procedures to manage PPH, presence or abscenss of disseminated intravascular coagulation [DIC] and its management, duration of ICU stay, and finall outcome were recorded and evaluated
Results: from the total 43 patients with PPH, 29 were admitted to the ICU. 6 were referred from other hospitals and the remaining were admitted in ordinary ward. The time interval between the onset of PPH and arrival was ranged between 2-72 hours. All patients were conscious on arrival. Five patients were hypotensive. Resuscitative measures were included oxygen supplementation, fluid resuscitation and blood transfusion. Hemorrhage was controlled with uterine massage and drug administration in 6 patients, 23 patients underwent surgery. 5 patients had DIC which was managed with blood component therapy. Mean Duration of stay in ICU was 3 days. We didn't detected in this retrospective study any registered mortality
Conclusion: PPH is one of the most common causes of obstetric ICU admission. If the management of patients with PPH is carried out in a unit with high therapeutic qualities quality, it would lead to low maternal mortality
ABSTRACT
To evaluate the effect of intramuscular [IM] ephedrine before injection of propofol, to reduce hypotension. It was a prospective, hospital based study conducted during March 2003 to December 2003, at Nikookary Hospital, Tabriz Medical Science University, Iran. This study was performed on one hundred patients who were candidates for elective ophthalmic surgeries randomized to two groups of 50 patients. In one group [group A] ephedrine 10mg [2cc] and in other group [group B] sterile water 2cc were injected intramuscularly. Twenty minutes before induction of anesthesia or before injection of propofol, during intubation, in 1[st], 4[th], 7[th] and 10th minutes of anesthesia blood pressure and heart rate were measured in both groups. The mean values were compared in two groups. There was only one case with significant mean diastolic blood pressure drop at 1[st] minute after intubation in group A comparing with group B. P=0.001. In other cases, differences of mean blood pressures were not significant. Also heart rates in all mentioned minutes were significantly higher in group A than group B. P<0.05]. IM injection of ephedrine before induction of anaesthesia with propofol does not have any significant effect in decreasing of patient's hypotension during operation, however it increases their heart rates. According to the potential hazards of the later complication, especially in old patients, this procedure is not recommended