Transcutaneous electrical nerve stimulation (TENS) for pain control after vaginal delivery and cesarean section.

OBJECTIVE: The present study aims to determine the efficiency and reliability of transcutaneous electrical nerve stimulation (TENS) in the management of pain related with uterine contractions after vaginal delivery and the pain related with both abdominal incision uterine contractions after cesarean section. METHODS: A hundred healthy women who underwent cesarean section under general anesthesia were randomly assigned to the placebo group (Group 1) or the TENS group (Group 2), while 100 women who delivered by vaginal route without episiotomy were randomized into the placebo group (Group 3) or the TENS group (Group 4). RESULTS: The patients in Group 2 had statistically lower visual analog scale (VAS) and verbal numerical scale (VNS) scores than the patients in Group 1 (p < 0.001 for both). The patients in Group 4 had statistically lower VAS and VNS scores than the patients in Group 3 (p = 0.022 and p = 0.005, respectively). The analgesic requirement at the eighth hour of cesarean section was significantly lower in the patients who were treated with TENS (p = 0.006). The need for analgesics at the eighth hour of vaginal delivery was statistically similar in the patients who were treated with TENS and the patients who received placebo (p = 0.830). CONCLUSION: TENS is an effective, reliable, practical and easily available modality of treatment for postpartum pain.

Lowered serum total L-carnitine levels are associated with obesity at term pregnancy.

OBJECTIVE: This study aims to compare the serum total l-carnitine concentrations of obese and non-obese pregnant women and to identify the role of L-carnitine in both maternal and fetal weight gain during pregnancy. METHOD: This study reviews 118 healthy women with singleton term pregnancy (≥37 weeks). The characteristics of the recruited subjects were analyzed according to their pre-pregnancy body mass index (BMI). RESULTS: The women with pre-pregnancy BMI < 18.5 kg/m(2) had significantly higher serum L-carnitine levels whereas the women with BMI > 29.9 kg/m(2) at term pregnancy had significantly lower serum l-carnitine levels (p = 0.001 for both). The neonates born to women with BMI > 29.9 kg/m(2) at term pregnancy had significantly longer height and wider head circumference (p = 0.001 for both). Serum total L-carnitine levels correlated significantly and negatively with pre-pregnancy body weight, pre-pregnancy BMI, pregnancy body weight, pregnancy BMI and serum triglyceride levels (r = -0.397, p = 0.001; r = -0.357, p = 0.001; r = -0.460, p = 0.001; r = -0.463, p = 0.001 and r = -0.216, p = 0.019, respectively). There was a significant and positive correlation between L-carnitine and HDL values (r = 0.243, p = 0.008). CONCLUSIONS: The crucial role of L-carnitine in pregnancy metabolism suggests that nutritional supplementation of this amino acid can be offered to women who are either overweight or obese at the beginning of the pregnancy.

Efficacy of transcutaneous electrical nerve stimulation for pain relief in women undergoing office endometrial biopsy.

AIM: To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) for decreasing pain related with office endometrial biopsy. METHODS: In this prospective study, 65 women undergoing office endometrial biopsy were randomly allocated to receive 550 mg oral naproxen sodium plus active TENS (Group I, n = 33) or 550 mg oral naproxen sodium plus placebo TENS (Group II, n = 32). The intensity of pain perceived by the patients was measured using a 10-cm visual analog scale (VAS) before insertion of the speculum, when the cervix grasped, immediately after biopsy, and 15 min after the procedure. The effect of anxiety (Spielberger's state anxiety inventory) on pain scores was also investigated. RESULTS: There were no statistical significant differences between groups in age, weight, body mass index, gravidity, parity, education, and menopausal status (p > 0.05). The pain scores before insertion of the speculum, when the cervix grasped, and immediately after biopsy were similar in both groups (p > 0.05). But at 15 min after the procedure, there was a significant reduction of the mean VAS pain score in naproxen sodium plus TENS group, compared with the naproxen sodium plus placebo TENS group (0.14 ± 0.47, 1.44 ± 1.37, respectively, p < 0.0001). The mean anxiety scores were 48.19 ± 6.71 and 45.85 ± 6.22 in Group I and Group II, respectively. We did not find any significant correlation between anxiety and VAS pain scores (p > 0.05). CONCLUSIONS: TENS appears to be successful in decreasing pain only after the procedure undergoing office endometrial biopsy. It can be used as a simple, cheap, safe, and effective pain relief method.