The Rate of Cesarean Section and Newborn Apgar score In Two Types Of Physiological Delivery and Facilitated Delivery in Mothers with First Pregnancy.

INTRODUCTION: Labor pain is often severe and its lack of relief can have a bad effect on the mother's physiological condition. Accurate measurement and appropriate treatment of pain is an important problem. There are several choices for the control of labor pain, however, each method has its own risks and benefits regarding its efficiency and availability; therefore, the aim of this study was to compare the rate of cesarean section and newborn Apgar in two types of physiological delivery and facilitated delivery among mothers with first delivery. MATERIALS AND METHODS: This case-control study was conducted on mothers aged 18-35 who went to the hospital to give birth. In the present study, 8 sessions (90 minutes each session) were held to prepare mothers from 20 to 37 weeks of pregnancy. Candidate mothers for physiological labor were hospitalized without intervention and in the active phase of labor, and their labor stages were planned physiologically. The pain intensity of mothers was asked using a scale (VAS) during labor every half hour (according to the pain scale from 0 to 10). The average score of pain during the first and second stages, type of delivery, amount of postpartum bleeding, length of the stage of delivery, infection, and fever after delivery, Apgar score of the baby, perineal status, mother's satisfaction and the rate of hospitalization of the baby in NICU were recorded. Furthermore, the level of satisfaction with childbirth was evaluated with the help of Mackey's standard satisfaction questionnaire. RESULTS: The average age of the physiological delivery and facilitated delivery groups was 26.37 ± 5.23 years and 26.58 ± 5.79 years, respectively. Physiological delivery significantly required less conversion to cesarean section. The most common etiology was caesarean section in the physiologic labor group, and a drop in NST was reported in the facilitated group. The analysis of the results demonstrated no significant difference between the etiology of cesarean section and the study groups. The Apgar score in the physiological group was significantly better than the facilitated group. There is no significant relationship between the study group and the amount of bleeding during delivery. Furthermore, there was no significant relationship between the study group and the incidence of postpartum infection. The rate of NICU admission in the facilitated group was found to be significantly higher than physiological delivery. CONCLUSION: The results of this study revealed that the rate of caesarean section, the rate of need for NICU, newborns' Apgar score, and the rate of mothers' satisfaction in physiological delivery group were significantly different from the other groups, but the rate of wound infection and the amount of postpartum bleeding in the two groups showed a significant difference.

The impact of physiologic and non-physiologic delivery on the mother and neonate outcomes; a comparative study on the primi gravid mothers.

OBJECTIVE: To compare the effect of the physiologic and facilitated labor on the mother and neonate outcomes in the prim gravid women referring to Arash Hospital. MATERIALS AND METHODS: This clinical trial study was performed on 200 low risk pregnant women referring to Arash Women's Hospital in 2012-2013. Mothers were divided into two groups of 100 patients using a simple random sampling method. The first group received the on-pregnancy and physiologic labor training and the second group was nominated for facilitated labor without training. The mother and neonate outcomes in these two delivery methods were then compared. RESULTS: The rate of cesarean section in the physiologic group was significantly lower compared with the intervention group (p = 0.001). Also in the first stage of labor, VAS was measured to be noticeably lower in the physiologic group in comparison with the intervention group (p = 0.001), while the difference of VAS between the two studied groups was found not to be significant in the second stage of labor. In terms of duration of the labor and neonatal Apgar score two groups were not considerably different (p > 0.05). Moreover, the laceration rate in the physiologic group was determined to be noticeably higher as compared to the intervention group (p = 0.001). The groups were considerably different in terms of the vaginal bleeding and maternal satisfaction (p = 0.001). CONCLUSION: This study revealed the lower rate of cesarean section, abnormal vaginal bleeding and pain score in the physiologic group compared with the facilitated group. Moreover, mothers of the first group were more content with the labor process.

The effects of oral pregabalin on post-operative pain of lower limb orthopedic surgery: A double-blind, placebo-controlled trial.

BACKGROUND: Post-operative pain is one of the problems, wherein lack of control on it has many side-effects such as tachycardia, hypertension, myocardial ischemia, decreased alveolar ventilation, and poor wound healing. AIMS: In this study, we evaluated the pre-operative administration of pregabalin sufficiency and security in relieving post-operative pain after lower limb orthopedic surgery and reducing the need for opioids and their possible side-effects. MATERIALS AND METHODS: This study is a randomized, double-blind clinical trial. It was performed on 60 patients under lower limb surgery by spinal anesthesia. Patients were randomly allocated to two groups, one group has received a 150 mg pregabalin capsule 2 h before surgery and the other group has received placebo as a control. In both groups at 2, 6, 12, and 24 h after surgery, the patients were evaluated and the pain score, the score of sedation, incidence of nausea and vomiting was recorded in the checklists. Then, the data were analyzed by SPSS v16. RESULTS: Visual analog pain scores at all hours in pregabalin group significantly reduced compared to the placebo group (P < 0.0001). Also, in the pregabalin group nausea and vomiting scores at all hours, sedation levels at 2 h and 6 h post-operatively, and pethidine consumption in all hours have significantly been reduced. CONCLUSION: A single pre-operative oral dose of pregabalin 150 mg is an effective method for reducing post-operative pain and pethidine consumption in patients undergoing orthopedic surgery.