scholarly journals Towel curettage for a new definition of postpartum period after cesarean section

Author(s):  
Suzan Elsharkawy

Background: The objective of the present study was to compare effect of towel curettage as a new technique, to no curettage in caesarean section on postpartum period duration and hemoglobin level.Methods: Prospective, randomized controlled trial included 403 eligible participants that were attending Elshatby maternity hospital in the duration of this study (2016) and scheduled for primary caesarean section. The patients were randomized into two groups A and B. Group A had towel curettage after manual separation of the placenta, where the decidua and the placental bed were thoroughly curetted by a surgical towel. Group B had manual separation of placenta only.Results: Towel curettage actually shortens the puerperal bleeding days by almost a week and the volume of blood loss by around half a gram/dl, a situation that could be of great concern in the developing countries where iron deficiency anemia can be considered endemic.Conclusions: Suzan towel curettage is a new, simple, cheap methods that deceases duration of puerperium and the amount of useless blood loss post-partum, which may save a good percentage of women from suffering the negative influences of iron deficiency anemia.

2017 ◽  
Vol 24 (01) ◽  
pp. 95-101
Author(s):  
Syed Mohsin Turab ◽  
Muhammad Furqan ◽  
Shah Nawaz Jamali ◽  
Syeda Amber Zaidi

Objectives: To Analyze and compare the effect of oral vs parenteral iron therapyon various hematological parameters in women suffering from post-partum iron deficiencyanemia. Study Design: Comparative, randomized and prospective study. Setting: Departmentof Pharmacology, HCMD, HU in collaboration with the Dept of Obs/Gynae, JPMC Karachi.Period: January to December 2015. Subjects and Methods: 40 patients divided in two groupsA and B of 20 each. Group A received oral iron (Tab Iberet 525 mg once daily) for a period of 3months while group B was treated with intravenous iron sucrose complex (Inj Venofer 100mg/Amp) the total no of doses were calculated according to Hemoglobin deficit. Hemoglobin,Hematocrit and MCV were observed at day 0, 45 and 90 of the treatment. Results: Group Ashows a mean increase of 25.85% at day 90th of the treatment in comparison to this group Bshows a much better result with a mean increase of 36.71% in Hemoglobin conc. At the end of12 weeks therapy. Conclusion: Parenteral iron therapy was found to be an effective means oftreatment in patients with postpartum iron deficiency anemia.


Iron deficiency anemia (IDA) in pregnancy, i.e., prepartum anemia, is associated with premature birth, low birth weight, and small for gestational age of the newborn and is furthermore closely associated with the occurrence of anemia after delivery of a child, i.e., in the postpartum period .Post-partum anemia is a common problem throughout the world. through this study aim of the work ( frequency of post-partum anemia and risk factors for its development) The study showed that percentage of antepartum anemia was about 64.3% this percentage postpartum increased to about 65.4% and 13.6% of those with antepartum normal hemoglobin level became anemic. The main causes of postpartum anemia are prepartum iron deficiency anemia in combination with excessive blood losses at delivery. Post-partum anemia is not affected by demographic data, obstetric history, ante-partum u/s finding and obstetric history. Antepartum bleeding was not significantly associated with postpartum anemia. The more the estimated blood loss during labor the more the postpartum anemia. Through follow up of post-partum anemia cases and treated it according type of anemia (oral, intravenous, folate supplementation and blood transfusion). Outcome of treatment of anemia after 8 weeks, 61.02 % was improved and 8.98 % was not improved, due to malabsorption or non-adherence to drug usage. Conclusion: The main causes of postpartum anemia in this study are prepartum iron deficiency anemia and the amount of blood loss at delivery. this study’s results suggest that screening of women with peri delivery Hb


Author(s):  
Rashmi Pareek Ayatullah Hosne Asif ◽  
Nisha Kumari Ojha

Background: Anemia in adolescent girls possess greatest burden on their health as it leads to poor cognitive development, poor reproductive health and if not treated may lead to intrauterine growth retardation in their developing fetus. The prevalence of anemia among adolescent is 27% in developing country and 6% in developed country. The Government of India has launched National Anemia Control Programme, to prevent and control anaemia in children and adolescents. But the problem is still persisting because of many issues like - poor palatability, intolerance to the drug used, poor absorption of the drugs used, constipation, discoloration of stool, unpleasant odor and taste etc. result in poor compliance and therefore non adherence to the therapy which finally results in poor improvement. By looking at the magnitude of the problem, an Ayurveda drug Vajravatakmandura has been selected for the study and the present study was undertaken to evaluate the efficacy of the trial drug in iron deficiency anemia in adolescent girls. Material and methods: 100 subjects satisfying inclusion and exclusion criteria were selected and were randomly divided in two groups. In group A, the trial drug Vajravatakmaņdura was administered and in group B, IFA tablets were given for two month of duration with follow up at every fortnight. Result: Both the trial and control groups showed extremely significant result over subjective parameters. Trial drug Vajravatakmaņdura in group A was found more effective over the subjective parameters - weakness, palpitation, pallor and loss of appetite with % gain of 39.77%, 39.39%, 39.17%, 38.09% respectively. Statistical analysis between before and after treatment findings of objective parameters, extremely significant (P less than 0.0001) improvement was found in both groups in all parameters, except for RBC count in group A, which was significant. No adverse effects were reported during entire period of study by any of the patients in trial group treated with trial drug. Conclusion: The trial drug “Vajravatakmandura” is effective, safe and palatable for the management of iron deficiency anemia in adolescent girls.


Author(s):  
Adam K. Lewkowitz ◽  
Molly J. Stout ◽  
Emily Cooke ◽  
Seon C. Deoni ◽  
Viren D'Sa ◽  
...  

Objective Iron-deficiency anemia (IDA) can have serious consequences for mothers and babies. Iron supplementation is recommended, but the administration route is controversial. We sought to conduct a randomized controlled trial (RCT) testing the effectiveness and safety of intravenous (IV) iron compared with oral iron on perinatal outcomes in pregnant women with IDA. Study Design This open-label RCT randomized patients with IDA (hemoglobin [hgb] <10 g/dL and ferritin <30 ng/mL) at 24 to 34 weeks' to oral iron or single 1,000-mg dose of IV low-molecular weight iron dextran over one hour. The primary outcome was maternal anemia at delivery (hgb < 11 g/dL). Secondary outcomes were mild/moderate or severe adverse reactions, maternal hgb and ferritin at delivery, blood transfusion, gestational age at delivery, birth weight, neonatal hgb and ferritin, and composite neonatal morbidity. Analysis was as per protocol. Results The trial was stopped early for logistical reasons, and the data analyzed as preliminary data to inform a larger, potentially externally funded, definitive trial. Of 55 patients approached, 38 consented. Of these, 15 were withdrawn: 5 received IV iron from their primary obstetrician after being randomized to oral iron and 10 declined to receive IV iron. Of the remaining 23 patients, who were included in the analytic population, 13 received oral iron and 10 received IV iron. The rate of maternal anemia at delivery (hgb < 11 g/dL) was high overall but significantly reduced with IV iron (40 vs. 85%, p = 0.039). Rates of maternal hgb < 10 g/dL were significantly lower in the IV iron group (10 vs. 54%, p = 0.029). There were no severe adverse reactions and similar rates of mild/moderate reactions between groups. Conclusion IV iron reduces rates of anemia at the time of admission for delivery, supporting a larger RCT comparing IV versus oral iron for the treatment of IDA of pregnancy powered for definitive clinical outcomes. However, issues uncovered in this RCT suggest that patient, clinician, and systems-level barriers associated with different IDA treatment modalities must be considered prior to conducting a larger RCT. This study is registered with clinicaltrials.gov with identifier no.: NCT03438227. Key Points


2017 ◽  
Vol 66 (5) ◽  
pp. 56-63
Author(s):  
Anna S. Atajanyan

The review article defines iron deficiency anemia, the mechanisms determining iron deficiency in pregnancy, the complications of pregnancy, childbirth and the postpartum period, the methods of correction and prevention of iron deficiency, including a modern alternative to oral iron intake-its intravenous forms, which contribute to a rapid increase of iron levels. And also do not have toxicity and are easily tolerated.


2021 ◽  
pp. 56-57
Author(s):  
Anupama Anupama

Aim – The aim of the study was to study the effect of sublingual misoprostol for prevention of PPH. Materials and Methods – This was a prospective, randomized, double blind, placebo controlled study. Inclusion criteria were women aged 20-40 years with 38-40 weeks of gestation who underwent elective caesarean section. Exclusion criteria were women have risk factors for post-partum haemorrhage, active thromboembolic disease and intrinsic risk for thrombosis. Participants were randomly assigned to misoprostol group or group A (n=50) and placebo group or group B(n=50). Group A received 400µg of sublingual misoprostol after delivery of the baby, group B received placebo tablet at the same time. Primary outcome measures were blood loss from delivery of the placenta to the end of the caesarean section to 2 hours postpartum, haemoglobin estimation was done in all patients pre operatively and 24 hours post operatively and the change in concentration was noted. Secondary outcome measures were need for additional uterotonics, use of additional surgical interventions to control post-partum haemorrhage. Result – Blood loss from both placental delivery to the end of caesarean section and from end of caesarean section to 2 hours postpartum were signicantly lower in the study group. (p<0.0001). Change ifn haemoglobin concentration in study group was also signicantly less than in the control group. (p<0.0001). Total amount of Oxytocin required was signicantly less in the study group (p=0.01). The number of women requiring other oxytocics (inj. Methyl ergometrine, inj. Carboprost) was signicantly less in study group (p=0.0078). Conclusion – Sublingual misoprostol has been found to be effective in preventing PPH.


PEDIATRICS ◽  
1961 ◽  
Vol 27 (2) ◽  
pp. 199-203
Author(s):  
M. Silvija Hoag ◽  
Ralph O. Wallerstein ◽  
Myron Pollycove

Blood loss from the gastrointestinal tract was measured in 13 infants with iron deficiency anemia, using radioiron as a tracer. The radioiron was given intravenously; radioactivity in the erythrocytes and feces was measured for the following 3 to 4 weeks. The percentage of total Fe administered that was recovered in the stools varied between 0.75 and 16.4%, with a mean of 5.75%. This represents loss of whole blood in the stools varying from 7 to 107 ml, with a mean of 41 ml during the observation period. Occult blood loss from the gastrointestinal tract appears to be a significant factor in the development of iron deficiency in early childhood.


Sign in / Sign up

Export Citation Format

Share Document