12 research outputs found
The effect of pre-pregnancy body mass index and gestational weight gain on pregnancy outcomes in urban care settings in Urmia-Iran
Get PDFBACKGROUND: Nutritional status of women has been considered an important prognostic indicator of pregnancy outcomes. Few studies have evaluated patterns of weight gain and pre-pregnancy body mass index in developing regions where malnutrition and poor weight gain as well as maternal obesity have significant influences on the pregnancy outcome. This study aims to show effect of pregnancy body mass index and the corresponding gestational weight gain on the outcome of pregnancy. METHODS: On a prospective cross sectional study, two hundred and seventy women from urban areas of Northwest Iran were recruited for participation during their first eight weeks of pregnancy. Body mass index (BMI) was categorized and gestational weight gain was divided into two groups of normal and abnormal based on recommendations of Institute of Medicine (IOM) published in 1990. Chi square and one way ANOVA were used in the univariate analysis of the association between weight gain and corresponding adverse outcomes including cesarean, preterm labor and low neonatal birth weight. Adjusted odds ratios for adverse outcomes were determined by multiple logistic regression models, while controlling for the following factors: maternal age, parity, and education. RESULTS: Both pre-pregnancy BMI < 19 and abnormal weight gain during pregnancy were found to be associated with low neonatal birth weight defined as < 2500 g. Abnormal weight gain, during pregnancy was not related to an increased risk of preterm labor or cesarean delivery but it was highly associated with low birth weight (LBW)(P < 0.05). CONCLUSION: Low pre-pregnancy BMI is an established risk factor for LBW. Abnormal gestational weight gain may further complicate the pregnancy as an additional risk factor for neonatal LBW. All women, regardless of their pre-pregnancy BMI may be at risk for abnormal weight gain and hence low birth weight. Pre-pregnancy and gestation nutritional assessments remain significant part of all prenatal visits
Some Viewpoints about Apnea of Prematurity in Neonates under Inguinal Herniorrhaphy: A Brief Review
Get PDFInguinal hernia is more common in premature male babies. UsingGeneral Anesthesia (GA) for the repair operation may cause apnea inthem. Caudal anesthesia on the other hand provides effective anesthesiaand analgesia without the complication of GA. Here we discuss differentmethods of anesthesia in inguinal herniorrhaphy and their merits anddownfalls
Evaluation of Maternal and Fetal Hemodynamic Alterations in Delivery in Epidural and Combined Spinal-Epidural Analgesia: A Randomized Clinical Trial
Get PDFBackground: The pain of vaginal delivery is considered as the worst experience in women life that negatively affects mother and fetus. The most important methods advised by anesthesiologists for pain reduction include epidural and combined spinal-epidural analgesia. The ideal method provides convenient pain relief and guarantees maternal and fetal safety, simultaneously. Fetal heart rate (FHR), fetal movement (FM), and maternal hemodynamics (i.e. blood pressure (BP), heart rate (HR), and SpO2) monitoring are the most available ways for controlling the fetus and mother’s conditions during the delivery process.
Methods: This randomized-blinded clinical trial was performed on 100 pregnant women (50 cases in each group) during labor under epidural or combined spinal-epidural analgesia using lidocaine, fentanyl, and bupivacaine. FHR, FM, BP, HR, and SpO2 were monitored and recorded by blinded nurses. Data were analyzed by SPSS 22.
Results: There were no significant differences in FHR, FM, and Apgar scores between the two groups. No significant difference was found between the two groups in maternal hemodynamics. Generally, FHR, maternal BP, and HR were in the normal ranges. The C/S rate was lower in the epidural group but not statistically significantly.
Conclusions: In our survey, epidural and combined spinal-epidural analgesia were comparable in terms of FHR, FM, and maternal hemodynamics. Therefore, there is no priority in using each of the methods. The monitoring of FHR and maternal hemodynamics is essential during analgesia. It is suggested that further surveys evaluate the incidence and causes of C/S after analgesia
The effects of intravenous magnesium sulfate on hemodynamic status and pain control in patients after laparotomy surgery: A double blind clinical trial
Get PDF Aims and background:  A major surgery such as a laparotomy can induce severe pain in a patient. However administration of pain control medications can have dramatic effects on the hemodynamic status of the patient. Therefore, the aim of this study was to investigate intravenous infusion of magnesium sulfate for pain control and its’ effect on the hemodynamic status of the patient after laparotomy surgery. Materials and methods:    In    this    clinical    trial    ,    80    patients    undergoing    laparotomy    surgery    were    randomly    classified    into intervention and control groups based on exclusion and inclusion criteria. The intervention group received a bolus of magnesium sulfate 50 mg /kg half an hour before surgery, and then an infusion of 500 mg /hr. for 24 hours    after    surgery.    P    <0.05    was    considered    significant. Findings: No    significant    difference    was    seen    before    and    after    surgery    between    the    intervention    and    control    groups    regarding hemodynamic status or pain severity up to 6 hours after surgery. However by 6 hours after surgery, the severity of pain in the intervention group was lower than in the control group. This difference was statistically significant    (P    =    0.01).    Conclusion: Magnesium sulfate has little effect on the hemodynamics of the patients undergoing surgery, but also    was    not    effective    for    the    control    of    pain    in    the    first    hours    after    surgery    However        six    hours    after    surgery    a    pain control effect was noted
Occupational Exposures to Anesthetic Gases in Operating Room
No full textDespite the significant role of environment in human safety, the impact of operating room environment on staff health was considered in the middle of 1990s.1 Operating room staff, particularly women are among high risk groups due to exposure to chemicals, ionizing radiation,2 drugs, pathogens-induced blood infection, needle stick injuries and contact with contaminated secretions, blood and body fluids.3,4 However, one of the occupational hazards is exposure to anesthetic agents.5 Anesthetic gases are the primary source for hospital air contamination.6 These gases are rapidly eliminated from the body due to their low solubility.5 Therefore, there have been reported several neurological toxic, immunosuppressive, reproductive effects, carcinogenic, genetic damage, liver-kidney and respiratory adverse effects.7 Repeated exposure may lead to cellular damage, increases in cell proliferation, hyperplasia and finally tumor development.5 The effects of chronic exposure to anesthetic gases on the medical staff and team"s health and well-being are of prime important. In survey of occupational exposures literature from 2000 to 2016, general information about occupational exposures to anesthetic gases in operating room was collected. The most important finding of the articles reviewed and published concerning the dangers of anesthetic gases in the operating room staff is occupational exposure to anesthetic gases, including genotoxic damage and fetal abortion and abnormalities and liver toxicity in the operating room staff. Genotoxity is associated with waste inhaled anesthetic.8 Significant amount of inhaled anesthetic gases was found in dental surgery clinics, resulting in spontaneous abortion and liver disease.9 Primary studies on N2O toxicity due to exposure with N2O showed reproductive problems, but this concern was not demonstrated.10 The approaches for diminishing of operating room staff exposure-related risks include appropriate guidelines such as lowering their work hours in operating rooms, considering recommended exposure limit for special groups such as pregnant women or those with hepatic dysfunction, providing comprehensive training course, improving ventilation scavenger system, utilizing standard equipment as far as possible and promoting self-awareness
