The Effect of Education on Oral Feeding Supporting Practices in Preterm Babies on Health Professionals in NICU: A quasi-experimental study

Objective: The aim of this study was to determine the effect education on oral feeding supporting practices in preterm infants on healthcare professionals. Material and Methods: The study was a single group with pretest-posttest quasi-experimental design conducted at a medical faculty hospital in Turkey. A sample of 44 NICU healthcare professionals (nurse and physician) participated in an education programme. Data were collected using the Demographic Characteristics and Preterm Infant Feeding Qestionnaire Form. Participants were split into groups of 8 to 10 person and the education course was completed in average 45 minutes per day for five days. Prior to the education program, participants completed the pretest. The posttest was completed two weeks after completion of the education course. Data were analyzed using McNemar test and paired t test. Results: The average age of the participants is 26.14±4.81. Of the 44 participants, 86.4% were nurse, 13.6% physicians and 88.6% were female. While 63.6% of the healthcare professionals had NRP certification, 70.5% of them did not have the neonatal intensive care nursing certificate. It was determined that 40.9% of the participants were not educated about preterm infant feeding, while those who participated in the training were found to receive breast milk training in the context of in-service training. The mean rate of correct pretest answers was 58.69%, whereas the mean rate of correct posttest answers was 78% (p<0.001) Conclusion: It has been determined that the education given on oral feeding supporting practices in preterm infants improves knowledge the healthcare professionals’

Does the presence of anhydramnios affect the duration of medical abortion?

Objectives: The aim of the study was to determine whether anhydramnios affected the duration of medical abortion in cases with various indications as compared to cases with normal amniotic fluid volume. Material and methods: Patients who were admitted to our clinic because of medical abortion between January 2010–December 2013 were included in this retrospective study. A total of 32 pregnant women with anhydramnios (study group) and 67 pregnant women with normal amniotic fluid volume but with fetal abnormality (control group) were included in the study. Patient age, gravidity, parity, gestational age, previous delivery route, and duration of the abortion were recorded. Results: Mean duration of the abortion in the study group was 71.93 ± 47.51 h as compared to 79.08 ± 52.62 h in the control group. There were no statistically significant differences between the two groups in terms of duration of the abortion (p = 0.516). Also, we found no statistically significant differences in duration of the abortion with regard to previous delivery route (p = 0.220). Conclusions: There were no statistically significant differences between the study group and controls in terms of duration of the abortion. In addition, neither parity nor previous delivery route affected the duration of the abortion

The effectiveness of the double B-lynch suture as a modification in the treatment of intractable postpartum haemorrhage

A broader range of more effective compression techniques are needed in the patients who have an intractable postpartum haemorrhage due to uterine atony despite medical treatment and B-Lynch sutures. The aim of this study was to report the outcome of a series of patients with haemorrhage who were managed by double B-Lynch suture. Fourteen patients who were treated in a tertiary hospital between July 2010 and February 2015 were included in the study. The intractable haemorrhage rate was 0.35% over 5 years (14/4000 births). Bleeding was controlled in all the patients with a double B-Lynch suture. The mean age of the patients was 24 ± 3.4 years. The mean estimated blood loss was 1696 ± 272.075 mL, and the mean transfusion rate was 4.2 ± 2.5 units. Pregnancy was observed in five patients at follow up. The double B-Lynch suture seems to be an effective and reliable solution to an intractable postpartum haemorrhage resulting from uterine atony and has no unfavourable impacts on fertility. It should be considered before the use of any aggressive surgical techniques such as a hypogastric artery ligation or a hysterectomy. This the first study to investigate the effectiveness of the double B-Lynch suture, and we showed that the hysterectomy and/or hypogastric artery ligation rate can be decreased by adding a second B-Lynch suture in cases where the medical treatment or a single B-Lynch has failed.Impact statement What is already known on the subject? Uterine atony is the most common cause of a primary postpartum haemorrhage. When a simple massage of the uterus and medication failed to manage this condition, various surgical solutions have been sought, including uterine compression sutures, uterine artery ligation, devascularisation of the uterus, internal iliac artery ligation and, ultimately, a hysterectomy. The B-Lynch suturing technique is particularly useful because of its simplicity of application, life-saving potential, relative safety and capacity for preserving the uterus and subsequent fertility. To-date, this suturing technique, when applied correctly, has been successful with no problems and no apparent complications. However in the cases of when it falls, usually a hysterectomy or a hipogastric artery ligation is preferred. What does this study add? A ‘double B-Lynch suture seems to be an effective and reliable method in an intractable postpartum haemorrhage due to a uterine atony and has no unfavourable impact on fertility’. What are the implications of these findings for clinical practice? The double B-Lynch suture seems to be an effective, reliable and technically easy method. With this aspect, it might be considered before any aggressive surgical techniques, such as a hypogastric artery ligation and hysterectomy in selected cases

Reproductive outcome after hysteroscopic septum resection : a retrospective study

Amaç: Primer infertilite ve düşük veya prematür doğum öyküsü olan sekonder infertilite tanısı ile başvuran ve uterin septum saptanan olgularda histeroskopik septum rezeksiyonu sonrası gebelik sonuçlarının ve hızlarının retrospektif olarak saptanması. Gereçler ve Yöntem: Eylül 2009- Mart 2014 tarihleri arasında Mustafa Kemal Üniversitesi Kadın Hastalıkları ve Doğum kliniğine başvuran, histerosalpingografi ile uterin septum tanısı koyduğumuz primer veya sekonder infertil hastalara histereskopik septum rezeksiyonu uygulandı. 16 hasta primer infertilite; 20 hasta ise düşük ve/veya prematür doğum öyküsü olan sekonder infertilite grubunda idi. Hastaların retrospektif olarak verileri tarandıktan sonra hastalar aranarak operasyon sonrası gebelik bilgilerine ulaşıldı. Bulgular: 20 vakada komplet septus, 16 vakada parsiyel septus izlendi. Ortalama operasyon süresi 27,5 ± 7,0 dk. İdi. 4 (%11,1) vakada işlem sonrasında asherman sendromu gelişti. 3 (%8,3) vakada işlem sonrası servikal yetmezlik tespit edildiğinden dolayı servikal serklaj uygulandı. Histeroskopik rezeksiyon sonrası 25 olguda (%69,4) konsepsiyon sağlandı. Bu 25 olgunun 19'unda (%52,8) gebelik terme kadar ulaştı. 2 olguda ise düşük meydana geldi. Primer ve sekonder infertil kabul edilen grupta term gebelik hızı sırasıyla %53,3 ve %52,4 olarak bulundu. Histereskopik septum rezeksiyonu sonrası sekonder infertil gruptaki habituel abortuslu hastaların spontan düşük hızı %61,9 'dan %4,8 'e düştü ve canlı doğum oranları %19 'dan % 61,9 'a yükseldi.Sonuç: Histeroskopik septum rezeksiyonu gerek primer, gerekse sekonder infertil olgularda fertiliteyi olumlu bir ölçüde artırmaktadır. Bu yüzden infertilite veya tekrarlayan gebelik kayıpları saptanan olgularda septum varlığı araştırılmalıdır. Bu tür olgularda operasyon süresinin ve hastanede kalış süresinin kısalığı, ayrıca daha sonraki gebeliklere vajinal doğum şansı tanıması açısından histeroskopik yaklaşım tercih edilmelidir.Aim: To determine the conception and term pregnancy rates following the hysteroscopic resection of the primary and secondary infertile women with a septate uterus. Material and Methods: In 36 patients admitted to our department, from September 2009 to March 2014, with primary and secondary infertility (previous abortions, premature deliveries), uterine septum was detected via HSG. Primary and secondary infertility categories consisted of 16 and 20 patients, respectively. A retrospective study investigating reproductive outcomes following septum resection was conducted. Results were compared between pregnancies prior to and after the septum resection. Results: The mean duration of the operation was 27.5 ±7.0 mn. After septum resection, asherman syndrome was observed in 4 (11.1%) patients and 3(8.3%) patients was required cervical cerclage. 25 patients have conceived (69.4%) following the resection. Of these 25 cases, term pregnancy was achieved in 19 patients (52.8%). In primary and secondary infertility groups, the term pregnancy rate was found to be 53.3% and 54.2%, respectively. In secondary infertility group, the miscarriage rate for those who had experienced 2 or more previous miscarriages decreased from 61.9% to 4.8%. The term delivery rate also rose from 19% to 61.9%.Conclusion: Hysteroscopic septum resection promotes the fertility both primary and secondary infertility patients. Thus, patients with a history of recurrent pregnancy and infertility necessitates the investigation for the presence of the uterine septum. Hysteroscopic surgical approaches should be preferred in regard to the short duration of the operation and the hospital stay as well as the increased chance for the vaginal delivery in the next pregnancies following the operation