ABSTRACT: To determine the effect of 200 μg of intravenous nitroglycerin in the release of retained placenta by controlled cord traction.
In this randomized controlled study, 40 women with a placenta retained for 30 minutes received intravenously 200 μg of nitroglycerin or a normal saline solution before umbilical cord traction was initiated. The rates of successful removal of the retained placenta in the study (n=20) and control (n=20) groups were compared, as were blood pressure, pulse rate, blood loss, and adverse effects.
The placenta was released in only 15% and 20% of the participants in the study and control group, respectively. The remainder of the participants required general anesthesia and manual removal of the retained placenta regardless of group assignation. Blood pressure fell in significantly more women in the study group, but there were no differences in estimated blood loss or minor adverse effects.
Intravenously administered nitroglycerin did not facilitate the release of retained placenta by umbilical cord traction. However, cord traction may be performed longer than 30 minutes to attempt releasing the placenta before operative manual removal is initiated.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 02/2011; 112(2):103-6. · 1.41 Impact Factor
ABSTRACT: To evaluate the efficacy and level of satisfaction from mefenamic acid and hyoscine when used for pain relief during saline infusion sonohysterography.
In this double blind randomized controlled trial, 141 nulliparous women were allocated to receive 500 mg of mefenamic acid, 10mg of hyoscine or a placebo, which was packed in the same outer capsule. Saline infusion sonohysterography (SIS) was performed 30 min later by one operator. Pain and satisfaction scores were evaluated using a 10 cm visual analog scale. Baseline characteristics, pain and satisfaction scores were compared among the three groups. Pain scores were recorded before, after catheter insertion, during, immediately after, and 30 min after the procedure.
No statistically significant differences were found in baseline characteristics, pain and satisfaction scores among the three groups. Maximum pain during SIS was 4.40 ± 3.34, 4.67 ± 3.14 and 4.85 ± 3.19 in the mefenamic acid, hyoscine and placebo groups respectively. There was a 31.1% prevalence of intrauterine abnormality and the most frequent finding was endometrial polyp.
There is no benefit in using mefenamic acid and hyoscine in the prevention of pain occurring from SIS.
European journal of obstetrics, gynecology, and reproductive biology 12/2010; 155(2):193-8. · 1.97 Impact Factor
ABSTRACT: To compare the percentage of sperm tail membrane swelling under hypo-osmotic conditions between sperm treated with pentoxifylline and 2-deoxyadenosine.
Experimental in vitro study.
Thirty normal semen samples from male partners of infertile couples were collected. After sperm preparation by two-layer Percoll gradient method, each sperm sample was divided into three specimens. Pentoxifylline and 2-deoxyadenosine were separately added into two specimens, while the third specimen was used as a control. Hypo-osmotic swelling test was performed in all specimens. Percentage of swollen spermatozoa in each specimen was evaluated.
The mean percentage of swollen spermatozoa in the semen samples supplemented with pentoxifylline and 2-deoxyadenosine were both significantly higher than those in the control (82.8 +/- 7.7 and 83.0 +/- 9.5 vs 70.8 +/- 12.7; p < 0.001). There was no significant differences of swollen spermatozoa between pentoxifylline and 2-deoxyadenosine (p = 0.898).
Addition of pentoxifylline and 2-deoxyadenosine to the sperm prepared by the two-layer Percoll gradient method can almost equally enhance the sperm membrane integrity. Therefore, it may be beneficial to add these compounds to sperm preparation for use in assisted reproduction.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 02/2007; 90(2):211-5.
ABSTRACT: 1. To compare the accuracy of clinical and sonographic estimations of fetal weight in pregnant women. 2. To determine the contributing factors that may affect the accuracy of these two methods.
297 pregnant women who were admitted at labor room, Siriraj Hospital during the period of January 6 to February 26, 2004 were enrolled. The fetal weight was estimated clinically by the physicians, then blindly followed by sonographic estimation within 24 hours before delivery. The mean absolute error was calculated from the absolute of the difference between the estimated fetal weight and the actual birth weight of each method. Main outcome measurements were simple error, absolute error, absolute percentage error, and accuracy within 10% of actual birth weight.
The accuracy of clinical estimation of fetal weight was similar to sonographic estimation. The accuracy within 10% of both methods were 66.7 (95% CI 61.3, 72.0) and 65.3 (95% CI 60.1, 71.0), respectively. The estimation by both methods tend to be underestimated with the mean of absolute error 264.7 +/- 299.6 and 265.0 +/- 236.3 grams, respectively, and the mean of percentage error 9.0 +/- 9.7 and 8.6 +/- 6.9% of actual birth weight. The accuracy amongst possible contributing factors were compared and analyzed. The only one factor effect the accuracy significantly was actual birth weight < 2,500 grams in clinical estimation (P < 0.05). Sensitivity and specificity for prediction of birth weight lower than 2,500 grams was 82.6, 94.2% by clinical and 64.4, 97.6% by sonographic estimation. The positive predictive value and negative predictive value of both methods were 54.3, 98.5% and 82.9, 93.9%, respectively, while the efficacy was 93.3 and 92.6%.
Intrapartum clinical estimation of fetal weight was accurate as sonographic estimation, while the mean of error in grams or in percentage of birth weight were indifferent. The low-birth weight influenced the accuracy of clinical estimation significantly. However, clinical estimation is good enough for screening of the low-birth weight because of its high sensitivity and negative predictive value.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 3:S1-7.