The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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J. Matern. Fetal. Neonatal. Med. · Jun 2020
Randomized Controlled TrialCurative effect of remifentanil on labor analgesia in newborns.
Objective: To investigate the curative effect of remifentanil on analgesia in newborns. Patients and methods: One hundred and twenty full-term puerperae from January 2013 to December 2013 were selected and randomly divided into three groups: remifentanil patient-controlled intravenous labor analgesia group (Group A, n = 40), patient-controlled epidural analgesia (PCEA) group (Group B, n = 40), and spontaneous labor group (Group C, n = 40). General conditions, visual analogue scale (VAS) score, labor stage, bleeding, delivery mode, neonatal asphyxia rate, oxyhemoglobin saturation in puerpera, and umbilical arterial blood gas analysis indexes of the fetus were measured. ⋯ The active phases in the first stage of labor in Group A and B were significantly shorter than that in Group C (p <.05). There were no significant differences in general conditions, VAS score before analgesia, the second and third stages of labor, delivery mode, bleeding, neonatal asphyxia rate, oxyhemoglobin saturation, pH value, partial pressure of oxygen (PO2), and partial pressure of carbon dioxide (PCO2) among three groups (p > .05). Conclusions: Remifentanil intravenous labor analgesia is not superior to PCEA, but does not increase adverse effects, suggesting it might be a supplementary method of PCEA.
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J. Matern. Fetal. Neonatal. Med. · Apr 2020
Randomized Controlled Trial Multicenter StudyMaternal car driving capacity after birth: a pilot prospective study randomizing postnatal women to early verses late driving in a driving simulator.
Background: Women are commonly advised to avoid driving following cesarean section (CS), however, this advice is based upon little evidence. Aims: We aimed to assess a woman's capacity to drive a car postbirth using a driving simulator to objectively examine driving behavior and competencies. Materials and methods: We conducted a pilot, prospective, randomized study from a tertiary referral hospital in Sydney, Australia. ⋯ At 7-8 weeks, all women were driving, without an accident. Conclusions: Although the study is limited by small sample size, there was no difference in driving capability by early versus late driving time since birth, nor by mode of birth. Further research is needed, but we cannot provide evidence to discourage well women from driving from 2-3 weeks post birth.
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J. Matern. Fetal. Neonatal. Med. · Jan 2020
Randomized Controlled TrialDoes intact umbilical cord milking increase infection rates in preterm infants with premature prolonged rupture of membranes?
Objective: To investigate whether intact umbilical cord milking (I-UCM) can aggravate infection or result in other undesirable complications in preterm infants with premature prolonged rupture of membranes (PPROM). Methods: Neonates vaginally delivered between 28 and 37 weeks' gestation and complicated by PPROM before birth were randomly divided into two groups according to the cord clamping procedure: I-UCM before clamping and immediate cord clamping (ICC). Various parameters of the study participants were compared between the two groups. ⋯ However, preterm neonates in the I-UCM group had higher serum hemoglobin and hematocrit levels (p < .05) and received fewer blood transfusions (p < .05) than those in the ICC group. Conclusion: Milking the umbilical cord to a preterm neonate with PPROM will not aggravate neonatal infection or result in other undesirable complications. This simple procedure will improve hemoglobin values and hematocrit levels and may lessen the need for transfusion during the neonatal period.
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J. Matern. Fetal. Neonatal. Med. · Nov 2019
Randomized Controlled Trial Multicenter StudyPatient satisfaction and cosmetic outcome in a randomized study of cesarean skin closure.
Objective: To evaluate patient satisfaction and patient and physician assessment of scar appearance after cesarean skin closure with suture versus staples. Methods: Women undergoing cesarean delivery (CD) at ≥23 weeks' gestation via low-transverse skin incisions at three hospitals in the CROSS Consortium were randomized to receive skin closure using subcuticular absorbable suture or nonabsorbable metal staples. The primary outcome of this substudy, patient satisfaction, was assessed by surveys at the postpartum visit using a 10-point Likert scale. ⋯ Observer Scar Assessment Scale scores were median 12 (IQR 9, 15) for sutures versus 13 (IQR 9, 16) for staples; p = .01. Conclusions: Satisfaction with the closure method, satisfaction with the scar's appearance, and patient and physician assessments of scar cosmesis were all superior in those closed with suture. These results further support the use of sutures for cesarean skin closure.
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J. Matern. Fetal. Neonatal. Med. · Jun 2019
Randomized Controlled TrialThe effect of prophylactic oral tranexamic acid plus buccal misoprostol on blood loss after vaginal delivery: a randomized controlled trial.
The objective of this study is to evaluate the effect of prophylactic oral tranexamic acid (TA) plus buccal misoprostol on the amount of blood loss after vaginal delivery in women at low risk for post-partum hemorrhage (PPH). ⋯ In settings like rural area or home delivery in which oxytocin is not available, alternative oral TA plus buccal misoprostol may be considered as an effective line in prevention of PPH.