Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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Randomized Controlled Trial
Experience with a gonadotrophin-releasing hormone agonist prior to myomectomy--comparison of twice- vs thrice-monthly doses and a control group.
The aim of this randomised prospective study was to investigate the impact of preoperative gonadotrophin-releasing hormone agonist (GnRHa) compared with a control group with myomectomy. A total of 36 women (n = 36, group 1) with fibroids were randomised to receive either two monthly doses (n = 18/36, group 1a) or three monthly doses of goserelin (n = 18/36, group 1b) prior to myomectomy. ⋯ There were no significant differences among the three groups with respect to: (1) mean intraoperative blood loss; (2) preoperative and postoperative blood transfusion or (3) length of hospital stay. The only advantage of administering GnRHa prior to myomectomy for symptomatic fibroids in our population was a higher haemoglobin level prior to surgery among the women who received three doses of the drug.
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Randomized Controlled Trial Comparative Study
Effect of oronasopharyngeal suction on arterial oxygen saturation in normal, term infants delivered vaginally: a prospective randomised controlled trial.
Oronasopharyngeal suction (ONPS) with a suction bulb at birth is a traditional practice in the initial management of healthy infants in Iran and many other countries. The purpose of this study was to compare the effects of oronasopharyngeal suction (ONPS) with those of no suction in normal, term newborns delivered vaginally. A total of 170 healthy term infants of first and single uncomplicated pregnancies, with clear amniotic fluid, vaginal delivery and cephalic presentation, enrolled in the trial during labour. ⋯ Newborns receiving suction showed a statistically significant, lower mean partial carbon dioxide pressure (PCO2) and a significantly higher partial oxygen pressure (PO2) of umbilical artery. Although the differences were statistically significant, these were not considered clinically significant because values remained within normal ranges. According to this study, ONPS is not recommended as a routine procedure in normal, term infants delivered vaginally.
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Randomized Controlled Trial Comparative Study
Paracetamol vs dexketoprofen for perineal pain relief after episiotomy or perineal tear.
A randomised controlled trial was conducted to investigate efficacy of paracetamol and dexketoprofen trometamol for perineal pain relief after perineal repair. Subjects were randomly assigned to receive two doses of either 50 mg of intravenous dexketoprofen trometamol via slow i.v. infusion (Group I, n = 49) or 1,000 mg of paracetamol via intravenous infusion (Group II, n = 46). The main outcome measure was a VAS (visual analogue scale) for pain recorded at 1 h (VAS 1). ⋯ There was no difference among groups in terms of pain scores at the beginning (VAS 0). The pain was decreased in 70% of the patients in Group I and in 62% of the patients in Group II (p = 0.502). Both paracetamol and dexketoprofen are effective in perineal pain relief after episiotomy or perineal tear repair.
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Randomized Controlled Trial Comparative Study
A randomised controlled trial of sublingual misoprostol and intramuscular oxytocin for prevention of postpartum haemorrhage.
This study aims to evaluate the efficacy and side-effects of 200 μg sublingual misoprostol vs 5 IU i.m. oxytocin, administered immediately following cord clamping in normal non-augmented vaginal delivery, in prevention of postpartum haemorrhage (PPH). A total of 104 women were randomised into three groups: misoprostol group (28 patients); oxytocin group (37 patients) and control group (39 patients). Misoprostol and oxytocin significantly minimised the blood loss during the third stage of labour and reduced the need for additional treatments for PPH as compared with the control group. ⋯ However, a significant decrease in systolic and diastolic blood pressure, associated with tachycardia was observed in the oxytocin group. In conclusion, sublingual misoprostol appears to be less effective than i.m. oxytocin in the prevention of PPH; however, it has the potential advantages of being easily used, cost-effective and stable at room temperature. Therefore, sublingual misoprostol is still a feasible drug for routine management of third stage, especially in areas with limited medical facilities.
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Randomized Controlled Trial
Does saline irrigation reduce the wound infection in caesarean delivery?
The aim of this prospective randomised study was to estimate the effect of saline wound irrigation before wound closure in the prevention of infection following caesarean delivery. Participants with indications for elective or emergency caesarean section were randomly allocated to two groups. A total of 260 women who underwent wound irrigation before wound closure and 260 did not. ⋯ There were also no significant differences between the groups in terms of factors known to influence wound infection. The incidence of wound infection was 7.3% for the control group and 6.5% for the saline group; however, the difference was not significant (relative risk: 0.88; 95% confidence interval: 0.45-1.74; p=0.86). In conclusion, saline wound irrigation before wound closure did not reduce the infection rate in patients undergoing caesarean delivery.