Clin Exp Obstet Gyn
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Clin Exp Obstet Gyn · Jan 2006
Randomized Controlled TrialPostoperative analgesia after cesarean section by continued administration of levobupivacaine with the On-Q Painbuster system over the fascia vs ketorolac + morphine i.v.
This study aimed to detect if continuous local infusion of levobupivacaine with the On-Q Painbuster system provided postoperative analgesia of similar quality to morphine + ketorolac i.v. in patients undergoing cesarean section. ⋯ The i.v. system with morphine and ketorolac is more effective than levobupivacaine subcutaneous infusion in reducing postoperative pain associated with cesarean section.
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Clin Exp Obstet Gyn · Jan 2006
Case ReportsPrenatal diagnosis of vasa previa through color Doppler and three-dimensional power Doppler ultrasonography. A case report.
Vasa previa occurs in pregnancy when one of the membrane vessels extends down to the level of the internal cervical os, ahead of the fetal presenting part and unsupported by the placenta tissue or umbilical cord. The rupture of the vessels might happen spontaneously or artificially and frequently results in fetal exsanguination and demise. Ultrasound prenatal diagnosis is highly important as it allows the identification of patients at risk, thus an elective cesarean can be performed before rupture the membranes. We report a case of vasa previa diagnosed through color Doppler mode in the 30th week of gestation, emphasizing the contribution of three-dimensional power Doppler to the adequate mapping of aberrant vessels, which greatly contributed to the success of the perinatal result.
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Clin Exp Obstet Gyn · Jan 2006
Comparative StudyThe influence of the mode of anaesthesia in the incidence of neonatal morbidity after an elective caesarean section.
We conducted a study of all the cases of elective caesarean section over a three-year period from 1 July 2001 to 30 June 2004, with the aim to compare general, epidural and spinal anaesthesia in respect to the incidence of neonatal respiratory morbidity. ⋯ The different anaesthesia techniques in elective caesarean section do not seem to influence neonatal respiratory morbidity.
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Clin Exp Obstet Gyn · Jan 2006
Placental umbilical cord whole blood transfusion to combat anemia in the background of advanced rheumatoid arthritis and emaciation and its potential role as immunoadjuvant therapy.
Rheumatoid arthritis is the commonest form of inflammatory arthritis and affects about 1-3% of the population in the West and even more in the developing world due to the compounded factors of late detection and inadequate treatment in the overall background of poverty, deprivation, and improper macro and micronutrients in the diet in a sizeable segment of the population. Nearly 90% of patients with aggressive disease will become clinically disabled within 20 years. Furthermore, in patients with severe disease or extra-articular symptoms, mortality is equal to that for patients with triple artery coronary artery disease or Stage IV Hodgkin's lymphoma. ⋯ Each case was passed through the institutional ethical committee. The patients received two to six units of freshly collected placental umbilical cord blood without encountering any clinical, immunological or non-immunological reactions. Three days after completion of the transfusion of placental umbilical cord blood, the peripheral blood hematopoietic stem cell (CD34) estimation revealed a rise from the pretransfusion base level (.09%), varying from 2.03 to 23%, which returned to base level in most of the cases at the three-month CD34 re-estimation, without provoking any clinical graft vs host reaction in any of the patients.
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Clin Exp Obstet Gyn · Jan 2006
Randomized Controlled TrialPlacental umbilical cord blood transfusion: a new method of treatment of patients with diabetes and microalbuminuria in the background of anemia.
Diabetes mellitus is the commonest endocrine disease in all populations and all age groups. It is a syndrome of disturbed intermediary metabolism caused by inadequate insulin secretion or impaired insulin action, or both. Anemia is a common accompaniment of diabetes, particularly in those with albuminuria justifying tubulointestitial injury or reduced renal function. ⋯ We have not encountered any clinical, immunological or non-immunological reaction so far in either group. Fetomaternal cell traffic has been implicated as the cause of scleroderma in mothers delivering male babies. In the present series, we did not see any such rare and unusual complication due to neonatal blood transfusion in the adult system in Group B patients in the six years from the initiation of the study.