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Register a new userStudying Effect of Uterine Massage on the Immediate Postpartum Hemorrhage among Primiparae
دراسة تأثير المساج الرحمي على حدوث النزف ما بعد الولادة مباشرة عند الخروسات
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تشكّل نزوف الخلاص سببا" رئيسيا" لوفيات الأمهات على مستوى العالم, وتعتبر مسؤولة عن وفاة حوالي 125000 سيدة سنويا في البلدان المتطورة , وفي معظم الحالات 67 – 80% يكون سببها العطالة الرحمية, يعتبر المساج الرحمي إجراء بسيط وله تأثير كبير في منع نزوف الخلاص ويمكن استخدامه في المناطق ذات الدخل المحدود. الهدف: تقييم تأثير المساج الرحمي على حدوث النزف ما بعد الولادة مباشرة عند الخروسات.أدوات البحث وطرائقه: أجري البحث على عينة قوامها 40 سيدة خروس في مشفى الأسد الجامعي و مشفى التوليد والأطفال بمحافظة اللاذقية. تمّ تقييم النزف بواسطة استمارة ملاحظة ضمّت جدول زمني للمساج الرحمي ولنتائجه على شدة وكمية النزف من خلال قياس الخضاب و الهيماتوكريت قبل تطبيق المساج الرحمي وفي نهاية الإجراء. النتائج: أظهرت النتائج تناقص كمية النزف في المجموعة التجريبية, كان معدل الخضاب و الهيماتوكريت أعلى بشكل هام إحصائيا (10.4 ملغ/دل, 32.3%)(P=0.029*)(P=0.015*) عند الخروسات اللواتي تلقين المساج الرحمي. التوصيات والمقترحات: تقترح نتائج الدراسة الحالية على ضرورة تطبيق المساج الرحمي لجميع السيدات بعد المخاض و الولادة نتيجة فعاليته في إنقاص فقدان الدم ويوصى به أيضا في تعليم الممرضات على كيفية تطبيقه
Postpartum Hemorrhage (PPH) is the leading cause of maternal death worldwide. In the developing countries, it is responsible for the death of about 125 000 women each year. In most cases 67-80% are caused by uterine atony. Uterine massage would represent a simple intervention with the potential to have a major effect on PPH and maternal mortality in under resourced settings. Aim: The aim of the present study is to study the effect of uterine massage on the immediate postpartum hemorrhage among primiparae. Materials and Methods: The study was conducted of al-Assad Hospital and Children & Obstetrics Hospital (Lattakia), a convent sample of 40 primiparae women. Checklist application form was used to assess the postpartum hemorrhage by hemoglobin and hematocrit measurement before applying uterine massage and after the end of procedure. Results: This study demonstrated that the rate of hemorrhage decreased in the experimental group, hemoglobin and hematocrit was higher (10.4 mg/dl, 32.3%) (P=0.029*) (P=0.015*) among primipara who received uterine massage. Conclusions and Recommendations: Our present study results advice to apply uterine massage for all women after labor and delivery because its effective in reducing blood loss. It is also recommended to learn nurses how to apply uterine massage.
Artificial intelligence review:
Research summary
تتناول هذه الدراسة تأثير المساج الرحمي على حدوث النزف ما بعد الولادة مباشرة عند الخروسات. النزف ما بعد الولادة هو السبب الرئيسي لوفيات الأمهات حول العالم، حيث يعزى في معظم الحالات إلى العطالة الرحمية. تهدف الدراسة إلى تقييم فعالية المساج الرحمي في تقليل النزف بعد الولادة. أجريت الدراسة على 40 سيدة خروس في مشفى الأسد الجامعي ومشفى التوليد والأطفال في اللاذقية. تم تقسيم العينة إلى مجموعتين: مجموعة تجريبية تلقت المساج الرحمي ومجموعة ضابطة خضعت لروتين المشفى. أظهرت النتائج أن المساج الرحمي قلل من كمية النزف بشكل ملحوظ، حيث كان معدل الخضاب والهيماتوكريت أعلى في المجموعة التجريبية. توصي الدراسة بتطبيق المساج الرحمي لجميع السيدات بعد الولادة وتعليم الممرضات كيفية تطبيقه.
Critical review
دراسة نقدية: تعتبر هذه الدراسة ذات أهمية كبيرة نظراً لتناولها موضوعاً حيوياً يتعلق بصحة الأمهات بعد الولادة. ومع ذلك، يمكن الإشارة إلى بعض النقاط التي قد تحتاج إلى تحسين. أولاً، حجم العينة صغير نسبياً مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم التطرق إلى الآثار الجانبية المحتملة للمساج الرحمي بشكل كافٍ. ثالثاً، كان من الممكن تضمين مجموعة مقارنة إضافية تتلقى علاجاً دوائياً فقط لمعرفة الفرق بين التدخلات الدوائية وغير الدوائية. على الرغم من هذه النقاط، تظل الدراسة قيمة وتقدم توصيات عملية يمكن تطبيقها في الرعاية الصحية.
Questions related to the research
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ما هو الهدف الرئيسي من الدراسة؟
الهدف الرئيسي من الدراسة هو تقييم تأثير المساج الرحمي على حدوث النزف ما بعد الولادة مباشرة عند الخروسات.
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ما هي العينة المستخدمة في الدراسة؟
العينة المستخدمة في الدراسة تتكون من 40 سيدة خروس تم اختيارهن من مشفى الأسد الجامعي ومشفى التوليد والأطفال في اللاذقية.
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ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟
النتائج الرئيسية أظهرت أن المساج الرحمي قلل من كمية النزف بشكل ملحوظ، حيث كان معدل الخضاب والهيماتوكريت أعلى في المجموعة التجريبية مقارنة بالمجموعة الضابطة.
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ما هي التوصيات التي قدمتها الدراسة؟
توصي الدراسة بتطبيق المساج الرحمي لجميع السيدات بعد الولادة وتعليم الممرضات كيفية تطبيقه نظراً لفعاليته في تقليل فقدان الدم.
References used
International Labour Organization, Safe maternity and the world of work, Switzerland, 2007. Available at: http:// www.ilo.org/publns
Kotelchuck M, An Evaluation of the Kessner Adequacy of Prenatal Care Indexand a Proposed Adequacy of Prenatal Care Utilization Index, Journal of public health, America, 1994; Vol. 84,No.9,1414
Joint Policy Statement, Normal childbirth , J Obstet Gynaecol Can, Canada, 2008;Vol.30,No(12):1163
(Koung Lo. Postpartum practices among Cambodian mother in Preah vihear province: A qualitative study of beliefs and practices. Master thesis. Cambodia. Mahidol university, faculty of graduate studies;(2007
/Dans La .Patient satisfaction with intrapartum and postpartum nursing care. Memoire, University of Buea, Cameroon - 2009.Available at http://www.momireonline.com
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Skin-to-skin contact (SSC) between the mother and her infant immediately postdelivery
is an important procedure that must be included in the care given to mother and
her infant many health benefits. The mother's desire and reaction towards (SSC) is
the
decisive factor in the success of this procedure, so the current study aimed to investigate
the initial reaction of 200 women towards (SSC) immediately after their vaginal delivery
were randomly selected from the obstetric hospital and national children in Lattakia, data
were collected using a questionnaire developed for this purpose. The study showed that
nearly three-quarters of mothers agreed to have contact with their children in (SSC) and
nearly three-quarters of approvals preferred to be covered. The highest rate of response to
approvals for contact with their children immediately after birth was the expression of joy
in child and then hugging and kissing him. While the highest response of non-approvals for
contact with their children immediately Post-Delivery refused to touch the child because
they were suffering of pain. The study recommended that every mother in the labor room
be investigated for carrying her naked child or swaddled with a blanket immediately after
birth, not forcing them to immediately postpartum (SSC), the study recommended to
continuing education and training sessions to provide all midwives and nurses working in
the labor rooms with information and skills (SSC) for all mothers immediately Post-
Delivery, and further research on nurse and midwife information on the importance of
prompt (SSC) immediately Post-Delivery.
The study comprised 85 patients between 40-48 years old ,those have complained of DUB as either menorrhagia ,hyper menorrhea or both, the study was divided to :
Group A(50 patients): were given Norethisterone orally 5mg*3/daily for 6 months.
Group B (35 patients ):whose IUS was inserted for them and followed up for 1 year.
-The commonest side effect in GA was discomfort from taking the medicine 3times daily for long times (70%)while in GB was lower abdominal pain and low back pain(28,85%).
-The necessity to discontinue the treatment in GA was (61%)while in GB was(5,7%).-
-The improvement in Hemoglobin concentrate was better in GB than GA .-
-The successful of treatment was( 76% )in GA while( 88,35% ) in GB .-
-The total abdominal hysterectomy rate was( 22%) in GA while in GB( 8,55%)
The bleeding after delivery (Postpartum Hemorrhage-PPH) is the most important complications that occur after a natural or cesarean delivery, and represents about a quarter of maternal mortality around the world. Midwives play a basis role in preventi
on of bleeding after birth. So This research aims to evaluate the knowledge of midwives about using strategies to prevention and management the bleeding after delivery. Its sample included all midwives in obstetrics departments in Alasad University, Children and Obstetric, and Tishreen University Hospital all in Lattakia city. Data were collected using a questionnaire developed by researcher. The results according to strategies used in prevention and management of bleeding after delivery showed that 60% of the level of knowledge of midwives were "inappropriate". There were significant inverse relationship (P = 0.006) between ages of midwives and level of knowledge. Also showed a significant inverse relationship between number of years of experience with the midwives and level of knowledge (P = 0.01). So we suggest conducting training sessions and educational lectures for midwives with respect to the strategies used in prevention and management of bleeding after delivery, and must evaluate the midwives information about prevention and management of bleeding after delivery periodically and continuously.
This study was carried at Al Assad hospital, Lattakia. It is a retrospective study of uterine leiomyoma patients who had been accepted in the Department of Gynecology during the period between 1/6/2011 and 1/6/2013 .
The study included 103 patients.
We documented information for each patient: age, signs and symptoms, number of pregnancies and births, clinical and vaginal examination, ultrasound, blood tests: hemoglobin, hematocrit and red cell values, and the type of surgical treatment.
The prevalence of uterine leiomyoma in this study was 5.1%.
The most clinical manifestation of uterine leiomyoma was abnormal uterine bleeding (63.1 %).
Hemoglobin was less than 12 g / dL at 59.22% of cases.
Hematocrit was less than 36% at 57.28 % of cases.
This confirms that uterine leiomyoma patients are at high risk of anemia,
(we depended on cut off point of WHO for hemoglobin and hematocrit), and the anemia is by iron deficiency because the average values of red blood cells were less than normal.
Myomectomy is the surgical option among young women who want to reproduce or maintain menstruation, while abdominal and vaginal hysterectomy are surgical options for older women or who have completed their reproductive life .
PIVH is the most common neonatal intracranial hemorrhage.
Incidence range between20-59% .Most of PIVH occur in the first week of
life. There are different opinions about the time of onset and timing of
screening. This study aimed to know incidence
, symptoms, classification,
predisposing factors and outcome of PIVH in our NICU, and the best time
of screening .
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