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Register a new usercomparison of complications of sharp curettage and vacuum aspiration for first trimester abortion
مقارنة اختلاطات التجريف الحاد و بالممص في إسقاطات الثلث الأول من الحمل
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Tishreen University ورقة بحثية
Publication date
2016
fields
Medicine
and research's language is
العربية
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Shamra Editor
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يعتبر الإسقاط الاختلاط الحمليّ الأكثر شيوعا" للحمل الباكر, لذا لا بد من إتّباع إجراءات آمنة و فعالة لتدبيره. يعتبر الإفراغ الجراحي للرحم إحدى الطرق المتبعة لتدبير إسقاطات الثلث الأول للحمل, و هذا يتطلّب استخدام الرّشف بالممص أو التوسيع و التجريف الآلي (الحاد). هدف البحث و مبرراته: توصيف اختلاطات و مزايا و عيوب استخدام الرشف بالممص الكهربائي و تجريف الرحم الآلي في تدبير إسقاطات الثلث الأول للحمل, و تحديد الطريقة الأكثر فعالية و أمان في التدبير. مواد البحث و طرائقه: تضمنت الدّراسة 100 مريضة بقصة إسقاط ناقص أو منسي أو بيضة رائقة, بعمر حملي ≤ 12أسبوع حملي من مراجعي قسم التوليد و أمراض النساء بمشفى الأسد الجامعي باللاذقية بين تموز 2013 و تموز 2014. قسمت المريضات إلى مجموعتين: الأولى50 مريضة تم تدبيرهنّ بالرّشف باستخدام الممص الكهربائي, و الثانية 50 مريضة خضعن للتجريف الحاد. تمت جميع الحالات تحت التخدير العام. معايير الإخراج تضمنت: الحالة الحموية, الأمراض الداخلية و الجراحية الشديدة, اضطرابات التخثر, حالة غير مستقرة هيموديناميكيا. النتائج: الخصائص السّريريّة متشابهة في مجموعتي الدراسة. لم تسجل أية حالة وفاة والدية أو انثقاب رحم أو تمزق عنق رحم أو نزف غزير مهدد للحياة أو نقل دم في كلا المجموعتين. يترافق إفراغ الرحم بالتجريف الآلي بحاجة أكبر للمسكنات بعد الجراحة مقارنة مع الممص الكهربائي (P=0.022). يترافق إفراغ الرحم بالتجريف الآلي بفقد كمية أكبر من الدم مقارنة مع الممص الكهربائي اعتمادا على تغير قيم الخضاب (P=0.001). مدة الإجراء و الاستشفاء أقصر في مجموعة الرشف بالممص الكهربائي مقارنة بالتجريف الحاد. المجموعتان متشابهتان من حيث تمام الإفراغ. الخلاصة: بينت نتائج الدراسة أنّ فعالية الرّشف بالممص الكهربائي تماثل التجريف الحاد من حيث نجاح الإجراء في تدبير الإسقاط, لكن المعاناة من الألم و فقد الدّم كانت أكبر في مجموعة التجريف الحاد.
Abortion is the most common complication of early pregnancy, so that should be effectively managed with safe and appropriate procedures. Surgical evacuation of the uterus for management of first trimester abortions usually involves vacuum aspiration or sharp curettage. Objective:To compare the complications of electric vacuum aspiration (EVA) and sharp curettage (D&C) for first trimester abortions, and detect the method that ensure more safety and efficacy. Subjects and methods: The study included one hundred women with incomplete abortion, missed abortion or blighted ovum, gestational age less than 12 weeks whom come to the department of obstetrics and gynecology at Al-Assad university hospital in Lattakia , Syria between 1 July 2013 and 1 July 2014. They were allocated into two groups, group A (n = 50) underwent EVA and group B (n=50) underwent D&C. The procedures were performed using the general anesthesia. We excluded: febrile state, clotting disorders, sever medical and surgical complications, unstable hemodynamic state. Results: Clinical characteristics were similar in the two groups. There were no reports of maternal deaths, cervical laceration, uterine perforation or blood transfusion recorded in the two groups. Blood loss was greater with D&C group than with EVA group (0.001). need an analgesic was greater with D&C group than with EVA group (0.002). Duration of operation and hospitalization was significantly shorter with EVA group than with D&C group. The two groups were similar in success procedure. Conclusion: The efficacy of EVA was the same as that of D&C in successful the procedure, but pain and blood loss were experienced more in the D&C group.
References used
KNUDSEN‚L‚M. Reproductive rights in a global contex. Vanderbilt University press‚ pp.2006; 1-2
MOHAMED ABD EL GHAFAR. Comparative study of dilatation and curettage, manual and electric vacuum aspiration as methods of treatment of early abortion in Beni Suef, Egypt . International Research Journal of Medicine and Medical Sciences Vol. 1(1), pp. 43-50, March 2013
SAY‚L.; KULIER‚R.; GULMEZOGLU‚M.; CAMPANA‚A. Medical versus surgical methods for first trimester termination of pregnancy.Cochrane Database Syst Rev. 2005, 25: CD003037
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In this study , 103 pregnant women with the diagnosis of missed abortion
in the second trimester of pregnancy had been accepted to terminate the
pregnancy, by one of two methods : In the first group (53 patients ) we
used vaginal Misoprostol (cyto
tec ) ; in the second group (50 patients) we
used the classic method by insertion of Foley catheter followed by
induction of uterine contractions by oxytocine . (intravenous infusion ) .
Uterine curettage is considered the fundamental procedure in the treatment of
abortions especially in complete and missed abortions in many counties despite the availability of many alternative methods to treat these cases. It is also widely used as
a diagnostic means to diagnoses the endometrial abnormalities which cause abnormal uterine bleeding. This research aims to figure out complications rate which occur during uterine curettage and the subsequent complications rate and to identify the most important causes of them for the purpose of knowing the efficiency and the safety of the diagnostic and therapeutic uterine curettage.
Objective: To compare the effectiveness of Misoprostol administered
intravaginally every 12 versus 6 hours for termination of pregnancy in the
first and second trimesters.
Methods: Fifty six pregnant patients at 7 – 22 weeks of gestation were
ran
domized to receive 800 μg (first trimester) and 200 μg either every 12 or
every 6 hours for 48 hours.
Results: The incidence of abortion within 48 hours after initial dose, in the
first trimester was 100% in the two groups, in the second trimester the
incidences were 95.5 and 100%. The incidences of abortion by a single dose
in the first trimester were 85 and 10% in the 12 and 6 hours groups
respectively (P <0.001) The mean abortion intervals 8.3 , 20.2 and 12.4
hours in the 12 and 6 hour group respectively. Side effects were similar in
both groups.
Conclusion: Misoprostol administered vaginally is effective for termination
of first and second trimester pregnancies in non scared uterus. Giving the
medication at a shorter interval from 12 to 6 hours appeared to have no
significant benefit.
Research was conducted on a sample of 45 patients in the Department of hemodialysis in Alssad University Hospital in Latakia, It was implemented two policies nursing care included each policy applied on two experimental groups I and II for a period o
f 3 months, and the patients were monitored patients using the form author 3 parts of a demographic data and the activities of nursing care and monitoring the occurrence of complications. Results: The results showed the effectiveness of the application of the policy of nursing care, including exercise program in the prevention of the occurrence of complications during hemodialysis, effectiveness of exercise in the prevention of complications during hemodialysis, regardless of the activities of the sports program applied.
Conclusions: conclude from the study that the application of the policy of nursing care, including exercise program contributes to the prevention of the occurrence of complications (high / low blood pressure, nausea and vomiting, muscle spasm) during a session of hemodialysis.
Non Vascularized fibular Bone Grafts are consider one of the most method
which used in limp sparing surgery.
This study aims To knowledgement the early and later complications of the Non Vascularized fibular
grafts in bone reconstruction following
bone tumor resection.
the retrospective study was performed at 40 patients with malignant and benign
tumors, the study lasted from January 2007 to January 2011. during this period 40 surgical operation
were performed. This study depends on the arshef of bone Tumors unit- Albairouni hsspital.
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