Magnesium sulfate (MgSO4) is used extensively for prevention and treatment of eclamptic seizure (1, 2) and is considered as the ideal anti–convulsant drug in preeclampsia and eclampsia (3). The effect of Magnesium sulphate in vitro and in vivo on relaxing human uterine contractility was widely reported. Magnesium has a calcium antagonist effect that decreases calcium intracellular concentration and inhibits contraction process (4-6).
Many studies done during normal labor failed to prove the effect of magnesium sulfate on uterine muscle on prolonging labor or prompting cesarean section (7-10). However one study in mild preeclampsia during labor induction reported that i.v. magnesium sulfate resulted in a significantly higher maximum oxytocin dose required in labor when compared to placebo (8).
Oxytocin is the uterotonic drug commonly used in obstetrics. It is routinely administered in both normal and cesarean delivery to initiate and maintain adequate uterine tone for minimizing blood loss and preventing postpartum hemorrhage (11). It is vasodilator acting on vascular endothelial receptors causing a calcium-dependent response through stimulation of the nitric oxide pathway (12).
The aim of this study was to find out the impact of MgSO4 on the bolus dose requirement of oxytocin to achieve adequate uterine tone in patients with mild preeclampsia during CS.
Materials and methods
After obtaining approval from our Institutional Review Board and written informed consent, 80 parturients with mild preeclampsia between 18-40 years old were included in this randomized, double-blind study. The study was done at Saad Specialist Hospital, Alkhobar, Saudi Arabia between March 2012 and December 2013. Any parturient diagnosed as mild preeclamp...
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...ne value.
Depending on a previous study (14), the mean difference and the pooled standard deviation were calculated and the sample size was estimated (40 in each group), with power of study being 80% and confidence interval being 99%.
Data were statistically described in terms of mean standard deviation ( SD), or frequencies (number of cases) and percentages when appropriate. Comparison of numerical variables between the study groups was done using Student t test for independent samples. For comparing categorical data, Chi square (2) test was performed. Exact test was used instead when the expected frequency is less than 5. p values less than 0.05 was considered statistically significant. All statistical calculations were done using computer program SPSS (Statistical Package for the Social Science; SPSS Inc., Chicago, IL, USA) version 15 for Microsoft Windows.
The Bishop score is a pelvic scoring system developed to make it easier to determine whether a multiparous woman was a suitable candidate for induction of pregnancy. Although the information in the Bishop score was known by many obstetricians for many years, Edward H. bishop is credited because he pulled the pieces together and formed an organized system accompanied by research and statistics to back up his findings. His paper is called the “Pelvic Scoring for Elective Induction”. In this paper, Bishop describes basic minimal requirements that must be met before any patient can be considered for elective induction of labor (1964).
1. Preeclampsia. Women with this condition have high blood pressure during pregnancy, accompanied by water retention and protein in their urine. It can lead to complications including babies with low birth weight. However, if diagnosed and treated early, affected women can deliver normal babies. Treatment includes consuming a healthy, low salt diet and engaging in regular exercsie as recommended.
Mazel, Sharon, and Heidi E. Murkoff. "Placenta Previa." What To Expect When You Are Expecting. 4th ed. New York: Workman Publisher, 2008. 552-53.
As defined by Lowdermilk, Perry and Cashion, preterm labor is “cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy”. Preterm birth is a dramatic event causing distress for both the child and parents. There is a significant amount of information available on the risk factors related to preterm labor. Seeing the ineffectiveness of interventions directed towards known risk factors emphasizes the lack of maternal understanding of possible underlying pathways.
Collected data were subjected to analysis of variance using the SAS (9.1, SAS institute, 2004) statistical software package. Statistical assessments of differences between mean values were performed by the LSD test at P = 0.05.
The mother may has to go through unexpected labor pain during labor, which is pacified by induction
Magnesium sulfate is used as a tocoytic medicine to slow uterine contractions. It is given intravenously until contr...
Bell, M. (2010). A historical overview of preeclampsia-eclampsia. JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing, 39(5), 510-518. doi:10.1111/j.1552-6909.2010.01172.x
eclampsia in a pregnant woman can put her and her unborn child at risk. A risk
Postpartum hemorrhage is the leading cause of maternal mortality in the world, according to the World Health Organization. Postpartum hemorrhage (PPH) is generally defined as a blood loss of more than 500 mL after a vaginal birth, more than 1000 mL after a cesarean section, and a ten percent decrease in hematocrit levels from pre to post birth measurements (Ward & Hisley, 2011). An early hemorrhage occurs within 24 hours of birth, with the greatest risk in the first four hours. A late hemorrhage happens after 24 hours of birth but less than six weeks after birth. Uterine atony—failure for the uterine myometrium to contract—is the most common postpartum hemorrhage (Venes, Ed.).(2013). Other etiologies include lower genital tract lacerations, uterine inversion, retained products of conception and bleeding disorders (Kawamura, Kondoh, Hamanishi, Kawasaki, & Fujita, (2014).
Opiods are the most popular class of drugs used for post-cesarean analgesia. They are most useful in treatment of somatic pain. Use of morphine, diamorphine, fentanyl, sufentanil, meperidine, nalbuphine and buprenorphine is well documented. The various opiods differ in their potency and severity of side effects. A discussion of the merits and de-merits of each is beyond the scope of this article. The common minor side effects include nausea, vomiting, pruritus, shivering and urinary retention. Respiratory depression, especially late-onset, is a more dreaded complication.
The authors of this article have outlined the purpose, aims, and objectives of the study. It also provides the methods used which is quantitative approach to collect the data, the results, conclusion of the study. It is important that the author should present the essential components of the study in the abstract because the abstract may be the only section that is read by readers to decide if the study is useful or not or to continue reading (Coughlan, Cronin, and Ryan, 2007; Ingham-Broomfield, 2008 p.104; Stockhausen and Conrick, 2002; Nieswiadomy, 2008 p.380).
With the onset of labor the hormone estrogen is elevated so that it higher than progesterone, thereby reducing the relaxing effects of progesterone on the muscle. The rise in estrogen levels increases the uterus sensitivity to other factors that will stimulate uterine contractions. These include prostaglandins from the fetal membranes, and oxytocin from the mother’s posterior pituitary gland. The estrogen also increases the number of gap junctions which are connections that allow the uterine muscles to contract as a unit. Prostaglandins, which are produced by the deciduas and membranes, help to prepare the uterus for oxytocin stimulation at term. Once labor has begun, oxytocin helps to maintain labor. Oxytocin does not alone initiate labor, but it may work in conjunction with other substances. There is also evidence of fetal oxytocin secretion. Oxytocin receptors in the uterus, at the start of labor, increase considerably and reach their peak at the time of delivery. The oxytocin will have little effect if the receptors on the uterine muscle are not developed. The fetus, it seems, also plays a role. The fetal membranes release prostaglandins in large amounts during labor. Along with the fetal oxytocin concentrations released, fetal cortisol is also released in large amounts due to the fetal adrenaline. The release of cortisol acts as a possible uterine stimulant. For labor
"Transactions of the Washington Obstetrical and Gynecological Society."Google Books. N.p., n.d. Web. 20 May 2014.
Although childbirth appears to be a calm and unforgettable moment for mothers and family members, there can be severe complications that can affect not only the mother, but also the delivery and the child; on the contrary, the process may also run smoothly without any