Uterine Hypertonia

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Bhavani Shankar Kodali - One of the best experts on this subject based on the ideXlab platform.

  • Changes in cardiac index during labour analgesia: A double-blind randomised controlled trial of epidural versus combined spinal epidural analgesia - A preliminary study
    Wolters Kluwer Medknow Publications, 2017
    Co-Authors: Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
    Abstract:

    Background and Aims: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or Uterine Hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. Methods: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia. The Electrical Cardiometry Monitor ICON® was used to continuously determine maternal CI non-invasively, heart rate (HR) and stroke volume at baseline and up to 60 min after initiation of either intrathecal or epidural analgesia. In addition, maternal systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Results: Both SBP and DBP had a similar, significant decrease following initiation of either epidural or CSE analgesia. However, parturients in the CSE group (n = 10) demonstrated a significant decrease in HR and CI compared to the baseline measurements. On the other hand, the parturients in the E (n = 13) group showed no decreases in either maternal HR or CI. Foetal heart changes were observed in four patients following CSE and one patient following an epidural. Conclusion: Labour analgesia with CSE is associated with a significant decrease in HR and CI when compared to labour analgesia with epidural analgesia. Further studies are necessary to determine whether a decrease in CI diminishes placental blood flow

Stephanie Yacoubian - One of the best experts on this subject based on the ideXlab platform.

  • Changes in cardiac index during labour analgesia: A double-blind randomised controlled trial of epidural versus combined spinal epidural analgesia - A preliminary study
    Wolters Kluwer Medknow Publications, 2017
    Co-Authors: Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
    Abstract:

    Background and Aims: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or Uterine Hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. Methods: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia. The Electrical Cardiometry Monitor ICON® was used to continuously determine maternal CI non-invasively, heart rate (HR) and stroke volume at baseline and up to 60 min after initiation of either intrathecal or epidural analgesia. In addition, maternal systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Results: Both SBP and DBP had a similar, significant decrease following initiation of either epidural or CSE analgesia. However, parturients in the CSE group (n = 10) demonstrated a significant decrease in HR and CI compared to the baseline measurements. On the other hand, the parturients in the E (n = 13) group showed no decreases in either maternal HR or CI. Foetal heart changes were observed in four patients following CSE and one patient following an epidural. Conclusion: Labour analgesia with CSE is associated with a significant decrease in HR and CI when compared to labour analgesia with epidural analgesia. Further studies are necessary to determine whether a decrease in CI diminishes placental blood flow

Rard Barrera Patricia - One of the best experts on this subject based on the ideXlab platform.

  • Características clínicas de trabajo de parto y su relación Con el sufrimiento fetal agudo en madres atendidas en el Hospital II-2 Minsa Tarapoto. Periodo Junio-Setiembre 2014
    Universidad Nacional de San Martin, 2014
    Co-Authors: Arévalo Rioja Lucía, Rard Barrera Patricia
    Abstract:

    This research is a descriptive correlational, cross-sectional, conducted in order to determine the relationship between the clinical characteristics of labor and fetal distress in mothers treated at the Hospital II-2 MINSA Tarapoto. Period June-September 2014. The study population consisted of 40 mothers whose births concomitant with acute fetal distress that were treated at the Hospital II-2 MINSA Tarapoto from June to September 2014 that formed the study group. Data collection was performed by reviewing medical records, which were processed through SPSS to determine the relationship between variables of study; reached the following conclusions: in most patients, the clinical characteristics of labor were normal or physiological; some clinical feature of labor dystocia were dystocia Uterine Hypertonia and dynamic as hyper systole (22.5%); dystocia fetal presentations (15.0%); cervical dystocia (17.5%). In newborns with acute fetal distress, they had nuchal cord (27.5%); thick green liquid amniotic fluid or green (37.5%); fetal bradycardia (27.5%); plus the DIPS DIPS II and III (32.5%). Also 90.0% of infants had moderate depression minute (Apgar of 4-6); then the 67.5% achieved good recovery condition of the newborn (Apgar of 7-10) at 5 minutes. Clinical signs of acute fetal distress concomitant with some clinical characteristics of labor were expelling meconium; circular cord; dystocia fetal heart rate; newborn with severe to moderate depression. Concluding: there is no statistical relationship (p> 0.05) between clinical characteristics of labor and fetal distress in mothers treated at the Hospital II-2 MINSA Tarapoto. June - September 2014 period.La presente investigación es un estudio descriptivo de tipo correlacional, de corte transversal, realizado con el objetivo de determinar la relación que existe entre las características clínicas del trabajo de parto y el sufrimiento fetal agudo en madres atendidas en el Hospital II-2 MINSA Tarapoto. Periodo Junio setiembre 2014. La población de estudio estuvo constituida por 40 madres cuyos partos concomitaron con sufrimiento fetal agudo que fueron atendidos en el Hospital II-2 MINSA Tarapoto de junio a setiembre del 2014 que conformaron el grupo de estudio. La recolección de datos se realizó mediante la revisión de historias clínicas, las cuales fueron procesadas a través del paquete estadístico SPSS para determinar la relación que existe entre variables de estudio; llegando a las siguientes conclusiones: en la mayoría de las pacientes, las características clínicas del trabajo de parto fueron normales o fisiológicos; algunas característica clínicas del trabajo de parto distócicos fueron: distocias de la dinámica uterina como hipertonía e hipersistolia (22.5%); presentaciones fetales distócicas (15.0%); distocia de cérvix (el 17.5%). En los recién nacidos con diagnóstico de sufrimiento fetal agudo, se presentaron circular de cordón (27.5%); líquido amniótico verde espeso o verde fluido (37.5%); bradicardia fetal (27.5%); además el DIPS II y DIPS III (32.5%). Asimismo el 90.0% de los recién nacidos presentaron depresión moderada al minuto (Ápgar de 4 a 6); luego el 67.5% alcanzó una recuperación de buena condición del recién nacido (Ápgar de 7 a 10) a los 5 minutos. Los signos clínicos de sufrimiento fetal agudo que concomitaron con algunas características clínicas de trabajo de parto fueron: expulsión de líquido meconial; circular de cordón umbilical; distocia la frecuencia cardiaca fetal; recién nacido con depresión severa a moderada. Concluyéndose: no existe relación estadística (p>0,05) entre las características clínicas de trabajo de parto y el sufrimiento fetal agudo en madres atendidas en el Hospital II-2 MINSA Tarapoto. Periodo Junio-Setiembre 2014.Tesi

Oei, Sg Guid - One of the best experts on this subject based on the ideXlab platform.

  • Placental abruption recorded with real-time electrohysterography : case report
    'Informa UK Limited', 2014
    Co-Authors: Vlemminx, Mwc Marion, Hout-van Der Jagt, Mb Beatrijs Van Der, Oei, Sg Guid
    Abstract:

    Brief Introduction: A non-invasive technique based on real-time electrohysterography (EHG) is recently developed by our group and being tested at the labour ward (PUREtrace, Nemo Healthcare, Eindhoven, the Netherlands). We present a case of placental abruption and Uterine Hypertonia recorded with real-time EHG. Materials & Methods: Not applicable. Clinical Cases or Summary Results: A 33-year-old pregnant woman at 35 weeks of gestational age in her second pregnancy presented with vaginal blood loss. Her obstetric history revealed a uterus unicollis bicornis and an intraUterine fetal demise due to placental abruption at 26 weeks of gestational age. In the current pregnancy, prophylactic aspirin 80 mg was described from 12 up to 36 weeks. At admission there were no signs of fetal distress or retroplacental hematoma. The vaginal bleeding stopped, however several days later the pregnancy was complicated by preterm rupture of membranes followed by contractions and two centimetres of dilation. The fetal heart rate tracings showed a normal fetal condition, while monitoring Uterine activity using external tocodynamometry was inconclusive. Therefore it was decided to use the EHG, by means of the Nemo Healthcare system consisting of a single abdominal electrode patch (Tocopatch, see Figure 1) and PUREtrace module connected to a Philips Avalon FM30 fetal monitor (Philips, Eindhoven, the Netherlands), which provided a cardiotocogram for real-time interpretation. Only half an hour later the pregnant woman presented acute onset of classical abruption signs such as severe abdominal pain, nausea, vomiting and fetal heart rate abnormality. The electrohysterogram showed a typical pattern of extreme Uterine Hypertonia (see Figure 2). Maternal vital signs were stable without vaginal blood loss. Within 15 minutes after the event an emergency caesarean delivery was performed, showing total detachment of the placenta. The neonate was born with a heart rate of 30 beats per minute and required neonatal resuscitation: Apgar score 0/6/8, umbilical artery pH 7.00, base deficit 17 mmol/L and neonatal body weight 2560 grams. During admission at the neonatal intensive care unit the newborn infant showed good clinical condition and no neurological sequels. Conclusions: This is the first report of real-time electrohysterography during placental abruption. The EHG showed a very typical pattern. Early recognition of this typical pattern might become important in patients with high risk of placental abruption. (Figure presented)

Corrina M Oxford - One of the best experts on this subject based on the ideXlab platform.

  • Changes in cardiac index during labour analgesia: A double-blind randomised controlled trial of epidural versus combined spinal epidural analgesia - A preliminary study
    Wolters Kluwer Medknow Publications, 2017
    Co-Authors: Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
    Abstract:

    Background and Aims: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or Uterine Hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. Methods: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia. The Electrical Cardiometry Monitor ICON® was used to continuously determine maternal CI non-invasively, heart rate (HR) and stroke volume at baseline and up to 60 min after initiation of either intrathecal or epidural analgesia. In addition, maternal systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Results: Both SBP and DBP had a similar, significant decrease following initiation of either epidural or CSE analgesia. However, parturients in the CSE group (n = 10) demonstrated a significant decrease in HR and CI compared to the baseline measurements. On the other hand, the parturients in the E (n = 13) group showed no decreases in either maternal HR or CI. Foetal heart changes were observed in four patients following CSE and one patient following an epidural. Conclusion: Labour analgesia with CSE is associated with a significant decrease in HR and CI when compared to labour analgesia with epidural analgesia. Further studies are necessary to determine whether a decrease in CI diminishes placental blood flow

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