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Article
Comparison of Oral Misoprostol with Conventional Uterotonics in the Management of Third Stage of Labor

Authors: Hameedah Hadi --- Zahida A. Al- Saadi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4103-4110
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Randomized prospective control study it is objective to compare effect of oral misoprostol with conventional uterotonics in the management of the third stage of labor.Aim of study: The incidence of Hemorrhage and the decrease in hemoglobin concentration is the main out comes of the trial. Secondary outcomes included the occurrences of sever postpartum hemorrhage.Patient and method: This study was done in Department of obstetrics and gynecology at Baghdad Teaching Hospital. In controlled trials a pregnant women total number 280 were randomized into four groups, as followed: Group I: received oral misoprostol 400 Mg, followed by two doses of oral misoprostol 100 Mg 4hours a part. (n=72), group 2: received intravenous infusion of oxytocin10 IU plus oral misoprostol 400 Mg followed by two doses of 100Mg oral misoprostol 4 hours apart group 3: received intravenous infusion of oxytocin 10 IU. (n=69), group 4: received intravenous infusion of 10 IU oxytocin plus intramuscular administration of methylergometrine (methergine) 0.2 mg. (n=77). The data of 40 women were excluded from the study because of loss to follow up, previous cesarean deliveries performed after randomization n=25, pre delivery hemoglobin was unavailable n= 10, postpartum percentage of hematocrit unavailable n=5. Main measures, the incidences of postpartum hemorrhage and the changes in hematocrit concentration from before delivery to 24 hours postpartum, in those women used oral misoprostol in management of third stage of labor with or without the use of other uterotonicsResult: Shows, Mean blood loss in misoprostol group was not significantly higher than blood loss in oxytocin group and oxytocin misoprostol group, but there was statistically significant difference when compared with oxytocin-methylergometrine group.Conclusion: Oral administrated misoprostol is as effective as conventional oxytocic in prevention of postpartum hemorrhage


Article
Effectiveness of an Education Program on Nurses- Midwives' knowledge toward Postpartum Hemorrhage at Delivery Room of Maternity Hospitals in Baghdad City
فاعلية البرنامج التعليمي في معارف الممرضات القابلات باتجاه نزف مابعد الولادة في غرفة الولادة لمستشفيات الولادة في مدينه بغداد

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Abstract

Objectives: To find out the effectiveness of education program application on nurses-midwives' knowledge toward prevention and management of postpartum hemorrhage in delivery room and some socio demographic characteristics Methodology: a quasi -experimental "test-retest"design has carried throughout the present study with the application of a pre –test and post- test for nurses-midwives' knowledge toward postpartum hemorrhage. The study was conducted in six hospitals in Baghdad: Fatima Al – Zahra for Maternity and Pediatric, Al -Elwia maternity, Baghdad Teaching, AL-Imamine Al - Kadhimin Teaching, Al-Karckh maternity and Al-Yarmouk Teaching hospital for the period from 27th May 2018 to10th December 2018. The sample was conducted on Non-probability (purposive sample) of (97)nurse-midwife. Who were evaluated by using as questionnaire for the nurses-midwives' knowledge which consisted of two parts; the first part included the socio-demographic characteristics of the nurses and the second part included The knowledge of nurses - midwives towards prevention and management of postpartum hemorrhage consists of 43 questions in the form of multiple choices. Descriptive statistical and inferential analyses were used to analyze the data . Results: The result indicates that nurses - midwives' knowledge and practices about prevention and management of PPH have been greatly improved after their being exposed to the education program. Recommendation: The necessity of making periodical training program must conduct regularly in all obstetric hospitals for all nurses and midwives in the delivery rooms, operating theaters, maternity and maternity and emergency obstetric wards, and it should be mandatory

الهدف: تهدف الدراسة الحالية إلى معرفة فاعلية تطبيق البرنامج التعليمي على معارف الممرضات -القابلات باتجاه الوقاية وإدارة نزف ما بعد الولادة في غرفة الولادة.وإيجاد العلاقة بين معارف الممرضات- القابلات وبعض الخصائص الاجتماعية. المنهجية: استخدم تصميم شبه تجريبي"الاختبار واعادة الاختبار" مع تطبيق الاختبار القبلي والاختبار البعدي لمعارف وممارسات الممرضات –القابلات باتجاه نزف مابعد الولادة .اجريت الدراسة في ستة مستشفيات في بغداد:فاطمة الزهراء للولادة والاطفال ,العلوية للولادة, بغداد التعليمي,الامامين الكاظميين التعليمي,الكرخ للولادة ومستشفى اليرموك التعليمي, للفترة من 27 ايار 2018 الى 10 كانون الاول 2018,تم اختيار عينة غرضيه غير احتمالية متكونة من 97 ممرضة- فابلة, وتم استخدام استبانة لرصد المعارف والتي تكونت من جزئين الجزء الاول تضمن المعلومات الديموغرافية للممرضات-القابلات والجزء الثاني تضمن معرفة الممرضات - القابلات نحو الوقاية من نزف مابعد الولادة وادارته يتكون من 43 سؤال بشكل اختيارات متعددة, تم استخدام الاحصاء الوصفي والاستنتاجي في تحليل البيانات. النتائج: اظهرت نتائج الدراسة أن معارف الممرضات- القابلات حول الوقاية من نزيف ما بعد الولادة وإدارته قد تحسنت بشكل كبير بعد تعرضهن للبرنامج التعليمي.التوصيات: ضرورة إجراء برنامج تدريبي دوري بانتظام في جميع مستشفيات الولادة لجميع الممرضات والقابلات في غرف الولادة, غرف العمليات ، وأقسام التوليد والطوارئ ،ويجب أن تكون إلزامية

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