Covid
Ramesh Baradaran Bagheri
Abstract
Introduction: TXA may lessen the need for hysterectomy, lessen the risk of developing severe anemia, and prevent the need for blood transfusions, all of which could significantly advance the objective of lowering maternal mortality, according to several RCTs that have examined the prophylactic role of ...
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Introduction: TXA may lessen the need for hysterectomy, lessen the risk of developing severe anemia, and prevent the need for blood transfusions, all of which could significantly advance the objective of lowering maternal mortality, according to several RCTs that have examined the prophylactic role of the drug (described in the discussion). Material and Methods: To make TXA injection, 1 gram (10ml) of TXA was diluted in 100ml of sterile saline. To those in the study group, TXA was infused intravenously for more than 15 minutes, at least 20 minutes before making a skin incision. The control group received no medication at all. All of the participants received spinal anesthesia. Surgery was performed by assistant professors with an MD degree and at least three years of experience. Results: Primary outcomes included blood loss from placental delivery to the conclusion of surgery and the percentage of hemoglobin difference, while secondary outcomes included the length of surgery and the percentage of patients who lost more than 500 ml of blood. There was a significant difference between the two groups in these primary and secondary outcomes. Conclusion: TXA significantly decreased the amount of blood lost during LSCS. Being in a hypercoagulable state during pregnancy increases the risk of thrombotic events. However, there were no negative side effects or complications in the first few weeks after delivery when this antifibrinolytic was used. So, when subjects are undergoing LSCS, TXA can be applied effectively and safely.
Medicine
Ramesh Baradaran Bagheri
Abstract
Introduction: The common perception that this treatment has no serious side effects is probably influenced by this flawed evidence. In this large population-based study, our goals were to determine whether there was an independent relationship between the amount of oxytocin exposed during labor and the ...
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Introduction: The common perception that this treatment has no serious side effects is probably influenced by this flawed evidence. In this large population-based study, our goals were to determine whether there was an independent relationship between the amount of oxytocin exposed during labor and the risk of developing severe PPH and to determine whether the prophylactic use of oxytocin after delivery affected this relationship. Material and Methods: women who had straightforward pregnancies and delivered term singletons vaginally. Cases were 1483 women with severe PPH, which was indicated by peripartum hemoglobin changes of less than 4 g/dl or the requirement for blood transfusions. 90 women from a randomly selected group of expectant mothers without PPH served as the controls. Using two-level multivariable logistic regression modeling, the independent relationship between the oxytocin level during labor and the risk of developing severe PPH was examined and quantified with ORs. Results: After adjusting for all possible confounders, oxytocin exposure during labor was linked to a higher risk of severe PPH when prophylactic oxytocin was not given after delivery. With more oxytocin injected, the association became stronger. The risk of severe PPH was approximately three times higher for total doses between 2 and 4 IU and six times higher for total doses over 4 IU. Conclusion: A separate risk factor for severe PPH appears to be oxytocin during labor. Our findings add to the body of evidence highlighting the need for precautions to reduce maternal complications when oxytocin is used to speed up labor, including strict indications, the use of the lowest effective dose, and careful efficacy evaluation.