Online ISSN: 2515-8260

Keywords : Cesarean section

Transverse Abdominis Plane Block For Management Of Postoperative Cesarean Section Pain

Mustapha Amin Fahmy El-Sayed; Abdulmagid Mahmoud Sarhan; Ahmed T. Abdellatif; Amr Ahmad Abdel-Rahman

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 2, Pages 2446-2453

Background: pain after Cesarean delivery (CD) can negatively affect ambulation, breastfeeding, and maternal bonding. The aim of this study was to determine whether a correctly performed TAPB can provide better control of acute postoperative pain during the first 48 hours after CS and if it can provide a faster postoperative recovery.
Patients and methods: included 32 participants who underwent elective caesarean section assigned randomly into two groups. Group A: 16 patients received TAP block. Group B: 16 patients did not receive any block. Medicine Ten centimeters visual analog scale (VAS) was also explained during preoperative visit. The postoperative pain was evaluated at 1, 2, 4, 8, 12, 18 and 24 hours by using VAS for pain scoring that was explained to the patients
during preoperative visit as a 100 millimeter horizontal line with verbal anchors at both ends. Results: Our study showed that there is statistically significant difference between the studied groups regarding VAS pain scorebaseline or at any point of time (significantly lower in TAP block group). In each group, there is significant change (increase) in VAS pain score over time. There is statistically significant difference between the studied groups regarding time for first analgesia (significantly longer in TAP block group). Number of patients who need nalufin was significantly higher in control group (ten patients within control group versus only one in TAP block group). Also, there is statistically significant difference between the studied groups regarding patient satisfaction. More than half of patients (56.2%) within TAP block group were very satisfied while half of those within
control group felt neutral (neither satisfied or not). Conclusion: Transverse abdominis plane block represents a viable alternative to common analgesic procedures performed for acute postoperative pain control after a CS.

Effect Of Polarized Light Therapy On Incisional Pain After Cesarean Section

Anan Abd El Shafey Anter Ahmed; Khadyga Said Abdel-Aziz; Mohamed Ahmed Mohamed Awad; AbdelRahman Hegazy AbdelWahab Mahmoud; Ahmed Aref Ahmed Hussein

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 3445-3453

Objective: This study was conducted to investigate the effect of polarized light therapy on incisional pain after (SC). Methods: Forty primipara women complaining from incisional pain post CS participated in this study. They had a single full term fetus during their gestation. The participant's ages ranged from 25-35 years. The control Group (Group A) were treated by traditional medical treatment immediately after recovery from anesthesia. The Study Group (Group B) were treated by traditional medical treatment immediately after recovery from anesthesia and polarized light therapy with energy density of an average of 2.4 J/cm2 15 minutes/session, one session /day for 5 consecutive days. Visual analogue scale (VAS) and electronic algometer were used to measure intensity of incisional pain post CS in both groups (A&B) before and after treatment. Results: Results of this study found that there was significant decrease of VAS and significant increase of pressure algometer after treatment in both groups A and B when compared with corresponding pre-treatment values (p<0.05). there was significant difference in mean values of VAS and pressure algometer between both groups (A and B) after treatment (p<0.05) (with favor of group B, more decrease VAS and more increase in pressure algometer). Conclusion: It can be concluded that polarized light therapy for 5 consecutive days' post SC is an effective adjuvant therapy in treatment of incisional pain through reducing visual analogue scale (VAS) and increasing electronic algometer.

Retrospective analysis of the birth histories of women who have suffered bleeding in order to optimize approaches to the prediction and prevention of postpartum bleeding

Poyonov O. Yoldoshevich; Karimova N. Nabidjanovna

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 2, Pages 6236-6243

The aim of our study was to retrospectively examine the history of childbirth and the quality of primary care for bleeding and evaluate the prescribed rehabilitation measures for women who have suffered postpartum hemorrhage and massive bleeding. The materials and methods of the study were 242 birth histories with postpartum hemorrhage for the last 6 years (2013-2018) in the city maternity hospital of Bukhara. The average age of the patients was 26.7 ± 1.2 years. The obstetric pathology leading to bleeding mainly consists of uterus hypotonia - 143 (59.1) and large fetus - 68 (28.1), and preeclampsia and DIOV are equal amounts - 33 (13.64). Only about 20% of women who had postpartum hemorrhage underwent early rehabilitation in the form of prescribing contraceptives.The aim of the research was to study the effectiveness of modern principles of stopping postpartum obstetric bleeding. From 127 cases of bleeding in 101 women (79.5%) the childbirth were with the operational method. With the development of blood loss was renderedstepwise ways to stop bleeding. During hemostasis of the bleeding, ligatures were imposed on the ovarian arteries and the ascending branch of the uterine artery for ischemicization of the uterus, which was effective in 30 (30%) women, and in 114 (89.7%) women managed to achieve organ-sparing tactics.

Implementation of Clinical Pathways as an Instrument for Controlling Service Costs in Hospitals

S A Andri; T P Bangun; J P Widodo; ThinniNurul Rochmah

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 5, Pages 831-835

The total real hospital costs for Social Health Insurance (BPJS) Kesehatanpatients undergoing cesarean section are much higher than the collectible costs using the Indonesia Case-Based Groups (INA-CBGs) package as the basis of their payment policy. The purpose of this study was to determine the effect of using clinical pathways as a means of controlling the total real hospital costs of BPJS Kesehatan patients undergoing cesarean section.This research used action research. The clinical pathway was applied to BPJS Kesehatan patients undergoing cesarean section from January 1 to March 31, 2014, and compared the real hospital costs between that period and BPJS Kesehatan patients undergoing cesarean section from October 1 to December31, 2013. From the 126 study groups, 65 clinical pathway forms (51, 58%) were complete. The average real hospital cost was significantly higher after the implementation of CP with p = 0.019. The average length of stay, service costs, and hospital costs were significantly lower in the complete CP form group with p = 0.012, p = 0.013, and p = 0.012 respectively.This study demonstrated that implementing the clinical pathway can reduce the actual length of stay and hospital costs in C-section patients, and demonstrated that using the clinical pathway can make services more efficient.