Research code: 997684
Ethics code: IR.IUMS.FMD.REC.1399.227
Clinical trials code: 0
1- Iran University of medical sciences, Department of Pediatrics, School of Medicine Shahid Akbar-Abadi Hospital
2- Iran University of medical sciences, Department of Pediatrics, School of Medicine Shahid Akbar-Abadi Hospital ,bordbari.a@iums.ac.ir
3- Iran University of medical sciences, Department of Anesthesiology, School of Medicine Shahid Akbar-Abadi Hospital Iran University of Medical Sciences
2- Iran University of medical sciences, Department of Pediatrics, School of Medicine Shahid Akbar-Abadi Hospital ,
3- Iran University of medical sciences, Department of Anesthesiology, School of Medicine Shahid Akbar-Abadi Hospital Iran University of Medical Sciences
Abstract: (484 Views)
Background: Childbirth pain is considered one of the most severe labor problems and important causes of childbirths' fearing for mothers (1), which has led to the use of anesthesia methods (2). The use of these methods due to a significant reduction in labor pain increases maternal satisfaction during NVD (Normal Vaginal Delivery) (3). Among these methods, the use of regional anesthesia compared to other methods has a growing trend (4). Although the use of analgesic methods can improve labor pain, there is still insufficient information about its effect on maternal and neonatal outcomes (6). One of the recent issues for researchers in this field is the relationship between umbilical cord status (ABG: Atrial Blood Gas) and painless delivery (7). The aim of this study was to evaluate the effect of painless delivery on ABG of the umbilical cord in neonates referred to Akbarabadi Hospital in 2018.
Materials and Methods: This was a cross-sectional study. The research place was Akbarabadi Hospital affiliated with Iran University of Medical Sciences. A total of 340 umbilical cord specimens of infants born through painless Normal Vaginal Delivery (NVD) (N =142) and routine NVD (N = 198) who referred to Akbarabadi Hospital in Tehran during 2018. Before starting the study, a data collection form was provided in which had demographic information about mothers including age, previous pregnancies, type of previous deliveries, and gestational age All mothers' case information and records were also carefully reviewed. Only mothers who wanted NVD and had more than 37 weeks gestational age were included in the study. All pregnancies of mothers were Singleton (Inclusion Criteria). On the other hand, no specific disease or anomaly was observed in their pregnancy ultrasounds. Mothers with a history of any specific disease such as diabetes, hypertension, placenta previa, placental abruption, and gestational age outside the range of 37 to 42 weeks were excluded from the study. After selecting the sample population, pregnant mothers were divided into two groups of painless NVD (study group) and routine NVD (control group); this division was according to the request and desire of mothers at the time of delivery.
Painless NVD was induced by injection of spinal anesthesia. The medicine used for anesthesia was Sufenthalil (a dose of 10 micrograms). Immediately after delivery, the umbilical cord was clamped at 10 and 20 cm intervals, and the umbilical cord was cut between the two clamps, and one cc of umbilical artery blood was transferred into the heparin syringe. The blood sample was then immediately transferred to a laboratory for ABG testing. In addition, data on Apgar scores of the first and fifth minutes of the baby, infant weight, gender of the baby, and age of pregnancy; duration of labor, and the use of oxytocin were recorded and collected. Blood sampling in the labor room and determination of Apgar score in all samples were performed by pediatricians. The collected data were analyzed using SPSS software version 25 (version 25, SPSS Inc., Chicago, IL). Quantitative data was displayed as Mean ± SD (mean and standard deviation). An independent sample-t-test was used to compare the mean data between the control and study groups. In this study, P-value equal to or less than 0.05 was considered statistically significant.
Results: The results showed that the mean and standard deviation of birth weight (BW) was 3229.83 ±413.24 (range = 4600-5050) grams, gestational age (GA) was 38.91 ± 1.06 weeks (Range = 42-37) and neonatal Apgar score was 8.94. ± 0.28 (range = 7-10). The results showed that the mean gestational age in the painless NVD group was significantly lower than the control group (P = 0.012). The results showed that there was no statistically significant difference between pH, PCO2, and HCO3 between normal and painless NVD groups, while this difference was significant for Base Excess (BE) (P <0.001). Considering that in addition to the type of delivery, GA and BW can also affect ABG and Apgar, a linear regression test was used to analyze the data in this section, and the association between type of delivery, GA, and BW with ABG and Apgar was investigated. Based on this test, it was found that there was no association between type of delivery, GA, and BW with PH, PCO2 and HCO3, and Apgar, but there was a significant relationship between the type of delivery and BE (P <0.001).
Conclusion: According to the results, there was no statistically significant relationship between most of the ABG parameters (except BE) in the two groups of painless normal delivery and normal delivery. It is recommended that additional (more specific) studies with higher sample size and longer duration More be done to further investigate the various forms of this issue.
Materials and Methods: This was a cross-sectional study. The research place was Akbarabadi Hospital affiliated with Iran University of Medical Sciences. A total of 340 umbilical cord specimens of infants born through painless Normal Vaginal Delivery (NVD) (N =142) and routine NVD (N = 198) who referred to Akbarabadi Hospital in Tehran during 2018. Before starting the study, a data collection form was provided in which had demographic information about mothers including age, previous pregnancies, type of previous deliveries, and gestational age All mothers' case information and records were also carefully reviewed. Only mothers who wanted NVD and had more than 37 weeks gestational age were included in the study. All pregnancies of mothers were Singleton (Inclusion Criteria). On the other hand, no specific disease or anomaly was observed in their pregnancy ultrasounds. Mothers with a history of any specific disease such as diabetes, hypertension, placenta previa, placental abruption, and gestational age outside the range of 37 to 42 weeks were excluded from the study. After selecting the sample population, pregnant mothers were divided into two groups of painless NVD (study group) and routine NVD (control group); this division was according to the request and desire of mothers at the time of delivery.
Painless NVD was induced by injection of spinal anesthesia. The medicine used for anesthesia was Sufenthalil (a dose of 10 micrograms). Immediately after delivery, the umbilical cord was clamped at 10 and 20 cm intervals, and the umbilical cord was cut between the two clamps, and one cc of umbilical artery blood was transferred into the heparin syringe. The blood sample was then immediately transferred to a laboratory for ABG testing. In addition, data on Apgar scores of the first and fifth minutes of the baby, infant weight, gender of the baby, and age of pregnancy; duration of labor, and the use of oxytocin were recorded and collected. Blood sampling in the labor room and determination of Apgar score in all samples were performed by pediatricians. The collected data were analyzed using SPSS software version 25 (version 25, SPSS Inc., Chicago, IL). Quantitative data was displayed as Mean ± SD (mean and standard deviation). An independent sample-t-test was used to compare the mean data between the control and study groups. In this study, P-value equal to or less than 0.05 was considered statistically significant.
Results: The results showed that the mean and standard deviation of birth weight (BW) was 3229.83 ±413.24 (range = 4600-5050) grams, gestational age (GA) was 38.91 ± 1.06 weeks (Range = 42-37) and neonatal Apgar score was 8.94. ± 0.28 (range = 7-10). The results showed that the mean gestational age in the painless NVD group was significantly lower than the control group (P = 0.012). The results showed that there was no statistically significant difference between pH, PCO2, and HCO3 between normal and painless NVD groups, while this difference was significant for Base Excess (BE) (P <0.001). Considering that in addition to the type of delivery, GA and BW can also affect ABG and Apgar, a linear regression test was used to analyze the data in this section, and the association between type of delivery, GA, and BW with ABG and Apgar was investigated. Based on this test, it was found that there was no association between type of delivery, GA, and BW with PH, PCO2 and HCO3, and Apgar, but there was a significant relationship between the type of delivery and BE (P <0.001).
Conclusion: According to the results, there was no statistically significant relationship between most of the ABG parameters (except BE) in the two groups of painless normal delivery and normal delivery. It is recommended that additional (more specific) studies with higher sample size and longer duration More be done to further investigate the various forms of this issue.
Type of Study: Research |
Subject:
Pediatric Disease
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