جستجوی مقالات مرتبط با کلیدواژه « دیلاتاسیون » در نشریات گروه « پزشکی »

Considering the excruciating process of labor as well as anxiety and fear of natural childbirth, it is necessary to find an appropriate substance for expedite progression of labor and shortening labor duration in pregnant women. This study was performed with aim to determine the effect of topical magnesium sulfate on effacement, dilatation, and labor duration in primiparous women.

This randomized controlled clinical trial study was conducted in 2022 on 98 primiparous women with full-term pregnancy that had referred to Qazvin Kosar Hospital for delivery. Patients were randomly divided into intervention and control groups. After diagnosis of active phase, in the intervention group, 10 cc of magnesium sulfate 50% and in the control group, the same amount of distilled water was poured on the cervix during vaginal examination. The amount of effacement and dilatation at the beginning of the active phase and then every 2 hours, as well as mother's age, gestational age, number of pregnancies, BMI, type of delivery, duration of labor, Apgar score, weight of the baby, duration of contractions and intervals of contractions were recorded in the checklist. Data analysis was done using SPSS software (version 16) and Fisher's exact, Chi-square, t-test and Mann-Whitney tests. P<0.05 was considered statistically significant.

Duration and intervals of contractions in first and second examination were not significantly different in the intervention and control groups (P>0.05). Mean effacement in the intervention group at the start of active phase was 55.61±3.80 and after two hours was 70.21±4.19, which was statistically significant (P=0.021(. Mean dilatation in the intervention group at the start of active phase was 4.57±0.57 cm and two hours after was 7.31±0.71 cm, which was statistically significant (p=0.043(. Mean effacement and dilatation in the control group at the start of active phase and two hours later was not statistically significant (P>0.05).

Topical magnesium sulfate is effective on improving dilatation and effacement during labor and help speed up delivery.

Effacement and dilatation are important factors affecting the progress and duration of labor. Impairment in their progression can disrupt the normal progress of labor and lead to maternal and neonatal complications. For many years, topical magnesium sulfate has been used experimentally for labor progression in Iran. Therefore, this study was performed with aim to determine the effects of topical magnesium sulfate on progression of effacement, dilatation and duration of labor in nulliparous women.

This double-blind randomized clinical trial was conducted on 72 nulliparous women with term pregnancy that had referred to Tehran Mahdieh hospital for delivery from March 2016 to September 2017. The participants were randomly divided into two groups of magnesium sulfate and placebo (n=36 in each group). In the magnesium sulfate group (intervention), 10 cc of magnesium sulfate 50%, and in the control group, 10 cc of distilled water was poured on the cervix in the beginning of the active phase, and the labor progress was assessed in two groups. Data were analyzed by SPSS software (version 17) and using independent t-test, Mann-Whitney, Chi-square and Fisher's exact tests. P<0.05 was considered statistically significant.

Mean duration of active phase of first stage of labor was 1.75±1.13 hours in magnesium sulfate group and 3.85±1.87 hours in placebo group, that was 2.10 hours longer than magnesium sulfate group (P=0.001). The drop-in hemoglobin levels was significantly lower in magnesium sulfate group than in the control group (P=0.022). The number of normal vaginal delivery was higher in magnesium sulfate group, but this difference was not statistically significant (P=0.429). There were no significant differences between two groups in terms of neonatal Apgar score, ruptures in birth canal and the mother’s postpartum conditions (p>0.05).

The use of topical magnesium sulfate on the cervix in the active phase improves effacement and dilatation and shortens the duration of labor. Since there are very few studies on this subject, performing further studies are recommended.

The main objective of the present study was to evaluate the effect of Primary balloon angioplasty (PBA) versus hydrostatic dilatation (HD)in the fitting of suitable fistulas for hemodialysis . in An interventional study 38 patients were compared. in two groups of 19patients among patients. There was no difference in risk factors between the two groups. There was no fistula deficiency in the PBA group and all fistulas were functional in this group. The rate of intervention in PBA relative to HD was significantly increased from 5 to 42%, respectively. The mean age of puberty was 53 days in HD and 31 days in PBA, which was significant. PBA is a safe and efficient procedure for embedding necessary fistulas for dialysis, especially in small veins. This initial duct opening procedure has fewer times and less reciprocal intervention Key words: dilatation, Primary balloon angioplasty, hydrostatic, hemodialysis

Labor is a painful and prolonged process. Applying an uncomplicated method to reduce the length of delivery and severity of pain can increase maternal satisfaction and decrease the rate of cesarean section. Topical magnesium sulfate is empirically used to improve the effacement and dilatation of the cervix. The purpose of this study was to examine the effect of improving these variables on the intensity of labor pain.
This double blind clinical trial was conducted among 60 nulliparous women with full-term pregnancy. The participants were randomly divided into two groups of 30 individuals. The patients in the magnesium sulfate group received 10 cc of magnesium sulfate 50% and the control group were treated by 10 cc of distilled water poured on the cervix in the beginning of the active phase. Thereafter, the labor progress was studied in the groups. At the beginning of the active phase and two hours later, the severity of pain was measured using visual analog scale. Data analysis was performed using independent samples t-test, Mann-Whitney U test, Chi-squared test, and Fisher's exact test in SPSS software, version 17. P-value less than 0.05 was considered statistically significant.
Prior to the intervention, the intensity of pain was not significantly different between the two groups. After 2 hours of intervention in the control group, the mean pain intensity significantly increased (P=0.04), while in the magnesium sulfate group, the pain intensity did not change significantly. Two hours after the intervention, the mean of effacement and dilatation in the magnesium sulfate group was higher (P˂0.001).
The application of topical magnesium sulfate reduced the duration of labor by improving the cervical condition. In addition, it reduces the intensity of labor pain. However, it did not have a negative effect on the severity of uterine contractions.

Adenomyosis is a common benign disorder in premenopausal women. It may be presents with uterus enlargement, pelvic pain, abnormal uterine bleeding and dysmenorrheal. The main objective of this study was to assess prior uterine surgery was a risk factor for adenomyosis.
In this cross-sectional study, we reviewed the medical records of all women who underwent hysterectomy for benign and nonemergency gynecologic condition between 2001 – 2006 in Shariate hospital of Bandar Abbas. Data included: age, gravidity, parity, abortion, prior uterine surgery and uterine size by physical examination before hysterectomy, were collected from the clinical records and the information about adenomyosis was obtained from pathology records. Analysis was done using SPSS-16, descriptive statistics, T test and ANOVA. Significant level was set as P Of the 191 participants , 72 (37.7%) women had pathologically confirmed adenomyosis. The prevalence of adenomyosis in this study was 37.7%. women with adenomyosis reported a history of prior uterine surgery more frequently than women without adenomyosis but age, menarch, gravidity, parity and history of abortion were similar between the 2 groups.
This study indicated that adenomyosis had significant correlation with prior uterine surgery. And, confirmed that we can decrease prevalence of adenomyosis with decreased unnessecery uterine surgery.

Rigid broncoscopic dilatation is the lifesaving method for management of severe tracheal stenosis carried out under general anesthesia. However, for both anesthesiologist and bronchosco-pist, this procedure represents a most challenging practice. Inhalational induction which maintains spontaneous ventilation is commonly recommended in these patients. However, it needs a long time to reach the appropriate levels of anesthesia, and also airway instrumentation can precipitate coughing and complete airway obstruction. This paper describes our experience with rigid bronchoscopic dilation procedures performed with intravenous rapid induction of anesthesia in patients with severe postintubation tracheal stenosis. We conducted a retros-pective chart review of one hundred patients with severe post intubation tracheal stenosis who underwent rigid bronchoscopy for dilation of stenosis under general anesthesia at Masih Daneshvari and Kasra hospitals from Nov. 2011 to Sep. 2012. A rapid sequence induction of anesthesia was performed by intravenous injection of sodium thiopental and succinylcholine. Then an appropriate size of rigid bronchoscope was introduced into the trachea. If the airway was secured, dilatation of stenosis was done serially by different sizes of rigid bronchoscopes. Demographic, stenosis characteris-tics, and complications were recorded. There were 76 males and 24 females with mean age of 31.5±17.5 years. Following induction of anesthesia, the airway was rapidly secured in the first attempt with rigid bronchoscope in 97 patients. In 3 patients insertion of rigid bronchoscope was encountered with some problems, although airway control was done well and no major complications occurred. The intravenous rapid sequence induction of anesthesia by use of succinylcholine is safe for rigid brochoscopic dilatation in patients with severe post intubation tracheal stenosis. Close communication between the anesthesia and surgical teams are mandatory for the safe outcome of this procedure.

Using bouginage or balloon dilatation is the standard treatment for benign esophageal strictures. Aَbout two-thirds need repeated dilatations. For preventing recurrent strictures, many medications such as mitomycin-C have been used. Mitomycin-C is a special antibiotic with anti-neoplastic characteristics, which inhibits fibroblast proliferation, reduces collagen production and decreases scar formation. In this study, 12 patients with benign esophageal stricture during Azar 1386 to Bahman 1387 in Imam Khomeini Endoscopy Department were included. Esophageal endoscopy was done and mitomycin-C was applied on the place of stricture using a cotton ball. Then, response to treatment was categorized in three groups of complete response, partial response and non-response to treatment. Average number of using mitomycin-C was 4 ± 3 times. Mean interval between endoscopies before using mitomycin-C was 3. 5 ± 1 weeks and after using this agent was 8. 5 ± 4. 3 weeks. There were 4 cases of complete response, 5 cases of partial response and 3 patients of non-response. Conservative treatments in management of benign esophageal strictures are preferred to more invasive treatments. However, it seems using a topical solution of mitomycin-C carries better responses and reduces the rate of recurrent dilatations.

Uterine cervical incompetence is one of the risk factors for preterm labor and it is characterized by painless cervical dilatation and prolapse of membranes into the vagina in the second or third trimester of pregnancy. The aim of this report is to discuss a term pregnancy following complete bed rest in cervical insufficiency.

A 24-year old woman with a history of uterine cervical incompetence was admitted to hospital with cervical dilatation and effacement at the 24th week of gestation. She had a successful term pregnancy with bed rest and expectant management at the 39th week of gestation.

Expectant management with bed rest in an appropriate position, along with anti-coagulant prophylaxis is an effective and safe method for the management of cervical incompe-tency in advanced stages of pregnancy.

Abortion is the most common complication of pregnancy with a 15% prevalence rate that occurs through first and second trimester. Physiologically, genitalia system can not discharge pregnancy products, because ripening of cervix and uterus contractions are absent as two essential factors in labor, however, ripening of cervix is more important than the other factor. This development refers to shortness, effacement and dilatation of cervix that normally begins before labor at the end of the 3th trimester. This is an applied, multi-variable, monoside-blinded study performed to assess the effectiveness of PG and folly catheter on labor duration, hospitalization period, hospital costs, incomplete abortion, nausea and vomiting and bleeding. 70 pregnant women of 14-28w in need of cervix ripening were assigned in two groups randomly. One group received vaginal supp of Dinoperoston (3mg), repeated after 6 hours PRN. For the other group, a folly catheter filled with 30 ml N.S.was inserted in internal OS. Oxytocin serum augmentation developed after 12 hours in both the experimental groups. The data collected by questionnaire, examinations and patient medical records. The Collected data were analyzed by chi-square, fisher exact and T-student tests. According to the research achievements, there is no significant difference between the two groups in respect of hospital costs, hospitalization period, incomplete abortion, nausea and vomiting and bleeding (P>0/05), but there was a significant difference in case of Bishop Score and labor period (P< 0/05). Considering changes of Bishop Score in folly catheter as observed to be more than PG group and labor period less than that of PG group, it seems more logical to recommend the application of folly catheter for ripening of cervix.

Despite wide use of hyoscine by midwives and doctors as an adjunct to labor, the obstetrics literature contains few references to the effect of this drug. This study was a double blinded, randomized controlled trial of primigravidas in Iran to determine the effects of hyoscine intravenous injection on parturition (labor).

One hundred primigravidas in uncomplicated spontaneous labor with cervical dilation less than 4 cm and cervical effacement < 50% were randomly assigned into two groups the experimental group ( N = 50 ) receiving 20 mg hyoscine and the control group ( N = 50 ) receiving placebo, with predetermined codes injected at the beginning of the active phase of labor. The groups were compared for labor progress, fetal tachycardia and bradycardia after 0.5 and 1h of injection, Apgar score and birth weight. Statistical methods for normally distributed variables included 2- tailed student T test and chi- square analysis. The accepted level of significance was p < 0.05.

The two groups were similar in respect to maternal age, gestational age , initial cervical effacement & dilation and mean birth weight. The mean change in the cervical effacement and dilation after 1 & 2 h of injection was significantly higher in those receiving hyoscine (p< 0.0001). There was a significant difference in the duration of active phase and second stage of labor in the two groups ( p < 0.0001 ). Fetal tachycardia and bradycardia occurred more frequently in patients in the hyoscine group as compared to the control group but the difference was not significant. The difference between the mean first and fifth- minute Apgar score was not significant, too.

This small study suggests the benefits of a single dose of hyoscine for labor progress and represents the first attempt to evaluate this medication. However, larger randomized studies are needed to establish the efficacy, safety, and optimal dose of hyoscine .

Achalasia, a Neurologic disease, causes incomplete relaxation of lower esophageal sphincter (LES) and aperistalsism of esophagus. There are several methods of treatment including: medical, botolinum injection, Balloon dilatation and surgery. In adults, balloon dilation is well recognized for the first line treatment, whereas in children there are several but limited studies that elucidate its efficacy in this group too, and several validate centers use it for the first line treatment, in pediatric achalasia. Yet, we aimed to evaluate the success rate of balloon dilatation for the treatment of pediatric achalasia in Iran and have a base line study in our country. twenty - five pediatric patients (12 boys, 13 girls) from 4.5 months to 14 yrs old with average (9.25 ± 4.61 yrs) in two hospitals affiliated to Tehran Medical University, treated with balloon dilation appropriate with age (TTS or achalasia specific balloon rigiftex) under direct vision endoscopy from 1997-2003. These patients undergo follow up after one, two, and then every six month with average 36. 7 months. If any recurrence of symptoms occured, with greater size balloon treatment were done. Improvement for children over 5 yrs old include: sum of symptom score after treatment to pre- treatment lower than 50% and the reccurrence upper than 50%. For achalasia under 5 yrs old improvement include: no vomiting, improvement of relaxation of LES and normal movement of it with breathing and no esophageal inflammation on endoscopy. All patients during treatment and 6 hours later were under direct controlling for any side effects (bleeding, perforation, etc). In this study any child with previous surgery on esophagus were excluded. In this study 39 dilation for 25 patients were done (1.56 for every patient). About 48% (12 patient) one, 48% (12 patient) two, and one patient undergo three dilation. One patient (4%) after two dilation had symptoms of achalasia and suffered from it, but because of refusal from third one, accepted as treatment failure and referred for surgery. Five pediatric patients were under 5 yrs old, that all of them (100%) improved after treatment and did not have any problem until our follow up. Over all 96% of patients respond to balloon dilation treatment that with respect to vantrappen table: 64% excellent, 8% good and 24% had moderate response. During our study there were no serious side effects. Balloon dilatation for treatment of pediatric achalasia is very effective and safe and can repeat for several times under direct endoscopy.