Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom.

Saving Mothers’ Lives. Reviewing maternal deaths to make motherhood safer: 2006–2008

Objective: To review the clinical aspects of postpartum hemorrhage (PPH) and provide guidelines to assist clinicians in the prevention and management of PPH. These guidelines are an update from the previous Society of Obstetricians and Gynaecologists of Canada (SOGC) clinical practice guideline on PPH, published in April 2000.

https://www.jogc.com/article/S1701-2163(16)34329-8/pdf

Active Management of the Third Stage of Labour: Prevention and Treatment of Postpartum Hemorrhage

Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anaesthesiologist, and subsequent determination of the responsible agent(s) with strict avoidance of subsequent administration of all incriminated and/or cross-reacting compounds However, correct identification of the causative compound(s) and safe alternatives is not always straightforward and, too often, not done This review is not intended to discuss acute management of anaesthesia-related anaphylaxis but summarizes the major causes of anaphylaxis during anaesthesia and the diagnostic approach of this rare but potentially life-threatening complication Apart from general principles about the diagnostic approach, history taking and importance of tryptase quantification, more specific confirmatory diagnostic procedures are organized on the basis of the major causes of perioperative anaphylactic reactions

https://faculty.washington.edu/ramaiahr/Review%20Articles/Anapylaxis%20diagnostic%20approach

Anaphylaxis during anaesthesia: diagnostic approach

BACKGROUND: ECG changes, similar to those seen during myocardial ischaemia, together with symptoms of chest pain, are common during Caesarean section (CS). We hypothesized that oxytocin administrat ...

/pdf/signs-of-myocardial-ischaemia-after-injection-of-oxytocin-a-2ooyfqrb8l.pdf

Signs of myocardial ischaemia after injection of oxytocin: a randomized double-blind comparison of oxytocin and methylergometrine during Caesarean section

Background The cardiovascular effects of oxytocin in animal models and women undergoing Caesarean section include tachycardia, hypotension and decrease in cardiac output. These can be sufficient to cause significant compromise in high-risk patients. We aimed to find a simple way to decrease these risks whilst retaining the benefits of oxytocin in decreasing bleeding after delivery. Method We recruited 30 women undergoing elective Caesarean section. They were randomly allocated to receive 5 u of oxytocin either as a bolus injection (bolus group) or an infusion over 5 min (infusion group). These women had their heart rate and intra-arterial blood pressure recorded every 5 s throughout the procedure. The haemodynamic data, along with the estimated blood loss, were compared between the groups. Results Marked cardiovascular changes occurred in the bolus group; the heart rate increased by 17 (10.7) beats min−1 [mean ( sd )] compared with 10 (9.7) beats min−1 in the infusion group. The mean arterial pressure decreased by 27 (7.6) mm Hg in the bolus group compared with 8 (8.7) mm Hg in the infusion group. There were no differences in the estimated blood loss between the two groups. Conclusion We recommend that bolus doses should be used with caution, and further studies should ascertain if oxytocin is equally effective in reducing blood loss when given at a slower rate.

Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section

The purpose of this study was to investigate the effects of 12-weeks Hatha yoga program on estrogen, depression-related hormones and depression scale in middle-aged postmenopausal women. The subjects were randomly assigned to a Hatha yoga group(n=20) and a control group(n=17). Hatha Yoga program was conducted 3 times a week, the 1st 40-50%HRR(RPE 12-13), the 2nd 50-60%HRR(RPE 13-14), and the 3rd 60-70%HRR(RPE 14-15) for 12 weeks. The test data were analyzed by repeated measures ANOVA, paired t-test, independent t-test and the alpha level of .05 was set for all tests of significance. The results of the study in the estrogen was significantly increased in Hatha yoga group and control group. Serotonin decreaed significantly in control group, although the changes failed to reach a statistically significant level in Hatha yoga group. Dopamine decreased in both Hatha yoga group and control group. Cortisol tended to be decreased in Hatha yoga group and to be increased in control group, although the changes failed to reach a statistically significant level. Depression scale decreased significantly in Hatha yoga group. In conclusion, Hatha yoga pogram had positive effect on estrogen, depression-related hormones and depression scale in middle-aged postmenopausal women. 

Effects of 12 Weeks Hatha Yoga Program on Estrogen, Depression-related Hormones and Depression Scale in Postmenopausal Middle-aged Women

The purpose of this study was to identify the effect of yoga exercise on psychosocial well-being index-short form; PWI-SF, cortisol and high sensitive-C reactive protein; hs-CRP in menopause women. Twenty-three subjects within menopause periods volunteered to participate in this study and they were randomly designated to yoga exercise group(n=12) and control group(n=11). All data was caculated by SPSS 23.0 and we used paird-t test, independent-t test, two way repeated measures ANOVA to make a results. As a results of this study, PWI-SF showed interaction between yoga group and control group. Also, yoga group had a significant decrease and control group showed significant increase. As well as hs-CRP indicated interaction between yoga group and control group and significant increased in control group. From this point of view, our study suggested that performing regular yoga exercise can relive the daily stress in menopause women and also can give a positive effects on the hs-CRP which related in metabolic disease. However, this study had a little limitation because we couldn`t control their any other physical activities and daily diets. Although we have had limitation, we expected that this yoga exercise could be used in clinical rehabilitation to improve psychological symptoms and positve metabolism in menopause women. 

The Effect of Yoga Exercise on PWI-SF, Cortisol and hs-CRP in Menopause Women

연구목적 본 연구의 목적은 태권도 서기자세와 스텝박스 운동을 통해 무릎관절염 노인 여성의 건강체력을 증진하고 환자의 통증 완화와 성장호르몬에 긍정적 영향을 미쳐 골 관절 기능을 향상을 유도하여 무릎관절염 환자의 건강한 삶에 기여 하고자 한다. 연구방법 본 연구는 만 65세 이상 75세 이하의 여성노인을 대상으로 8주간 운동군(n=11), 대조군(n=9)으로 구분하여 운동군에게 태권도 서기자세와 스텝박스 운동을 실시하였다. 태권도 서기자세와 스텝박스 운동방법은 주 3회, 60분으로 준비운동 10분 태권도 서기자세 운동 20분, 스텝박스 운동 20분, 정리운동 10분으로 실시하였다. 결과 본 연구의 결과는 건강체력 중 골격근량, 근력, 근지구력, 오른쪽 유연성, 왼쪽 유연성, 심폐지구력에서 모두 그룹×시기 간 상호작용효과가 나타났고 운동 전·후 시기 간 차이에서 운동군이 유의한 증가를 나타내었다. 또한, 그룹 간 변화량에서 유의한 차이가 나타났다. 통증은 그룹×시기 간 상호작용 효과가 나타났으며 운동 전·후 시기 간 차이에서 운동군이 유의한 감소와 그룹 간 변화량에서 유의한 차이가 나타났다. 성장호르몬은 그룹×시기 간 상호작용 효과 및 운동 전·후 시기 간 차이에서 운동군이 유의하게 증가하였으며 그룹 간 변화량에서 유의한 차이를 나타내었다. 또한, 그룹 간 차이는 운동후 유의한 차이가 나타났고, 변화량에서 운동군이 대조군보다 유의하게 증가하였다. 결론 이상의 결과를 종합해 볼 때 8주간의 태권도 서기자세와 스텝박스 운동이 무릎관절염 여성 노인환자의 건강체력, 통증 및 성장호르몬에 긍정적인 영향을 미친 것을 확인할 수 있었으며 이는 무릎관절염 환자에게 프로그램의 적절성을 보여주는 결과라 생각되며 추후 연구에서도 태권도 서기자세와 스텝박스 운동을 통해 또 다른 긍정적 결과를 도출할 수 있을 것이라 기대한다. 

The Effect of Standing Posture of Taekwondo and Step-Box Exercise on Physical Fitness, Pain and Growth Hormone in Arthritis Old Adults Women

본 연구는 11주간의 복합운동이 인슐린 저항성, 렙틴, GLP-1에 미치는 영향을 구명하기 위하여 만 55세 이상 65세 미만의 폐경이 2년 이상 지난 비만 여성을 대상으로 운동군(n=12), 대조군(n=12)으로 구분하여 실시하였다. 트레드밀 걷기운동과 탄력밴드운동으로 구성된 복합운동은 11주간 주 3회, 1회당 60분으로 실시하였다. 트레드밀을 이용한 걷기운동 방법은 1-4주는 40-49%HRR, 5-8주는 50-59%HRR, 9-11주는 60-69%HRR로 실시하였다. 탄력밴드운동은 1-4주는 OMNI-RES 3-4의 저강도, 5-8주는 OMNI-RES 5-6의 중강도, 9-11주는 OMNI-RES 7-8의 고강도로 실시하였다. 측정 변인들에 대한 그룹 및 시기 간 상호작용을 검증하기 위하여 two-way repeated measures ANOVA로 처리하였고, 측정된 자료의 그룹 내 차이는 paired t-test, 그룹 간 차이는 independent t-test를 실시하였다. 통계적 유의수준은 .05로 설정하여 다음과 같은 결과를 얻었다. 인슐린 저항성에 대하여 글루코스, 인슐린, HOMA-IR은 그룹×시기 간 상호작용 효과가 나타났다. 운동 전·후 시기 간 차이에서 운동군이 11주 후 유의하게 감소하였으며 그룹 간 차이는 11주 후 변화량에서 유의한 차이가 나타났다. 또한, 렙틴은 그룹×시기 간 상호작용 효과가 나타났고, 운동 전·후 시기 간 차이에서 운동군이 11주 후 유의하게 감소하였으며 그룹 간 차이는 11주 후 변화량에서 유의한 차이가 나타났다. GLP-1은 그룹×시기 간 상호작용 효과가 나타났고, 시기 간 주효과가 나타났다. 운동 전·후 시기 간 차이에서 운동군이 11주 후 유의하게 감소하였으며 그룹 간 차이는 11주 후 변화량에서 유의한 차이가 나타났다. 이상의 결과를 종합해 볼 때 11주간의 트레드밀 걷기운동과 탄력밴드운동으로 구성된 복합운동이 폐경 후 비만 중년여성의 인슐린 저항성, 렙틴, GLP-1에 긍정적인 영향을 미친 것으로 사료 된다. 

SH Koh

Papers

Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section

Effects of 12 Weeks Hatha Yoga Program on Estrogen, Depression-related Hormones and Depression Scale in Postmenopausal Middle-aged Women

The Effect of Yoga Exercise on PWI-SF, Cortisol and hs-CRP in Menopause Women

The Effect of Standing Posture of Taekwondo and Step-Box Exercise on Physical Fitness, Pain and Growth Hormone in Arthritis Old Adults Women

Effects of Combined Exercise on Insulin Resistance, Leptin, GLP-1 in Postmenopause Obesity Women