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Third Stage Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Alyssa R. Hersh, Jorge E. Tolosa
Compared with oxytocin alone, ergot alkaloids in addition to oxytocin are associated with a statistically significant reduction in the risk of PPH when compared to oxytocin alone for blood loss of 500 mL or more. A network meta-analysis found a significant difference in blood loss 1000 mL or more [14]. There were no differences in blood transfusion, retained placenta, or other neonatal outcomes. Unfortunately, the adverse side effects when ergometrine is added to oxytocin are important to consider, including nausea, vomiting, and hypertension [15].
Cardiac Emergencies in Obstetrics
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Sanjeewa Rajapakse
Fluid overload should be avoided due to the risk of pulmonary oedema. Ergometrine should be used only in cases of severe postpartum haemorrhage. Thromboprophylactic measures such as early ambulation, thromboembolic deterrent stockings and low molecular weight heparin are important in minimising the risk of venous thromboembolic disease. In women with severe heart failure, breastfeeding is discouraged to reduce the high metabolic demand and to enable early optimisation of medical therapy.
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
First stage of labour is shortened by:Artificial rupture of the membranes.Forceps intervention.Caesarean section.Ergometrine intravenously.Oxytocin drip.
Biosensors for the detection of mycotoxins
Published in Toxin Reviews, 2022
Akansha Shrivastava, Rakesh Kumar Sharma
Ergot alkaloids are the secondary metabolites of fungi and these are produced by various species of Claviceps. The effect of this group of alkaloids has been shown in the middle ages called "Holy Fire" or "St. Anthony’s Fire", also known as the disease ergotism. Other alkaloids include ergometrine, ergotamine, and ergotoxine (Crews 2015, Miedaner and Geiger 2015). There are two forms of ergotism: Gangrenous, which affects the blood supply to extremities and convulsive, and ultimately affects the central nervous system. The fungal species which produce these alkaloids include Claviceps purpurea (rye and other cereals), Claviceps paspali (forage grass), Claviceps fusiformis, Claviceps gigantea, and Sphacelia sorghi (an anamorphic form of Claviceps). The clinical symptoms of ergotism are a manifestation in the form of gangrene, abortion, convulsions, suppression of lactation, and hypersensitivity (Berthiller et al. 2017). The ingestion of ergot occurs through infected cereals, commonly in the form of bread produced from contaminated flour. A recently reported another alkaloid from the same class, purpurolic acid from plant-parasitic sclerotia of Claviceps purpurea has been reported and considered as highly toxic for animal feed (Roberts et al. 2016). Ergot alkaloids contamination has been reported in rye food, wheat food, multigrain food, rye feed, wheat feed, and triticale feed. Among these samples, rye feed contained the highest amount of ergot alkaloids, i.e. 12,340 µg/kg (Malysheva et al. 2014).
The efficacy of pelvic arterial embolisation for the treatment in massive vaginal haemorrhage in obstetric and gynaecological emergencies: a single-centre experience
Published in Journal of Obstetrics and Gynaecology, 2019
All patients were treated conservatively before embolisation. Intravenous fluid resuscitation was carried out in hypovolemic cases, and transfusion of blood products was performed in patients with decreased haemoglobin, and haematocrit values. DIC patients were managed with hemodynamic and/or ventilatory support, fresh frozen plasma (FFP), red blood cell (RBC), and platelet concentrates. Patients with uterine atony had manual uterine massage in additional to uterotonic agents such as oxytocin, intramuscular or intravenous methylergonovin/ergometrine, prostaglandin E1 analogue misoprostol, prostaglandin E2 analogue sulprostone, and the antifibrinolytic agent tranexamic acid. Primary repair was carried out in cases with vaginal or genital tract laceration, and uterine evacuation was performed in cases of placental remnant. Patients with vaginal bleeding despite primary treatment were referred for PAE. Embolisation procedures were performed by experienced and well-trained interventional radiologists (S.O., M.H.O., and H.D., with 5, 20, and 25 years’ experience, respectively) in the interventional radiology unit. Patients’ pre-embolisation data was summarised in Table 2.
An evaluation of elvitegravir plus cobicistat plus tenofovir alafenamide plus emtricitabine as a single-tablet regimen for the treatment of HIV in children and adolescents
Published in Expert Opinion on Pharmacotherapy, 2019
Vania Giacomet, Maria V. Cossu, Amedeo F. Capetti, GianVincenzo Zuccotti, Giuliano Rizzardini
Emtricitabine and tenofovir are primarily excreted by the kidneys by a combination of glomerular filtration and active tubular secretion. Drugs that reduce renal function or compete for active tubular secretion should not be administered with E/C/F/TAF because they may increase concentrations of emtricitabine and tenofovir and the risk of adverse reactions such as peripheral vasospasm or ischemia (e.g. dihydroergotamine, ergotamine, ergometrine), or myopathy, including rhabdomyolysis (e.g. simvastatin, lovastatin), or prolonged or increased sedation or respiratory depression (e.g. orally administered midazolam or triazolam). Co-administration of E/C/F/TAF and other medicinal products primarily metabolized by CYP3A such as amiodarone, quinidine, cisapride, pimozide, alfuzosin, and sildenafil for pulmonary arterial hypertension is contraindicated.