Background: Regional anesthesia increasingly used for gynecological surgeries, has advantage of decreased stress response to surgery, decreased cardiorespiratory depression, with improved postoperative analgesia.Methods: This randomized, prospective, double blind study was conducted at Amaltas Institute of Medical Sciences, Banger Dewas in Department of Anesthesia between June 2016-December 2016. Sixty patients who were posted for gynecological surgeries were enrolled and randomly divided into two groups: Group R received 3.5 ml (17.5 mg) 0.5% ropivacaine plain and Group L received 3.5 ml (17.5 mg) 0.5% levobupivacaine plain. The onset and duration of sensory and motor block and any undesirable side effects were noted.Results: Demographic parameters were comparable between the two groups (P >0.05). Onset of sensory and motor block was significantly faster in Group L, duration of motor and sensory block was significantly less in Group R. Patients in group R were hemodynamically stable (P = 0.032) compared to group L.Conclusions: Both ropivacaine and levobupivacaine have the desirable blocking property and can be used in gynecological surgeries. Ropivacaine showed shorter duration of sensory and motor block allowed early mobilization and early recovery of patients.
Result: Among total patients 300, at the end of 01 min the Apgar score 50.5 of oligohydramnios and 57.1 ployhydramnios whereas at the end of 05 min the score has improved and 24.2% of oligohydramnios and 28.6% of ployhydramnios seen to have Apgar score of<7.Chi Square Test Applied P-value-0.00 (p value<0.05 significant at 95% confident intervals) Significant correlation of SGA fetus with oligohydramnios which are associated with 50.2% of SGA fetus. Total patients among AFI abnormalities is 283, Normal -88(31.1%), Oligo 183(64.6%) & Poly 12(4.3%).
Conclusion:Low AFI specifically <5cmandabnormal color Doppler were significantly associated with adverse perinatal outcome in terms of low Apgar score and increased NICU admission, IUGR fetus. But Antepartum Oligohydramnios seen to have intrapartum fetal heart rate abnormalities causing fetal distress leading to increased cesarean section and adverse perinatal outcome in terms of MSL. Also Severe polyhydramnios i.e., >35cm is associated with adverse outcomes including prematurity, SGA, low 5-min Apgar score, prenatally diagnosed congenital anomalies and perinatal mortality. These cases require intensive fetal surveillance and proper antepartum and intapartum fetal monitoring in order to improve fetal outcome.
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