Background:Given the high prevalence of adverse perinatal outcome in the developing countries and the association between uterine artery (UtA) blood flow and fetal status in the uterine, in the current study, we assess the association between UtA pulsatility index (UtA-PI) at 30–34 week's gestation and adverse perinatal outcome.Materials and Methods:This cohort study included 100 pregnant women at 30–34 weeks’ gestation. At baseline, UtA-PI was evaluated with color Doppler through abdominal ultrasound. Then, adverse perinatal outcomes including preterm labor, intrauterine fetal death, preeclampsia, low 5-min Apgar score (<7), low umbilical arterial cord blood pH, admitted to Intensive Care Unit in the first 3 days of birth, low birth weight, infant with low weight, death of newborns, cesarean section for respiratory distress, and meconial amniotic fluid were recorded. Ultimately, the collected data were analyzed using SPSS, version 20.Results:The presence of small-for-gestational-age fetuses indicated the highest prevalent adverse prenatal outcome with the incidence of 13.3% and 58.5%, respectively, among pregnancies with normal UtA-PI as well as those with high UtA-PI (P < 0.001). Overall, given that sensitivity and specificity of high UtA-PI were 37.5% and 73.3%, respectively, it could not properly predict adverse perinatal outcome (P = 0.360).Conclusion:According to the results, although the incidence of some of adverse perinatal outcomes in pregnant women with high UtA-PI was higher compared to those with normal UtA-PI, this factor alone cannot predict adverse perinatal outcome well. Therefore, this factor may predict these outcomes well, in the subgroups with high-risk pregnancies or with some blood factors or with pregnancy complications.
Background: General anesthesia has been successfully replaced by various nervous block for surgeries. Objective: The purpose of this study was to examine the combined effect of ketamine and propofol for brachial plexus block. Method: In this double-blind randomized trial, 64 patients who underwent open fixation for forearm fracture were randomly assigned to group A (n = 32); comprising of patients who received both propofol (200 mg) and ketamine (50 mg) or group B (n = 32) who received only propofol (200 mg). The infusion was controlled in the groups to induce light-to-moderate sedation. The visual analogue scale (VAS) was used to evaluate pain in the groups. Additionally, parameters such as nausea and vomiting, patients’ satisfaction, blood pressure, heart rate, hallucination and the time of recovery were compared among the groups. Result: Due to the failure of nerve block, 7 patients were excluded from the study. A total of 64 patients were equally divided into two groups. Pain, nausea, vomiting, hallucination and patients’ satisfaction were not statistically different among the two groups. Whereas, changes in the blood pressure and heart rate were lesser in Ketamine-propofol group and however, were not reported to be statistically significant. Conclusion: Admixture of ketofol, containing a small dose of ketamine, is not an appropriate analgesic adjunct for upper arm nerve block, however, it does not increase the incidence of nausea, vomiting and hallucination. Highlights:
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