Publications by authors named "Negar Eftekhar"

3 Publications

  • Page 1 of 1

A double-blind randomized trial on subendometrial injection of vasopressin to control bleeding in postpartum hysterectomy due to abnormally invasive placenta.

Int J Gynaecol Obstet 2021 May 9;153(2):228-233. Epub 2021 Feb 9.

Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Objective: To investigate the effect of subendometrial vasopressin injection in patients with abnormally invasive placenta (AIP), who underwent cesarean section and hysterectomy.

Methods: This randomized double-blinded clinical trial was conducted on pregnant women diagnosed with AIP grade 4 and 5 by ultrasonography during cesarean section. Women were randomly divided into two equal groups including group 1 (vasopressin) and group 2 (control) who underwent 20 units of vasopressin and 20 cc normal saline injection, respectively. Vasopressin and placebo were injected subendometrially 1 cm medial to the uterine vessels into the lower uterine segment. The exclusion criteria include presence of myocardial infarction, cardiomyopathy, congestive heart failure, uncontrolled hypertension, chronic obstructive pulmonary disease, pelvic malignancy. The outcome of the study was total quantitative blood loss during the cesarean section. We estimated blood loss by measuring the blood volume in one of the suction bottles with addition for weight changes of mops, pads, and soaked linen savers.

Results: Sixty patients were recruited into the study, 30 as the vasopressin group and 30 as the controls; with no excluded case. The amount of bleeding in the vasopressin group was significantly lower compared with that in the control group (P < 0.001). In the vasopressin group, 83.4% of patients had bleeding of less than 1.5 L, while only 3.3% of the control women had bleeding of less than 1.5 L (relative risk = 5). In addition, the number of injected packed cells was lower in the vasopressin group (P < 0.001).

Conclusion: It was shown that vasopressin injection can help prevent excess hemorrhage and the subsequent risks of anemia or blood transfusions during abdominal hysterectomy in women with AIP.
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May 2021

Successful tracheal necrosis management using a pedicle pectoralis flap: A case report.

Turk Gogus Kalp Damar Cerrahisi Derg 2020 Jul 28;28(3):547-551. Epub 2020 Jul 28.

Department of Thoracic Surgery, Tehran University of Medical Science, Tehran, Iran.

Thyroidectomy is considered an overall low-risk procedure. However, severe life-threatening complications, including tracheal necrosis may occur postoperatively. A 45-year-old male patient was referred to our clinic for papillary thyroid carcinoma surgery. The patient had mediastinitis signs and symptoms seven days after total thyroidectomy. Subsequent imaging demonstrated air leak and with mediastinitis as the primary diagnosis, and the patient underwent reoperation. During the operation, four necrotic tracheal rings were found to be the source of air leak. Due to tissue inflammation and infection, neither primary repair with tracheal resection and anastomosis, nor strap muscle plugging procedure were feasible. Therefore, a pedicle flap derived from the right pectoralis major muscle was transferred to the necrotic trachea. The patient"s clinical condition improved after the operation and subsequent bronchoscopies confirmed healing of trachea. During six-month follow-up, no complications were observed. In conclusion, the technique discussed in the current report shows promising outcomes for reconstructing large tracheal defects in inflammatory conditions where primary repair techniques are not suitable.
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July 2020

Does intravenous fentanyl affect Apgar scores and umbilical vessel blood gas parameters in cesarean section under general anesthesia?

Acta Med Iran 2011 ;49(8):517-22

Department of Anesthesiology, Imam Khomeini General Hospital, Tehran University of Medical Sciences, Tehran, Iran.

The administration of opioids during induction of general anesthesia is a matter of challenge in obstetric anesthesia. The aim of this study was to investigate the effects of intravenous fentanyl before induction of general anesthesia on the"1st and 5th minutes' Apgar scores" in neonates with elective cesarean surgery. In a double blinded randomized clinical trial on 60 parturients undergoing elective cesarean surgeries under general anesthesia in Vali-e-Asr Hospital, in Tehran, Iran, were divided randomly into two groups; the intervention group and the control. In intervention group, intravenous fentanyl 1µg/kg was administrated three minutes before anesthesia induction. The induction route, laryngoscopy and tracheal intubation were the same in the groups. The blood pressure (BP) and heart rate (HR) measures were recorded before anesthesia induction (as baseline measures) and so during laryngoscopy and intubation. The 1st and 5th minute's apgar scores and the pH of umbilical cord arterial and venous samples were compared in two groups. The systolic and diastolic blood pressure, mean arterial pressure and heart rate changes before and after induction and in various times after intubation showed significant difference between two groups (P<0.05). The 1st and 5th minute's Apgar scores of the neonate and umbilical cord arterial and venous blood gas analysis were not statistically different between two groups (P>0.05). Based on the results of this study, the administration of 1 µg/Kg intravenous Fentanyl, three minutes before induction of anesthesia for cesarean section can lead to a stable hemodynamic situation in mother and showed no effects on neonate`s outcomes. Fentanyl showed no effects on Apgar scores and on umbilical cord arterial and venous blood gases analysis and it probably can be used safely in elective cesarean surgeries. More studies are required to obtain a clear view.
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March 2012