Surgical glove perforation in obstetrics

Article Abstract:

Surgical gloves are a physical barrier that can protect medical personnel from infectious blood-borne organisms residing in their patients. Concern has risen because of the dangers of transmission of hepatitis B and human immunodeficiency viruses. Accidental perforation of surgical gloves occurs at varying rates with different medical uses, ranging from 5.8 to 48 percent. It is important to identify the causes of glove perforation during particular procedures so that they can be avoided. This study examined the rates and causes of glove perforations in obstetric procedures. The gloves of all surgical personnel used during cesarean and vaginal deliveries and postpartum tubal ligations for one month at a hospital were collected and examined. In all, 754 gloves used during this period were examined, as were 100 unused gloves for control purposes. One hundred gloves were found to be perforated, for an overall perforation rate of 13.3 percent. No perforations were found in the unused gloves. Perforation rates were highest for scrub technicians, but those holes were discounted because perforation during the procedure was questionable. This left a rate of 11.7 percent for 690 gloves. Glove perforations were more likely to occur during cesarean deliveries and vaginal lacerations or episiotomies, and in gloves worn by chief resident personnel. Most perforations occurred on the fingers, and on the nondominant hand. These results indicate that medical personnel involved in pelvic procedures have a significant risk for glove perforations and thus exposure to patient blood. These risks may be decreased by using more than one glove and by closer monitoring during the procedures. (Consumer Summary produced by Reliance Medical Information, Inc.)

Safety and security measures, Practice, Medical personnel, Virus diseases, Disease transmission, Protection and preservation, Rubber gloves, Gloves (Surgery), Obstetrics

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Effect of epidural analgesia on the primary cesarean rate

Article Abstract:

Epidural anesthesia involves the injection of an anesthetic agent, which causes loss of sensation, into the epidural space, which lies above the outer membrane covering the brain and spinal cord. This type of anesthesia may be used to relieve labor pains during childbirth. However, some studies suggest that the use of this anesthesia may be associated with prolonged labor, cause abnormal positioning of the fetus, and increase the need for forceps during delivery. Epidural anesthesia has also been reported to be associated with an increase in the rate of cesarean section in the general population as well as specific groups of women, such as women in their first pregnancy and those having a difficult labor. Hence, the relation between epidural anesthesia and rate of cesarean section was assessed. The rate of cesarean section was determined among 1,084 deliveries occurring over a 15-month period, during which epidural anesthesia was available as needed. The results were compared with the cesarean section rate over a 15-month period when epidural anesthesia was not available. These findings show that the availability of epidural anesthesia on demand does not increase or otherwise alter the rate of cesarean section. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Management, Evaluation, Complications and side effects, Risk factors, Peridural anesthesia, Cesarean section, Epidural anesthesia, Analgesia, Labor, Complicated, Labor complications

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